The amount of cheating the system is scary

[Adultautismdiagnosis]

I find it so concerning how many people on here and beyond are perfectly happy to cheat the system to get MJ e.g. people taking photos of their scales while holding a weight behind their back so they look heavier. Another example is a friend of mine who knows someone finishing MJ so she's going to buy her remaining pens off her. She only needs to lose a stone and is on no way in need of weight loss injections.

It's also concerning the amount of people giving medical advice on here when they are in no way qualified or experienced e.g advising people on supplements to take, advising people to count clicks etc.

Then those that are in 1000+ calorie deficit a day.

It's all just so completely unregulated and rather worrying.

I know I'll get slated. I'm on MJ legitimately myself and need it. I just worry that the more this stuff happens the more likely it is that people will get seriously ill. I also worry they'll make the process so difficult that it'll put off people who genuinely need it.

Ah ok I think that makes sense

Im on it 3.5 stone down and two to go - pleased there won’t be an issue once I get into the healthy range
at what BMI do you have to stop can I ask?

@Lardychops it depends on the pharmacy. Some will continue to prescribe as long as your BMI doesn't fall too low. Some have a BMI where they will stop prescribing. The website Monj has a page summarising the policies of pharmacies for which it has information on maintenance.

https://monj.co.uk/mounjaro-maintenance-pharmacies/

Thanks for that very helpful x

I think you’ve misunderstood- my point and reason for introducing that to the post was that why criticise someone who begins with a BMI of slightly less than 30 but allow another to continue to a low BMI.

I just ventured on to a FB ‘support group’ and there was a picture of a woman who looked to be about a size 10/12, saying she’d just started and asking how much could she expect to lose in her first week. A few people asked how she’d got a prescription when her BMI can’t have been very high (she didn’t reply to that) but everyone else was posting positive replies.

Part of the issue is the media reporting around this - describing it as some kind of ‘magic fat buster’ when it’s nothing of the kind. I’d have no issues with there being more intense regulation. That would ensure that only those who are genuinely struggling with obesity, have access to the drug. I just signed up to a new supplier last night and it was actually far easier than others have been. I had to upload a full length photo but everyone knows that stuff is easy to fake with the right tools. With previous suppliers, I’ve had to have a video consult first.

Ultimately, what other people do to their bodies is none of my concern. If it were me, I’d be scared to mess about with a powerful drug unnecessarily but then people will always choose to do daft things with their health and bodies.

For me, I’m being sensible with MJ. This will be my third month on 5mg and it seems to be working fine. I lose around 6lbs per month and I eat around 1100 cals a day. I’m just not interested in food. I’ve still got about 3 stone to lose and I’m doing my best to build up core strength so that I’ll be in a good position when I eventually taper down.

Oh, right. Well, as I said, I don’t have any big issues myself with people starting with overweight BMIs. But initially the treatment guidelines were to stop prescribing when someone reached BMI of 23 (often not more than a few pounds below 25) probably exactly for the reason that they would then have lost enough to be officially a healthy weight - 23 is the upper cut off for health for people from some BME populations. I assume that was widened once the reality of maintenance became apparent as originally maintenance dosing was originally not allowed either. BMI is a blunt measure and I’ve lost count of the number of threads on here over the year cheerily telling people that BMI 23 is ‘still overweight really’ so I can understand why some people feel they need to lose more to feel a healthy weight for them.

On the flip side, I know quite a lot of people who have lost a lot of weight are quite happy now with BMIs of 26/27 as they feel so much better than they did with a BMI of 40. And the number of people whose BMI is now very low having started at over 30 is far smaller. I also think (not a radical opinion) that MN has a lot of posters for whom thinness is a worrying goal and that BMI of 23 is a healthy BMI for the vast majority of people even if not size 8. I’d be perfectly happy there and longer term will hope to stay between 23-25.

Surely maintaining with WLI at a healthy weight BMI is no different to first taking WLI at a healthy weight? Physically I mean? Morally and philosophically there seems to be a lot of judgement about it where there really doesn't need to be.

Well, I’d say not, because if you become obese in the first place you clearly have a problem that the drugs are helping to address and prevent you gaining the weight again. Bariatric specialists everywhere are saying this is probably lifelong medication for obesity - although I think other maintenance meds are on the horizon. Whereas someone taking them to drop a stubborn stone doesn’t have those underlying issues and doesn’t need to use medication to lose weight really - it just makes it a lot easier to do so.

I wonder if at some point there'll be provision made for formerly but not currently obese people to start WLIs. We all know people who've previously been obese and lost weight through traditional methods are more likely than not to put it back on. So someone with a BMI of 27 who's weighed that for ages is at lower risk of obesity than someone with a BMI of 27 who used to be obese. A history of obesity wouldn't count as a qualifying condition for an overweight person now, would it?

The drugs are for treating the metabolic condition obesity. A person with obesity who has lost weight is still a person with obesity and therefore still meets the prescribing criteria. (Just as someone with high blood pressure would remain on medication after treatment has brought their blood pressure down.) Someone who has always been a healthy weight does not have obesity and therefore doesn’t meet the prescribing criteria.

I think the problem with the 'stubborn stone'is if it creeps on fairly quickly at menopause. Then women get into a cycle of dieting trying to lose it and it gradually creeps up and up until it is 2 stone. Then 3. So in that case perhaps a reset back to premenopausal weight and possible cortisol and insulin sensitivity might actually be the thing to do as early as possible.

I think this is a philosophical point rather than a factual medical one.

Edited to say I totally agree that obesity is a medical condition, not philosophical!! I mean it is moot if there is more risk when someone is at a healthy weight after obesity compared to someone who is just overweight.

Also people do come off blood pressure medication?

I think it’s a fairly factual medical one, for bariatric specialists anyway.

And it’s very common for people to remain on medication that is successfully preventing an issue, yes.

You could argue of course that people could just live with the extra stone and be a bit bigger than they were which would be the healthier option for many people! The drive for thinness at an age where it’s not natural for most women to be so slim is relatively new. For a very long time it was accepted (and still is in a lot of places) that you got a bit stouter as you got older.

Yes I agree, I've edited my post.

An extra stone is not a problem. It's when that heralds a slow down in metabolism and an increase in insulin resistance and cortisol. Then that stone can easily become 3 or 4 stone.

The fact that someone has stayed overweight rather than become obese is relevant though, as is the proportionate health risk of being overweight rather than obese.

Hmm not sure how that is philosophical and what isn’t factual. Drugs are used in populations they have been tested in. For WLI that is people with diabetes and/or obesity, who are metabolically very different from people who don’t have diabetes and/or obesity. You can’t generally get hold of treatment for a condition that you haven’t actually been diagnosed with.

People come off WLI too, I was just trying to explain why people might stay on a medication once their condition is apparently cured. Someone with the metabolic condition of obesity still has it even when they are no longer fat. This is why many will regain if they stop taking the drug.

But your scenario is that this happens when they try to lose the stone. Which could be avoided if they just lived with it!

I don’t disagree at all with the idea that medicating insulin sensitivity in general is a positive thing if it prevents other health conditions though.

I don’t understand why people aren’t getting gallstones, which happens to some when you lose more than 2lb a week.

I agree, but also the huge mental load of stopping yourself getting obese can be awful. Part of my mental health was getting very poor constantly trying to stop myself getting obese. I would say I've spent the last 10 years struggling with it, then became obese anyway. Something happens to menopausal women!

I’ve read a lot of your arguments. I just don’t really understand why you care? The medication is safe, it’s been tested and for the vast majority of users has minimal to no side effects. If they choose to obtain it while not needing it, that’s on them. As someone who’s BMI was over 50, I cannot see why anyone else is arsed that one used this medication?

Some people are getting gallstones. As they do with any form of weightloss. But not everyone will get them, again like with any form of weightloss. It’s not an inevitable result of losing weight.

I think what im trying to say is that an extra stone that suddenly appears around menopause usually means there is more to come!

I’ve said from my first post (and I haven’t made many so perhaps you’re mixing me up with someone else?) that I have no real moral objection to someone who is overweight using these meds. I’m just trying to factually answer the question about why someone who has lost weight can access the drugs at a normal BMI.

ETA what I DO care about is people buying shit that isn’t licenced MJ as that is dangerous to them.