AIBU to question GP incentives for prescribing weight-loss drugs?

[NinaNinComPoop]

And to ask what other prescribed medication awards GPs with financial incentives?

Beginning in April 2026, GPs in England will receive financial incentives, averaging £3,000 a year, to increase the prescription of weight-loss drugs, specifically Mounjaro (tirzepatide), to eligible patients. This move is part of a government initiative to accelerate the NHS rollout of these treatments to manage obesity, with up to £25 million in ring-fenced funding.
BBC +2
Key Aspects of the New Initiative:

• Targeted Incentives: The bonus is intended to encourage GP practices to prescribe Mounjaro to those with the greatest clinical need, rather than just those who can afford private prescriptions.
• Eligibility Restrictions: Despite the push, access remains restricted to specific groups. Initially, this includes patients with a BMI of 40 or higher (or 37.5 for certain ethnic groups) who also have at least four weight-related conditions. The eligibility threshold is expected to drop in 2026/27.
• Concerns over Implementation: While aimed at improving access, some GP leaders and experts have voiced concerns that the incentives may not overcome the "stark divide" in access and could strain GP workloads.
• Alternative Care Models: Amidst the focus on medication, some GPs are also expanding "social prescribing" to improve mental and physical health through non-clinical activities like community projects, which can in some cases reduce the need for medication.
• BBC +5

The move follows a broader push to make weight-loss treatments "to the many, not the few," aiming to reduce the long-term health burdens on the NHS.

But this is how it works for all medications! Why are you singling out WLI?

Shall we guess?

I’m very wary about taking medications and even more wary now.

Can you explain why?

They don’t know the long term effects of these medications which is scary too.

The BHF verdict states that More research is also needed to find out how weight-loss injections impact people’s risk of developing cardiovascular disease and their overall health if they take them long term.

Why would GPs want cash incentives knowing this?

Because Mounjaro (tirzepatide) is relatively new, its long-term safety profile beyond 72 weeks remains unknown, though it has a stable record in clinical trials. Known potential long-term risks include serious digestive issues (gastroparesis), gallbladder problems, pancreatitis, kidney injury from severe dehydration, and a possible increased risk of thyroid cancer (thyroid C-cell tumors).

Potential Long-Term Risks and Concerns:

• Thyroid Cancer Concern: Animal studies indicated a risk of thyroid tumors, including medullary thyroid carcinoma; it is unknown if this occurs in humans.
• Pancreatitis: A potential serious side effect causing severe stomach pain, which can be recurrent.
• Gallbladder Disease: Increased risk of gallstones or inflammation, particularly due to rapid weight loss.
• Stomach Paralysis (Gastroparesis):Mounjaro slows digestion, which may lead to severe, long-term gastroparesis.
• Kidney Injury: Severe nausea, vomiting, and diarrhea can cause dehydration, potentially leading to acute kidney failure.
• Weight Regain: Studies show that a significant majority of patients regain weight once they stop taking the medication, with one study showing 82% of participants regained at least a quarter of the weight they lost.

Key Considerations:

• Safety Data Limitations: While 72-week studies showed efficacy with no new negative long-term safety signals, long-term effects beyond that period are not yet fully understood.
• Management: Potential side effects often require consistent monitoring of blood pressure, kidney function, and blood sugar.
• Contraindications: It should be avoided by those with a personal or family history of medullary thyroid cancer or serious digestive issues.

These medications have been studied for 20+ years. Even if they were new, they're not just handing out unregulated, untested drugs and saying good luck, we don't know what they'll do but take them anyway!

This is AI slop!

Don’t take them then. No one is forcing you to.

I suppose if OP finds it concerning that GPs are paid money for doing things, now she's learned that this is actually how primary care works and isn't specific to WLIs, being less comfortable with any of it is at least a consistent response. Perhaps she will soon have more AI slop to share wrt other things GPs are funded to do.

This has always been the case and always will be. It’s how all medical practices in the UK get paid. Hospitals get paid for operations they perform, too.

I don’t understand the hysteria about these injections. We’re about two to three years down the line from them being introduced to the private market and there isn’t been anything like what we were promised. People dropping dead in the streets, their bones snapping etc etc. all that’s happening is people (largely women) are getting healthier and happier and some people don’t like that.

Do you really need AI to make these points for you?

These drugs are not relatively new. They’ve been in use for years.

All of these risks are similar to the risks associated with other medications. Take a read of the information leaflet of paracetamol next time you take one.

I agree @aredrosegrewup

Don't take any meds then.

You don't need a whole thread just because you're not taking meds.

QOF points…….

It’s not ‘cash incentives’ - it’s payment for work that NICE etc have determined has a risk/benefit profile that is worth it. To have an experienced GP look at your record and talk to you about whether a WLI would be a good idea for you or not is expert work. Most primary care payments aren’t based on getting GPs to prescribe drugs, they are based on getting GPs to identify people who would benefit and to talk to them about it. If the person or the doctor decide together it’s not a good idea, usually the doctor still gets the payment.

The seriousness of the potential side effects of WLI shows just how bad for you obesity is. All those side effects - and it’s STILL much, much less risky than being obese.

If people do things to stay healthy, like loose weight, manage their asthma, lower cholesterol, have good diabetes control, get vaccinated etc. it saves the NHS a lot of money in treatment.

So it makes sense to put money in to encourage GPs to get people in for reviews, get diabetes clinics booked in, offer weight management appointments (including prescribing if appropriate).

We actually really could do with doing more of this if we could.

Sounds like a damned good idea to me. Getting the population slimmer and hopefully fitter too might just help to reduce the benefit bill. Not to mention saving a substantial amount of suffering of course.

Why is ChatGPT starting threads

It’s for the practice not the individual gp and is to cover the additional work that safely prescribing them will take. It’s the lack of monitoring that concerns me greatly about private prescriptions and why I would never get them without in person care.

Give over. The BHF say that wli reduce the risk of heart attacks and strokes and reduce the risk of dying from heart disease. Yes, the risk of some other diseases increases but the huge improvement in cardiovascular health outweighs these for most people. Yes, more studies are needed but BHF are not saying, as you imply, that they are not safe.

And surely, surely you know that obesity is a major cause of heart disease?

https://www.england.nhs.uk/2026/04/million-people-offered-wegovy-cut-heart-attack-stroke-risk/

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/weight-loss-injections-explained

• Weight Regain: Studies show that a significant majority of patients regain weight once they stop taking the medication, with one study showing 82% of participants regained at least a quarter of the weight they lost.

FFS. Is this is supposed to be an argument AGAINST wli? That people only maintain up to 75% of their weight loss if they stop taking the medication??? Give me strength.

Ask ai about the health benefits of weight loss injections. Ask if there have been any over and above unmedicated weight loss. Ask for an unbiased response and references. Then get on with your day.

Just to clarify, you are clearly trying to imply that BHF are saying there is a risk to cardiovascular health from taking wli. This is completely untrue. They say wli are beneficial for cardiovascular health (as is losing weight) but that more research is needed on the specifics risks and benefits.

Gp were getting £75 for every single
person they prescribed antidepressants to and they get paid a LOT for vaccinations! Where’s your outrage on that? Medications which are actually turning people’s health conditions around successfully and will
be around in pill form eventually for a very long time and saving the NHS billions of pounds and you have a proobl with them?!’n where’s your outrage about vaccinations?!?! Maybe start doing research into the very poor people overseas in Africa etc that bill
gates and his wife are using to experiment on!! THAT is something that is actually really horrific
a

I think the threshold for BMI and health conditions should be lowered. Surely the cost of providing these drugs is outweighed by the cost of treating obesity related health conditions in the long term? BMI of 33 and over with two obesity related conditions maybe.