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.

That’s exactly what would be said to an alcoholic - you’ve managed 3 weeks off booze, try 3 months, then 3 years. There isn’t a magic drug that stops alcoholics wanting to drink, so they have to do the hard work on abstinence themselves. You could certainly ask to be referred for psychological help.

This!

the 90’s happens to be when computers and computer games became accessible to the public, followed by smart phones in the 00’s

it’s not just food, or car culture, although admittedly our obesity rates are better than the direct comparison of the US, but also the fact that everything is at our fingertips and we don’t need to move for shopping, entertainment, work…

I understand and completely sympathise with you @Hakunatomato

I have mj for my type 2 diabetes and as far as I am aware will be on it for life, since I’ve started I’ve lost 5 stone, my sugar levels have dropped to nearly normal and my kidney/liver function is improving with every blood test I have. I nearly have a healthy bmi now which I haven’t had since I had my youngest child who’s now a teen.

The hoops I had to jump through to get it was incredible. At one point I privately paid for wegovy but it made me so ill I had to stop.

I have been over weight due to an autoimmune disease for around 10 years controlled by steroids on and off which meant my weight ballooned rapidly - I tried every diet under the sun and never shifted what I needed to.

One thing I will say is I’ve had next no to support from the NHS regarding diet etc all of what I have achieved is by researching myself. And one fundamental thing which I thought would change hasn’t sometimes I still crave all the ‘bad’ things carbs, cheese and sweet treats.

Sadly the nhs just can’t afford to do what it needs to in its current state and it’s entirely the GP’s fault they can’t prescribe it. I bet they’d love to but sadly we are governed by inappropriate policies.

Also the judgement on this thread is awful but then that’s what I have come to expect now a days

Wow would you be this rude face to face?

(edit for spelling)

and yet... the number of people signing up for marathons, ultra-marathons, trails, sports competitions, world trips is rocketing.

Some people chose to make use of the free time they gained by doing other things.

It's a choice, lay down on the sofa and eat, or put a pair of trainers or a swimsuit and go out.

As an over weight high BMI person that eats their emotions so easily I was debating as to whether the use of a weight loss injection could help me lose weight, but in the back of my mind there were thoughts as to whether it would be doing the losing for me or would my mind set actually change and I'd use the time on it to be able to learn to change my eating habits, make better food choices and learn to control portion sizes.

I'm assuming by your post that doesnt nessessarily happen and you can become dependant on using the injections.

I am saying it's OK to take WLI - though I wouldn't. It should not need to be taken for life. Up to 6 months after you achieve target weight. Or 2-3 years in total. No-one should be having it after that IMO.

I think it's dreadful that people with obesity finally find something which helps with dramatic results and then it's taken away from them again because the greedy manufacturers decide they want to make even more out of their misery.

Absolutely no fan of Big Pharma, but that is really a ridiculous comment. They invest £$billions in drug research, all at risk on the basis they find something worth selling, with the specific intention of recouping their costs and making a huge profit. Welcome to capitalism. The people "with obesity" - and I am one - found nothing. Big Pharma developed it, and they are not taking it away, they are doing what their job is and what the shareholders want them to.

If you want pharmaceuticals that are developed and produced at low cost based on need and not profit, then it isn't obesity that you need to fix - it is the economic system.

If you read the convo I was having with the poster, @Dramatic , it's satirical mockery of the standard advice. Humour?

OF COURSE it isn't simple. There is nothing at all simple about obesity.

Wow the bitches are out in force today.

OP it really is a shame that the criteria is so strict. Have you had a look at wegovy?

I think you need to look at this differently. The jabs have started you off now you need to take control. Diet, exercise. The body coach app has good results for food and exercise.

I wonder if she means blood sugar levels, rather than HBA1c. That would make more sense, from having a reading of 19 down to 5.5.

You’ve done fantastic already and the drug has obviously helped be the kickstart you needed.
It’s up to you now, you can’t blame the doctor.
Also, people do understand, willpower comes and goes with most of us, but if you want to achieve your goal you’re going to have to find some.

This

@Hakunatomato There is huge misunderstanding of the difference between NICE guidelines for Mounjaro for weight loss and diabetes. We are prescribing as per for the public | Tirzepatide for treating type 2 diabetes | Guidance | NICE share.google/Pll7QRSyZTU4ehYD9 NICE Mounjaro and diabetes and are taking people on who have been buying privately. Check if there is local guidance in place as not all ICB's have taken on the guidance fully.

I’m not sure what you mean by your “everything is handed to you on a plate” comment. Who are you referring to exactly?

Your GP has no choice here. The guidelines are set and the GP has to adhere to them. You’ve done really well so far. Yes I know that weight loss and obesity is complex, but your posts make you come across as having no personal responsibility at all. You decide what you eat. If you stop MJ, stick to a suitable eating regime and your HBA1c shoot up again, then you may be suitable for the injections as part of your DM management regime. But it’s now over to you to start that, I’m afraid.

It's is not the GPs fault, NICE Guidelines won't allow it currently. You can argue if that is right or wrong, but getting angry at an indvidual GP is totally unfair.

I have to buy my own HRT because i had an early menopause and need a higher dose than GPs are allowed to prescribe and I am on a waiting list for an NHS menopause specialist. My GP has done further training in menopause, and would happily prescribe it, but the computer literally says 'no' and blocks her from inputting above the maximum 100mcg allowed. It's not her fault, and she does sign off all my request for blood tests that i need for the private menopause clinic though, to help me out as much as possible.

Nobody needs an injection in place of will power. As someone who has lost over 100lb through sheer gruelling hard work, not much sympathy over here. Sorry

It is NOT the wholesale cost to the NHs. You can look up the tariff price yourself on NHS business services. The 10mg pen is £107.

OP you were very unreasonable to expect most people to understand how game changing this drug is - you must surely have understood you’d receive loads of “work on your willpower” responses. Presumably these people tell alcoholics to just have one drink.
That said, it’s not your GP’s fault- the NICE guidelines are very strict. Similar situation for me - morbidly obese but because I exercise like a mad thing I’ve so far managed to avoid any of the qualifying illnesses, so I’m paying for it myself and will have to continue to do so, even if that means getting into debt. Personally I think these drugs should be available through salary sacrifice to reduce their net cost to the patient, reflecting the long term benefit to the NHS of them self funding.

Some of the replies on here are incredibly ignorant of obesity, diabetes and weight-loss injections.

GLP-1s don't just stop food cravings/reduce appetite etc.. We've had drugs that do that for decades and none of them are anything like as effective as GLP-1s. GLP-1s have a number of mechanisms of action. They help to regulate blood sugar and a whole host of other endocrine functions. For people with type-2 diabetes they're fantastic at normalising HbA1c (with or without co-existing overweight or obesity). For people with overweight or obesity this blood sugar regulation in turn helps them to lose weight. Mounjaro is especially effective because of its effect of GIP.

OP- well done on the weight loss.

Unfortunately your GP cannot prescribe Mounjaro even if they really wanted to as you don't currently fit the prescribing guidelines. You can ask for a referral to a tier-3 weight management service who may in turn be able to prescribe Mounjaro, another GLP-1 or offer alternatives such as weight-loss surgery.

The alternative is to continue to self-pay. Semaglutide (Wegovy/Ozempic) is cheaper than Mounjaro so perhaps investigate that with your private provider.

Your GP can also do social prescribing - such as reduced cost exercise classes/gym membership or membership of things like Weight Watchers. Those will help you to maintain your progress.

It IS a perverse outcome of the prescribing guidelines that people such as you aren't currently deemed unwell enough to benefit from drugs that we know are hugely effective and that will save the NHS huge amounts of money in the long run. That is, unfortunately, something that happens all too often within the NHS because short-term budgets trump long-term costs.

For all the people saying "stop eating shit". Do better; your ignorance is embarrassing.

who's the bitch?

Demanding that the NHS provides drugs you can buy yourself, or you do not need with lifestyle change, when NHS already doesn't provide life-saving treatments or treatment absolutely necessary for some kind of quality of life?

Do the work, or go for the easy option and grab some drugs as opposed to people surviving?

yes, call people a bitch because they don't have the same priorities, you are right.

@Hakunatomato , your situation is indeed frustrating and I hope the day will come when these medications are widely available from the NHS but at present they are not unfortunately. This is not your GP’s fault, they are prevented from prescribing to you unless you have a BMI of 40> and 4 of specified additional health issues. They may wish they could prescribe to you but they cannot. Had you not spent your money and your HBA1C was still high you may have qualified although I believe at the moment the NHS only funds this for two years which is ridiculous and also needs to change.

Surely the time to request mounjaro from your GP was a year ago when your hba1c was so high . It could have been prescribed then for type 2 diabetes.
I was prescribed it by my diabetic nurse last November. I’ve now lost over 4 stones with 2 more to go .
Im sorry you can’t have it on the NHS now but you seem to have done it the wrong way round .