Extremely hacked off by GP. Won’t prescribe Mounjaro

[Hakunatomato]

I have been self funding Mounjaro for the past year, and have a debt on credit card because of it. As a result, my HBa1c has gone from 19 to 5.5. I have lost almost 5 stones, now down to 16 .stones so effectively I have put my diabetes into remission as a result. I can no longer afford it because of the price rises and have asked my GP to start prescribing it. Their response is that because my blood sugar is now nearly normal they won’t do it, despite me having a bmi of 46. When I finish the course I have I now have to watch my good work go in to reverse and watch my health decline. All for the sake of the £30 a week is would cost my GP at wholesale NHS cost. If I put the weight back on again and wait while my blood sugar levels rise and I will have to apply again. I am so pissed off.. The relatively small cost as opposed to what the bills will be when my Diabetes returns doesn’t make sense.

"We have more variety now, it's cheaper, it's everywhere, it's convenient...."

That does not mean that you have to buy it and eat it, exercise some self restraint

Good point. Many countries don’t have an obesity crisis like the UK. They more than likely have other issues though.

Eeeerm, my gestanional diabetes was controlled that way too. My dad´s diabetes couldn´t be controlled diet only, not even diet plus pill, he had to be moved on to insulin, he was a walking skeleton by then. I think you may be making too many assumptions.

I don't know why you're hacked off , you should have gone to the GP at your heaviest weight . As you're type 2 , this is who MJ is for, too late when you've already lost 5.5 stone.

You can't reverse diabetes 2 , you can put it into remission . I've been type 2 for over 20 years but fortunately, don't need MJ.

When you say you need MJ or your blood sugars will shoot up, you cannot be on it for life.

I use Wegovy and have lost three stone so far. I usually gain a stone a year living on 600-800 calories a day and spending 3 hours exercising daily. I have PCOS and most likely lipoedema. Before this drug post puberty I have never eaten out, had a takeaway, eaten a slice of birthday cake, drank a fizzy drink etc. (and didn't really before puberty). With wegovy I eat around an extra 1000 calories a day and can now eat outside of my home. I now live like other people following a healthy diet, eating more, and no longer have mobility issues due to exercising with increasing weight on my joints/inflamed fat. I no longer have palpitations. There are tens of thousands of women like me. No one believed us before the weightless and incredibly hardly anyone believes us now! I will need to take this drug, or something similar for the rest of my life. I will not be able to afford it. My food bills were low before, but have now increased.

It’s not your gp that’s declining it, it’s NHS England. They set the rules. Speak to the diabetic nurse at the surgery though.

Anyone (predictably but frustratingly) mentioning willpower has zero idea about the real causes of obesity.

Umm yes Dr's do tell depressed people to cheer up its not that bad "ive had patients in MUCH WORSE situations than you and they cope just FINE without pills go on now give it a go"

It's the same as the old eat less move more for people who are overweight or have you tried a star chart for your non verbal autistic child because they will clearly do anything for a sticker 🙄

Take a walk breathe some fresh air go touch some grass is the go to response to dr I'm working 60 hours a week my kids arnt sleeping so I'm not sleeping my parents are old and I'm expected to look after them and I'm struggling....have you tried taking a walk?

It isn't your GP's fault, the thresholds are set by the NHS.

I use MJ, and self fund it. I work on the principle that I was solely responsible for the food that i put into my mouth, so I am also solely responsible for the burden (both financial and otherwise) of "undoing" the result.
It isn't just about greed, or laziness, those who have struggled with weight are well aware of this, so ignore the asps on the subject.

You've done incredibly well so far, but using MJ should also have taught you better eating habits.
There are things that you and i both know its best not to touch while on the stuff, and that should help you going forward if you can no longer self-fund due to the price rises. Also there are cheaper alternatives such as Wegovy et al.

Was the diabetes obesity related?

Don't just let things go with the view to getting it on the NHS. You have done amazingly well to take control of your weight. At 16 stone you are now well placed to increase your exercise levels and try to manage your calorie intake through diet and lifestyle changes. The reward is feeling so much better than you did when you were morbidly obese. And without the side effects of medication. Believe in yourself. You can do this!

I see the fatists are out in full force on this thread! With no helpful suggestions and lots of judgement.

Congratulations on all that you have lost so far @Hakunatomato and on putting your diabetes into remission and improving your health so much. Those are tremendous achievements. I agree that it is a shame that there is no MJ prescription to be had from the NHS for your situation now. However, that sadly isn't going to change any time soon and whilst I get your frustration, you are going to have to look at other solutions.

Was your GP open to the possibility of diagnosing Ozempic? If not, could you consider changing to Wegovy (the same stuff)? This is considerably cheaper than MJ and lots of people are moving across because of the price hikes.

I agree, there is also such ignorance about the effects of Mounjaro on insulin secretion and glucagon suppression. It's not just about reducing appetite and food noise. It controls blood sugar better and there is evidence that it make make adipose tissue more metabolically effective, improving fat oxidation. Obesity and insulin resistance are strongly linked and it becomes much more difficult physiologically to lose weight by the standard 'eat less, move more'.

Congratulations on your weight loss, OP!
It's frustrating when you can see your goal within reach, but the guidelines prevent it. Is it possible for you to switch to Wegovy instead? Alternatively it might be worth looking into subscriptions for longer-term maintenance doses instead - they could be cheaper.

Put a small amount of what you were paying for the jabs towards lots of healthy food- or maybe seek some therapy to get to the bottom of why you have put on so much weight and feel you can't control your appetite.

It's not your GP who is 'condemning you' to gain weight, but yourself as you're completely negative about losing weight with jabs.

Sorry to be harsh.

I see the fatists are out in full force on this thread! With no helpful suggestions and lots of judgement.

I know. You have to be pretty dim in 2025 to believe morbidly obese people are just the same as thin people but with less willpower.

Are you planning on taking it forever, though?

Well done on your amazing weight loss and health benefits OP. So many ignorant comments about "stop scoffing" and "have more willpower" on here. If only it were so simple. People's bodies seem to hold onto weight at different rates and recent research into willpower has found people have a finite amount of it at any one time.

I think what you are getting at in your post is a real emerging issue for health policy and politics more generally. This is partly because the weight loss drugs seem to be helpful to a much larger group of people per head of population than other "rationed" drugs which might have a benefit for particular diseases but which people can't access on the NHS.

If I was Nigel Farage I would literally put "NHS WLI for all" in my manifesto.

On the practicalities. Someone from the pharma industry will be along in a minute, but I think that - after a period of time for copyright has elapsed - cheap generic copies of new drugs are allowed to be made. Is this 10 years??? IDK exactly. (At this point Ozempic etc will probably look like old hat.)
However this doesn't help anyone in the same position as the OP right now.
I agree with the OP that prevention is - usually - better than cure (which in purely economic terms is more expensive).
The big question is: how far should the state (ie in this case the taxpayer funded NHS) be responsible/cover the costs of the OP's weight loss and how far should she herself be responsible? The "stop scoffing" PPs say she's on her own. But I am not sure she should be.

Why wouldn't she? Huge swathes of the population are on lifelong medicines.

Get a second/weekend job?

She hasn't necessarily reversed her diabetes. Remission is rare with T2--if you look at the Newcastle University studies, some people achieve it but I definitely did not despite losing the magic 15 kilos and more.

My numbers are in the normal range and have been for 3 years now. I would be willing to bet if I stopped the meds, I'd be right back where I started. For most T2 diabetes it's diet, exercise and meds. Of course some people achieve it without meds and I'd like to be one of them. But I'm not, too bad, how sad.

I hate this country. There is no reward for working and doing the right thing

I am sorry OP, but coming from someone in another country, this statement sounds ridiculous.

You are blaming your country now for not just handing over something you want, and are stamping your feet about it. Imagine if every single person got everything they wanted as a reward for being a good citizen.

I'm sorry the GP isn't able to prescribe mounjaro. I'm on my weight loss journey without mounjaro (due to an allergic reaction), and have got my BMI down from 45 to 42 so far. I've found the thing that's really helped is taking the mindset that I'm recovering from an addiction rather than just going on a diet. When I get cravings I actively try and unpack what has triggered that specific craving to try and understand myself more. I'm also starting Overeaters anonymous next month.

Being forced to do things this way, without medication has taught me that when you're at the point of morbid obesity like I am, the reality is that getting to the root of the issue is the only way to truly keep my weight off forever. Anything else is just a sticking plaster. The weight loss is slow at the moment but that's because I can't truly fix my body before I've fixed my mind.

I'm not going to lie doing this is really hard. I've learnt there is so much under the surface triggering my unhealthy relationship with food. But 8 months in and what I'm doing is working, I'm steadily losing the urge to eat all the time, and I don't really crave the bad stuff anymore.

I'm not giving advice as such because everyone's journey is personal. I just thought I'd share because as someone who is also morbidly obese... I get it's not just as simple as eat less and move more, and I hope something in this lengthy comment can help you x

It's a lot to do with, as PP says, the readily a available junk food and "food" being cheaper than it ever has been. We spend a tiny % of our income on food compared to previous generations, and we think "treats" should be a daily thing. The size of those treats is also enormous. My mum still bakes fairy cakes in the tins she (and her mother before her) has always used. They are a tiny mouthful now, when we're used to cup cakes and muffins, but were entirely normal to everyone 3 decades ago.

I also think it has a lot to do with the fact that no one walks anywhere. For various reasons I stopped using my car this summer. I've done all my commuting and errands on foot. Obviously I realise that's not practical for everyone, but the fact is I am easily covering 10-12 miles a day just going about my normal business. That's c. 800 calories a day, more if you're overweight and it's what everyone would have done as a matter of course 2 generations ago.

This the guidance, have a read and you might be able to fight your case.

www.nice.org.uk/guidance/ta924/chapter/1-Recommendations

The future of weight loss drugs is that the hope is for eg Mounjaro in the form of a daily pill - these are in development - that is much cheaper and more sustainable than a costly weekly injection.

Once these are on the market and with a bit of luck more affordable either privately or on the NHS, I fully expect half of you to change your minds about what willpower is, who is greedy and who isn't, and what constitutes a healthy mindset.