Do you agree there should be more checks before drugs are prescribed.?

[RedHillLady]

There has been a lot in the media recently about how the current system is too weak and needs to be more robust.
I think we are going to see increased regulation soon and I see that as a good thing.

I have a very good friend who (like me) has suffered from an eating disorder throughout his life. He was going through a good phase, decided to lose a few lb and doctored photos of himself (takes literally less than 30 seconds if you have the appropriate skills.) Mounjaro has been absolutely catastrophic for him. He weighs less than ever before, is severely underweight, and the ED is ruling his life. He says that even if he does get better, Mounjaro has added an extra layer of complication to his ED- he's always going to know how easy it is to "take back control."

Yes, he should take responsibility for his own health, but EDs are so so common and no healthcare professional would prescribe for him if they could actually see him in the flesh.

I also think that the lax rules around prescribing does lead you to think that it can't be that serious if they're not even regulating it properly.

WLI are amazing and transformative, but they can really damage people too.

You can buy laxatives everywhere and people with EDs abuse them massively. Nobody is calling for prescriptions for them. Whatever you do will not be enough to protect some people from taking them inappropriately.

@WhatTheKey from what you have said, it sounds as though your friend abused the system. I have sincere sympathy for his eating disorder and where it has taken him. However, your friend must have doctored the photos he sent and provided a false starting weight, otherwise he would never have been prescribed MJ. He also would not have been prescribed if he had declared an eating disorder. The rules aren't lax, he chose not to follow them and was not truthful with the prescriber.

More checks will definitely lead to a higher cost to the consumer. It won't be the pharmacies taking the hit. This is clearly a big money market.

I'm on the fence. I assumed there would be more to the consultation than completing a form and sending some pictures of me in a tight T-shirt. I've found the support on my mumsnet month group invaluable so I haven't felt alone but of course no one on mumsnet is qualified to give medical advice.

Med express wrote to my GP but they got a short shrift response in return telling them to ask me for my medical records. I've not seen the GP since I've been on MJ but I've brought my BMI down from 31 to 27 and my blood pressure from mild hypertension to the lower end of normal.

I am a bonus dose user. This medicine is expensive and there is no difference between the medicine in the pen from start to finish. The dose is taken using a sterile syringe and within the 30 days of opening. I am aware of the dosing and carefully check this. I was quite alarmed at the recent post by someone who took 8.5mg over her usual 2.5mg and hope she wasn't unwell as a result.

I'm thrilled to have discovered MJ and to finally shift my perimenopausal weight I had been struggling with. If MJ was any more expensive it would have been prohibitive to me and I'd not have been able to take it.

@Bilbette the seal is pierced by the pen needles for each dose. What do you consider is different piercing it with another sterile needle for a 5th time than the 4 previous doses?

Surely by that way of thinking the 3 doses after the first could also have contaminants in?

I'll always take the last bit that's left over.

That's really sad. I do think it easy to become obsessed with weight and what the numbers say on the scales.

He wasn’t going through a good phase if he went to these lengths to get the drug and then abused it.

and people with ed abuse all types of drugs the issue isn’t the drug, or the fact people can lie and cheat, it is the illness and the person themselves.

but to declare someone was in a good phase when they did this, is misguided to say the least.

I wonder whether there would be a way of ensuring a verified ID was shown and then each prescription needs to be linked to your NHS number. In my opinion there also needs to be a way that if you are hospitalised due to mounjaro all prescribers are alerted and you can no longer have it prescribed online.

Sadly there are lots of people who for a number of reasons decide to abuse a whole variety of drugs including prescription drugs, I did 6 months working in A and E and so many people take extra doses of drugs even controlled drugs or give prescription drugs to friends. I know a friend who ended up hospitalised after she hurt her back because her mum gave her left over prescription medication from when she hurt her back thinking it would be fine as it was a similar issue, it wasn't fine for her and she ended up very unwell and if she'd have attempted to get the drugs prescribed by her GP they would have been able to inform her why these drugs were not suitable for her.

Weight loss injections are the current hot topic, hopefully in a years time the hype will have died down.

I'm actually amazed you're amazed. Pretty much everyone wants to be slim and here, for the first time in human history (apart from famines) is a relatively effortless way to achieve it, so you have massive demand for something driven by social aspiration, and then a cut off BMI for the "solution" which is higher than the "slim" which is aspirational - most people with a BMI of 25 are not slim in a way that would be considered aspirational- that's more like 21-22. So you have a perfect storm for some artistic license.

Re other drugs:

ADHD drugs - big yes - people lie to get them
Opiate painkillers - big yes - people lie to get them/ get more of them (registering with multiple private doctors with back pain etc)

So people lie to get smart, get high and get thin.

And people mess around with doses of pretty much everything. This is not new. DF was a pharmacist and he'd constantly have stories about the stuff people did which seemed logical to them but was a bit "wtf?"- loads of people ignored "swallow whole" and crushed stuff up, for example- a few people ate canasten pessaries but I think that was genuine error. Using the bonus dose wouldn't even come close to this weirdness but where people are paying out of pocket, you're going to have people trying to eke out the pens.

That’s fair, the issue I think is folks taking such issue with these injections, when we all know so many drugs are abused, for example ketamine is a horse tranquiliser, it is also drug of choice for many idiots on a night out.

the point I think the poster is making is these are you’d assume reasonablely normal people. Lying, faking photos, putting heavy stuff in their pockets to weigh more, buying fakes from hairdressers, fucking about with dosing based on tik tok bullshit, using it past its expiry date. All to get thin.

a poster posted a whole ago she was a slow responder, then bizzarely told us she took hardly any of the product as she followed some bullshit micro dosing. Another poster as said, took more than 3 times the dosage she should have. Of expired medicine, someone else blatantly lied to get the drugs then wondered why she wasn’t well.

now it’s a small minority in reality, v small. But what that small minority do is some crazy ass shit.

and that’s before you even get to the weird obsessives who can’t get the drugs or don’t need them and haunt the forum arguing no one should take them, using the bingo card as their bible.

Micro dosing is not crazy ass shit unless it’s spaced too close together. Show me one example of where someone has suffered health complications from taking too little of the product. Taking too much is entirely different and obviously very dangerous. I find it crazier that people take so much that they can’t eat anything all day and end up in hospital vomiting or think that it’s okay to lose 14 pounds in a week when the guidelines say 1-3 lb per week.

It’s crazy ass shit when you then complain the drug doesn’t work 😂

edut and losing 14 lbs in a week is also crazy ass shit. It’s not a competition.

Well yeah it’s potentially stupid but taking too little isn’t dangerous whereas taking too much definitely is. There are numerous doctors who prescribe microdoses though so it’s not some crazy thing and many people have good results on them. Obviously the manufacturer isn’t going to endorse it but it’s doesn’t make it wrong.

Silly me! I assumed it was that the profit margins were higher.

Not really. Maybe more checks to make sure minors are not buying it, but I think any drug is open to abuse. Some people will take it who shouldn't, but we don't want a nanny state.
I know a parent who is injecting her 10 year old, and was going to do same for the 8 year old sibling. Both kids are huge! That worries me! I don't know if thy are being medically supervised
.

They ate great drugs and can be very helpful.. but.like all drugs come with side effects and some serious risks harm…including death.
I have been asked to prescribe them to people with a normal BMI or BMI below prescribing threshold and people with an eating disorder.
where I practice you need a consult with a doctor ..this should still be the case.
I am horrified that people are able to upload photos and get a script..this is absolutely not safe.

Of course there should be.

But In a world where eating disorders, obesity and poor diet are common, it was inevitable that these drugs would be abused.

The US has a crisis with opioids, half a million people have died from an overdose in the last 20 years. Now we (and they) may have an even greater crisis with weight loss drugs.

Let's just hope there are no serious (and as yet unrecognised) side effects because a huge number of people could be harmed. And even if there are not, the choice to continue to eat rubbish and not improve diet and life style will not help anyone.

Thin does not necessarily equal healthy.

I agree with your concern over those with eating disorders getting these drugs as yes that is a concern and could lead to fatalities in that population.

But I'm going to guess you don't actually know much about these drugs so a couple of things.

1 they are not addictive so the comparison to the deaths caused by opiods is not really accurate. Opioid exposure can very much lead to addiction which is impossible to cure. Even when addicts are clean the relapse rate is massive and that is if they have access to things like rehab to begin with. This drug is not addictive and unlike opiods has a very safe profile. By that I mean that even if you overdose on it they are not fatal in the same way opiod overdoses are.

1. You don't just eat shit and lose weight. In fact continuing to eat unhealthy food will worsen any side effects. It manages blood sugars so reduces the cravings for unhealthy high sugar food and slows gastric emptying meaning you are not in a perpetual state of hunger. This allows patients taking the drug the clarity to focus on healthy eating.

Also in terms of it making you unhealthy well study after study have shown the long term health benefits of taking this drug. These include improved cardiovascular health, lower blood pressure, decreased risk of neurodegenrative disease ( more clinical trials currently underway here) along side a host of diseases

https://www.bbc.co.uk/news/articles/c9d5pq4y5wpo

To be clear I am not against a tightening of restrictions to ensure that they are not being missed in those with ED or being injected into children in an unsupervised way 🙄 but the shaming of people taking it by insinuating they are just too lazy to be healthy shows a drastic misunderstanding of obesity.

I'm on MJ, prescribed by my GP. I appreciate that WL drugs are transformative but I'm appalled at how easily they are abused. Personally, I think that they should only be prescribed by your own GP and only after a full consultation.

Well it’s quite a mouthful….

also most people measure very accurately with a sterile syringe and needle so it’s not true.

i actually agree that an in personal initial consultation and monthly in person weigh ins would be ideal but the costs either to the NHS or to us would be astronomical. Also after a while we don’t really need it.

The online forms would be ok if no one lied but of course they do.

Still think that on the whole the introduction of these drugs to our current society is a good thing and will save the NHS money (assuming people pay for them privately)

Do you have any stats for what’s appalling you? Anything to back it up? As I can only see hospital admissions in different regions and deaths, which is incredibly low.

I presume it’s by private prescription as Mounjaro is not available on the NHS and the vast majority of GPs would not prescribe it because they are not able to. Different if you have a private doctor obviously but if I went to my GP, I would not be able to obtain Mounjaro. The majority of people can’t afford private healthcare. It’s a nice thing to sit there and say everyone should have to go via their GP when you know that’s not going to be possible.
Also, GPs are not experts on this drug. They will do the same screening tests as any online pharmacy does. They might weigh you in the consulting room to see if your weight is what you say it is but most people are actually truthful when they state their weight (half the country is overweight or obese). So it doesn’t add that much more having to go through your GP.

IMO, the way it is marketed is what is most problematic (and attractive to people with ED).

I frequently Google it and add it to carts to buy later, fortunately, my logical brain is in charge atm, not my anorexic one. My logical brain knows that all MJ et al do is reduce your weight by making it easier to reduce your calories via appetite reduction. I am very capable of reducing my calorie intake without any additional help. A weird, fucked up part of my brain enjoys feeling hungry and would miss the feeling if I used MJ.

However, the anorexic voice in my head looks at all of marketing, the proclamation of it being a miracle drug, and the only way to successfully lose weight and says "We need to get our hands on that right very now. It must do something magical that isn't explained by science." It doesn't matter that the science doesn't make sense. We need it and we need it now.

If it was cheaper, and it is predicted to become cheaper, my anorexic brain would probably win out. I already know where I can get it without my GP being informed.

If it was marketed solely as what it is (an appetite reduction tool) I would likely not be the slightest bit interested in it.

Prescription medications should not be marketed. We either need them to stay healthy or we don't. Marketing is not necessary or safe.

It is available from NHS GPs for the treatment of diabetes but I agree with everything else you said.