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.

In fact these medications underline that obesity is a disease, and a treatable one. The drugs make tiny adjustments to the body’s chemistry, and we get slim.

It’s more analogous to depression than cancer. People who don’t have depression often find it hard to understand why people with it don’t just do the positive things they themselves do to maintain good mental health. I often feel this myself. Why doesn’t he go for a walk? To the gym? Surely fresh air would be better than pills? Like obesity, depression has a strong social link at a population level and the causes are difficult to untangle, and easy just to blame on individuals. Both got worse with lockdowns. Both need both medicine and social changes, like making sure mothers of young children have enough time and money to exercise and eat well. Early intervention is better for both, and both are often longterm problems.

My bmi was higher than yours,, I take blood pressure tablets , statins and have a heart condition plus another illness that is a marker for NHS weight loss jabs
My Dr refused me but when when I asked if I could self fund , he agreed so I did .
I'm sure I qualify for it , but it wasn't worth the hassle or the time spent doing it .

Exactly!

And the fact that it really is a disease, and now a treatable one, rather than a moral failing is sending some people in to a total head spin.

I said it earlier it’s for them it’s about rhe aesthetics. Either not liking their bodies or struggling to maintain their weight and they think everyone on tnem is doing so for aesthetics. That we stay on for aesthetics;

this drug by default makes women more conventionally attractive. Because being slim is considered more conventionally attractive than being fat; and being able to take the drug, as you’ve deep enough pockets. And stay on it, as they are even deeper. Slim is seen as desirable, enviable.

the fact obesiry is actually a lethal disease and is now being medically treated to save lives and prolong quality of life , is irrelevant to them.

and instead of hating the game, big pharma due to the price point, the nhs, they hate rhe player.

look at the poster up thread, lost 4 stone in ten months, has to come off as she can’t afford so has decreed she’s lucky as they don’t work for her but wants no one else to be prescribed on line now as she cant afford it any more. So as she can’t access them any more she wants no one to access them. If she could afford it, she’d not be thinking that, she’d be placing her order as normal and enjoying her weight loss and improved health.

My GP once told me that I shouldn’t fill up on vegetables/salad “because vegetables have calories in too!” I rolled my eyes so hard I almost saw my brain.

Her'non obese ' friends must be so lucky, having insulin resistance, dopamine seeking, out of control food noise and manage to curb it! Oh wait they don't! That's what mounjaro does, that's why it works. That's why when you try and come off no matter how much you try and control your eating and appetite your hormones and brain are working against you, some people's hormones and brains aren't broken and they remain a healthy weight, some people have to tweak theirs with mounjaro which is why it works, stop taking it and your hormones and brain will probably go back to making you fat, just like if you stop hrt you'll go back to your poorly regulated hormonal self.
There's nothing wrong with taking these drugs they stop people being obese, if you want to stop then stop, but why the moral judgement? It's bizarre.

I don’t know where you’re getting “resentful and jealous” from. I’m really not. And those saying I’m morally judgemental are the ones morally judging me, and doctors, and anyone else who doesn’t agree with them!🤣🤣

The reason I’m only coming off them now is because I bought about six or seven months ahead in august. At the time I was losing well, but i think it was probably a placebo affect to some extent. I have always had lots of food noise and can eat enormous portions. The fact that I’ve lost weight has been mostly down to what I’ve chosen to eat. Yes I have continued on the pens because I might as well, having spent £100s on them. But I’m not particularly nervous about coming off them, as my food noise is always there.

And I really do believe that online prescription needs changing because I have spent a lot of time on the Mumsnet WLI threads and Facebook groups, and seen a lot of people cheating to be prescribed medications (putting weights in pockets etc) and seen other people looking like they’re going to get eating disorders at the end of the journey. At one point I had 10 pens amassed in my fridge. Yes, great for saving money, but I bet there were a lot of pens sold on etc. And it really should have flagged up on my medical records that I’d had all those. I have used them sensibly, but I might not have. THATS WHY I think it needs changing, because it’s not safe. And my judgement of SOME people comes from all these months of following how people use it. I know a couple of people that use all their calories for wine at weekends and barely eat so they can do that and still lose weight. Sometimes the “ what I ate” thread is like a boasting page for how little they’ve eaten, and I think it’s really unhealthy to continue eating like that for life.

But hey, judge me how you like.

I just don't get the moral judgement about them at all. But it's not particularly surprising given the moral judgement about obesity full stop.

One thing I have found is that it's reset my body back to were it was before I started having weight difficulties (long before I became obese). I was a healthy weight for 28 years and then bam. Food noise, insatiable appetite etc. 3 years of just about maintaining a healthy BMI through self denial and essentially abuse of my body, 8 years of desperately trying to manage my weight in the overweight category. Then 2 years on the drugs and it was like I'd gone back 10 years. It was amazing. I felt "normal". I've been off them 2 years now and apart from a small gain of what I assume is water weight, I've kept my 4.5stone loss with virtually no effort - the same way I maintained my weight for the first half of my adult life.

We can only go with what you wrote, I’ve no idea why you wrote you were coming off as you couldn’t afford them any more if that was not the case.

@Ohyeahitsme that's interesting, I have tried to come off, not very successfully, I might try again, just from a cost point of view, if I could afford it easily I wouldn't dream of coming off, I feel so much better on it, no creaky joints, no alcohol, just calmer in general.
The judgement is insane though, it should be entirely personal as to whether someone decides to stay on it, I wouldn't dream of telling my husband to come off his methotrexate, despite it being a horrible drug with lots of long term implications health wise in and of itself, because he's so much happier being free from the symptoms of psoriatic arthritis that made his life a misery for years, no one else has told him to either, including his gp, because there's no judgement.

It is the case that I’m coming off them for financial reasons. I’m on the higher pens and can’t justify £250 a month when I still have a huge appetite and food noise. If they worked perhaps I would scrabble more money together, but I’m largely relying on willpower and making good choices so stopped isn’t a difficult decision. The money saved might as well go to a personal trainer or something to help me stay on track. Perhaps a nice holiday. I’ll save a fair bit.. I’m pretty confident I will be fine. I know there will be some ups and downs but I think I’ll be able to deal with it. But thanks to those sneering good luck with that!🤣. Nice ladies!

Not all medications work for all people. Many people have to try different anti depressants before they find one that works and it'll be the same with weight loss medications. For others the side effects are intolerable - my DH takes statins due to congenital high cholesterol (i.e. not related to diet) he's had some awful side effects and has had to switch out to different ones before finding one he could tolerate. Most people tolerate statins well with no side effects. Similarly, WLI are tolerated well by many but some have awful side effects.

Because the medication works in essence, more and more funding is in place to research different ones which people will get on with better when they become available, whether an individual wants to try them again is obviously a personal decision. I guess it depends how significant the impact of obesity is having on a person - I started taking them as obesity was stopping me from doing things I loved and others I wanted to do.

You need to go back and read what I wrote again. That’s not what I meant at all, and I think you know that, you’re just being obtuse. I never said I didn’t want anyone to be able to access them, just that they needed to be more regulation and help alongside them.

And I’m enjoying the weight loss and improved health already, but a lot of it has come down to my choice of food and willpower. I would say 40% jabs, 60% me. I’m hoping/fairly confident I can continue it once I stop. I’ll still have a stone or two left to go. But you keep pecking at me if it makes you feel good.

I agree. That’s why I started too. I was seven stones overweight and starting to get into dodgy health territory. I’d had a lot of deaths and sadness over the past few years, comfort age a lot, and it felt like time to pick myself up. And I hoped that the jabs would help me get to the other end of the journey, or at least on my way, so that I would only have one or two stones to lose rather than a overwhelming amount.

*Ive been on GLPs for ten months. I will be coming off them for financial reasons in another couple of months….I also think that the prescription for these drugs online needs to stop. It needs to be done face to face so that it can’t be tricked with people putting weights in their hands etci

i don’t need to read it again, you do. This is what ypu wrote. Now you’re attacking people for thinking you’re coming off for financial reasons and you want them to stop. When that’s exactly what ypu wrote.

I've lost and kept off 18st through diet, exercise and therapy.

No bitterness here 🙂

She's saying she wants the process tightening up, which is not unreasonable given how easy it did used to be to get them - when I started them they didn't even ask for a photo of me.

What @Gingercar may not realise is that they are now much harder to get - lots require a video call and all require a "live" photo, i.e. you can't upload a photo you have previously taken/ of someone else. Some require a video of you saying specific things. It's also much, much harder to get loads of pens from different prescribers at once. But if that poster hasn't bought any for a while she may not realise that.

For goodness sake, I’m not attacking anyone. Why are you so prickly? You said I said I was lucky they didn’t work for me and I didn’t want anyone else to be prescribed them as they didn’t work for me. Which is absolutely untrue. Every point I have written I’ve explained why or clarified, but hey you seem to be missing that and I really can’t be bothered typing another long post for nothing.

Why does it matter so much if my opinion differs from yours? I still believe these drugs are too open to abuse to be prescribed online, but that doesn’t mean I don’t think they should be prescribed at all. My opinion doesn’t mean that they will stop being prescribed online! And just because I don’t want to stay on them and I think SOME people are staying on them to enable themselves to continue eating poorly doesn’t mean you have to think or do the same. We can all have different opinions. It’s a discussion. Don’t take it so personally.

But as regards the original post, whether the doctor was right or wrong, the way he spoke to the OP was definitely wrong and wasn’t going to get his point across. For what it’s worth, my son is a fairly newly qualified doctor and they are studying them as part of their training. I actually think it would be a good area for a dr to specialise in. It’s going to be a big “market”.

Thanks for understanding what I meant. I probably haven’t ordered a pen since late November. I had to hold a paper with the date on for that. It’s good if they are tightening up.
I surely can’t be the only one that has read threads on the WLI page where someone is just under the limit to get a pen and people have suggested putting things in their back pockets etc, “that’s what I did”.

And like I said, I think it would be good if it could be prescribed alongside a course like the diabetes prevention course, where you get a dietician and advice. I started out with Voy, who were pretty good for personalised support. They just got expensive.

TBF, I haven't had a provider (and I switched around A LOT who didn't offer additional support in one form or another. Usually a course about diet and exercise, sometimes with a one to one personal support assistant. I didn't use it as I'm really knowledgeable about diet and it's not the reason I became overweight (as in my diet wasn't bad, I just ate way too much because I was constantly really hungry - I was fully aware of appropriate portion size, how to make a low calorie, high volume meals etc). I guess you could make engagement mandatory.

That’s interesting. I think I’ve had six or suppliers and not had any particular offers of support from any other than Voy. I didn’t particularly need it either, I’m well aware of what I should be doing, I just didn’t do it. For me it was sugar, I ate a lot of chocolate etc. I totally believe I was a sugar addict. But the diabetes prevention program has been good because they weigh you every month. And it’s been good watching people change over the ten months (those that are still coming! Probably 2/3 of the participants have dropped out).

And I’m enjoying the weight loss and improved health already, but a lot of it has come down to my choice of food and willpower. I would say 40% jabs, 60% me.

That’s an important point to make @Gingercar. Everyone experiences food noise and cravings so willpower plus the jabs is part of the solution.

They're expensive because that sort of support costs. Which is one reason why this being proactively offered alongside isn't necessarily ideal, or even particularly beneficial. People like the sound of support, but there's no evidence it actually works to combat obesity.

I don't think the example you give here is a reason why everything should be face to face either. If someone is so near the cusp that they can reach it by putting things in their back pockets, they can dose themselves up on enough immodium to not shit for a couple of days then have a big meal and a pint of water before their appointment.

The reality is there's not enough slack in healthcare systems not to base many things on trust, which is why the NHS also takes patients word for it in a lot of monitoring.

As an aside , I'm impressed your Dr has the time to call you to tell you off !
Not weight loss related , but I'm into week 4 of waiting for an appointment about a facial skin lesion that my Drs surgery told me I would get an appointment within 10 days for .
I've contacted them twice since the 10 days was up to enquire but have been told I'm in the system and will have to wait to get the appointment .

I was running 5 miles four times a week at BMI 21 and in my 30s so I’m not surprised your GP is worried. If you’re working out enough you can maintain, otherwise it’s ridiculous.