BMI 35 - will GP prescribe? Or is buying privately the only way?

[Pancakepipsqueak]

I have been told today that my left atrium in my yard is borderline dilated due to my weight. I am 15.5 stone and 5ft 6 giving me a BMI of just over 35. I am a size 16-18. I exercise regularly (rock climbing, long walks, swimming) but food is a struggle. I will diet, lose weight then something breaks and I will just revert. I have been previously treated for an eating disorder which makes me weary of v low calories (or counting calories) as I become obsessive and descend into restrict, binge etc.

Would a GP prescribe weight loss injections? I've been researchng semaglutide and the NICE guidelines indicate BMI of 35+ would indicate them but all the stories I've seen on here have been people who have gone privately for them which I just cannot afford it.

Any advice/insight?

GPs at the moment can't prescribe injections. If you look closely at the NICE guidelines it needs to be prescribed by a tier 3 weight management service. In our area injections are not even available through that so only privately available. However it is definitely worth asking your GP to refer you to the tier 3 service if they do offer them.

Thank you. I must have missed that when I read it (it's a long document ). I will ask for referral. Thanks!

Apparently there is no tier 3 service where I live at the moment (and hasn't been for at least 4 years) so I guess only privately available here.

It's private only

But semiglutide isn't used as much anymore

Look into mounjaro. Expensive, but works well for most

I am currently on tier 3 of the weight management service on the NHS. I aired for referral in summer 2022, had my first appoint in September 23, was diagnosed with severe sleep apnea in December 23, did weight management fat club online in January and now in settled on my CPAP I've got a weight management physio app in July. I'm hoping after that I'll be prescribed the injections by around December. I'd prefer to try them before surgery.

But I've been very lucky, in some places the waiting list isn't even open. It's a nhs postcode lottery to say the least

Thank you for the insight. I hope you get sorted.

NHS postcode lottery is right. My area only has a tier 2 weightloss service available so I couldn't even get referred.

I was referred to the tier 3 on our area on my request, in the hope of being prescribed a GLP-1 jab as had BMI of 35 and hypertension, only to discover they don't have a prescribing doctor. Could get on the wait list for a gastric sleeve if I wanted to though - ridiculous really.

I dont know anyone in the UK who has been prescribed for weightloss, even with other co-morbidities, only for diabetes.

I think it might even be difficult for you to get weight loss medications (eg Mounjaro) prescribed privately due to your previous treatment for an eating disorder. In the U.K. the Prescribing guidelines recommend not to prescribe these medications for patients with a history of eating disorders. I would suggest talking to your GP about this aspect and getting support- good luck x

I went to my gp. Have a bmi of over 42. Pre diabetes, high cholesterol, previous heart operation, fatty liver, PCOS and the list goes on. Didn't even get referred to weight management. It's a shame they want to wait until you're seriously straining the NHS before they'll prescribe for weight loss. I was actually hoping my bloods would turn up full diabetes but they didn't so I've bought mounjaro

GPS can prescribe, but usually only if you have diabetes.

Agree with PP that your history of eating disorders would probably prevent you from being prescribed the jabs (even privately). I’ve heard of people being refused them for that reason.