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.

I've been increasing my calories slowly to maintenance calories after eating in a deficit for so long. I didn't get to my goal weight and then BAM! start eating 2000 calories a day. It's been trial and error and making sure my lifestyle changes were consistent and achievable long term. My body composition has also changed which means I have alot of muscle, and I train alot so these calories are now very much needed to fuel my body. I could have stopped the injections abruptly as soon as achieved goal weight, but this I wanted to make sure I was eating in maintenance calories before coming off so I didn't experience sudden rebound hunger. I have already stated several times, that I am coming off them, very slowly! I'll be GLP-1 free by end of June and I hope I can continue to maintain with my lifestyle changes, new body composition and not feeling hungry by eating too little. I hope I can maintain without them, I know many can't which is why GLP-1s can be prescribed long term at goal weights to treat obesity.

Says who? People regaining weight after stopping WLIs is quite normal. The human body doesn't care about anyone's 'should'.

There is an argument to be made that it would be better for OP to have a maintenance dose keeping her at a higher BMI than now. But useful discussion on this point isn't likely to be possible with a GP who thinks MJ can't be prescribed to anyone with a BMI of under 27.

Kelly Osbourne isn’t on them. She says for some time, she is mentally struggling at the moment, i suggest you believe her and not make her out to be a liar.

i have been maintaining on them for a year, my weight is very stabile and healthy, as that’s what they are designed for.

That's fair enough if you're slowly coming off them. I was just saying it sounds like you've got to the point now where you dont really need it anymore. I'm glad they helped you so much.

I'm not condoning the doctor scolding you and not listening to you though. That must have been really annoying. Something tells me they wouldn't have spoken 'at' a man like that?

First people tell you to not use WLI cause you have to be on them for rest of your life. Now what someone is on the maintenance dose, suddenly you're suppose to stop it cause you're too skinny.

I know right! 🤷‍♀️😅

The letter didn't state 'a need for close monitoring' it was to say that the pharmacy was closely monitoring. The pharmacy letter was clearly a letter for information only purposes. There were no concerns. It was a very standard letter from a pharmacy.

I’ve been on MJ, so am a vocal supporter of their use in weight loss, however my clinic won’t prescribe down to that BMI. I was BMI 36 when I started but their cut off is a BMI of 23. They automatically start titrating you down and prepping for maintenance at 23.

Your GP is right. You shouldn’t need it now and the risk of being on GLP1 inhibitors are only outweighed by being overweight, which you no longer are. From a clinical perspective, you should be off them.

Yes, i was very much spoken 'at' rather than it being a call from a concerned GP.

I definitely don't want to need them anymore and i am prepared to come off them and just hope that I can maintain without.

The jabs have helped me make healthier choices so we'll see!

I don’t think that they would have a leg to stand on legally if a patient was denied healthcare because they chose to loose weight with WLI, would a GP deny anyone who dieted healthcare unless it was done via a gp or nhs referral? Can you imagine if everyone who wished to address a weight problem had to do so via an nhs referral because otherwise their GP has threatened withdrawing support/heath care, if anyone using WLI is denied healthcare from their GP these are your rights:

Your rights as an NHS patient

Under guidance from the about:blank NHS and professional standards from the about:blank General Medical Council:

• GPs must not refuse general NHS care because you are receiving private treatment elsewhere.
• You remain entitled to NHS consultations, prescriptions, referrals, and monitoring for other health issues.
• Your GP should not discriminate against you for choosing private treatment.

So your GP cannot remove you from the practice or deny routine care because you are using a pharmacy-prescribed medication.
Hope this info helps clarify your rights 😊

Well I’m staying on at 20 bmi, I’m healthier than I have been in years and my gp and prescriber support that,

I need it to stick to 2000 calories in maintenance, for now anyway. It's really none of your or anyone else's business why a person may want to remain on the medication despite eating what you view as a 'normal' amount. If I could have stuck with a 'normal' amount of food I would never have got obese in the first place.

I think that if the GP was sufficiently concerned to telephone you, then they should also have taken the time to listen to you @Willowy2 . I have IBS and two different types of inflammatory arthritis and MJ definitely helps with both. I'm not looking to lose any more weight but find a low dose of the MJ helps me maintain and also helps me manage my other conditions. Your GP should have been open to hearing how your conditions have improved.

I thank heavens that we are allowed some bodily autonomy and can make our own decisions to some extent with WLI. Of course there are some people who will go to extremes, just like they do with cosmetic surgery, cabbage diets or Turkey teeth, but that doesn't mean that most people taking WLI are unhinged. Most just want to be healthier and manage their weight better.

What a shame that your GP was not open to a discussion about your overall health and wellbeing thus far and your plans for next steps. For sure they could have given you some guidance about where a healthy BMI fits in your journey, that would have been sensible, but instead the conversation has led to a negative outcome.

Yes, why do you ask?

That's not how obesity works

It sounds to me like you are taking it responsibly with a plan to come off it at the right time for you. But I don’t think it was all that unreasonable with your GP to call you to discuss to check this. I appreciate you felt like you were being told off. But essentially it seems to me like they just wanted to know your plans for next steps (unless I have missed something).

Recovery from obesity is a long term process. Obesity damages fat cells and the endocrine system and this damage is not fixed by simply losing weight. It's not well researched or understood but the likelihood is that bodies need to maintain weight loss for a significant period before the damage caused by obesity is healed (if at all)
Stopping the medication too soon is likely to lead to weight gain for most people because of physiological mechanisms, not lack of willpower or bad habits.

The medication makes it possible for me to eat 2000 calories. Without it I would likely eat a lot more and gain a lot of weight. Is that difficult to understand? If I could stick to 2000 calories without medication I would never have got obese in the first place.

Personally I don't think it's remotely difficult to understand!

I would suggest that as a health care professional you educate yourself on the current use of MJ as a maintenance therapy. I really hope you don’t spout off like this to your patients
I am a nurse working g in Primary care in a specialist role. The evidence for its use to maintain the weight loss is there for all to find

Yes that is a tad concerning.

I intend to stay on a maintenance dose forever.

I know if I stopped that food noise would return and my appetite would rocket.

i think a lot of medical professionals don’t actually know that much about the medication. Especially if they aren’t weight loss specialists

I can see their point. BMI of 20 and taking weight loss jabs and still eating 2000 calories. Bonkers.

‘Your body’ is the most ridiculous response! Who has to treat that body when things start failing or going wrong? Yeh that would be the doctor on the NHS!!

I'm due to start ADHD meds at some point this year so I am hoping that helps too as food has always being dopamine seeking behaviour for me. The way MJ quietened my mind at the higher doses, not just food noise, but all noise, was really quite remarkable.