My doctor rang me to tell me off!

[Willowy2]

I'm just posting to have a little rant!

I've been in MJ for 18 months. Started at a BMI of 30 and mu BMI is now 20 and I'm on a maintenance dose which I aim to come off fully by the 2 year mark in August.

Yesterday my doctor rang me to say he got a letter from a pharmacy that I'm on MJ but my BMI is too low, why am I on it, it's dangerous, this is the first he's heard of it, it's only for BMIs 27+ etc.

Firstly - a letter first appeared on my GP record in October 2024 as I can see a copy on the NHS app.

Secondly - The most recent letter states I am maintaining and that they can prescribe maintenance down to BMI of 19 with close monitoring and it's been verified that I was previously eligible. I've been with the same pharmacy since November 2024.

Thirdly - When I tried to explain the above he wasn't listening and just kept repeating how dangerous it was!

Honestly, I was in shock when I came off the phone. Are GPs really that clueless about this medication?

I've seen a few posts where people haven't wanted to disclose to their GP as their GP is clueless / judgemental etc. And the responses are usually things like that the letter just gets uploaded to your file, as if you're going to get a phone call from your actual GP....Well turns out I did.

He just kept repeating BMI of 27+. Right, so I get to a BMI of 27 then, have to stop the medication just to get fat again and repeat?

He wasn't interested in me saying how I train regularly, eat 2000+ calories a day, the best health I've been for ages.

Honestly, I was furious, felt told off like a child!

Anyone else had similiar from their GPs? Clueless, absolutely clueless.

Not my GP, but an acquaintance who is one. She wanted to know ‘how on earth ‘ I’d ‘got hold of it’ when my starting BMI wasn’t high enough (it was 44!) and was shocked when I said I bought it from an online pharmacy- ‘Why? You could get it on the NHS with a BMI like that’ - and had to be reminded of the four co-morbidities that make you eligible. She then had a go at me about avoiding UPFs but being happy to ‘fill myself full of medication.’

I was a bit taken aback but I suppose being a GP doesn’t mean that you’re automatically a.not bonkers or b.a fount of all knowledge. I just sidled away and went to talk to someone else.

He's right

I’d complain to the practice manager.

It’s ridiculous. Your body. I have a health issue (b12) but I can’t have regular jabs, I have to wait until I’m in deficit (ie poorly) for the NHS to step in. I pay privately 🤷‍♀️

Honestly, some GP’s are clueless about things. I can only assume they don’t do further training when these things come out and any knowledge they have (or don’t have) is self read from the internet.

I’d be impressed that the doctor is even interested tbf .

No he’s not, she’s on a maintenance dose ! She hasn’t started it with a bmi of 20

Not a GP but I am a health professional. I can see where the GP is coming from. BMI 20 is actually on the lower side and yet you are taking medication that can potentially have quite bad side effects (and we don’t really know about the long-term effects as it hasn’t been around long enough). As your GP I would be concerned about this too. It must be amazing to be in this shape but to someone who has never taken WLI, it all seems absolutely barmy to still be using it at BMI 20.

Do you really need the jabs if you are able to eat 2000 calories?

I can understand why those with conditions like PCOS or obesity need the help to stick to a strict low calorie limit, but 2000 is just normal. Your gp might suspect you are using it as a crutch or are incubating an eating disorder.

Me too, I’d love my doctor to ring me once in a while!

It sounds like you’re aiming for a BMI of 19…

My GP was delighted and asked all about my experience because he wants to know more about the drugs. He recommended (on the basis of the research he’d seen) that I stay on for at least 2 years once I’ve reached target weight.

He is one of two really good GPs I’ve ever had.

It has been around for a long time and we know more about the long term effects than for many other drugs.

The uncomfortable truth is that GPs likely understand the potential long term effects of this drug better than the general population. These side effects are probably worth the risk for those whose obesity leaves them prone to seriously health issues but for everyone else it’s a risky game.

Yes it’s surprising that your GP rang you but I can understand their concern.

Isn’t BMI of 18.5?classed as underweight? Think makes sense GP would be concerned as to why you’re still on it tbh.

Decades!

It is a drug and a Dr has told you it is dangerous - I am flabbergasted at the responses saying carry on! A BMI of 20 is low - below the middle of the 'good' range.

Our local guidance is that GLP1s should no longer be prescribed when BMI is 22, so I can see where he’s coming from.

I think it’s professionally irresponsible for pharmacists to prescribe until your BMI is 19, certainly at a significant dose.

You take these medications and are able to eat 2000 calories?

GPS don't just ring you for no reason OP. I'm leaning towards you're not being completely honest about some of your post.

He has a point. Ringing as concerned. Not clueless as you put it. He has many years of medical training and no doubt professional training as a GP and will understand the MOA of these drugs and associated risks better than you unless of course you’re a pharmacologist/pharmacist/ endocrinologist etc so I wouldn’t discount his opinion.

No drug is safe and it seems that he feels there is a negative benefit risk balance for you still continuing to take it at your current weight. Up to you of course what action you take but if your approach is correct (in your view) why so annoyed?

I agree with your GP. If lifestyle changes are made while you're on the WLI, you shouldn't need them now that you are at the low end of BMI.

It's a maintenance dose.

You are not qualified to say "As your GP I would be concerned about this too" - you're not a GP.

Complain OP. Not ok.

I've been on them nearly 2 years. I'm eating 2000+ calories as I've been increasing slowly to 'maintenance' which is surely the whole point? My goals at the moment are building more muscle, I have been training consistently for a year now. I am titrating down. I have no plans to order any more pens. I'm on the lowest possible dose, spaced out. My last dose will be in June. It's also bee amazing for my fibromyalgia and rheumatoid arthritis in reducing inflammation. Surely this is a well thought out plan rather than stopping suddenly, rebound hunger etc and gaining weight? Yes I am on the lower end of BMI but I've always had a small frame, when not obese. I'm strong and healthy. I was more than happy to dicuss with my GP, but I felt like I was being told off!