Regulators looking to cut off maintenance below 25 BMI

[Bigfatsunandclouds]

Oushk have said that they are currently trying to fight with regulators to stop people being cut off from MJ at 25 BMI.

Apparently regulators don't like prescribing below that and that basically means unless you continue to remain at 25 or above you won't be able to be prescribed even for maintenance.

This is worrying as many see this as a lifetime medication after years of obesity but at least to maintain at a lower BMI for a little while to ensure the weight stays off. This seems like utter madness - this is surely going to lead to yo yo use of the meds which seems counterintuitive.

BMI in a lot of cases is a stupid archaic measurement anyway.

Fully agree with you

This is worrying. I'm just below 25 and hoping to lose another 7/8lbs. I was going to reduce my dose to 2.5mg from 5 and remain there.I've cleaned up my diet and I'm exercising. I don't want to spend the rest of my life yoyo dieting. I've already done it for 40 years.

Fully prepared to be slated but it may also be to help decrease any potential long term side effects - such as the pancreatic study they are now running. The thing with damage to the pancreas is that it can go undetected for a long time - so MJ patients currently being recorded having a medical episode may be low, but aren’t necessarily representative of how many individuals are experiencing silent damage and increased risk for one of the least treatable (and most aggressive) forms of cancer. Don’t want to offend anyone - just offering a possible explanation.

ETA: I think MJ is a great resource!

Very disappointing and a bit scary if the regulators do take that approach.

But to be blunt, Oushk are a tiny provider and while they might appear vocal to their followers (who again are fawning over them and thanking them for "fighting" for them) they have no real influence with regulators.

They would need to align with larger clinical networks or patient rights groups.

Do you have a link for this statement? Ouskh has just failed their inspection so I wonder if this is about their prescribing practice or all prescribing practice.

Op, can you let us know where you saw this and the exact context. It's very worrying news if true

This is one of the problems with monjaro. Many people don't take any responsibility for changing their lifestyle and rely solely on the benefits of this "wonder drug".

If a person has achieved a BMI of 25 then why shouldn't they put the effort in to maintain that weight?

They need to learn how to be healthy now that the drug has taken away the dangers of being obese or they'll just yoyo up and down for the rest of their lives.

I think in the context of failing their GPhC inspection and being issued with an Enforcement notice to be implemented by the end of July, I am not that concerned about what they are saying about BMI and cut off. There seems to be some much more serious issues with the way they are currently running their pharmacy.

This is worrying

I'm not planning on being on MJ for life but I can't imagine I'll be ready to come off the moment I reach a healthy BMI. It takes time to form good, lifelong habits, and I'm hoping to get down to a lower BMI so I've got wiggle room if I do regain a bit

@ThejoyofNC
This is not the time to be rolling out the same old tropes of people are fat because they're greedy, lazy and stupid. It's like telling someone with T2D or high BP or high cholesterol that you're going to take away their medication as it's worked and now they can manage their illness themselves through lifestyle changes.

I'll try to be measured in my reply. Mj does more that just restrict appetite. It regulates how your body metabilises insulin. If you have insulin resistance (as I do) and stop taking MJ then I lose that benefit and will need an even greater (unhealthy) calorie restriction to lose weight.

But that isn't going to happen by taking them off the drug at a BMI of 25

That's exactly what will create a yoyo dieter. And tbh if you aren't experiencing side effects and can maintain a healthy weight with MJ, I don't really see the problem with relying on it. Obesity comes with pretty significant health risks.

@Burnserns @KrankyKumquat This is the whole "context", just posts reacting to Oushk now asking for a tape measure in their weight verification calls (not clear yet why if it is for height or waist measurements) and Hira chatting to customers and everyone panicking. A bit casual and unprofessional imo.

Hira has commented in the Facebook group about stricter regulations coming in and about the cut off. I've not seen anything official yet.

And yes many people with insulin resistance and conditions e.g. PCOS are on medications such as metformin for life. If MJ provides a better outcome for them why shouldn't they take it for life?

If it enables people to lead healthy lives, reduces their risk of obesity and developing conditions such as T2 DM what's wrong with them being on the medication long term? There are many many medications that do less that people take long term

To be fair to them, it seems like quite a few of the online pharmacies have failed too. It seems that the media negativity have sparked something, perhaps a good thing or maybe a crackdown. Who knows.

And many people, in their haste to bash those lazy fat people for cheating, haven't researched how the drug actually works.

I think it's just a question of the pharmacies having had enough time since the guidelines were issued at the start of Feb to implement appropriate practices, so anyone inspected now and not doing so cannot explain that reasonably.

Curate, MedExpress and Chemist4U have all recently failed their inspections, as well as Oushk.

They failed in 5 areas in May 😱

• The risks associated with providing pharmacy services are identified and managed
• The safety and quality of pharmacy services are regularly reviewed and monitored
• All necessary records for the safe provision of pharmacy services are kept and maintained
• Pharmacy services are managed and delivered safely and effectively
• Medicines and medical devices are: obtained from a reputable source; safe and fit for purpose; stored securely; safeguarded from unauthorized access; supplied to the patient safely; and disposed of safely and securely

Even medexpress only failed in two in April

• The risks associated with providing pharmacy services are identified and managed
• Pharmacy services are managed and delivered safely and effectively

Ugh, storm in a teacup! She needs to get off that Facebook group. This is not professional and its going to send people into a panic ( there is a tandem thread on the maintenance sub on Reddit.)

I think she's done great things with her company and spear heading maintenance in the UK, but these comments are professionally irresponsible.

This is really scary. I'm on a maintenance dose of 7.5 to maintain my BMI of 23 and have been for a year. I can't bear the idea of having to go back to either starving myself and feeling hungry all the time or regaining all the weight and the health problems that go with it. I think if this happens a lot of desperate people are going to resort to ordering it from grey market sources with all the associated risks.

@Nifty50something I think if you are ordering with a responsible pharmacy that can meet all the requirements of the GPhC then I would not worry about this. I think this is all a deflection away from the enforcement action that's been applied to this particular pharmacy, rather than a genuine shift in focus from the GPhC.

@Burnserns I heard there was something going on in reddit encouraging people to write to regulators or something. That is more likely to get some action if they form a patient group than a wee pharmacy in Hyde who thinks they have any influence and has spent so much time in the last 2 months creating a chat forum when they had so many inspection report failures to deal with.

They also keep implying the laws are continuing to get stricter. They aren't, the actions they are taking with measuring tapes is to meet the ones they failed to meet. Not sure if that means they need to redo all the weight verification calls they have already done again with a tape measure 🙈

To be fair to Oushk not sure if they have just been unlucky being inspected since the new guidelines came out and they didn't have time to respond as they do seem to be trying with having video calls while others are still only doing pictures, for example Pharmulous hasn't been inspected since April 2024, Cloud October 2023, Medicine Marketplace August 2023 etc

Hmmm. But feeling hungry is pretty much what a lot of people do, day in and day out, for years.

My BMI is around 21 so in the healthy range. I maintain this by restricting what I eat to an extent - which means feeling hungry some of the time, and not eating everything I want, in the quantities that I would like to. And also by exercising, plus walking a fair amount.

So excuse me if I’m not particularly concerned that, after being given a drug that’s essentially enabled you and many others to lose a lot of weight without these feelings of hunger, you now may have to use the willpower and control many of us have been forced to use all along.

Yes, I’m sure there are some naturally slim people who don’t feel like this, but a lot of the people you see with BMIs of eg 21 are pretty damn hungry for at least some of the time.

It may or may not happen, worry about it when or even if it does.