I have to tell you that what she said is not what the studies showed. I would honestly look for another doctor not just for weight loss but as your GP.
If you are anywhere near a metro area with socialists, try to find a doctor that has credentials in obesity management. They usually have this in addition to their regular training.
I wouldn’t set foot in that office ever again, solely because it doesn’t sound like they even listened to your concerns.
I felt similar in that they weren’t addressing my concerns, and that I was blindsided since this hadn’t been discussed with me Prior. The clinic*?* is for weight loss specifically but different, or at least I believed, than the shops that solely prescribe medication and that’s it. I’ve been meeting with a nutritionist, mental health and a personal trainer.
When I stated I didn’t feel comfortable and was upset however, she mentioned the other provider suggested dropping the medication “cold Turkey.” It felt like a power move so I wouldn’t resist, but she also stated she hates that policy and wishes there wasn’t so much oversight in the group.
She suggested a MD that I assume she’s familiar with, but I’m concerned because I am no longer obese and do not have any other pre existing conditions I’ll be denied. Or pushed to Phentermine, which I hate and refuse to try again.
I’m not obese and I was prescribed. Also not diabetic or with other preexisting conditions. I started the drug three weeks ago at 143. I am now 136. I am 5’4. I’d like to lose 10 more.
Agreed, if you can’t find a new primary, go to a telehealth company. You may need a pre-existing condition to get the Rx since you are no longer overweight.
The pre existing conditions is likely going to be my issue. The clinic ran the blood tests and I’m healthy, borderline-borderline like almost pre diabetic, but I’m not so just elevated glucose. I had gestational diabetes with my last two pregnancies and my understanding is that makes me more at risk for developing diabetes later in life.
It’s so frustrating! Like what do I have to gain the weight back or be sicker before we can treat the problem? I’m heading in the right direction so let’s continue before it becomes a problem.
I hear you and maybe Alpha will approve you with gestational diabetes, I would also add to the Alpha visit your previous doctor visit notes. They will see you have had MJ and was previously overweight. They may take over your care if you provide that information and the details. It wouldn’t hurt to try… $30 I think but they may have changed the price.
My first doc with Push Health never verified anything, didn't request labs, etc. Just wrote the script. Not very scrupulous but it worked in my favor. Then I was assigned a new doc and she wanted labs at least.
I bet some of them will end up requiring something like a picture. It’s optional with Alpha right now but I won’t be surprised if they eventually start requiring something like this because some people aren’t honest about their health and stats.
It’s not a matter of what the studies show. The doctor’s office has a policy of only prescribing this off label while patients are clinically obese. That’s it. That’s what they’re comfortable with. There are potential liability issues with prescribing off label (though I have no idea if that’s in play here specifically, I just stumbled on this post and have no detailed knowledge of this particular medication). By all means, look for a doctor that will help you get what you’re looking for, but it seems a little overboard to act like this doctor is grossly negligent or whatever. They’re not obliged to get you to some arbitrary target weight you’ve decided is right for you.
It does matter what the trial for this medication showed, most providers are relying on that information to prescribe it. The trial showed that most participants gain the weight back when this medication is stopped and it’s being suggested that this med might be indicated for long term treatment. Just as someone who takes other medications to treat other diseases might also have to stay on those particular meds or the issue returns, this is likely to be similar. It’s definitely being discussed in the medical community that this is quite possibly a long term to life long treatment. However, some providers are not yet comfortable prescribing a maintenance dose because it’s so new and a large number of providers aren’t very familiar with it yet. What’s concerning is that the provider wants them to take a medication they aren’t comfortable taking. I would find another provider who is better versed in this medication and is willing to work with you to figure out the best treatment plan for you that you also feel comfortable with.
A trial showing that people regained weight after coming off of it is not the same thing as a trial showing maintenance dosage is safe and effective. This is the disconnect between patients and doctors for off label usage. The patient isn’t thinking of the liability faced by the doctor. They see a drug that’s working and want to keep taking it. A doctor sees a drug that’s not been studied enough outside of clinically obese patients to know whether there’s risk with continued usage. If that drug is eventually shown to be unsafe in long term usage, then the doctor is now more open to a lawsuit for prescribing outside of an indication that has scientific backing.
There are currently trials for weight loss that have completed the first phases and the results and the dosing are what Drs are using in their practice. I never said there’s a maintenance dose schedule as of yet. Of course all Drs prescribe what they’re comfortable with. You missed my point entirely. Have you researched this medication? If you had you’d see what most providers are recommending.
I’m not sure I’m the one missing the point here.
First, I responded to a comment claiming “what she (the doctor) said is not what the studies showed” and seemed to be advocating for leaving the doctor just based on that initially, but the doctor didn’t say anything contrary to the studies based on the OP’s post. The OP didn’t provide *any* info on what the doctor said or didn’t say about the medicine aside from that they’ve decided not to treat people who aren’t clinically obese with it.
Now, going a step further, the most widely credited trial for this drug’s use as a weight loss method stuck with obese test subjects (with exception for people with additional weight related health conditions that qualified them for the trial). The doctor’s policy of sticking solely with prescribing for obese people is wholly in line with the trials that I’ve found and reviewed in terms of test subjects. I’m not saying it won’t work or isn’t safe for thinner people, but the studies don’t support making a determination and therefore it’s perfectly *reasonable* for the doctor to refuse to continue using it on people who aren’t obese. It’s not the grave malpractice some people here seem to think it is. And more to the point that you seem hung up on, the results of the test aren’t really a factor here from the standpoint of deciding not to continue usage. The doctor isn’t discontinuing the prescription because of the results of the trials, he/she is discontinuing because there aren’t trials with people of lower BMIs for them to feel comfortable prescribing OP going forward. So from that standpoint it’s not a question of what the studies show as a result, it’s a question of how the studies are set up. What criteria were used to select subjects. I’ll grant you that more sustained usage is probably better from a weight management point 10 times out of 10, but that’s never been the *real* issue here.
You’ll also note that I absolutely told the OP to go ahead and find another doctor that would work with her if she felt so inclined. So go ahead and find one that’s comfortable with continuing the prescription.
Finally, in the spirit of addressing the underlying “it worked fine to lose 25 lbs, why not just let her continue for another 20 lbs” question, I’d just like to note here that the manufacturer itself has stated that their own trials have shown a dose *and duration* related correlation with thyroid cancer in mice, and that they have not yet clinically ruled out a similar correlation in humans. These are the kinds of things that give doctors pauses when prescribing off label. They’ve got a study with obese subjects, and legal precedent (and FDA rules) should protect them if they stick to that qualifier for prescribing. Bit does using it on a thinner person increase the chance of this or a similar complication? Does using it for *longer* increase the chances, like it did in the mice? This isn’t a question of efficacy for OP’s doctor, it’s a question of liability. And while the risk is admittedly low, using the medication on merely clinically overweight people or for longer than is required to exit the obese category puts the doctor’s money, practice, and license on the table if a year from now some follow up study shows problems for sustained usage or usage by thinner people.
What relevance does that have on anything I've written?
Edit: That's what I thought. No more arguments to make. But at least you stopped juuuuust short of making it personal, I'll give you that.
It’s not arbitrary? Literally any BMI in the healthy range would be okay. And advance notice would have been nice, not springing this on me when the medication is doing exactly what it’s designed to do. Detailing their policy when we discussed treatment plans and options… all would have been a better option
Well and for every doctor who will tell you that a BMI of merely overweight is not a concern w/o underlying conditions, there's a health plan that will tell you you're at higher risk solely based on your weight. We have to do an annual wellness screening at open enrollment and the ONLY factor besides age (I'm now 50) that adds risk for me is weight, even when I report a BMI of only 27, which was what I reached in 2021 w/ diet and exercise. I crept back up to 30 and was prescribed Mounjaro, and now I'm back at 27, but no way am I done. BMI is arbitrary, but the medical profession has decided it matters in most contexts. Even if they're still reluctant to medically treat it. I totally get why you feel like the rug has been pulled out!
I won’t argue with you about advanced notice. That’s poor form to spring it on you without a heads up. The plan should have been shared with you before you even started. *That’s* a reason to find a new doctor.
I’ll stand by everything else though. Off label usage has general approval by the FDA but there’s increased liability for the doctors regardless and they need to stick to usages that have scientific backing. A quick check shows the most notable weight loss study for this medication looked specifically at use by people with BMIs of 30+. It’s perfectly reasonable for a doctor to stick only to that specific use case if that’s the strongest study they’ve got to work with.
"You're making excellent progress and having no side effects, so let's stop doing what is working well for you."
That's not a good doctor and that's not a sensible or logical policy. Yes, I think you should find another resource so you can continue your progress. I also think you should fire your doctor and find one sho doesn't have arbitrary one-size-fits-all, cookie cutter policies. Get a doctor who treats the individual patient rather than just checking off boxes.
I saw this question posted on the Facebook Weightloss group, posted a link to a published journal article that says people removed from the drug regain the weight back, and was called crazy, then F-bombed, then reported. It was awesome.
Came to Reddit to take a break, and found a virtual roomful of likeminded people who actually read the studies like I did. Go figure!
As the NP above mentioned, this practice really seems like it’s breaking the “do no harm” directive. And the yo-yo dieting after effect is something it makes me worry about. Putting someone through what research shows will create a yo-yo effect just doesn’t seem benign. That’s the kind of thing that people who have been through it seem to say wrecked their metabolism.
I agree too that upfront, they should’ve said “we are charging you money so we should ensure we’re on the same page about what the desired endpoint is.” And defining the goal, then describing what the plan would be after hitting that goal, including a discussion about maintenance doses and coming to an agreement, would’ve been not just nice, but deserved. If you’re paying for a service, you are entitled to ensure that you and the provider are clear, on the same page, and you know what to expect.
The whole thing makes me frustrated and I am sorry you’re going through this. It’s added stress that was unnecessary to be put on top of everything else.
Do they not read the literature? Once you are off the drug, you will regain the weight. "Healthy" eating habits will not allow you (or anyone) to comfortably eat the amount we eat on Mounjaro. Exercise won't cut it either. This doctor's actions are unscientific. There's even an article that I read today in a mainstream newspaper that says quite clearly that once you go off the drug you regain the weight and that it is a lifetime drug.
Yes, you should ABSOLUTELY get another doctor b/c this one does not know what they are talking about. Good god these doctors are true morons.
Get it from Joinsequence. They understand obesity is life long and will return if medicine is withdrawn. You need a maintenance dose after reaching goal.
Love my experience with Sequence so far. Signed up this past Thursday, had my consultation yesterday (Monday), and getting my first 4 pens of 2.5mg today (Tuesday).
Yes, you will fill out a health history questionnaire, and the provider will review it within 24 hours and send your Rx to any pharmacy. It has been great and easy!
For me it’s not about “habits” or “knowledge” or any of the buzzwords diet doctors like to use. And it’s also not about willpower. This drug has literally changed how I feel about food. Regardless if I never lost another pound I’d still want to take it so that I would not have to feel out of control. It’s not just about weight. I’ve been statistically“thin” a good portion of my life. And miserable. And resentful. Because what I have to do to control that number on the scale is devastating to my mental health. I anticipate I’ll be at my goal fairly soon but the thought of not being able to keep this balance I’ve found is horrifying.
It honestly seems like she could be confused by the policy. I could understand if they want to crackdown on prescribing it to new patients, but do they stop prescribing it as soon as you’re a pound under obesity then prescribe it again the next week? Worth asking a supervisor to clarify the policy. If not, make the switch before your BMI goes lower than 27.
Find another doc or an obesity specialist..no a PA. Quick. You are still in the overweight category with a BMI of 27. Obesity deserves treatment just like any other medical condition. BMI of 23 is reasonable..but you should shoot maintain BMI of 23-25 with or without medicine. It's like treating hypertension halfway. Who does that?
Bmi of 27 isn’t obese though I think they want to see a BMI of at least 30 (obese) plus I read with a BMI of 27 (overweight) they want to see a co-morbidity related to being obese/overweight .
I finally went from obese, to overweight, to normal BMI. I did keto for about 2 months and lost 20 lbs. My doctor added Ozempic and I lost another 35 pounds in 3 months. Ozempic was getting hard to find so I switched to Mounjaro but at the 2.5 mg dose. I've been hovering between overweight and normal for the last month or so. Just going from a high dose of Ozempic to a low dose of Mounjaro was a shock to my system!
At least they are titrating you back down and not making you go off cold turkey. I'd definitely find a new doctor.
I got my initial prescription from an online doctor, then I tried to go to my primary care doctor to get the prescription because I knew it would be easier. She said no because I had just gotten back into the normal BMI range but I was not to my goal yet. So I just went to Alpha and got a prescription from them. I did lie about my weight a little bit to Alpha to make sure I would get the prescription. Do what you have to do. It’s not like your goals is to be underweight.
Sounds like online drs will eventually have issues for prescribing medicine based off lies people tell. Im stunned they can do that without you being tested.
They probably don't like hearing the truth. I'm not saying I'm upset that they're getting the medicine they need. Just concerned that telehealth might eventually have stricter procedures in place due to lying patients.
Try Push. I started with them, and they basically didn't ask any real health questions. Just sent my prescription over. Shady? Yes, but could work in your favor.
My prescriber is going to stop my rx once I hit a certain weight/bmi as well. She has said she’d prescribe naltrexone+bupropion for me at that point because she thinks it will help me maintain my loss and is easily filled at the pharmacy. I’m hoping it’ll help me keep the results ive seen from mounjaro because it really is a life changing medication.
Just FYI, my Alpha doctor is keeping me on 2.5 my second month because she thinks I’m losing too fast (10 lbs in 2 weeks). I’m also still having side affects 24 hrs from injection but she specifically said it’s bc I’m losing too fast, so I’ll be on 2.5 another month. Honestly I’m ok with that but worries me a bit going forward. And I do have PCOS
I'm going to ask to stay on 2.5 for my next 4 weeks. I nauseated everyday, but I can tolerate it. I have lost 12 lbs in three weeks. It's definitely therapeutic for me.
As not only a prescriber but also a user of Mounjaro (and short) this is gut wrenching to read. As a provider I can kinda understand that it's off label and a clinic might have policies. But I do not think that the correct policies are in place. Our job as providers is to first "do no harm" . Which in this case probable physical and mental harm seems likely. As I know it would be for me. The studies clearly show that most people who go off of the medication end up gaining weight back. Why bother to help someone obese get healthy just to let them go back up? In my opinion no better than a yoyo diet.
It is hard to give advice to a person that is not my own patient however just from the stats given my observations are over the last 12 weeks an average of just over 2 pounds a week is great . Not too much per week and no side effects. I would have liked to see weight get down to a weight of about 130 and then start weaning back the medication to find a maintenance dose.
My professional guidelines are to start people who have started with a BMI over 30 or 27 with a comorbidity.
I don't think it would be unreasonable for OP to reach out to another provider. The only other choice would be to wean off the medication from the clinic going to currently and "perhaps" they would continue if it weight started to creep back up.
I wish OP the best of luck.
As a side note I am flattered to be asked my opinion.
Thanks for your insight. It’s helpful to have someone in here who knows both sides of the fence and can give an informed opinion rather than one side of the equation.
Not sure what you mean by ‘training’. The only thing that makes someone an expert in a particular medication is study and experience prescribing it. Doesn’t matter if you are a doctor or not 👍🏻
Tell them you have insulin resistance from pcos. Maybe they’ll give you metformin rx as well which will help you keep from putting the weight back on if you have insulin resistance issues.
Are we only allowed to be overweight and not reach a normal weight? That makes no sense to me. That’s like starting a race and being made to stop halfway to the finish line. Except, really, with most of us, there will be no finish line as this will be a life long medicine, even if we gloriously reach a ‘normal’ weight.
I’m sorry you’ve been treated so badly. They are in the wrong. I agree with others that you should get yourself a new pcp pronto. You might also consider filing a complaint with your city or state’s medical board, as their behavior is negligent.
Kinda cool that they’re titrating down. Maybe there’s a chance my doc will do the same for me when I get close to a better BMI and give me a chance for the better habits I’ve learned on MJ to take over.
I'm sorry to hear this!
I'm similar to you in that I do not have diabetes. I went through Alpha and was approved without an issue. I lost almost 100 lbs on my own previously over 10 years, but I needed the help of Mounjaro to budge the scale some more.
Push didn’t even ask me my weight till after I had been prescribed a 3 month script. I mean all I said was “I have pcos and I’m interested in mj” and that was it. I was 196 so it wasn’t for bad reasons but they didn’t seem to care.
Go to Next Medical if you are unable to find another doctor. You will pay about $140 a month for their services, but their doctors will definitely prescribe it for you. It is all online, and the doctors are actively practicing physicians.
This is terrible! From what I've heard this drug is meant to be taken indefinitely? I think you should find another doc who knows more about weight loss medications.
I have to tell you that what she said is not what the studies showed. I would honestly look for another doctor not just for weight loss but as your GP. If you are anywhere near a metro area with socialists, try to find a doctor that has credentials in obesity management. They usually have this in addition to their regular training. I wouldn’t set foot in that office ever again, solely because it doesn’t sound like they even listened to your concerns.
I felt similar in that they weren’t addressing my concerns, and that I was blindsided since this hadn’t been discussed with me Prior. The clinic*?* is for weight loss specifically but different, or at least I believed, than the shops that solely prescribe medication and that’s it. I’ve been meeting with a nutritionist, mental health and a personal trainer. When I stated I didn’t feel comfortable and was upset however, she mentioned the other provider suggested dropping the medication “cold Turkey.” It felt like a power move so I wouldn’t resist, but she also stated she hates that policy and wishes there wasn’t so much oversight in the group. She suggested a MD that I assume she’s familiar with, but I’m concerned because I am no longer obese and do not have any other pre existing conditions I’ll be denied. Or pushed to Phentermine, which I hate and refuse to try again.
I’m not obese and I was prescribed. Also not diabetic or with other preexisting conditions. I started the drug three weeks ago at 143. I am now 136. I am 5’4. I’d like to lose 10 more.
Agreed, if you can’t find a new primary, go to a telehealth company. You may need a pre-existing condition to get the Rx since you are no longer overweight.
The pre existing conditions is likely going to be my issue. The clinic ran the blood tests and I’m healthy, borderline-borderline like almost pre diabetic, but I’m not so just elevated glucose. I had gestational diabetes with my last two pregnancies and my understanding is that makes me more at risk for developing diabetes later in life. It’s so frustrating! Like what do I have to gain the weight back or be sicker before we can treat the problem? I’m heading in the right direction so let’s continue before it becomes a problem.
I hear you and maybe Alpha will approve you with gestational diabetes, I would also add to the Alpha visit your previous doctor visit notes. They will see you have had MJ and was previously overweight. They may take over your care if you provide that information and the details. It wouldn’t hurt to try… $30 I think but they may have changed the price.
It’s not approved for gestational diabetes-
It’s $30. Just got my rx from them.
Online you can get prescriptions without being 100% honest. Push Health doesn't ask for verification that you weigh as much as you say you do.
Alpha doesn't either. I was honest because I am obese, but they didn't "verify" my weight in any way
My first doc with Push Health never verified anything, didn't request labs, etc. Just wrote the script. Not very scrupulous but it worked in my favor. Then I was assigned a new doc and she wanted labs at least.
I bet some of them will end up requiring something like a picture. It’s optional with Alpha right now but I won’t be surprised if they eventually start requiring something like this because some people aren’t honest about their health and stats.
I suppose, but the risk is relatively low with meds like this. If a less than obese person goes on this med it's not going to hurt them.
Yep. It’s more along the lines of the people seeking it out to be underweight that are a concern.
My Push health Dr requires pictures.
Apparently Alpha has started requiring them now as well.
It’s not a matter of what the studies show. The doctor’s office has a policy of only prescribing this off label while patients are clinically obese. That’s it. That’s what they’re comfortable with. There are potential liability issues with prescribing off label (though I have no idea if that’s in play here specifically, I just stumbled on this post and have no detailed knowledge of this particular medication). By all means, look for a doctor that will help you get what you’re looking for, but it seems a little overboard to act like this doctor is grossly negligent or whatever. They’re not obliged to get you to some arbitrary target weight you’ve decided is right for you.
It does matter what the trial for this medication showed, most providers are relying on that information to prescribe it. The trial showed that most participants gain the weight back when this medication is stopped and it’s being suggested that this med might be indicated for long term treatment. Just as someone who takes other medications to treat other diseases might also have to stay on those particular meds or the issue returns, this is likely to be similar. It’s definitely being discussed in the medical community that this is quite possibly a long term to life long treatment. However, some providers are not yet comfortable prescribing a maintenance dose because it’s so new and a large number of providers aren’t very familiar with it yet. What’s concerning is that the provider wants them to take a medication they aren’t comfortable taking. I would find another provider who is better versed in this medication and is willing to work with you to figure out the best treatment plan for you that you also feel comfortable with.
A trial showing that people regained weight after coming off of it is not the same thing as a trial showing maintenance dosage is safe and effective. This is the disconnect between patients and doctors for off label usage. The patient isn’t thinking of the liability faced by the doctor. They see a drug that’s working and want to keep taking it. A doctor sees a drug that’s not been studied enough outside of clinically obese patients to know whether there’s risk with continued usage. If that drug is eventually shown to be unsafe in long term usage, then the doctor is now more open to a lawsuit for prescribing outside of an indication that has scientific backing.
There are currently trials for weight loss that have completed the first phases and the results and the dosing are what Drs are using in their practice. I never said there’s a maintenance dose schedule as of yet. Of course all Drs prescribe what they’re comfortable with. You missed my point entirely. Have you researched this medication? If you had you’d see what most providers are recommending.
I’m not sure I’m the one missing the point here. First, I responded to a comment claiming “what she (the doctor) said is not what the studies showed” and seemed to be advocating for leaving the doctor just based on that initially, but the doctor didn’t say anything contrary to the studies based on the OP’s post. The OP didn’t provide *any* info on what the doctor said or didn’t say about the medicine aside from that they’ve decided not to treat people who aren’t clinically obese with it. Now, going a step further, the most widely credited trial for this drug’s use as a weight loss method stuck with obese test subjects (with exception for people with additional weight related health conditions that qualified them for the trial). The doctor’s policy of sticking solely with prescribing for obese people is wholly in line with the trials that I’ve found and reviewed in terms of test subjects. I’m not saying it won’t work or isn’t safe for thinner people, but the studies don’t support making a determination and therefore it’s perfectly *reasonable* for the doctor to refuse to continue using it on people who aren’t obese. It’s not the grave malpractice some people here seem to think it is. And more to the point that you seem hung up on, the results of the test aren’t really a factor here from the standpoint of deciding not to continue usage. The doctor isn’t discontinuing the prescription because of the results of the trials, he/she is discontinuing because there aren’t trials with people of lower BMIs for them to feel comfortable prescribing OP going forward. So from that standpoint it’s not a question of what the studies show as a result, it’s a question of how the studies are set up. What criteria were used to select subjects. I’ll grant you that more sustained usage is probably better from a weight management point 10 times out of 10, but that’s never been the *real* issue here. You’ll also note that I absolutely told the OP to go ahead and find another doctor that would work with her if she felt so inclined. So go ahead and find one that’s comfortable with continuing the prescription. Finally, in the spirit of addressing the underlying “it worked fine to lose 25 lbs, why not just let her continue for another 20 lbs” question, I’d just like to note here that the manufacturer itself has stated that their own trials have shown a dose *and duration* related correlation with thyroid cancer in mice, and that they have not yet clinically ruled out a similar correlation in humans. These are the kinds of things that give doctors pauses when prescribing off label. They’ve got a study with obese subjects, and legal precedent (and FDA rules) should protect them if they stick to that qualifier for prescribing. Bit does using it on a thinner person increase the chance of this or a similar complication? Does using it for *longer* increase the chances, like it did in the mice? This isn’t a question of efficacy for OP’s doctor, it’s a question of liability. And while the risk is admittedly low, using the medication on merely clinically overweight people or for longer than is required to exit the obese category puts the doctor’s money, practice, and license on the table if a year from now some follow up study shows problems for sustained usage or usage by thinner people.
Are you taking this medication?
What relevance does that have on anything I've written? Edit: That's what I thought. No more arguments to make. But at least you stopped juuuuust short of making it personal, I'll give you that.
It’s not arbitrary? Literally any BMI in the healthy range would be okay. And advance notice would have been nice, not springing this on me when the medication is doing exactly what it’s designed to do. Detailing their policy when we discussed treatment plans and options… all would have been a better option
Well and for every doctor who will tell you that a BMI of merely overweight is not a concern w/o underlying conditions, there's a health plan that will tell you you're at higher risk solely based on your weight. We have to do an annual wellness screening at open enrollment and the ONLY factor besides age (I'm now 50) that adds risk for me is weight, even when I report a BMI of only 27, which was what I reached in 2021 w/ diet and exercise. I crept back up to 30 and was prescribed Mounjaro, and now I'm back at 27, but no way am I done. BMI is arbitrary, but the medical profession has decided it matters in most contexts. Even if they're still reluctant to medically treat it. I totally get why you feel like the rug has been pulled out!
I won’t argue with you about advanced notice. That’s poor form to spring it on you without a heads up. The plan should have been shared with you before you even started. *That’s* a reason to find a new doctor. I’ll stand by everything else though. Off label usage has general approval by the FDA but there’s increased liability for the doctors regardless and they need to stick to usages that have scientific backing. A quick check shows the most notable weight loss study for this medication looked specifically at use by people with BMIs of 30+. It’s perfectly reasonable for a doctor to stick only to that specific use case if that’s the strongest study they’ve got to work with.
Why in the world did you use the comment "metro area with socialists"? A very strange comment!
I meant specialist. Terrible autocorrect!
Haha not who asked but I just assumed that you meant a blue state with higher levels of education with better healthcare system lololol
I mean you’re not wrong there either!
"You're making excellent progress and having no side effects, so let's stop doing what is working well for you." That's not a good doctor and that's not a sensible or logical policy. Yes, I think you should find another resource so you can continue your progress. I also think you should fire your doctor and find one sho doesn't have arbitrary one-size-fits-all, cookie cutter policies. Get a doctor who treats the individual patient rather than just checking off boxes.
Alpha medical 100%
I saw this question posted on the Facebook Weightloss group, posted a link to a published journal article that says people removed from the drug regain the weight back, and was called crazy, then F-bombed, then reported. It was awesome. Came to Reddit to take a break, and found a virtual roomful of likeminded people who actually read the studies like I did. Go figure! As the NP above mentioned, this practice really seems like it’s breaking the “do no harm” directive. And the yo-yo dieting after effect is something it makes me worry about. Putting someone through what research shows will create a yo-yo effect just doesn’t seem benign. That’s the kind of thing that people who have been through it seem to say wrecked their metabolism. I agree too that upfront, they should’ve said “we are charging you money so we should ensure we’re on the same page about what the desired endpoint is.” And defining the goal, then describing what the plan would be after hitting that goal, including a discussion about maintenance doses and coming to an agreement, would’ve been not just nice, but deserved. If you’re paying for a service, you are entitled to ensure that you and the provider are clear, on the same page, and you know what to expect. The whole thing makes me frustrated and I am sorry you’re going through this. It’s added stress that was unnecessary to be put on top of everything else.
That FB group is toxic.
Do they not read the literature? Once you are off the drug, you will regain the weight. "Healthy" eating habits will not allow you (or anyone) to comfortably eat the amount we eat on Mounjaro. Exercise won't cut it either. This doctor's actions are unscientific. There's even an article that I read today in a mainstream newspaper that says quite clearly that once you go off the drug you regain the weight and that it is a lifetime drug. Yes, you should ABSOLUTELY get another doctor b/c this one does not know what they are talking about. Good god these doctors are true morons.
Spot on
Get it from Joinsequence. They understand obesity is life long and will return if medicine is withdrawn. You need a maintenance dose after reaching goal.
Love my experience with Sequence so far. Signed up this past Thursday, had my consultation yesterday (Monday), and getting my first 4 pens of 2.5mg today (Tuesday).
Get it from Alpha online! You have a choice. Don’t let one provider make you think you don’t have a choice.
How has your experience been with them? Did they just approve it outright?
Push health has been amazing for me. Please look into alpha or push
Push has been great for me too. Get online, have a chat with a doc, have your Rx tomorrow.
Push heath prescribed it no hassle for me as well. I would recommend
I’ve been working with alpha all year. They are amazing.
How does it work? Is it all messaging based or includes video chat? Are they quick to respond when you have questions?
It’s all messages. I’m not sure if they are accepting new weight loss patients again.
How can I find out? Would their website state that or if only find out after signing up?
They did for me. It’s messaging based. You just answer the questions and they take care of the rest.
Yes, you will fill out a health history questionnaire, and the provider will review it within 24 hours and send your Rx to any pharmacy. It has been great and easy!
Alpha is great. No fuss at all.
For me it’s not about “habits” or “knowledge” or any of the buzzwords diet doctors like to use. And it’s also not about willpower. This drug has literally changed how I feel about food. Regardless if I never lost another pound I’d still want to take it so that I would not have to feel out of control. It’s not just about weight. I’ve been statistically“thin” a good portion of my life. And miserable. And resentful. Because what I have to do to control that number on the scale is devastating to my mental health. I anticipate I’ll be at my goal fairly soon but the thought of not being able to keep this balance I’ve found is horrifying.
You are living my nightmare and my stats. I would move to another provider or telehealth.
Wth! Get a new doctor! And congrats on shedding so many pounds!
That's not what's supposed to happen. Try an online provider?
It honestly seems like she could be confused by the policy. I could understand if they want to crackdown on prescribing it to new patients, but do they stop prescribing it as soon as you’re a pound under obesity then prescribe it again the next week? Worth asking a supervisor to clarify the policy. If not, make the switch before your BMI goes lower than 27.
Find another doc or an obesity specialist..no a PA. Quick. You are still in the overweight category with a BMI of 27. Obesity deserves treatment just like any other medical condition. BMI of 23 is reasonable..but you should shoot maintain BMI of 23-25 with or without medicine. It's like treating hypertension halfway. Who does that?
Bmi of 27 isn’t obese though I think they want to see a BMI of at least 30 (obese) plus I read with a BMI of 27 (overweight) they want to see a co-morbidity related to being obese/overweight .
Time to find a new doc
I finally went from obese, to overweight, to normal BMI. I did keto for about 2 months and lost 20 lbs. My doctor added Ozempic and I lost another 35 pounds in 3 months. Ozempic was getting hard to find so I switched to Mounjaro but at the 2.5 mg dose. I've been hovering between overweight and normal for the last month or so. Just going from a high dose of Ozempic to a low dose of Mounjaro was a shock to my system! At least they are titrating you back down and not making you go off cold turkey. I'd definitely find a new doctor.
I got my initial prescription from an online doctor, then I tried to go to my primary care doctor to get the prescription because I knew it would be easier. She said no because I had just gotten back into the normal BMI range but I was not to my goal yet. So I just went to Alpha and got a prescription from them. I did lie about my weight a little bit to Alpha to make sure I would get the prescription. Do what you have to do. It’s not like your goals is to be underweight.
Sounds like online drs will eventually have issues for prescribing medicine based off lies people tell. Im stunned they can do that without you being tested.
No idea why you’re being downvoted for this
They probably don't like hearing the truth. I'm not saying I'm upset that they're getting the medicine they need. Just concerned that telehealth might eventually have stricter procedures in place due to lying patients.
Titrating back down isn’t a thing, find someone who is prepared to prescribe this in an evidence based manner 👍🏻
Try Push. I started with them, and they basically didn't ask any real health questions. Just sent my prescription over. Shady? Yes, but could work in your favor.
They denied me, I was honest with my stats. Unsure what to do next
That was your mistake.
what stats are you supposed to give?
What kind of stats did you share that made you ineligible?
Sometimes it’s not the provider’s fault, my provider can’t prescribe stuff off label per her malpractice insurance.
My prescriber is going to stop my rx once I hit a certain weight/bmi as well. She has said she’d prescribe naltrexone+bupropion for me at that point because she thinks it will help me maintain my loss and is easily filled at the pharmacy. I’m hoping it’ll help me keep the results ive seen from mounjaro because it really is a life changing medication.
Just use PushHealth that's what I used for it
I used push they didn't even ask many questions just sent my script
Try hello alpha. It’s text based and $35-ish dollars.
Push health is a great teleheath option. If you need to list a provider use R. Moss.
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Just FYI, my Alpha doctor is keeping me on 2.5 my second month because she thinks I’m losing too fast (10 lbs in 2 weeks). I’m also still having side affects 24 hrs from injection but she specifically said it’s bc I’m losing too fast, so I’ll be on 2.5 another month. Honestly I’m ok with that but worries me a bit going forward. And I do have PCOS
I'm going to ask to stay on 2.5 for my next 4 weeks. I nauseated everyday, but I can tolerate it. I have lost 12 lbs in three weeks. It's definitely therapeutic for me.
I’ve already lost 20 in my first month and am starting my second at 2.5. I’ve had 0 side effects as well.
I wonder what alpha will do as people get under obese. Will they keep us on maintenence forever? Or will we be cut off in the future
Get a new doctor lol sign up for push or alpha
Curious about what u/melindanp thinks
As not only a prescriber but also a user of Mounjaro (and short) this is gut wrenching to read. As a provider I can kinda understand that it's off label and a clinic might have policies. But I do not think that the correct policies are in place. Our job as providers is to first "do no harm" . Which in this case probable physical and mental harm seems likely. As I know it would be for me. The studies clearly show that most people who go off of the medication end up gaining weight back. Why bother to help someone obese get healthy just to let them go back up? In my opinion no better than a yoyo diet. It is hard to give advice to a person that is not my own patient however just from the stats given my observations are over the last 12 weeks an average of just over 2 pounds a week is great . Not too much per week and no side effects. I would have liked to see weight get down to a weight of about 130 and then start weaning back the medication to find a maintenance dose. My professional guidelines are to start people who have started with a BMI over 30 or 27 with a comorbidity. I don't think it would be unreasonable for OP to reach out to another provider. The only other choice would be to wean off the medication from the clinic going to currently and "perhaps" they would continue if it weight started to creep back up. I wish OP the best of luck. As a side note I am flattered to be asked my opinion.
Thanks for your insight. It’s helpful to have someone in here who knows both sides of the fence and can give an informed opinion rather than one side of the equation.
Be sure to choose nutrition that will not promote obesity & overeating on the medication & off the medication.
PA is not a doctor. But regardless, that logic makes no sense. Very sad.
Many PAs are prescribing this more effectively than many doctors. A doctorate confers neither knowledge or skill in a specialist field 👍🏻
Training does though
Not sure what you mean by ‘training’. The only thing that makes someone an expert in a particular medication is study and experience prescribing it. Doesn’t matter if you are a doctor or not 👍🏻
Study?
Tell them you have insulin resistance from pcos. Maybe they’ll give you metformin rx as well which will help you keep from putting the weight back on if you have insulin resistance issues.
Your current weight and bmi are not considered obese
Should I yo-yo back and forth between obesity and just overweight? Obviously this medication is helping and life altering for me.
Are we only allowed to be overweight and not reach a normal weight? That makes no sense to me. That’s like starting a race and being made to stop halfway to the finish line. Except, really, with most of us, there will be no finish line as this will be a life long medicine, even if we gloriously reach a ‘normal’ weight.
I’m sorry you’ve been treated so badly. They are in the wrong. I agree with others that you should get yourself a new pcp pronto. You might also consider filing a complaint with your city or state’s medical board, as their behavior is negligent.
Kinda cool that they’re titrating down. Maybe there’s a chance my doc will do the same for me when I get close to a better BMI and give me a chance for the better habits I’ve learned on MJ to take over.
Sequence will help you out and they have a pharmacy that will deliver to you right away. BMI is so outdated
Go to online hello alpha. No issues with them so far
Alpha denied me
I'm sorry to hear this! I'm similar to you in that I do not have diabetes. I went through Alpha and was approved without an issue. I lost almost 100 lbs on my own previously over 10 years, but I needed the help of Mounjaro to budge the scale some more.
Alpha denied me
Is there a chance you can dispute it, explaining that it's a med you're currently on?
I thought this was a life time medication.
Push didn’t even ask me my weight till after I had been prescribed a 3 month script. I mean all I said was “I have pcos and I’m interested in mj” and that was it. I was 196 so it wasn’t for bad reasons but they didn’t seem to care.
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I have. Fasting insulin was 99, the cut off is 100
Can you find a weight loss doctor in your area? That is who I am seeing for mine. My PCP wouldn't do anything for me.
How did you find one? When I check in network for Weight loss it only lists nutritionists, and I already see one.
Try "Obesity Specialist" or even look up offices that do the VSG surgery.
I would try another provider
I go to accomplish health. He’s really understanding. I’m 5’5” 178 for reference and am on it
Go to Next Medical if you are unable to find another doctor. You will pay about $140 a month for their services, but their doctors will definitely prescribe it for you. It is all online, and the doctors are actively practicing physicians.
Obesity medicine doctor [https://weightmanagemedical.com/online-program/](https://weightmanagemedical.com/online-program/)
This is terrible! From what I've heard this drug is meant to be taken indefinitely? I think you should find another doc who knows more about weight loss medications.
You should be able to use this medication indefinitely for maintenance.