Prescribed Ozempic I didn't ask for - should I take it?

[DippyW]

Just seeking some advice. I'm 38 and been struggling with creeping weight gain since my last pregnancy (youngest now 3). Now 100kg with a BMI of 39. I'm definitely finding it harder to lose even with watching diet and exercise.

I was referred to an endocrinologist for other issues (PCOS, insulin resistance, perimenopause). Now on HRT but I was surprised when the doctor also wrote a private prescription for Ozempic. He said I could give it a go and see if it helped with weight loss.

I said I wasn't sure but would think about it. I'm sitting on the prescription now having not paid for it (it's £220 for 2 months supply).

In some ways I feel as though I've been handed this golden ticket to better health, but I'm nervous about the loss of bone density and muscle mass as I know that can worse in menopause and I'm already in early peri. Also if I'm honest I'm worried about dropping dead suddenly (!) or developing pancreatitis or some other awful complication.

I guess I'm just asking for others opinions/experiences... Is it worth a go? Has anyone else taken it on doctor's advice rather than asking for it themselves?

He prescribed Ozempic as its cheaper than MJ and I don't meet the NHS requirements for free prescription so would be paying out of pocket, but I don't really know the relative pros and cons to each, or even the price diff to be honest.

Thanks so much in advance for your advice!

It’s not a golden ticket, as you’d be paying for it, and you can get Wegovy privately for cheaper than the price you’ve quoted.

Loss of bone density and muscle mass is not inevitable and is a risk for any sustained weight loss. It’s easily mitigated by eating a healthy diet including protein and doing some exercise. No one drops dead from taking legitimately prescribed Wegovy, and pancreatitis is a very rare complication. You are also currently at a higher risk of getting pancreatitis due to being obese anyway. Losing weight via Wegovy would reduce your overall risk of pancreatitis.

Everyone who is taking Wegovy via private prescription is doing so on the advice of a doctor or qualified pharmacist - you don’t just buy it, you have to have an online consultation and provide evidence of your BMI etc.

Mounjaro tends to have fewer side effects, on average, than Wegovy. It also has two actions as it mimics two hormones where Wegovy only mimics one. As a result people tend to lose more weight on Mounjaro, but you can still lose all the weight via Wegovy.

Have a look at https://igovy.co.uk for a list of prices for Wegovy, and https://monj.co.uk for a list of Mounjaro prices. You can look at the tables without the new customer discounts to see what the retail prices are. Mounjaro is more expensive and gets more expensive at the higher doses.

Whichever one you choose, if you choose to take a WLI, you’d need to consider whether you can pay for them long term. The first step is losing the weight, the more difficult part is maintaining that weight loss longer term. Many people find they want to continue taking WLI once at their target weight.

I’m a bit confused by what you are asking really. Does it somehow feel more legitimate or justifiable that you were proactively offered it, albeit privately, than sought it out? I think you need to put that element out of your mind and simply ask yourself if you want to try a medication that will help you lose weight and improve your health, or do you want to give it another go, unmedicated (which you’ve presumably tried before). I think we’ve sort of come to accept/expect that we go to the doctor with any ailment and she whips out her prescription pad and we don’t have a huge amount of input into the decision. This is really the first time people in large numbers have been actively able to seek out a drug on their own behalf. But ultimately, as long as it’s from a legitimate source, you aren’t just handed it, you need to meet fairly strict criteria and be under the care of a medical professional.

While these drugs aren’t risk free, no drug is. If Our doctors sat and talked us through the package insert on any other drug, we’d probably decline! I take a number of medications for a chronic condition, unrelated to weight, and the package inserts are terrifying. Touch wood, the worst I’ve experienced are dry eyes and a delicate gut from them. I take them because they allow me to live a hopefully much longer and healthier life, and I’m choosing to feel the same about Mounjaro. I’d be lying if I said I didn’t have any anxiety about it, because I do. A part of my brain still buys into the message that I should be able to manage without, that I don’t NEED it in the same way I need my other drugs, and that somehow it will be my fault if it goes wrong. On the other side of that coin though, in 8 weeks I’ve lost 17lbs, chronic pain is greatly reduced, IBS has almost gone and I’m sleeping better than I have for years. Food has lost its power. I’m just starting my third cycle (still on lowest dose) and generally feel fine. Odd wave of nausea but nothing significant.

Anyway (long windedly!) forget about how you were prescribed and focus on whether you want to try it, accepting that if it works you may want/need to take it for a long time.

Hi Dippy.

The first thing I am going to say is your body your choice. But your body has endo and so you are struggling to lose weight. It’s like your body - and your hormones- are trying to sabotage your efforts. Unfortunately, not losing weight could cause you to experience more ill health as you get older, so it is worth considering carefully if this is a good option for you. It’s not a golden ticket, because you will need to put some effort in, but it is a helping hand.

GLP drugs are a solution that works well for some people. And whilst all drugs have side effects, for many people the risks of obesity are greater than the statistical risks associated with GLP drugs that are appropriately prescribed and monitored. Many people also report symptom relief from conditions like endo as an additional benefit.

If you do go ahead, you still need to eat a healthy, balanced diet. The stuff you know about fibre, protein and vegetables, whilst being careful with fats and carbohydrates. The difference is that with your hormones under control, it becomes easier to stick to healthy choices.

Take it steadily, and don’t go too far too fast, as that increases the risk of side effects such as pancreatitis and hair loss. Keep hydrated and do some exercise - weights if you can. Small children are a big help here - 10 minutes pushing a child on a swing or pulling a roundabout or even just pushing a pram all count.

I assume because it is a private prescription it was also a private Dr and not NHS?

Did he prescribe purely for weight loss because you discussed weight and you not being able to control it as an issue, or to treat your PCOS, insulin resistance, perimenopause symptoms?

I assume he told you about the positive effects GLP1 may have on your PCOS?

Although both are intertwined, if it was the latter, then it is a no brainer, you have been prescribed a medication by your Dr, why would you not take it?

If it is purely for weight loss/treating your severe (Class II) obesity that is recognised by the WHO as a chronic disease and can be assessed and treated by different health care professionals, not just Drs, then you have the same decision everyone else has who struggles to lose weight. Do I medicate or try diet/lifestyle again?

A couple of things I would consider (as I don't know how they work), with a BMI of 39 it is likely you will need GLP1 treatment for longer (I started with BMI 44 and have been on Mounjaro for 20 months), might it be more cost effective via one of the online providers, would you need to pay for a consultation with the endocrinologist to get a repeat private prescription each time or will the ongoing consultations be covered by an insurance?

Is any of your HRT oral? Did they say anything about/when prescribing accounted for the weight loss injections and the impact they can have on oral HRT?

Forget about how or who you were prescribed it by and focus on your BMI and what it means for your health. I had a BMI of 39 this time last year and after a GP told me I wouldn't be alive to see my kids grow up if I didn't lose weight and suggested I tried them. Lovely pep talk 😁

Anyway I've changed my life in the past 12 months I've been on mounjaro and am a normal BMI, losing nearly 6 stone and 35% of my body weight, have come off BP medicine and am really healthy. I've done this for me and my kids.

Yes muscle mass reduces in a calorie deficit but it's not just because I'm on a Wli as it'd happen on weight watchers or a more socially acceptable way of getting slimmer and more importantly healthy.

So look at the bigger picture about your health and what it means to you to be not a BMI of 39 and not a load of stories about fat jabs or skinny jabs in the daily fail.

Oh and I'd get mounjaro and cheaper because it's more effective from what I've read. But it's not a magic thing, you do have to work with it, be in a calorie deficit, watch what you eat and see it as a tool to the new you.

Good luck

Thank you all so much for taking the time to reply with such thoughtful, informed messages. I really appreciate it. Will reply more thoroughly later, just doing kid dinner now...!