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.

Yes and the fact that obesity and fat people still face stigma even when they are trying to get their weight under control. When they use medication - they'll put it all back on. When they use a maintenance dose once at goal weight - it's bad for you / you're too skinny now etc etc. Obesity is still seen as soke moral failing and the fact that there is now medication to treat this disease people do not like it one bit.

Ssshhh don't tell anyone, they'll be uproar 🤪

Yes WLI are widely prescribed by qualified practitioners, GPs are often judgemental pricks, and rely on naice compliant patients to agree with their sometimes absolute fucking nonsense regarding these drugs (and lots of other things), but at nearly 60 I've grown teeth and learnt to bite back. They are not the font of all knowledge, often gatekeep, and in my unfortunate experience are often woefully incompetent.

Let us know what the response to the complaint is op; it should at a minimum make him understand he was wrong, and hopefully remove the note from your notes and not subject anyone else to this.

Will do, thank you!

Thanks op and make sure his note is removed as it could cause you problems,

By August it could be 17

A GP. Not even one with a specialism in obesity.

OP got the medication legally, when her BMI was high. It's not a medication that is recommended that you just take for a short period until you have a BMI under qualifying. There's a process, a time on a therapeutic dose, a maintenance period and then a tapering off period.

As for the GP having a bigger understanding of the side effects, how on earth would they? The GP clearly has a really limited understanding of the medication given they didn't know the prescribing criteria!

Maintaining a healthy BMI on a low dose is what you are recommended to do and what the OP is doing.

Why would it be? She eats 2000 calories and weight trains. She's reducing her dose to maintain. Why would she end up with BMI 17 in August? How?

Hilarious that my BMI will be 17 by August 😅 I weight train and eat 2000+ calories a day including high protein. I'm looking to get stronger not skinnier. I want muscles that pop 💪

Why, she’s a grown up, mine is 20 and has been for over a year now, my weight is very stable, goes up and down 2lbs, and I’m maintaining on a low dose.i think maybe you don’t understand the drugs and how they work, how maintence works, and that’s fine, but maybe educate yourself before making silly comments.

whats the saying, it’s one thing to be thought a fool, and totally another to open your mouth and prove it,

I’m being nosey @Thelankyone - how long do you stay on a maintenance dose once you’ve reached a healthy weight? Do they say x months and then taper off?

For ever. These drugs bring so many healrh benefits and I don’t want to spend my time struggling to maintain my weight, been there don’t that, so I will stay on a low dose, stay healthy and fit, and not struggle to maintain my weight,

GPs are generally clueless about any positive health choices. Unless they are genuinely interested in a specific area, their professional development is sponsored by drug companies making money from the NHS.
There are some good and a few brilliant GPs out there, but they aren't your average GP. So long as you are doing your own research and due diligence, then trust yourself.

'What is the difference between God and a Doctor? ... God knows he is not a doctor' was a 'joke' from my nursing days-40 years ago.

Ah, so they’re similar to my thyroid meds or blood pressure medications, you take them indefinitely and perhaps tweak the dosage if anything changes (that’s what happens with my thyroid meds anyway).

I think a lot of people taking WLI don't want to hear the hard truth that it isn't a long term solution.

A BMI of 20 is on the lower end and consuming 2000 calories while taking WLI with a BMI of 20 isn't healthy.

Why do you say it isn’t a long term solution? All the medical evidence would disagree with you. Trials are demonstrating that for people with insulin resistance, WLIs are absolutely a long term solution.
Not only that, there are in fact many trials underway to license WLIs for long term use to treat cardiovascular disease and potentially Alzheimer’s, based on observations from long term weight loss trials.
Far from having long term risks, this treatment is showing huge benefits from long term use.

All drugs carry longterm risks that can take years to surface. I have an endocrine condition which was treated with a new “ miracle “ drug. I was part of the phase 3 trials. I have been taking it on and off for over 35 yrs. Ten years ago I was put on a screening protocol because after 20yrs of its use it was found to cause heart valve problems. I have echo cardiograms every 3 yrs to monitor the condition of my heart valves.

Interestingly one of the main side effects of the drug was rapid weight loss. This was on the initial high dose which was subsequently reduced. Can you imagine the massive headache this would have caused if it had been further marketed as a weight loss drug after this beneficial side effect had been observed.

Mounjaro is not the same as Wegovy because it has further pharmaceutical actions. It may have had the routine phased trials but these are limited to a very small group of participants and don’t necessarily reflect the effects we will see going forward. Many drugs that make it through phase 3 trials and reach the market are later withdrawn after side effects are reported.

Currently the next generation of GLP-1 are available on the black market. They are still in phase 2 and 3 trials but due to loop holes are being used by body builders to shed fat rapidly to increase definition of muscle. A number of garden shed labs in the uk have been raided and shut down in the last couple of months. There is a huge black market in weight loss drugs which preys on those who can’t access the legitimate sources either due to cost or not meeting criteria. It is an industry, not unlike the dermal filler and Botox industry that has outpaced safe regulation.

But I do agree that the potential for mass improvements in the health of the population is undeniable. It just has to be safe.
The op is upset at her GPs involvement but has been vague about their reasons. If they have a history of ED this could well have caused concern.

My late DSis was delighted when she managed to shift her middle aged weight gain by healthy eating and exercise. Unfortunately it was aided and abetted by a nasty little tumour in her pancreas that killed her within six months. Losing weight rapidly doesn’t cause tumours but using WLI may mask an underlying serious health condition. It would be remiss of her GP not to check weight loss if it appears outside the expected norm.

The GP has been remiss since October 2024 having only now noticed that the OP is taking Mounjaro. And they were incorrect in several of the statements that they made about its use and prescribing criteria. It doesn’t indicate a particularly good grasp of this area of medicine. The OP has plenty of reason to be miffed. I think assuming that the OP must have an eating disorder is a bit of a leap.

As is suggesting that people who lose weight might end up missing terminal cancer symptoms due to using GLP1s. Yet another dire consequence that people imagine will happen to people like me in the future.

For diabetics. Not for people who want to lose weight and self justify WLI as diabetic prevention.

Anyway we will wait and see what the long term effects are. We simply do not know yet regardless of how much people want to otherwise believe.

I will take the chance of dire future unknown side effects happily, having gone from morbidly obese to a healthy weight. The risks of remaining obese, morbidly so, are well known and I have now massively improved my health by using Mounjaro to shed the weight. It would have been a very poor decision for me to have decided to not take that chance.

Quite honestly who do they think they are? Telling people off like naughty children. I would tell them to call back and have an adult to adult conversation or fuck off!

About what?

I can't believe any GPs have time to sift through patient records to check whether they ought not to be taking GLP-1 and actually phone you to tell you off? How would they even know your current BMI was 20?