What opinion about WLI would you not normally admit to?

[LittleMissContrari]

Do you have an unpopular or unpalatable opinion?

Mine is that if you can't do the maths, you probably shouldn't be messing about with the dosage.

I hate it when I see threads entitled “Is anyone else starting Mounjaro this week?”

Noooo, there are millions of people on this drug, but you’re the only one starting this week. Or, alternatively, you could look at the board and see that there are groups for every month. Either join the group for your month, or if there isn’t one yet, make one.

Same goes if you get pregnant!

I didn't really consider how easy it would be to go too far at the other end and how dishonestly people could still obtain the medication. I feel like I'm using it responsibly and healthily but I can see how easily you could get into the 'just a little more' mindset.

I wouldn't be opposed to in-person services at pharmacies but a pp did highlight that you're then putting up barriers in various ways for some of the people who are the ones who would really benefit. So I don't know what the answer is but it's good to be aware of where people are being dishonest. Maybe GPs need to be informed as a matter of course.

That is worrying. How many of the people are seriously underweight and are getting legal medications such as Mounjaro which is only licensed through legitimate prescribers?

Disclosing previous eating disorders would usually be an automatic refusal to prescribe. There may be some pharmacies not making the correct checks frequently enough so some determined abusers of the medication may slip through.

I would have thought the numbers must be miniscule compared with those for people buying dangerous, fake, illegal products such as relabelled insulin, or powder in vials and syringes with unknown contents from hairdressers and other black market sources.

I never understand why data about people sourcing illegal drugs is used as evidence for stricter controls on legitimately prescribed medication.

Most pharmacies have really tightened up their follow up already, so the people abusing the legal medication to continue losing weight beyond a safe level should find it increasingly difficult to continue to be prescribed.

I can think of several threads started by MNers who have accessed the drugs by legitimately meeting the prescribing criteria but without disclosing a history of ED which should be an immediate contraindication, as you say. In at least two of the threads I'm thinking of the WLI had clearly triggered a relapse of the ED which the poster had no intention of treating. There's often an assumption that eating disorder = anorexia but only a fairly small proportion of people who suffer from ED are dangerously underweight. Many are overweight or obese.

It's a problem that currently private prescribers rely on the customer honestly and accurately self-reporting their medical history and this is going to have to change. There needs to be a clear link between medical notes and private prescriptions but the NHS could not cope with this at the moment. I've lost count of the number of threads posted on here asking for providers who won't notify your GP of your private prescription...

Absolutely not disputing this. So many people on here have been rejected for disclosing BED, but would probably really benefit from the medication without a danger of developing other disorders such as anorexia. (I'm not an expert.)

A few threads from people in danger with anorexia, etc, is a few too many, they are worrying. Those few do get lost in the sea of many thousands of other WLI threads from legitimate users, so I wonder if this is representative of the real world figures. That's what I was hoping PP could give a snapshot of from her real experience.

Removing illegal drug users from the figures of legitimate should give a truer picture of how much pharmacies need to change or for some to simply tighten up their processes.

In a perfect NHS, yes GP's would be involved, but I don't see that happening any time soon.

I think it's naive to think GP involvement will just fix everything. Other HCPs can be just as competent as a good GP or just as flawed as a bad one.

Remote/ video medicine is here to stay, so we need to get used to it and get better governance in place (which some pharmacies are doing better and quicker than others).

Eating disorders do kill, but so do obesity, type 2 diabetes, heart disease, fatty liver disease etc. Just because they're skinny doesn't make their life of more value than someone who is obese.

It would be shitty to post links but the threads I'm thinking about weren't anorexics. One was a bulimic poster with a history of BED who had started purging due to the nausea caused by MJ. The other was also bulimic and couldn't understand why anyone would choose to take a lower dose in order to feel some hunger because she was addicted to the feeling of total suppression and panicked at the feeling of normal hunger. I think of both posters often and I really hope they sought some help.

In person or live video calls to registered pharmacies with mandatory links to NHS notes and also medication reviews to check on how people are actually getting on with them would go a long way to solving the issue of people either developing EDs from using them, or picking up issues, or people getting them dishonestly without being a barrier to those who are eligible for them. Some pharmacies already do this so it shouldn't stop people who need it and should easily be possible.
Cracking down on the black market is a separate issue.

One of the issues in relation to eating disorders is that quite often you don't actually get a formal diagnosis of it. I've got a history of disordered eating, but within the context of anxiety, and have never had a diagnosis - they barely committed to the anxiety diagnosis. In much the same way Sertraline helped with the anxiety itself, and some other symptoms, Mounjaro is helping with the disordered eating. I am maybe at risk of having problems at the other end but I don't feel like I am. I've never chased suppression, excessive weight loss, or restricted my calories too much on Mounjaro - in fact I've made sure i have a healthy deficit and have taken steps to make sure I have higher calorie protein based options on the days I'm not quite at my calories - it's a target, not a limit. For the first time in a long, long time I have a good relationship with food and, importantly, nutrition. I do think the current process doesn't quite allow for this and at some point GP involvement for an expanded use of WLIs in the NHS could help so many people.

(Also just to add that Mounjaro hasn't impacted my anxiety itself either way which I seem to be fortunate with).

My unpopular opinion is that there's a section of mainly women on the forums and group who seem to have a smug sense of superiority when they tell you they've been on the lowest dose the entire time and how they've lost 4 stone etc. Really reminds me of the almond mum, 'I could never eat all that' side of mumsnet for some reason.

I’m one of those but i don’t mean it to be smug I think I’m just trying to suggest people don't move up when they don’t need to? Perhaps I don’t explain that so will bear it in mind for future posts! So many people are just changing full suppression and barely eating anything so I often say I have lost 6 stone on 2.5mg.

The converse of that are those that proudly declare they are on the highest doses/ask if they increase dose early as it validates the severity of their struggle so they must have been the ones with 'real' reasons, not their fault for being obese and have a more legitimate reason to use WLIs.

I think it tends to come down to reader interpretation and personal experience of doses whether we think someone is being smug or performative. I try be mindful of that, but it is hard at times!

Absolutely. People just can’t be bothered to go on pharmacy website to get basic information.

Or the ‘I have a pen but not sure if I should’

Or the ‘I have half a stone to lose can anyone tell me how to cheat the system’

Anyone who can’t follow basic dosing instructions and ends up double-dosing because they were “in a hurry” should seriously reconsider whether they’re capable of using this medication safely. If you’re a danger to yourself through carelessness, stop before you do real harm
If you can't do the very basic maths don't mess with doses

definitely this! If someone can’t follow basic instructions they shouldn’t be take medication! All of the pharmacy YouTube channels have basic how to vids but people just can’t be bothered to check - unbelievable really

I forgot two others. The first is the regular how can I get MJ without my GP knowing

And second is the infuriating I am starting this week do you want to join. FFS looking at the threads on the board is it not obvious that there is one for each month.

I’ve got another one, Trinck touting her voucher off code everywhere.

😂😂😂😂

meeeeeooooow..... lol need a saucer of cream???

Poor people are fatter than rich people because fat and sugar laden processed food is cheaper than high quality healthy food.
So that's a pretty vile opinion.
There are no slim yummy mummy's in the poor areas where I live.

Many many poor fat people, couldn't possibly afford hundreds of pounds a month on pens.

I can't stand all the dicking about with counting clicks, extracting extra doses, pens being used beyond the 30 day mark etc. I know this is my problem as I am a rule follower, but I always think, 'Just use it how it's been prescribed. You are not a pharmaceutical expert or a medical professional, you are barely able to type a coherent sentence and would probably have difficulty reading the back of a Lemsip packet. Follow the instructions!'

It's not impossible at all if you cut carbs and increase your protein.

I would also add 16:8 or 18:6 to above which (once you build up to it over a week, nudging an hour a day) is fine - it’s easier to feel full satisfied if the calories are in a shorter eating window having two substantial protein, fibre and healthy fat based meals from whole foods not UPF. Also going to 2MAD means less food noise - as I have my breakfast at 3pm always eggs and veg or yogurt and fruit - then only have to think of one meal to prepare every evening.

Also build up your step count each week by 1000 to 7000 - even if you are not walking outside - being up in your feet standing / pottering at home helps your BMR.

I can’t stand the whole “this might lead to people abusing them!!!” thing. We’re adults. If they want to do it, crack on

The problem is for us sensible adults we don’t want idiotic behaviour from others to mean big changes in prescribing.

I think maybe you mean it’s not impossible for you personally, as you’d not be running in, elbows out, to tell this poster what she can and can’t do, I assume?

I appreciate this may be specific to me but in my experience on and off WLI not all calories are equal - I had several weeks on strict 1100 cals a day but included toasted sandwiches, small amounts of pasta and the odd biscuit or bag of crisps and simply didn’t lose weight - other weeks full of next to no carb at all , mainly eggs, chicken, cottage cheese, prawn salads etc and I lost almost a kilo but same number of calories -
i lose at exactly the same rate as when I was on MJ if I stick to 1100 and next to no carb and I think anyone needs to at least try 6 months like this as first port of call before automatically just reaching for the WLI - what MJ did do was totally reset my mindset that I can’t lose weight - I can , but had to change the mindset