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.

Do you not have access to Google?

There’s loads of evidence from actual medical research that people who have lost weight via WLI after being clinically obese will likely need to continue taking a smaller dose of the medication for up to 2 years after reaching their target in order for the body to get used to being the new smaller size.

Sounds like the GP and other supposed medical professionals on here haven’t been keeping themselves up to date. 🤷🏻‍♀️

I would submit a complaint to the practice manager. Fine for the GP to call and check in but he went too far. Unprofessional, especially as he is essentially calling into question the judgment and professionalism of your private prescriber.

I heard Oprah explain what food noise was and it was different to what I understood. I had thought it was constantly thinking of that food and feeling compelled to eat it but Oprah explained it was more around calculating how much exercise she would have to do to address the lunch she had eaten. The constant analysis of food. It really made me think about the weight loss industry and how it in a way created the food noise or made it worse.

I have a friend whose GP wants her to take GLP for health reasons and she won't because of the stuff she reads about it online.

I have asthma and hate taking my inhaler (cos I just hate the chore and I am forgetful) and doc has never suggested I come off it or reduce it. Why is that? My peak flow is fine. It's accepted my peak flow is fine because of the steroids I inhale. And daily steroids are not without risk.

Obesity is a disease that you don't lose when you've finally lost the weight. It changes your body composition and your metabolism. This is why maintenance doses exist.

Obesity is a poorly understood condition.

Sorry to hear that OP, it's really unfair that you were told off.

I see a gynaecologist privately and he prescribes Mounjaro for me - this costs quite a bit more than going via one of the usual pharmacies (both for the appointment and the medication) but part of the reason is that I don't want to get my GP involved as I am also scared of a judgmental reaction.

I have PCOS and need to be on a maintenance dose - otherwise I just shoot right back up - although I also have a much lower BMI now than when I started (currently at 23). My prescribing doctor suggested this himself; he is monitoring me and is satisfied that I'm doing the right thing. He is highly qualified and makes sure I check in every two weeks.

@EnterQueene didn’t OP say the pharmacy had sent a letter flagging up a concern at someone thin injecting themselves with a drug to make them even thinner? Doctors are constantly threatened with litigation. If the GP had ignored the pharmacy alert, and OP had suffered some adverse effects, the GP could be found negligent for not intervening.

The GP was just doing their job. It’s really straightforward. And if the GP sounded irritated, it’s probably because they were. It was additional work that they could have done without.

Well I think we all know that plenty of private prescribers are dodgy as hell. There have been threads on here from people who have lied to private prescribers and got drugs they shouldn’t have. It’s easy. If you’re prepared to pay, you can get pretty much whatever you want.

No, the pharmacy sent their standard letter which they do with each order. The letter flagged no concerns, just said I was prescribed a maintenance dose and it had been verified my previous BMI etc and that I continue to be monitored. It also stated their guidelines on maintenance prescribing.

This is the myth many try and convince themselves of, however the WLI's were only parented and approved a few years ago - whilst the class of drug existed before in the treatment of diabetes, it was never as widely deployed or used as it is now - there is no long term safety data as yet, now that's the same with many drugs, you just take a chance.

I could eat 3000 calories if I wanted. I’m on WLI. We’re not all the same!

Well it makes a change to complain about the nhs caring too much 🤷‍♀️

Maybe gp had experience of another patient taking it too far. Amazing they are proactive. Don't think I've ever had proactive contact from my gp for anything ever.

Congratulations on your weight loss

But the reality is that if your health declines or you have medical issues, your GP will be the one picking up the bill for it, not you. .. My GP surgery has put out a notice that they aren't supporting patients who are using these privately and that includes blood tests. They are only supporting patients who are accessing WLI's through the weight management service at the hospital.

Why so rude? Do you talk to people like this in real life when they’re engaging in a conversation and asking clarifying questions?

A couple of people gave really helpful informative answers for which I’m grateful and it’s helped me understand the conversation better.

May I ask what you mean by “two tests?”

I agree with your GP.

There’s no need to speak to people like that. For a start it makes you sound like a moody teenager

That doesn't really sound like 'close monitoring'. Perhaps the GP thought that a letter from an online supplier mentioning the need for close monitoring was, at the very least, an indication that he needed to get in touch with you.

There seems to be some belief here that Drs have a kind of magic knowledge of the effects of drugs beyond those described in the BNF and all related literature. They don't. Semaglutide has been in use since 2017, it's not a new drug, and it might just be that this particular GP doesn't understand much about how it's used in weight maintenance as opposed to initial weight loss. Or it could be that he has knowledge of Willowy2's mental/physical health that isn't being disclosed here. To me, though, it sounds as though she has an effective and carefully thought out plan which has and will benefit her health long term. (Clinician here, not a doctor but I've had a lot of experience and training in delivering lifestyle/weight loss advice).

Yeah that's what I don't get. Eating 2000 a day is more than most ordinary people do without WLI, so why bother take them. If you can eat normally and maintain on 2000? It's just medication for no reason.

I assumed that was a typo for “two years”

Because the meds help her only eat 2000, without them she would eat a lot more, and would struggle hard and regain weight, like nearly every other formerly obese person. The only reason she can stick to 2000 consistency as she is on the meds.

It’s not subjective, it’s objective. Factually the mhra has licences the drugs for maintainanance and life time usage to prevent relapse, and within a healthy bmi. The doctor is factually wrong.

I don’t understand why mumsnet deleted my comment. I mentioned the bingo card and the fact this post will bring out all those against wli’s and all the misinformation thats being pedalled on this post and I was right!

OK so now we know why Kelly Osborne keeps on them.