New pharmacy rules announced

[CoverMeInMarmalade]

Pharmacies require stricter weight-loss jab checks www.bbc.com/news/articles/c5yeklrer39o

We knew it was on the cards but really frustrating if this now causes problems for those of us who are genuinely obese and need this drug to help save our health/lives.

Sorry what - are you accusing me of lying to get medication? Are you stable?

I have already finished my time on MJ so these changes don’t actually impact me FYI. My biggest weight is recorded on my medical record so my GP certainly did not “stop it” when I was taking it. Bizarre accusation.

Um. No. I meant you as in “one”. I don’t know you.

Perhaps you need to learn to communicate more effectively then cause how else would you expect me to understand:

I do see one big reason. You’re not eligible and lying to get them and if your doctor found out would stop it.

It was in the context of the reasons people would not want a gp to know. It was not about you.

good grief.

Unless I'm reading it wrong it just says the pharmacies will need to do an initial video call with evidence of weight. Surely that's not going to stop an obese person obtaining?

None of those are reasons to omit medication from medical records. MJ may not be terribly relevant for some of these things but it isn't the only medication you can access privately and it could be in some cases.

In fact not informing the GP of medication for the first two reasons is potentially fraudulent.

The issue of others accessing medical records is rather different. There are good safeguards to prevent unauthorised access to medical records at the surgery. If you access them on your phone then the security on your phone is down to you, delete the access if it is problematic, or talk to your surgery about how they record things, it isn't a reason to falsify medical records or keep your GP in the dark.

Just to reassure people, access to medical records by employers or legal teams still has to meet strict criteria. Weight loss injections are not relevant to security clearance, and would only be disclosed in legal cases if relevant to the situation.

People with abusive partners are best being honest with health professionals. It's their partner that's the issue not their records.

I think it’s good that there are stronger controls. Medicines aren’t sweets.

Also, I think the gp should be informed of any private medicine prescribed, partly for safety. What if they prescribe something which interacts with the private medicine (which they nothing about) - who’s liable, the doctor or the patient?

I totally agree with you. I get private prescriptions for migraines and other assorted issues and my GP has no idea, and no real interest.

Your last paragraph did strike me.

See if it's safe for someone who's BMI is 23 to be on a maintenance dose, why isn't it safe for someone who's BMI is 26? - I'm not asking you to answer this lol it just highlights the issue with the guidance.

I think the regulations are all over the place and again this is those in charge being caught off guard and having to react to things after the fact.

Anyone could see that the jabs were gonna be extremely popular over here, anyone could see that slimmer people would also want to use them because we've been bombarded by hollywood celebs waxing lyrical.

If the government, and agencies actually had a proper framework in place from the start then they wouldn't be making up policy on the hoof.

This is just a statement to placate the union for Local pharmacies who were moaning about online prescriptions a few weeks ago because they've lost a lot of business to online pharmacies. Let's get real, this isn't anything to do with safety. It's money.

@Snowmanscarf during a consultation - of course disclose. It’s the onus on the patient ?
I see little point in the GP being informed to simply file a letter or make money by charging to weigh people who otherwise have no health concerns.

@cakesandcandles absolutely agree. This is about money.

@FCforMounjaro And no matter what the regulations - People with money will always be able to get mounjaro - whilst people who are working their bum off to afford it will be charged more and more.

I expect the providers aren't too bothered about this as it means more money for them. It will also make it harder for users to shop around and move to a different supplier because they will probably just claim they need to do a complete review at £££ cost and/or suppliers won't supply info free of charge. It's going to be interesting to see how this pans out.

See if it's safe for someone who's BMI is 23 to be on a maintenance dose, why isn't it safe for someone who's BMI is 26? - I'm not asking you to answer this lol it just highlights the issue with the guidance.

I think the theory is about the underlying condition and the fact that WLD are a treatment for homonal issues, not 'simply' an appetite supressant.

IF you accept that obesity almost always involves hormonal inbalances at the core of it (as science seems to accept) then someone who has been greatly overweight, i.e. obese, is likely to have those hormonal inbalances even after they have been helped to come down to a healthy weight. Because those hormonal inbalances are long term, possibly even lifelong. Thus the drug is appropriate for them.

Someone who is only a little bit overweight and never reached obesity is less likely to have the underlying hormonal issue and possibly the small amount of extra weight is down to something else which cannot be treated with the medication. Thus, adding in hormonal 'corrections' may do more harm than good.

I'm not saying I am fully on board with this, but this is how I've heard it explained by one of the obesity scientists on a podcast.

I'd like to see people prescribed it who have a BMI of 25+

The way I see it if it can prevent obesity than that is better than trying to cure it.

I think the reasoning for the current guidelines is that for those with a BMI of 30 plus the benefit outweighs the risk whereas if someone has a healthy BMI the same might not apply?

I also guess they have to draw a line somewhere!

See if it's safe for someone who's BMI is 23 to be on a maintenance dose, why isn't it safe for someone who's BMI is 26

the risk of regain is high on someone who was previously obese. The person with the 26 bmi will not have as high a risk of becoming obese, it is not a given. As such they do not need a drug to help them lose weight in the chance ghey may become obese at some point.

See if it's safe for someone who's BMI is 23 to be on a maintenance dose, why isn't it safe for someone who's BMI is 26

In order to licence a drug the drug company basically has to prove that there is a benefit to the new drug entity at the stated dose/schedule that is "worth" any disadvantage (adverse events). Presumably Lily have provided data that shows the benefit of a maintenance dose v.s the high likelihood of regaining weight & the associated health risks but not provided data w.r.t. the drug being taken at a lower starting bmi.

@Arglefraster they’re actually doing studies on people with ‘healthy’ BMIs right now.

Be interesting to see the outcome.

@CoverMeInMarmalade Are the hormone Imbalances because of the obesity though? Or the other way round?

The same way that people who suffer from depression can actually have imbalances.

I’m not sure it’s not as cut and dry.

interesting none the less.

@cakesandcandles is that for semaglutide or for tirzepatide? What conditions are they looking to treat if it's not for weight loss?

I think the science is suggesting that leptin and/or insulin resistence (even before the stage of pre or diabetes) is at the root of much obesity.

It's obviously far more complicated than just that one sentence with other factors such as the impact UPFs have on our brains and bodies. And from what I gather, weight gain/loss can make those resistences worse. A bit like a snowball. But obesity science studies do seem to suggest that initial leptin resistence especially, exists before obesity - and is a leading trigger.

@SilenceInside both. They think it could be key to helping people with addiction issues. There also seem to be benefits with heart and brain health and they wonder if it could even slow down the onset of dementia.

It seems weight loss could be the least interesting part of the puzzle. Fingers crossed!!

@cakesandcandles so not likely to be approved for people with none of those issues, who want to use prescription medication to lose weight when already in the healthy weight range.

I do wonder how the research will balance weight loss against other benefits. If you are a healthy weight and you lose 22% of your body weight whilst taking a GLP-1 for a brain condition you would potentially end up dangerously underweight.

I suspect they will keep them on low doses, so limited weight loss. I know folks on here can lose a lot in low doses, but I think a lot of that is psychological and dieting, rather than the drug to be honest.

It isn't psychological.

People on placebo doses in the Mounjaro trials did not lose weight. People on the lowest dose tested, 5mg, did lose weight.

They are investigating ultra low doses for other conditions.