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 know! It’s a joke! Weight and WLM is a subject where people who have no clue about anything think they not only have an opinion, but that they’re compelled to give it.

ive had people I barely know notice I’ve lost weight, commented on it (which is dubious enough tbh) but then judgily say “you’re not doing those jab things are you?!”

like - honestly- why would you care? You don’t even know me, we’re not friends…

im now at BMI of 23/24, but I’m muscley, I’m working on building more muscle but definitely don’t want to drop any more weight. I’m going by the visual of me, I’m thin enough, but I need titrate down for a longer term, and if I can reduce or come off entirely I will.

strongly suspect I may have insulin resistance so may need to stay on a very low dose for a while or for life.

If my doctor did to me what your doctor did to you, I’d report them to the practice manager and the gmc,. There is no excuse or justification to proactively call a patient and give them erroneous medical advice. And you should ensure he is stopped as he will be doing it to others.

here is the complaint form for the gmc. His behaviour it’s dangerous. These meds are life saving and trying to stop patients accessing and making them come off, as he can’t even be bothered googling and reading for 2 mins is shocking, he has a duty of care. The notes are evidence of his fault.

https://www.gmc-uk.org/about/get-involved/complaints-and-feedback-about-our-service/how-to-raise-complaint

You may wish to go via practice manager first and explain the error, and the behaviour, and request the note is removed the doctor informed further on the meds, but state if this doesn’t occur it will go via the gmc due to the risk he poses to patients health,

I agree with @Tacohill. He should’ve listened to you and had a proper conversation about your WL plan- but it was good that he contacted you.

Good luck @Willowy2, you’ve got this and you won’t need the jabs soon.

No it wasn’t good he contacted her, he should only have contacted her if he was able or willing to have a conversation, he was neither willing or able. So he should have not contacted her till he was.

I wish people would stop quoting the “it’s been used for years so it’s safe” argument. Yes GLP-1 drugs have been prescribed for over a decade for type2 diabetes. We know that they are effective in controlling diabetes and lowering glucose levels. But we don’t know how they will affect people taking them for weight loss who don’t have type 2 diabetes.

Their use as weight loss drugs is very recent and there has been a lot of abuse of the private pharmacy prescribing route. This has been addressed by much more robust regulations. I suspect a lot of users will be getting phone calls from their GP re their BMI.

What is interesting is that in type 2 diabetes patients the weight loss is often not as dramatic. Patients experience big improvements in diabetes symptoms but weight loss is more of a side effect despite the hype. Like antipsychotics and anti depressants the drug may have very different effect on a healthy body than a diagnosed diabetic.

It can take years for longterm side effects to surface and in regard to GLP-1 drugs used in non diabetics we are a long way from knowing if they will cause damage.

It kinda makes sense because food noise could possibly be described as an addiction? Chasing the dopamine hit.

Yes. And OP is on a maintenance dose. A GP should be educated enough to know that people can maintain on the medication not just lose.

Otherwise all the diabetics using it for life would be dying of starvation.

I’ve just looked at the letter which my supplier sends to my GP each time they prescribe. It’s very well constructed and contains the following -

‘Your patient has provided us with their consent to communicate with you. Please note we are not
asking for specific information from their medical record or your opinion on the suitability of treatment.
The responsibility to treat remains entirely with us and our prescribers’

Any concerns about your BMI and prescription should really be raised with you by whoever prescribes, not your GP. Unless someone hasn’t declared a condition or a medication they really shouldn’t get involved

Correct, GP, s are imo, mostly clueless when it comes to glps, and just as judgemental it seems, op has been legitimately prescribed a medication which she's taking for maintenance, I would have told him /her to get to fuck.

Yep my letter literally says that the prescribing decision remains with them and that if the GP has any concern to discuss with 'us' (being the pharmacy), not the patient.

His knowledge of the human body has evidently not taught him about the prescription criteria for WLIs, though. Funny that. Rather than listening to him, when he's wrong, OP should listen to professionals who actually learn things about a drug before ringing up to fulminate.

This is pretty much what I was going to say.

OP, did your GP explain their concerns?

Sure a gp that knows the drugs like mine, who completely recommends and supports. A gp who doesn’t even know tne prescribing criteria, no, not so much. I mean it’s as basic as it gets.

I've sent a complaint email to the practice manager, so we shall see!

It does sound as if there’s a learning curve here for GPs. Are WLI the first type of medication being prescribed by online pharmacies and widely used by the public (without GPs’ input)? I have no idea.
I imagine that accessing most medications does require input from a GP, consultant, etc.

There is but they are expected to be educated, the government made that clear.

my surgery all the doctors have been on training courses, and they also have the pharma reps in to present to them the results of all on going trials. In addition most of them have been prescribing these meds for the last 20 years. My gp said she wished she could prescribe, and recommended me them, said she’d had great results on them, and had read all the trial data, she also said she would monitor me throughout, even though they were not supposed to, as ultimately I was her patient and my overall care was down to her.

im often aghast to realise not all GPs are created equal, and some like this guy don’t even bother to read the prescribing criteria.

@Thelankyone My question is really whether this is the first type of medication that’s been so widely prescribed in this way, or are other medications regularly prescribed by online pharmacies without your GP’s or a consultant’s input?

I have no idea and my point is that if it’s a new phenomenon, GPs need to adjust to it (and clearly some haven’t as well as others yet).

Hopefully my complaint email will help. It was calm but fair, and should hopefully encourage my GP to read the pharmacy letter properly and learn that maintenance prescribing is valid. That would be a good outcome.

@Crwysmam We do know how GLP1s affect people taking them for weight loss alone, without having Type 2 diabetes, because there have been all the necessary clinical trials specifically for weight loss alone, and GLP1s have been in use for a decade or so for this purpose, eg Saxenda, Wegovy, then Mounjaro.

Weight loss in T2 diabetics is less dramatic because the focus is not on weight loss, it is on blood sugar stabilisation. Once that's achieved, then doses are kept at the level needed for that, even if weight loss slows or stops.

An obese body is not a healthy body, we know that obesity brings with it changes to the body that mean that weight loss becomes harder and harder to achieve.

People seem to love to predict long term damage from GLP1 use, but only for obese people, never for T2 diabetics. Despite the fact that in all the clinical trials and longer history of use there is very very little evidence of any potential risk areas for this long term damage that people seem to like to predict.

I feel angry on your behalf OP

I think there are many others yes, multiple ones that pharmacies can now prescribe.

For example anti biotics pharmacies can now prescribe with no gp input. I have had Norethisterone prescribed to delay periods by boots. It also has the seven minor ailments thing where they can prescribe, from earache to uti’s.

i think this is the first widely prescribed one, as in millions of people on at once, but the rationale is the same as the other meds they prescribe, to take pressure off gp’s due to such limited risk

The minipill is also onr that can be prescribed by pharmacy's too isn't it? I got the mini pill online years ago to try as I couldn't be bothered with trying to get a GP appointment to discuss period management.

Viagra has been available via private prescription for a fair while too and I am sure there are very many thousands of prescriptions for it.

I think many people who haven't had a need to investigate private prescriptions are unaware what is available online in this way, and that weight loss injections are the first awareness that they might have of this model of healthcare.

I’m sick to my eyebrows of gp’s & consultants who don’t listen to their patients, mostly they seem to be male 🤔.
So sorry for you OP. But, technically speaking, we are paying them, so we only need to use whichever part of their services we like. Get rid of your anger training & have fun 😊.

Ignore him. He’s simply wrong. A maintenance dose is fine and actually the WHO have now said that GLP meds are a LONG TERM medication. My BMI is 19 and I still take 2.5/5mg as a maintenance dose. 😂