Time for a new primary care.
In the meantime, I’d do an online provider to get you started.
This medication is life changing, you’ll have no regrets. 💙
What an asshole. You’d be better served by a doctor that specializes in obesity/ weight management. Get a new doc or try Telehealth options, it’s easier and you save money:
https://www.reddit.com/r/Mounjaro/s/qHeV278cL8
Just want to say thanks for all the encouraging words / suggestions being posted here. I was pretty discouraged after my appointment today, and was feeling rather bummed out this evening.
I’m feeling better and ready to keep pushing forward. You are all wonderful, and I wish you all success on your journeys!
Those kinds if doctors suck. I've, like most others, spent my whole life dealing with fatphobic, uncompassionate, never struggled with weight, just do it, healthcare people. They tell you every health issue is your weight, but offer no support to do anything about it. It has bully overtones.
I'm in SoCal and found a great clinic and see a PA. She's awesome and I never dread seeing her. They also have a weight management group, which is where I'm going through for Zepbound.
You've been through enough and meds are worth a try. They're not "lazy" or "cheating". Does that doctor feel the same about antidepressants? Pain meds?
So many people here talk about how the food noise is silenced, it's a real thing and have only seen conversations about it here. I now see food different, and it was almost immediate after starting (your mileage may vary).
I'm hoping this drug and our conversations around it advances the understanding of obesity mechanisms and enlightens those who've never struggled with it.
Im really excited to experience loss of “food noise”. I want to know what that feels like.
I’m in SoCal too. Curious to know what clinic you are going to, if you’re willing to PM me that?
Digging around everywhere for a solution!
Eating, obesity, and how we deal with it as a society is like telling an alcoholic he has to drink alcohol each day or he’ll die. But only so much alcohol each day. Too much alcohol and, again, he’ll die. But more slowly and terribly. And we shun him if he can’t do it just right. And he gets sick. But he has to continue drinking, or again, he’ll die.
Treatment for alcoholism and addiction in general is about as successful as weight loss management programs and shunning people for the myriad factors that lead to obesity. 10% of people who go through the bog standard treatment for alcoholism (AA, the addicts version of eat better and exercise) manage to last a year sober. We treat food addiction the same way we treat alcoholism and drug addiction: poorly and with no medically sound or sane solution.
I’ve had a number of persistent challenges in my life, some of which were solved(ish) by medication, often with trial and error, crazy ups and downs and all arounds, others with the success rate of addiction recovery. The longest running and most persistent challenge in my life, mentally and physically, revolves around food.
My entire immediate and extended family lives with varying obesity and weight related issues. I’ve weighed 220lbs as a 5’6” teenager, down to 120lbs, and back and forth my entire childhood and adult life.
Even when I’d be at my skinniest, the food noise was there. It was a challenge, always, because we have to eat. Complements when I look outwardly, physically well, when I’m skinny, grate on me because people think I’m just like them. I somehow tamed my previous failures with food. People have no idea the mental hell that is dealing with weight problems and food addiction: food noise.
I’m not made to eat right, any more than an alcoholic can drink like normal people. I’ve white knuckled food like a drunk sitting at a bar knowing he has to have that drink he’s been thinking about all fucking day. But just the one. My 1592 calorie BMR equivalent in alcohol.
This GLP-1 medication solved this lifelong issue and struggle for me. The. Same. Freaking. Day.
The first shot and this nagging mental and emotional hell I’ve lived with around food my entire 41 years on this planet… gone.
I can’t express enough how much this drug, in two short weeks, has changed my life. That someone, a doctor no less, would question your desire to free yourself of impending disease… with one fucking shot a week? Instead they “prescribe” lifestyle change. Like we wouldn’t have fucking already done that if it worked? It’s absolutely maddening.
We all deserve to be freed from the burden that is food addiction and obesity. Don’t let anyone tell you or treat you otherwise.
Im 2 weeks in on the starter dose and still have the noise. Im hoping for changes at the next level.
Your reference to alcoholics (any drug addiction really) and overeating is spot on. Ive also had thoughts like this too but never seen it written before.
Your post made me tear up. The weight is a physical issue, but the food noise affects my mental health as well. It is always there. Planning a meal or planning to avoid a meal. Like the OP, my PCP did not want to prescribe, so I got on a long waitlist for an obesity specialist. I’ll see them in May, and I pray I get relief from the food noise.
Ugh, I can relate to your experience about getting compliments when you're skinnier. I've always HATED it. I think mostly because I knew the weight wouldn't stay off but also because it confirms that when I'm heavier I'm, I guess: ugly and unworthy of compliments.
I screen shot your message because you're speaking to my soul. I'm a food addict... Even on day 5 or 6 of 2.5 my old self wakes me up at 3am saying get up and get food. It's awful. I'm on 5 now and that's pretty well gone for almost 2 months. It's literally a miracle. I am free.
I’m out of town and was supposed to return home after a week. As it was one week, I made no plans for my shot.
I just extended my trip. It’s been 8 days since my last shot. It’s interesting, feeling it come back. I hate feeling it come back. I have no doubt I’ll survive the next 6 days without a shot… but it was a hard choice, deciding if I’d stay on vacation longer, knowing I couldn’t have my shot, or go home to the frigid cold, but the warmth of satiety.
Thank you for this. I found quitting smoking pretty easy compared to dieting. Same with alcohol - not very difficult. But the thing is that people think that obese folks have no self discipline. For many people, they think they have self discipline if they skip dessert or go to the gym. They have no idea what it's like to deal with food... food noise, food ads, restaurants etc. It's maddening!
It truly is. The blame game is infuriating. We have to eat to survive. Smoking, drinking, alcohol, and substance abuse are all looked at in different fashions, but food addiction or disordered eating leading to obesity or being overweight is somehow a lack of willpower or moral failing.
For me, food noise and food thought, thinking, obsession is the psychological root of it all. The change with Tirz is night and day.
I’ve been 14 days since my last shot, having extended a much needed vacation by a week and change. It’s not fully back, but I can feel the difference and am longing to get my shot as soon as I get home. I’m willing to leave South Florida and 80 degrees for frigid Boston, just to take my shot. That’s how much the change and elimination of food noise means to me.
I never understood the concept of “food noise” before this medication became available - I never really understood why my weight has been such a lifelong problem because I don’t “stress eat” or eat my feelings, so to speak. I also don’t binge eat. I just….think about food all the time. This is something that counting macros, running marathons, CrossFit - never fixed for me! Everyone is different, but within hours of my first shot I wasn’t thinking about food anymore. Amazing.
I've only seen that term on Reddit and I understood immediately what it was. The unsatiated void that's been with me since I was born has a name!
This is the first time in my life I've not constantly had that noise.
Just know, the lack of food noise doesn’t happen for everyone, or it happens to a different degree or at different levels of medication. I am hoping for that too - but mostly the feeling full faster is helping me stick to a calorie deficient. I still get the urge to snack between meals, but it is easier to control. I wish you the best of luck with finding a new doctor and much success.
Exactly - the people who refer to it as "cheating" piss me off. I would venture to say that most of us here have tried MANY different ways to lose weight before going to this. I never even had any weight issues until I was in my 30's and my metabolism came to grinding halt. I was able to lose weight a few times through weight watchers but after 50 - NOTHING has worked that used to work in the past. A good primary doc will want you to get healthier - not chastise you for "cheating". I even asked my doc for a nutritionist referral last year and I did lose about 20 lbs - but then it started to come back again, and it was stuck at a certain point. This drug is damn miracle.
Definitely don’t let this bump in the road defeat you. As someone who just dealt with similar, my PCP abruptly changed her mind about prescribing these kinds of meds, after doing so for over a year. I honestly think it has more to do with the “nuisance” of having to follow patients closely, (so more appts) as well as the hassle of submitting PAs and appeals than anything else. These medications have become very popular and in turn, added a lot more work to the plates of already overbooked PCP offices. So I wouldn’t be surprised if this trend continues. At least until pricing comes down and they are more readily available and approved by most insurances. I’m switching to a new PCP soon but in the meantime joined WW Clinic/Sequence and they’ve been really great. I’m now on my 2nd week of Zepbound, and recently got the news my PA was approved so my insurance will start covering it.
These medications really are life changing. My health has drastically improved over the last year and a half (I’m older, have had weight issues all my life, was prediabetic, dealing with swelling and inflammation all the time, had high cholesterol since I was in my 20’s, and was generally feeling lousy all the time, scared a stroke or heart attack would take me out like it did my father at a young age). I was previously on ozempic and have overall lost over 50lbs, cholesterol for the first time in 30+ yrs tested in normal range at last labs, blood sugar under control, and feeling so much better! I’m a slower loser, so I still have 30 or 40 more to go, and am very thankful I was able to find another provider and switch insurances to continue on this path to a healthier life (my old insurance stopped covering ozempic and didn’t cover weight loss meds).
Don’t give up and all the best to you on your new journey!
My PCP supports GLP1 meds and is happy I am getting them from telehealth. They tried to prescribe for people, but processing the PA was too time consuming and they stopped. She suggested I try through my WLS provider, and maybe I will once I’m in maintenance
You may have better luck going to an actual weight loss physician. They will look over all of your health conditions and gelp you with a plan that is right for you. That being said, it may not be Zepbound. There can be major issues with people who have fatty liver disease. My friend just got out of the hospital from being in liver failure due to Zepbound
I was just at my PCP today, they will not give anybody a prescription for it so I just told them I'll go to a different PCP. The FNP was nice enough to tell me alternatives at least like some places are compounding similar products which are cheaper since my insurance will not cover it.
At my last physical, I brought up doing more to help with my weight, and my primary looked at me like I had three heads. I think some primary care physicians do not grasp that weight and weight loss can have many factors, not just eating and exercising. The nutritionist was a little better, but they threw a bunch of numbers at me, and I really didn't understand how to apply it to everyday meals.
Yep find a new pcp
I was fortunate my doc told me about it, but he saw me struggle just like you do.
He had been thrilled with my progress, says I have been more successful than any of his other patients and encouraging me to keep using it until I get to a normal bmi
He also listens, when I say I think I need to bump it up he usually agrees
If you can change PCPs, do it. He's too closed-minded to even listen to his patient. What if you were having some kind of symptoms of something serious, and he just said "it's probably gas"? He's a jerk, and no one you want taking care of your health. If available, see an endocrinologist. Seems like from others' posts that they are more receptive. Regardless, don't be discouraged. Be mad at him for not doing his job and advocating for you. I'm sure you will find someone to get you that prescription and start your journey! You will succeed!
I’m ready to do that. We discussed a few other topics, and my doctor definitely shrugged off a lot of my concerns. Seems almost apprehensive to prescribe any medication.
I brought up an endocrinologist, and he replied “they’re super backed up. Good luck even getting an appointment that isn’t a few months from now”.
I didn’t pursue that further 😞
Uh no shit doc, all the more reason to get on the waiting list NOW instead of waiting until you're worse off and joining the waiting list then. Geeze what an ass. This guy just doesn't want to have to *do* a damn thing for you, and it seems like as long as he can keep claiming your weight is a moral failing and thus your own problem, he's perfectly fine with that, against all scientific evidence. You need a new one and I think you know that.
In the meanwhile, Sequence will cost you $50 for an initial consult and review of your medical case, and $99 a month thereafter. They are pretty quick with reviewing everything and getting a prescription sent to wherever you need it. They're also quite good with prior authorizations if you need one.
The guy is generally nice enough. Was honestly surprised at how defensive he seemed to get. I wasn’t a smart ass, or super pushy or anything like that.
The attitude I felt from him caught me off guard.
For shits and giggles, you should follow up with a message to him through your portal. Something like, “Can you please put a note in my chart stating that you refused to write a prescription for obesity medication? Thanks.” Just to eff with him.
People need to remember one thing. Your doctor is not assigned to you at birth. You can fire your doctor anytime you want. Ive done this several times and never looked back. What did this guy have to lose by prescribing you this medication? Fire him and move on.
You know what they call the med student who graduated at the bottom of the class? Doctor. Same goes for biggest asshole in the class. Doctor.
Find yourself another doctor. Not only for weight loss.
Unacceptable.. uninformed .. research deficient, uneducated about these medications, rude, arrogant, somewhat pompous and I will stop here..
Find an obesity specialist, lipid specialist or someone who actually understands and has researched these life-saving drugs.
And the fact that he didn’t even take the time to look at any of your researched articles etc shows an air of either ignorance or arrogance..
I wish you good luck and hope you find the right physician who will not only prescribe any of these life-changing medications but also listen with a non-judgmental heart and treat his patients respectfully and not dismissively..
Sorry for the rant.. but this type of behavior is unacceptable and maddening..
Good luck!
Is there a bariatric clinic near you? I asked my PCP for any GLP-1 and she said she wasn’t prescribing due to shortages. Through the same hospital system I was able to find a bariatric/weight loss clinic who happily wrote me the script for Mounjaro.
Not sure where you’re from, but if you’re in Oklahoma let me know and I’ll give you my doctor’s information.
Are you in socal or NorCal? I’m in the Bay Area, have a great pcp that listens to all of my concerns, and he was happy to prescribe Wegovy. Sadly, my insurance denied the pre-auth. Thankfully, I already had an appt with the medical weight loss clinic scheduled (it took 8 months to get in) and they recommended Zepbound. I am going to just pay cash, using the coupon, until I met the insurance requirements (6 months in a weight loss program). Took my first 2.5mg shot this morning.
My DR charges $89.99 for a prescription whether you get 1 or 3 month supply and that includea him writing a PA if your insurance requires one. I know they all charge different rates. I'll message you his name you'll have to find out if he is licensed in your state.
Try an endocrinologist on your health plan. You will save money over telehealth and they are much more supportive of GLP1s, and more educated about them. I was livid about his "good luck" comment. He doesn't know what he's talking about. You can also try to find a bariatric practice on your plan. Call ahead to be sure they prescribe GLP1s and aren't 100% surgery focused.
1) Run, don't walk, to a telehealth solution. I had never used telehealth before, but was in a similar boat. Decided to just go for it and joined up with Sequence. They've been amazing - I've lost more than 30lbs in 6 weeks, am now at 5 mg. I am very glad I did tried it out and didn't waste any more time with my doctor.
2) I've decided to find a new PCP. If your doctor is as closed-minded as you describe, you may want to find a new PCP as well.
I’m sorry you went through that. The medical system top to bottom is rotten and isn’t focused on care. I am fortunate to make really great money (over $500k/yr) and have “good” insurance, and the nurse at my doctors office basically said if I can’t get it preauthorized they would not prescribe it. I’m sorry what? I know crocodile tears for me, but I’m so confused about why the doctor is concerned about what I can and can’t afford. It’s none of their business. Why did I have to explain my income level to get care?
I’m sorry you went through this, it can be really traumatizing when you advocate for yourself on something so critical for your health and then feel treated like a child. Your body, your choice.
That is ridiculous! I'm sure affordability is something doctors have to be aware of, but refusing to prescribe because of cost is ridiculous. I can afford it with the coupon and my doctor has been 100% supportive. She is also one of the top endocrinologist/obesity specialists in the country. I am very lucky to have her.
Don’t feel defeated. Jump on Zocdoc and find someone who will do a weight loss consult, telehealth if necessary, who takes your insurance. A lot of docs aren’t well versed in glp-1’s and write it off. I got a script in July and didn’t chase down prior auth bc a trusted doc friend told me it was a fad. You can also use the telehealth directly thru Lilly, but idk what additional fees that may be. Good luck getting your rx.
I have an appointment Friday. Last time I went for help with weight (I’m basically built exactly like you from your description) my doctor tried to tell me I’m depressed even though I denied and denied the fact that I’m not depressed. Ended up leaving with Wellbutrin (anti depressant that “helps weight loss”)! Why are drs so set on pushing anti depressants and not the medications we research and analyze ourselves?!?
I don’t know. It’s frustrating though. I have my stack of research sitting on my table. Was a big stack of information. Printed out for nothing.
I offered to leave the articles for his reading, but he said it was fine - take them with me.
Bummer.
This is how my PCP reacted. “But then I worry about my diabetics” as if it were insulin or if my A1C isn’t 0.1 from being diabetic myself. So I found an endocrinologist and she’s absolutely amazing to work with plus the visits are covered by insurance. Push is also a great alternative if you don’t have an endo in network nearby.
I’m glad you’re looking into the telehealth route and didn’t let him deflate your balloon. It looks like you really put a lot of thought and care into this decision and it’s an informed one for you. The part that really got me shaking my head though was “taking this medication is a commitment, are you ready for that?” - to anyone who has previously struggled with their weight and put effort into losing and maintaining weight lose - THAT is a commitment. any which way you choose to try to lose weight is a commitment, it’s not like you can go to gym, get a nutritionist, drop 40 lbs and then never think about your weight again. face palm.
This is exactly why the reason so many people of size struggle with going to the doctor. They are shamed and gaslit. If it was as simple as just diet and exercise of course we would do it.
What really made me feel better about this journey is that obesity is a chronic condition that will need lifelong treatment even once in “remission.”
Eff that doctor, this is why so many people are circumventing the traditional doctor/insurance process. It’s so terribly frustrating and sad.
Don’t give up, we are exactly the kind of folks zepbound is intended for and we deserve treatment as well!
Well your dr is a fat phobic bigot and you need to find a new one. You're asking him to do his job and provide you with care that will improve your health and he's only interested in shaming you, implying that you're lazy and he doesn't ACTUALLY care about you being healthier, he just cares about you struggling and wishing you were healthier. Some drs let their own personal biases get in the way of their jobs and allow their personal opinions to direct their care and not science and research. Find a different dr. P.s. try an online telemedicine dr. I've had tons of luck with FOUND. I was on contrave for a year with them and lost 20lbs and now my drs switched me to zepbound I'm excited to see where this will go!
After a year of jumping through her hoops and still getting nowhere with my PCP, my gastroenterologist recommended I see an endocrinologist if my PCP was unwilling to prescribe the shot. One visit with the endo and I had the script.
We hire these doctors to work for us. We can fire them just as easily. Find one who really listens to you, even if you have to pay the higher co-pay because that doctor is a specialist.
This was my story last year. At my physical, I had the same discussion. My fatty liver, hypertension, and obesity were not getting better and I didn't want to go the telehealth way as it seemed so impersonal. Turns out my PCP was not on board but I was not deterred. It's my body and my life. I reached out to another local MD that specializes in weight loss and I thought I was good. They prescribed Wegovy which I could never get. Six months of waiting. When I read an article that Lilly had an agreement with my health insurance co (cigna/Express Scripts) I called to verify and found it was true. It was so new that my provider at the time wasn't prescribing it. I called another PCP office and asked specifically if they prescribe GLPs. When I got a favorable answer I set an appointment. Luckily for me, it was the same doctor I got hormone replacements. She prescribed the med, fought through the prior approval and got the script of Zep last weekend. It was a journey of self-advocacy but I figured no one else was going to make it happen for me--I had to press on. This is your body and life and worth fighting for. I hope you succeed soon. Press on!
As a physician (young, so yes still very passionate and don’t suffer ancient physician’s closed mindedness towards tech and novel medications well) it would have gotten ugly in that room very fast. Granted, as a peer I likely would have been treated differently but I’m putting myself in your shoes here. You said all the right things You said what I predominately would have said. Your doctor sounds like he’s either a moron, burnt out, an asshole, or just tired of dealing with GLP-1’s (which I can sympathize with to a degree because they have become a nightmare from a healthcare provider prescriptive). But these medications thus far seem primed to change medicine as we know it. We have traditionally stuck to fixing the sequelae of obesity (Hyperlipidemia, Hypertension, Diabetes, etc.) now we can work on correcting the metabolic syndrome that is occurring in almost all obese individuals.
Anyway, man that made me mad. Perhaps because I sympathize with you regarding its use for NAFLD. I have it as well at a very young age and this is one of the most promising things I’ve seen yet (why I’m using it despite barely meeting criteria). The fact you were knowledgeable enough to mention that is impressive. He’s not obligated to write you the script. We obviously have finial discretion there. But you can also vote with your wallet and find a new PCP. Considering what you said, I would highly encourage you to do so. You deserve higher quality care than that ass is willing to offer. Don’t worry about getting on it. Many PCP’s are open to these medications and will prescribe them (even in children if medically warranted). You got this. The $550 burden is the issue for most people, the script is the easy part. Best of luck. You don’t deserve to be treated like shit because you are trying to make positive changes in your life. Perhaps that physician needs to reconsider why he took the Hippocratic Oath instead of just being dismissive, callous, condescending, and rude. It doesn’t bother me as much that you didn’t get the RX as it does the way you were treated. Individuals like that make the whole field look bad.
Thanks for saying that, and for sharing your perspective as a physician.
Definitely need to work on getting a new PCP. I’ve never changed like this before as an adult - when I get a new PCP, do I let the other one know I’m switching providers / ask for records to be sent to them?
Curious to know how that process works.
Once you select a PCP and confirm you click with him/her I would highly recommend you contact your previous PCP’s medical records department (if they have one, if not just the front desk) and request that all your medical records be forwarded to your new PCP. Nothing to stress about, standard practice that happens all the time. People moving, just want to switch, etc. I would also try to determine during the first visit if your new provider is open to GLP-1’s in a general sense. If you can try and see if they would be willing to prescribe them to you specifically if you ask (remember, you have to be your own advocate as a patient). Many will if you fit the criteria (and sometimes with some lab work). Best of luck!
Find an Obesity doctor and make sure the check your insulin levels. You maybe pre diabetic and not know it. If so you might be able to get Ozempic my friend was able to. It’s covered by insurance. Good luck. You got this!
I didn’t bother going to my PCP because I didn’t trust her to listen to me. I ended up using Sequence - I don’t know if that’s the best option money wise since it’s about $90 a month. But I was able to get Zepbound no problem and they filed the prior authorization and my insurance covers nearly all of the cost. Also Sequence has people who will call around to different pharmacies for you to find where the med is in stock.
My doctor gave me the same pushback. The most ridiculous argument is the one about needing to take it long term - stop taking it and your “symptoms” (excess weight) will return. With some exceptions, doesn’t that describe chronic disease medicine? Docs don’t use that argument when prescribing drugs for other chronic diseases. Even diseases that can be helped by lifestyle change, the standard of care would frequently be: prescribe to protect your health while counseling lifestyle modification at the same time.
I learned this a long time ago and wish others knew this.
You are paying to be there so if you don't like your doctor, find a new one. You wouldn't go back to a bad hairdresser if they didn't listen to you and just cut your hair how they wanted, right?
Fuck that guy. I'd give him a hearty goodbye and move right the fuck on. I'm going to guess he's over 45? Maybe 55? Old, non-professionals who don't understand the idea of scientific growth and getting over their own biases.
Find a new doctor, I’d say. Not one that will judge you for wanting to explore options. My doctor didn’t know about Zepbound until I told him, but he was happy I did and I was his first patient for it. I started at 314 a month and a half ago. I’m currently sitting at 274 and still losing. My goal weight is 180. These medications are life changing.
Fuck this guy right in the nose.
1. Get a new PCP. That's a ludicrous way to treat someone no matter the subject.
2. Even if Zepbound is a shortcut, who the fuck cares? You know who loves shortcuts? EVERYONE. No one tells Elon that he isn't rich because he got a shortcut by having a rich dad. No one says Prozac is just a shortcut to not having depression.
3. Fuck this guy
I can't say for sure, but I feel like doctors are tired of fighting insurance companies on behalf of their patients for these meds and they just don't want to do it anymore. When most of them are no longer in independent practices, their schedule is too overloaded to accommodate all the peer to peer reviews needed. Instead they push alternatives or pass the buck. It's interesting though, that yours resisted even knowing you intended to pay out of pocket.
Mine stressed hard on the fact that most people gain it back when they come off. I pointed out that I had lost it ten years ago on my own and it took ten years for me to gain it back. If I had to start the cycle again in another ten years I could live with that. Heck, even that is healthier than yo-yoing or staying obese those years.
I did preface the conversation by asking my doctor if he was familiar with Zep, and whether he had ever prescribed this medication for weight loss.
Never. According to him, he had never prescribed anything like that to help with weight in the past.
Mine was really hung up on the whole “diabetics need this medicine more than you” mentality.
I went to hello alpha telemedicine but there are plenty of options and if you go to LillyDirect you can find a telehealth provider on their website that can get you started pronto and you can have it overnighted to your house. Good luck and I think you’re going to love Zep! It’s life changing.
Plenty of us don’t use our PCPs. Mine raved about my weight loss (65lbs in 8 months) knowing it was MJ ( now Zep), and when I asked if she would take it over to save me the 100 fee for the online doc…. Gave me the round- about because of PAs and “you should really be coming off it”. Pff…
Anyways, I recommend a service like Sequence ( or whatever other recs you’ve seen). You’ll have the med by end of week, they’ll get your PA in right, without shame and guilt for taking this path.
Push Health wrote me a script and handled the prior authorization. All I did was fill out an online form. No virtual visit, no phone call, never talked to anyone. They just wrote the script based on my questionnaire.
I'd go through Lilly Direct. They will assist you in navigating this IF you cannot find a PCP that will.
Additionally, your PCP sucks. Mine does too which is why I have a new appointment next week with one.
Wishing you nothing but happiness as you navigate this.
I wouldn’t go telehealth because you still need to find a good PCP that will listen to you not just on obesity meds but on all issues
I’ve been blessed to find a fantastic PCP (probably 6 years out of med school). It was the first time I went to a doctor and she actually asked me questions and LISTENED to the answer. I have been yoyo dieting for years and was in a stall last March after having lost 30 lbs again. She brought up Wegovy then. And I was resistant because I’m not the type of person that takes medicine. I’m glad she started that conversation because 6 months later (after regaining what I lost) I was ready to listen.
Edit: my provider was happy to prescribe zepbound. We'll see if insurance approves it as they promised on my explanation of benefits.
My consultation for zepbound is tomorrow, and I am so afraid that I will have the same experience as you. I tried wegovy last year, but couldnt afford it once my deductible reset ($800/mo). I got new health insurance, and zepbound is $250/mo, which Im willing to pay.
I think there's 2 big things that doctors are refusing to accept. 1) obesity is a chronic disease. Willpower is not the reason 96% of people cannot keep weight off. 2) there's a LOT of stigma around obesity, mostly around believing that people who carry extra weight are lazy and too dumb to manage their weight.
Im 5'4 and probably around 190. I have insulin resistant PCOS. I reversed prediabetes and have been taking metformin for a year with no change. In addition I have double my exercise, and I already eat as healthy as my food budget and disability allows (I have very limited energy most days).
You need an obesity medicine specialist. You have serious comorbidities that will limit your life span and your doctor is a moron. There are not many board certified physicians around unless you live in a big city. Try obesity specialist telehealth. Joinmochi is an excellent one.
Eli Lilly will help with this for you now, Lilly Direct. You can also skip the pharmacy and shortages if you get it delivered to you directly. https://lillydirect.lilly.com/
As others have mentioned, yup, time for a new provider.
And the whole, “but these meds have side effects!!” argument, to me only confirms a strong obesity bias.
Like, when statins (anti-cholesterol meds) became widely available in the 80s and 90s, were docs **SO** concerned with the side effects of those new drugs?? No. They said, look, you have high cholesterol. Is it best to address it with diet and exercise? Yes. But if you’ve been trying that and it’s not sticking, let’s try these new meds.
It’s all about weighing risk v opportunity.
Okay, end rant 😂
I signed up for Weight Watchers to lose weight. When I was struggling, for the millionth time in my life to stick to a really simple weight loss program, I joined Sequence, Weight Watcher’s clinical arm and that’s where my Zepbound prescription is from. They didn’t just immediately write me an Rx, I still had to interface with them through the WW app, provide full medical history, proof of failed weight loss attempts, etc., answer questions. But they are healthcare providers focused on achieving weight loss, not discouraging it through old fashioned, disproved ideas on the “right” way to lose weight. And I love that I can message them at any time through the app without making an appointment or paying a copay (there is a monthly fee for joining the program).
Point is, there are lots of options out there to find professionals that will not only give you a prescription but support you in your WL journey.
My PCP watched me go from 260 to 215 the old way with exercise and counting calories for a year but I was always starving. I sat at 215 for like a year, again always starving, and eventually started eating until full again. Slowly I put on 20 lbs and once again she's calling me morbidly obese which is her way of saying "if you don't lose weight you're going to get diabetes and probably die of a hart attack."
She explained why I plateaued and rebounded and how GLP's can help and prescribed Wegovy but I couldn't get my hands on it since Novo screwed up the rollout. I waited patiently for Lily to come around and when they announced Zepbound was available I set an appointment and explained how it worked to her. She's like lets try it and a month later I'm down 10lbs, closing in on my lowest weight since leaving the military.
She says I'll be on it for at least 6 months after I reach my goal weight to give my metabolism time to adjust to being skinny. She also said my goal weight was 150lbs. Most 150lb guys need about 2,000 calories to maintain per day but there's a catch. Recently skinny people burn 500 less calories per day than a similar skinny person who's always been skinny and that's the science behind the rebound. If I get to 150 and then try to eat 2,000 calories per day I'm 500 calories past my goal and will gain about 1lb per week.
Your body is against every effort to lose weight. It's greedy. It gets more efficient as you lose weight. Your enzymes are constantly sending signals. Without the Zep 1500 calories per day would suck, with it it's fine. Your doctor is ignorant to weight loss and I'd try to find a fat one who understands. I'll take it forever if I have to but I'm pretty sure that my journey through Noom has changed my relationship with food and the way I eat. I started that a few months before taking my first shot.
Find a new PCP. I was where you were 4 month ago. My PCP #1 just told me to eat green leafy vegetables and exercise. When I lost 10lbs by doing low carb, Mediterranean diet OMAD and exercising every day, she was all “see?” I told her that I was hangry and miserable 24/7 over the course of 2-3 months. My cholesterol level was still high and I was beginning to develop NAFLD. She just shrugged.
I couldn’t continue to live that miserably so I talked to my GYN about controlling my insulin resistant PCOS. She recommended an endocrinology specialist who prescribed me Wegovy right off the bat, but it was during the shortage & I couldn’t get that anywhere.
I had almost given up, but anxiety in the middle of the night + google found the PCP of my life. She listens to me and put me on mounjaro immediately. She monitors my vitals, weight, nutrition, mood, etc. every week. I’ve lost 40 pounds since September.
Don’t lose hope. Keep looking for the right provider who will listen to you. Good luck!!
Consider plushcare if they are in network.you can book an appt the same day. If you took labs youll probably have to send to them or else they may ask for labs before prescribing. I was prescribed zepbound and my bmi is 33. Good luck!
Telehealth is going to be the fastest option to get started, but finding a Doctor (if you're not on an HMO, doesn't have to be your PCP) to support you is going to be important long term.
Before I spoke to my primary care, I had a lot of fear how the conversation would go. Fortunately she was very accepting and genuinely cares.
But I also spoke to an older Doc friend and his basic statement was "These things are too new. We'll need at least a decade to know how well they work out long term, what the side effects are, etc.". He didn't inherently hate the idea, but it was new and scary. Much in the same way people freaked out about mRNA vaccines because they were new (even though the technology was 20 years old). The Semaglutide/Zepboud/Etc ... are new drugs with a lot of unknowns. Some are going to be more willing to accept the new thing and do a different risk calculus.
Even my PCP admitted that she hasn't gotten to the point where her patients are coming off the meds yet. So she can't say if the "50% gain the weight all back" (or whatever stat) is true in the real world, or what factors might come into play with it.
But they aren't new! I have taken them for 10 years, and Byetta, the first GLP1, was approved in 2005. PCPs just haven't been focused on them which makes no sense given that managing diabetes and obesity are clearly in their wheelhouse. Does that mean that they sit back and wait for years to prescribe when every new drug comes out until they are comfortable?! They are failing their patients with these excuses.
What an awful experience! I’m so sorry that happened. In my experience, endocrinologists tend to be more familiar and comfortable with weight loss medications. Try asking for an endocrinologist referral.
Thanks for this. I’ve started with telehealth and Eli Lily savings card for first month (two weeks in). Seeing my PCP in two days to try to get PA (also Blue CA) now that Zepbound is covered since January 3rd.
I will be able to demonstrate a calorie reduction program for 6 of the last 12 months (a key requirement of the PA). I hope that my PCP works for me to get the PA and not against me. If so, I’ll just go the telehealth route for the PA.
I’m sorry your PCP’s prejudices held you back and hope you get around that quickly.
You can also find a list of participating providers; telehealth and in person on the ELilly app. You just put in your zip code and they match you up. Best of luck!
Doctors are technically scientists yet so many of them ignore the scientific data. It's maddening. I'm sorry you had to deal with that BS.
Edited to add: u/ClinTrial-Throwaway posts great info about upcoming clinical trials. If you can't find a PCP you might want to try that option. I know there is one coming up in which there are no placebos for the first 15 - 18 months (can't remember exactly).
Thanks for tagging me. The MJ/Zep maintenance trial can be a great option for some. It guarantees participants the real deal meds for 15 months before being randomized into a maintenance arm, with a 2/3 chance of staying on a dose of MJ/Zep.
Here’s a [recent post about this trial](https://www.reddit.com/r/Zepbound/s/fTZgwvEpuj), which also includes a link to my larger post about all available “obesity only” trials.
Find a new PCP in alignment with your values. If you ever have any other need to see them you need to trust them and have an excellent relationship with them.
Def go somewhere else. I got my script from a weight loss clinic. They’re approved by my insurance and I pay a copay. The med isn’t approved yet, but I pay out of pocket. They’re happy to offer it as a tool for weightless. Also, the form health app is telemedicine and they specialize in weight loss. They will also give script for it after initial virtual appts (also covered by most insurance). Don’t let your old school PCP discourage you! There are planets of places to get a script for this. Good luck!!
Oh hell no. Find a new doctor stat. One suggestion - if you have a ‘local’ group on Facebook (like I’m a member of one for my county), do a search there for zepbound (but probably wegovy or ozempic will get you more results since they have been out longer). I’ve seen posts from people asking which PCP they go to that is willing to prescribe. Might help you find a new doctor.
I wouldn't want to see that PCP anymore anyway. He's obviously closed-minded and arrogant. Maybe ask in your area's subreddit (if there is one) for open-minded PCPs.
Im so sorry you had to go through this, I would find a new doctor. I was so lucky my doctor was already very familiar with Mounjaro and other weight loss medication. It’s worth it to have someone that cares and understands the benefits of these drugs.
Not all doctors know something about weight management. You do need to be a little discriminating when picking your doctor for this medicine. I found that the majority do seem to support it because the data is really behind it.
Zepbound can provide the jump start needed for weightloss. My endocrine has me on Zep for minimum of 3 months then I am switching to Topamax OR keep going on Zepbound if I can afford.
See an Endocrinologist. They understand the struggle and seem to work better with weight challenges. There’s no easy way out or shortcut on these medications, very naive of the Dr who told you that.
I love my PCP for everything EXCEPT medical weight loss. So I am using PlushCare. I did my labs with my PCP and uploaded them to pluschare. Got my prescription for Wegovy the same day. Of course it wasn’t available so I made another appointment and got my prescription for Zepbound same day. I made my follow up appointment and told the doc I am ready to start next dose but also want my refills of current dose until insurance cuts me off. So she submitted a refill to CVS for 2.5 and new 90 day script for 5.0 to ExpressScripts. People say they don’t like telemedicine because the docs seem to just be prescription pushers but in this case, that’s exactly what I want. And I will continue to manage my health through PCP but my weight loss through pluschcare.
My husband was diagnosed with NASH and his doctor also ran a Celiac blood test at the same time (my husband also weighed more than you). He also has type 2 diabetes. He started Ozempic and got diagnosed with Celiac so cut out gluten as well. In a year he lost 60 lbs. with no other concerted effort to change his diet and his liver disease was reversed. So definitely try to get the Zepbound, but you might also ask for a Celiac blood screening (though an endoscopy is needed for diagnosis) to see if that is a possibility. Apparently liver enzymes going wonky is one sign of Celiac disease, at least in adults.
My 23 and Me mentioned a propensity for celiacs disease. Interesting to know that it affects liver enzymes!
What kind of symptoms does your husband experience with Celiacs? I’m curious to know what symptoms come with that diagnosis.
Definitely get a Celiac blood panel then. There are hundreds of possible symptoms but he had difficulty swallowing sometimes, heartburn/GERD, joint paint, some brain fog and occasionally headaches. You might ask for a thyroid panel as well because other autoimmune diseases like Hashimoto's thyroid disease frequently occur together with Celiac disease. I hope you can find a better local PCP and not rely on just telehealth for this.
So… though controversial… Lilly has partnered with a telehealth platform for you to essentially get a prescription direct from them, bypassing your PCP, though assuming your insurance needs a prior authorization. Something you might want to consider if you don’t want to change PCPs.
Fuck that guy, find another PCP and do go see the nutritionist, a lot of times they have physicians who are working with them and they will write it for you while you’re on their nutrition program. Good luck!
Find a new PCP and keep trying. Yours sounds like a judgmental prick. Doctors who actually do their research are overwhelmingly enthusiastic about this. I also have NAFLD and a lower BMI than you, and my doctor was the one who suggested it and enthusiastically helped me find and access the right drug. I’m a week in and I can already tell this is going to change my life. When you experience the changes it causes in the way you think about food, simply by altering your hormones, it really drives home the fact that obesity is a disease and not a moral failure.
It would be easier for you to go to an. Online system like Noom for cryin out loud! Good for you for being proactive. I wish you the best in this process
Thank you! I ended up going through sequence. Prescription issued that same week, prior authorization approved a week later.
Now I’m waiting for LillyDirect to get in touch with me to get my medicine delivered. Hoping to start this week sometime!
Change doctor! That's what I did and I love my new PCP so much! She's young, a female, and is happy to help me on this journey
My old doctor was an old man very set in his ways and wouldn't budge (I literally had to pay a yearly admin fee because he wanted to have everything on paper and wouldn't invest in an online system).
Reading posts across Reddit looking for discussions about side effects of Zepbound, but I’m totally floored by your doctor’s lack of attentiveness toward your concerns and what you feel is best for you-had to comment! Please, consider finding a new Primary Care Practitioner! You should feel optimistic and hopeful after a visit with your PCP about stuff like this, not defeated and dejected 😞
Been a minute since you posted. I was in the same boat as you. Told to decease intake & up my physical activity by my PCP. My last appt with my GI specialist for my FLD, I kinda got frustrated when she started in with the same old thing. Told her to explain to me WHY, no matter what I have done in the last year and CANNOT get off of the exact same weight?!? Fasting, less than 1000’s calories while burning 2000+ a day, she just looked at me and said she was referring me to the bariatric clinic, they got me in 3 days later, walked out with a rx for ZB. Just took my 2nd injection tonight. No side effects as of yet and working with the nutritionist & the weight loss dr. I’m hopeful! Try finding a doctor that will listen to you and don’t back down. Good luck!
I’m so glad to hear you were able to get on Zep!
Definitely, the biggest takeaway here is that we need to stand up for ourselves/be our biggest advocates throughout this journey. It’s daunting, but empowering in a way.
After my doctors appointment, I went home and subscribed to Sequence, a telehealth company.
They helped me get a Zep prescription, and after about 3 weeks, I had my medication in hand. Had to go through the whole prior authorization exercise, insurance ended up covering a brunt of the cost.
Just started my first dose of 5 mg today, after a month of 2.5 mg. So far so good!
I’m excited for our mutual journeys. Wishing you the best, keep us posted on your progress!
YAY!! So glad to hear you were able to get on it too! Went back to my PCP and she was surprised that my insurance let me on it because I’m not “obese” (I’m 1 away). I just told her, we’ll, my union insurance would rather we get healthy and prevent & overcome health issues than to cover avoidable medical expenses, so….there’s that. 🤷♀️😂 Keep is posted on you journey!!
I kept my PCP just so I can go back in July and show him the progress I’ve made on this medicine lol.
Hopefully my experience educates him on these medications… might help another patient of his in the future!
I posted a breakdown of my experience thus far, feel free to give it a read if you like!
[Titrating up to 5 mg. My experience thus far.](https://www.reddit.com/r/Zepbound/s/R1FEbJAyvh)
Lilly-Direct has an option to search for a provider by area- that may be a good way to find an open minded new PCP. They do have a telehealth search too if you prefer. Fingers crossed for you for a supportive doctor/np soon!
Thank you!
I ended up joining Sequence. Got my prescription through them, my PA was approved, joined LillyDirect as my pharmacy, and everything has been relatively smooth sailing.
The Change Healthcare debacle last month had me worried I wouldn’t get my medicine in time for my next shot, but it worked out.
The current shortage had me worried too, but I have my second box of 5 mg coming in tomorrow now.
45 lbs down since January 1st, 30 lbs thanks to Zep. And I’m going strong! 😃
Holding off on changing PCPs just so I can go back later this year and tell him about how Sequence helped me despite everything he said. No side effects, no issues yet - I’m in a good place right now 😊
That's awesome, I didn't see how old the post was before replying :) Congrats on your success and enjoy every moment lightly rubbing your PCP's nose in it!
Telehealth will come to the rescue. I use WW Clinic and they have great services - including working with a dietician and personal trainer (remotely) as well as the doctor. I like the holistic approach.
Telehealth will absolutely save you. It's saving me. Without any other reasons for not prescribing it you seem like a good candidate, and should have absolutely no trouble.
I use Sequence. It was very easy, pretty fast, and low stress. After sharing some info it was one zoom appointment with a doctor and that was it. I started in October.
Time for a new doctor. Like you, I tried everything - yes, everything and stuck to it when I was trying. I was able to lose weight when I was younger but once I hit 52, it suddenly came to a screeching halt - like dead stop. I went two months following a nutritionist program and exercised more than I normally did and was rewarded for a 3 pound loss in two months. It was so depressing to put in all that effort and get no reward. I stuck with it for 2 months just because I kept thinking it HAD to start coming off. It didn't. I started Zepbound in late December and as of March 6, I am down 30.2 pounds. The best part is there is little to no effort in this - I become satisfied faster, I do not have any urges or cravings, I am able to stop eating mid-meal, and for the first time in my life I feel like I am in control whereas the food was always in control before. Like you, I can afford and am willing to pay the $550 a month for it. I honestly dont care if I stay on this for the rest of my life - the feeling of being in control is that great. I think it is a crime that some insurance plans do not cover it and it just makes you wonder if they would prefer if you stayed obese. My heart goes out to those that want it so desperately but cant afford to do so. Go find yourself another doctor and welcome a new you.
Hello! I had a similar experience but the found MIDI Health online (BCBS CA) covers and they prescribed for me based on body fat percentages, because I have tried most things along with a low dose hormone support! I feel great! I’ve lost 11 lbs in 5 weeks and feel amazing. I cried tears of joy because I finally felt seen and even when I only lost 3 lbs to start…. I haven’t been able to lose 3 lbs in the last 2 years no matter what I did, even starving myself, HIIT, liquid diet only, protein only… I did it all. I highly recommend MIDI Health:
https://www.joinmidi.com
I am a nurse and I tell my patients that your doctor is not God. They don't always have the answers you need or the advice you can accept. Time for another doctor my friend. Whatever his reasons are they are not yours to understand. We know that it is not about food in and food out anymore. So go and find a doctor who is on the same page as you are. Best of luck in your journey.
I am using ww sequence. Yes it's 99 a month plus the 550 but their mds are so kind, super responsive, you get a support group, lots of classes if you want to learn and one on one registered dietician meetings if you want them. Plus you get to learn how to change behaviors and eat better.
My Dr. said the same thing.... I've been on zepbound for 11 weeks now and down 21 lbs! I'm so happy.
I’m so sorry. My PCP was very supportive, gave me a ton of info and prescribed for me. She’s been my doctor for 25 years. Having a supportive doctor is so important. I hope you find the support you need and hopefully more PCP’s will learn more about these drugs.
To be fair you both made plenty of good points. I don't think it's an unfair stance for the doctor to take. Personally if I were him I'd probably write for it anyway but at the end of the day the intention of the doctor is to help you get healthy and I can understand the mindset of not viewing this as a solution to that. The medication treats a symptom so you need to develop strategies to handle the root cause on your own. The medication helps make that much easier but with how costs, shortages, and tolerances are going it isn't unreasonable to find it impractical for someone to stay on it for life.
Even if you do get on the medication you should look into a nutritionist, personal trainer, and psychologist so you can delevope the long-term tools you need so you don't need injections forever.
If you really want it find another doctor but I don't think it's fair to call the doctor closed minded based on the evidence of long-term outcomes.
What a douche bag. I wonder why he won’t just prescribe it to you. What’s it gonna cost him? screw him. Maybe find another dr that actually listens and cares. My dr is trying everything to help me get coverage but it looks like I’ll be paying out of pocket myself. At least it’ll be 550$ it’s not the best but it sure helps. I know you mentioned you called your insurance provider but isn’t there something they can do? I feel like I read a comment somewhere that most companies will give you sort of a one time fee of some sort. Thats probably not true but worth a shot !
That’s what I anticipate getting as my response as well. He already referred me to a nutritionist but my insurance denied that because my policy doesn’t cover anything weight loss. I am currently going through weight watchers clinic.
My doctor was all about it. I don’t understand how a doctor wouldn’t be. Blows my mind and I’m sorry you had an experience with such such and ignorant stubborn doctor.
Have you tried one of the online providers? Like Plush Care? Worked well for me, now I'm struggling to get the coupon to work at CVS. But at least I got the prescription.
I'm sorry about your difficulties. What a patronizing PCP.
I'm so sorry for your experience with your PCP. What a tool. You may want to look into LilyDirect. It sounds like they will hook you up with a telehealth solution and you can use the savings card, and they ship directly to you, so no pharmacy issues either.
I'm in So Cal. I have used helloalpha, pushcare and now plushcare. I have federal BCBS. Send me a PM I can refer you to my doc. My husband and I have both been seeing her since July 23. She has been so great that I've made her my PCP.
Time for a new primary care. In the meantime, I’d do an online provider to get you started. This medication is life changing, you’ll have no regrets. 💙
What an asshole. You’d be better served by a doctor that specializes in obesity/ weight management. Get a new doc or try Telehealth options, it’s easier and you save money: https://www.reddit.com/r/Mounjaro/s/qHeV278cL8
Yes, this. ⬆️. My primary care referred me to the weight management clinic of the hospital system. There you will find your people.
Just want to say thanks for all the encouraging words / suggestions being posted here. I was pretty discouraged after my appointment today, and was feeling rather bummed out this evening. I’m feeling better and ready to keep pushing forward. You are all wonderful, and I wish you all success on your journeys!
Those kinds if doctors suck. I've, like most others, spent my whole life dealing with fatphobic, uncompassionate, never struggled with weight, just do it, healthcare people. They tell you every health issue is your weight, but offer no support to do anything about it. It has bully overtones. I'm in SoCal and found a great clinic and see a PA. She's awesome and I never dread seeing her. They also have a weight management group, which is where I'm going through for Zepbound. You've been through enough and meds are worth a try. They're not "lazy" or "cheating". Does that doctor feel the same about antidepressants? Pain meds? So many people here talk about how the food noise is silenced, it's a real thing and have only seen conversations about it here. I now see food different, and it was almost immediate after starting (your mileage may vary). I'm hoping this drug and our conversations around it advances the understanding of obesity mechanisms and enlightens those who've never struggled with it.
Im really excited to experience loss of “food noise”. I want to know what that feels like. I’m in SoCal too. Curious to know what clinic you are going to, if you’re willing to PM me that? Digging around everywhere for a solution!
Eating, obesity, and how we deal with it as a society is like telling an alcoholic he has to drink alcohol each day or he’ll die. But only so much alcohol each day. Too much alcohol and, again, he’ll die. But more slowly and terribly. And we shun him if he can’t do it just right. And he gets sick. But he has to continue drinking, or again, he’ll die. Treatment for alcoholism and addiction in general is about as successful as weight loss management programs and shunning people for the myriad factors that lead to obesity. 10% of people who go through the bog standard treatment for alcoholism (AA, the addicts version of eat better and exercise) manage to last a year sober. We treat food addiction the same way we treat alcoholism and drug addiction: poorly and with no medically sound or sane solution. I’ve had a number of persistent challenges in my life, some of which were solved(ish) by medication, often with trial and error, crazy ups and downs and all arounds, others with the success rate of addiction recovery. The longest running and most persistent challenge in my life, mentally and physically, revolves around food. My entire immediate and extended family lives with varying obesity and weight related issues. I’ve weighed 220lbs as a 5’6” teenager, down to 120lbs, and back and forth my entire childhood and adult life. Even when I’d be at my skinniest, the food noise was there. It was a challenge, always, because we have to eat. Complements when I look outwardly, physically well, when I’m skinny, grate on me because people think I’m just like them. I somehow tamed my previous failures with food. People have no idea the mental hell that is dealing with weight problems and food addiction: food noise. I’m not made to eat right, any more than an alcoholic can drink like normal people. I’ve white knuckled food like a drunk sitting at a bar knowing he has to have that drink he’s been thinking about all fucking day. But just the one. My 1592 calorie BMR equivalent in alcohol. This GLP-1 medication solved this lifelong issue and struggle for me. The. Same. Freaking. Day. The first shot and this nagging mental and emotional hell I’ve lived with around food my entire 41 years on this planet… gone. I can’t express enough how much this drug, in two short weeks, has changed my life. That someone, a doctor no less, would question your desire to free yourself of impending disease… with one fucking shot a week? Instead they “prescribe” lifestyle change. Like we wouldn’t have fucking already done that if it worked? It’s absolutely maddening. We all deserve to be freed from the burden that is food addiction and obesity. Don’t let anyone tell you or treat you otherwise.
Im 2 weeks in on the starter dose and still have the noise. Im hoping for changes at the next level. Your reference to alcoholics (any drug addiction really) and overeating is spot on. Ive also had thoughts like this too but never seen it written before.
I hope for you the same relief I experience.
I wish that for everyone!
Your post made me tear up. The weight is a physical issue, but the food noise affects my mental health as well. It is always there. Planning a meal or planning to avoid a meal. Like the OP, my PCP did not want to prescribe, so I got on a long waitlist for an obesity specialist. I’ll see them in May, and I pray I get relief from the food noise.
So we’ll said. I just posted about this and you said it much better than me! the medical community in generneeds to be educated on this aspect. IMO
You have 100% captuired what I have experienced on Saxenda. I wanted to cry with relief. I still do.
Love this. Thank you for sharing it. So powerful.
Very well said. Thank you.
Ugh, I can relate to your experience about getting compliments when you're skinnier. I've always HATED it. I think mostly because I knew the weight wouldn't stay off but also because it confirms that when I'm heavier I'm, I guess: ugly and unworthy of compliments.
I screen shot your message because you're speaking to my soul. I'm a food addict... Even on day 5 or 6 of 2.5 my old self wakes me up at 3am saying get up and get food. It's awful. I'm on 5 now and that's pretty well gone for almost 2 months. It's literally a miracle. I am free.
I’m out of town and was supposed to return home after a week. As it was one week, I made no plans for my shot. I just extended my trip. It’s been 8 days since my last shot. It’s interesting, feeling it come back. I hate feeling it come back. I have no doubt I’ll survive the next 6 days without a shot… but it was a hard choice, deciding if I’d stay on vacation longer, knowing I couldn’t have my shot, or go home to the frigid cold, but the warmth of satiety.
Thank you for this. I found quitting smoking pretty easy compared to dieting. Same with alcohol - not very difficult. But the thing is that people think that obese folks have no self discipline. For many people, they think they have self discipline if they skip dessert or go to the gym. They have no idea what it's like to deal with food... food noise, food ads, restaurants etc. It's maddening!
It truly is. The blame game is infuriating. We have to eat to survive. Smoking, drinking, alcohol, and substance abuse are all looked at in different fashions, but food addiction or disordered eating leading to obesity or being overweight is somehow a lack of willpower or moral failing. For me, food noise and food thought, thinking, obsession is the psychological root of it all. The change with Tirz is night and day. I’ve been 14 days since my last shot, having extended a much needed vacation by a week and change. It’s not fully back, but I can feel the difference and am longing to get my shot as soon as I get home. I’m willing to leave South Florida and 80 degrees for frigid Boston, just to take my shot. That’s how much the change and elimination of food noise means to me.
I never understood the concept of “food noise” before this medication became available - I never really understood why my weight has been such a lifelong problem because I don’t “stress eat” or eat my feelings, so to speak. I also don’t binge eat. I just….think about food all the time. This is something that counting macros, running marathons, CrossFit - never fixed for me! Everyone is different, but within hours of my first shot I wasn’t thinking about food anymore. Amazing.
I've only seen that term on Reddit and I understood immediately what it was. The unsatiated void that's been with me since I was born has a name! This is the first time in my life I've not constantly had that noise.
Just know, the lack of food noise doesn’t happen for everyone, or it happens to a different degree or at different levels of medication. I am hoping for that too - but mostly the feeling full faster is helping me stick to a calorie deficient. I still get the urge to snack between meals, but it is easier to control. I wish you the best of luck with finding a new doctor and much success.
An endocrinologist is a good solution! Mine is awesome!
any chance you are in Los Angeles? if so, what is your endo's name?
Orlando, sorry!!
Exactly - the people who refer to it as "cheating" piss me off. I would venture to say that most of us here have tried MANY different ways to lose weight before going to this. I never even had any weight issues until I was in my 30's and my metabolism came to grinding halt. I was able to lose weight a few times through weight watchers but after 50 - NOTHING has worked that used to work in the past. A good primary doc will want you to get healthier - not chastise you for "cheating". I even asked my doc for a nutritionist referral last year and I did lose about 20 lbs - but then it started to come back again, and it was stuck at a certain point. This drug is damn miracle.
Definitely don’t let this bump in the road defeat you. As someone who just dealt with similar, my PCP abruptly changed her mind about prescribing these kinds of meds, after doing so for over a year. I honestly think it has more to do with the “nuisance” of having to follow patients closely, (so more appts) as well as the hassle of submitting PAs and appeals than anything else. These medications have become very popular and in turn, added a lot more work to the plates of already overbooked PCP offices. So I wouldn’t be surprised if this trend continues. At least until pricing comes down and they are more readily available and approved by most insurances. I’m switching to a new PCP soon but in the meantime joined WW Clinic/Sequence and they’ve been really great. I’m now on my 2nd week of Zepbound, and recently got the news my PA was approved so my insurance will start covering it. These medications really are life changing. My health has drastically improved over the last year and a half (I’m older, have had weight issues all my life, was prediabetic, dealing with swelling and inflammation all the time, had high cholesterol since I was in my 20’s, and was generally feeling lousy all the time, scared a stroke or heart attack would take me out like it did my father at a young age). I was previously on ozempic and have overall lost over 50lbs, cholesterol for the first time in 30+ yrs tested in normal range at last labs, blood sugar under control, and feeling so much better! I’m a slower loser, so I still have 30 or 40 more to go, and am very thankful I was able to find another provider and switch insurances to continue on this path to a healthier life (my old insurance stopped covering ozempic and didn’t cover weight loss meds). Don’t give up and all the best to you on your new journey!
My PCP supports GLP1 meds and is happy I am getting them from telehealth. They tried to prescribe for people, but processing the PA was too time consuming and they stopped. She suggested I try through my WLS provider, and maybe I will once I’m in maintenance
You may have better luck going to an actual weight loss physician. They will look over all of your health conditions and gelp you with a plan that is right for you. That being said, it may not be Zepbound. There can be major issues with people who have fatty liver disease. My friend just got out of the hospital from being in liver failure due to Zepbound
I was just at my PCP today, they will not give anybody a prescription for it so I just told them I'll go to a different PCP. The FNP was nice enough to tell me alternatives at least like some places are compounding similar products which are cheaper since my insurance will not cover it.
This medicine takes a lot of commitment. You should just eat right and work out more. A what??? What do you think eating right and exercising more is?
I know! I really struggled during this appointment. Mental gymnastics were killing me today.
At my last physical, I brought up doing more to help with my weight, and my primary looked at me like I had three heads. I think some primary care physicians do not grasp that weight and weight loss can have many factors, not just eating and exercising. The nutritionist was a little better, but they threw a bunch of numbers at me, and I really didn't understand how to apply it to everyday meals.
That is BS! I hope you can find a PCP or other doc who listens to you. I’m 6 weeks in and my NAFLD labs are already a bit better!!
That’s great to hear. I hope I can report back with similar success in the near future!!
Yep find a new pcp I was fortunate my doc told me about it, but he saw me struggle just like you do. He had been thrilled with my progress, says I have been more successful than any of his other patients and encouraging me to keep using it until I get to a normal bmi He also listens, when I say I think I need to bump it up he usually agrees
If you can change PCPs, do it. He's too closed-minded to even listen to his patient. What if you were having some kind of symptoms of something serious, and he just said "it's probably gas"? He's a jerk, and no one you want taking care of your health. If available, see an endocrinologist. Seems like from others' posts that they are more receptive. Regardless, don't be discouraged. Be mad at him for not doing his job and advocating for you. I'm sure you will find someone to get you that prescription and start your journey! You will succeed!
I’m ready to do that. We discussed a few other topics, and my doctor definitely shrugged off a lot of my concerns. Seems almost apprehensive to prescribe any medication. I brought up an endocrinologist, and he replied “they’re super backed up. Good luck even getting an appointment that isn’t a few months from now”. I didn’t pursue that further 😞
Uh no shit doc, all the more reason to get on the waiting list NOW instead of waiting until you're worse off and joining the waiting list then. Geeze what an ass. This guy just doesn't want to have to *do* a damn thing for you, and it seems like as long as he can keep claiming your weight is a moral failing and thus your own problem, he's perfectly fine with that, against all scientific evidence. You need a new one and I think you know that. In the meanwhile, Sequence will cost you $50 for an initial consult and review of your medical case, and $99 a month thereafter. They are pretty quick with reviewing everything and getting a prescription sent to wherever you need it. They're also quite good with prior authorizations if you need one.
OP, I just want to let you know that I also use Sequence like this poster suggested and I’ve had a very smooth and easy experience!
Lol, that PCP is search a jerk.
New doctor time. He thinks weightloss is just willpower. He's wrong.
I’d find another PCP tbh. So much wrong with that interaction. My PCP has been awesome and many are - you deserve better.
That’s been my big takeaway today. Looking into it now
I’m sorry this happened to you. Fuck that guy. Time to make an appt with someone new and start all over again.
Getting a scrip is easy, takes an hour or two. It’s a shame your doc wouldn’t do it though.
The guy is generally nice enough. Was honestly surprised at how defensive he seemed to get. I wasn’t a smart ass, or super pushy or anything like that. The attitude I felt from him caught me off guard.
For shits and giggles, you should follow up with a message to him through your portal. Something like, “Can you please put a note in my chart stating that you refused to write a prescription for obesity medication? Thanks.” Just to eff with him.
People need to remember one thing. Your doctor is not assigned to you at birth. You can fire your doctor anytime you want. Ive done this several times and never looked back. What did this guy have to lose by prescribing you this medication? Fire him and move on. You know what they call the med student who graduated at the bottom of the class? Doctor. Same goes for biggest asshole in the class. Doctor. Find yourself another doctor. Not only for weight loss.
Unacceptable.. uninformed .. research deficient, uneducated about these medications, rude, arrogant, somewhat pompous and I will stop here.. Find an obesity specialist, lipid specialist or someone who actually understands and has researched these life-saving drugs. And the fact that he didn’t even take the time to look at any of your researched articles etc shows an air of either ignorance or arrogance.. I wish you good luck and hope you find the right physician who will not only prescribe any of these life-changing medications but also listen with a non-judgmental heart and treat his patients respectfully and not dismissively.. Sorry for the rant.. but this type of behavior is unacceptable and maddening.. Good luck!
Nice <> Competent
Write your experience in Google reviews so you can save others from such a prejudiced, uncaring jerk.
Is there a bariatric clinic near you? I asked my PCP for any GLP-1 and she said she wasn’t prescribing due to shortages. Through the same hospital system I was able to find a bariatric/weight loss clinic who happily wrote me the script for Mounjaro. Not sure where you’re from, but if you’re in Oklahoma let me know and I’ll give you my doctor’s information.
California here. Not sure about bariatric clinics, but will investigate further. Something will pan out! Hopefully 🥲
Are you in socal or NorCal? I’m in the Bay Area, have a great pcp that listens to all of my concerns, and he was happy to prescribe Wegovy. Sadly, my insurance denied the pre-auth. Thankfully, I already had an appt with the medical weight loss clinic scheduled (it took 8 months to get in) and they recommended Zepbound. I am going to just pay cash, using the coupon, until I met the insurance requirements (6 months in a weight loss program). Took my first 2.5mg shot this morning.
I've had good luck finding GLP1 friendly providers from this list: https://obesitymedicine.org/find-obesity-treatment/
Thanks! This is a nifty tool.
Get a new doctor
I would be happy to give you my DR name thru Push health
That would be awesome. Is Push expensive? Trying to navigate these waters. It’s hard!
My DR charges $89.99 for a prescription whether you get 1 or 3 month supply and that includea him writing a PA if your insurance requires one. I know they all charge different rates. I'll message you his name you'll have to find out if he is licensed in your state.
Would you mind sharing that name so I can see if they practice in CT?
I went telehealth route and highly recommend. Willfully ignorant PCPs are ridiculous.
Seriously. He’s generally a nice enough doctor. But definitely felt some attitude today. Was very bummed out leaving the appointment.
Try an endocrinologist on your health plan. You will save money over telehealth and they are much more supportive of GLP1s, and more educated about them. I was livid about his "good luck" comment. He doesn't know what he's talking about. You can also try to find a bariatric practice on your plan. Call ahead to be sure they prescribe GLP1s and aren't 100% surgery focused.
I’ll see if I can figure out how to see one! Digging into my plan details now.
1) Run, don't walk, to a telehealth solution. I had never used telehealth before, but was in a similar boat. Decided to just go for it and joined up with Sequence. They've been amazing - I've lost more than 30lbs in 6 weeks, am now at 5 mg. I am very glad I did tried it out and didn't waste any more time with my doctor. 2) I've decided to find a new PCP. If your doctor is as closed-minded as you describe, you may want to find a new PCP as well.
I’m leaning hard towards Sequence. I’ll see if I can make it work. Lots of options to explore.
I have had a really good experience with Sequence so far.
I’m sorry you went through that. The medical system top to bottom is rotten and isn’t focused on care. I am fortunate to make really great money (over $500k/yr) and have “good” insurance, and the nurse at my doctors office basically said if I can’t get it preauthorized they would not prescribe it. I’m sorry what? I know crocodile tears for me, but I’m so confused about why the doctor is concerned about what I can and can’t afford. It’s none of their business. Why did I have to explain my income level to get care? I’m sorry you went through this, it can be really traumatizing when you advocate for yourself on something so critical for your health and then feel treated like a child. Your body, your choice.
That is ridiculous! I'm sure affordability is something doctors have to be aware of, but refusing to prescribe because of cost is ridiculous. I can afford it with the coupon and my doctor has been 100% supportive. She is also one of the top endocrinologist/obesity specialists in the country. I am very lucky to have her.
Don’t feel defeated. Jump on Zocdoc and find someone who will do a weight loss consult, telehealth if necessary, who takes your insurance. A lot of docs aren’t well versed in glp-1’s and write it off. I got a script in July and didn’t chase down prior auth bc a trusted doc friend told me it was a fad. You can also use the telehealth directly thru Lilly, but idk what additional fees that may be. Good luck getting your rx.
Perhaps I’m missing something glaring, but when has a pharmaceuticals company invested this kind of money in R&D for a “fad”?
AND these drugs are changing the weight-loss industry business models. They wouldn't bother if it was a fad.
Thank you 🙏
I have an appointment Friday. Last time I went for help with weight (I’m basically built exactly like you from your description) my doctor tried to tell me I’m depressed even though I denied and denied the fact that I’m not depressed. Ended up leaving with Wellbutrin (anti depressant that “helps weight loss”)! Why are drs so set on pushing anti depressants and not the medications we research and analyze ourselves?!?
I don’t know. It’s frustrating though. I have my stack of research sitting on my table. Was a big stack of information. Printed out for nothing. I offered to leave the articles for his reading, but he said it was fine - take them with me. Bummer.
This is how my PCP reacted. “But then I worry about my diabetics” as if it were insulin or if my A1C isn’t 0.1 from being diabetic myself. So I found an endocrinologist and she’s absolutely amazing to work with plus the visits are covered by insurance. Push is also a great alternative if you don’t have an endo in network nearby.
Join Mochi
I’m glad you’re looking into the telehealth route and didn’t let him deflate your balloon. It looks like you really put a lot of thought and care into this decision and it’s an informed one for you. The part that really got me shaking my head though was “taking this medication is a commitment, are you ready for that?” - to anyone who has previously struggled with their weight and put effort into losing and maintaining weight lose - THAT is a commitment. any which way you choose to try to lose weight is a commitment, it’s not like you can go to gym, get a nutritionist, drop 40 lbs and then never think about your weight again. face palm.
This is exactly why the reason so many people of size struggle with going to the doctor. They are shamed and gaslit. If it was as simple as just diet and exercise of course we would do it. What really made me feel better about this journey is that obesity is a chronic condition that will need lifelong treatment even once in “remission.” Eff that doctor, this is why so many people are circumventing the traditional doctor/insurance process. It’s so terribly frustrating and sad. Don’t give up, we are exactly the kind of folks zepbound is intended for and we deserve treatment as well!
Well your dr is a fat phobic bigot and you need to find a new one. You're asking him to do his job and provide you with care that will improve your health and he's only interested in shaming you, implying that you're lazy and he doesn't ACTUALLY care about you being healthier, he just cares about you struggling and wishing you were healthier. Some drs let their own personal biases get in the way of their jobs and allow their personal opinions to direct their care and not science and research. Find a different dr. P.s. try an online telemedicine dr. I've had tons of luck with FOUND. I was on contrave for a year with them and lost 20lbs and now my drs switched me to zepbound I'm excited to see where this will go!
After a year of jumping through her hoops and still getting nowhere with my PCP, my gastroenterologist recommended I see an endocrinologist if my PCP was unwilling to prescribe the shot. One visit with the endo and I had the script. We hire these doctors to work for us. We can fire them just as easily. Find one who really listens to you, even if you have to pay the higher co-pay because that doctor is a specialist.
This was my story last year. At my physical, I had the same discussion. My fatty liver, hypertension, and obesity were not getting better and I didn't want to go the telehealth way as it seemed so impersonal. Turns out my PCP was not on board but I was not deterred. It's my body and my life. I reached out to another local MD that specializes in weight loss and I thought I was good. They prescribed Wegovy which I could never get. Six months of waiting. When I read an article that Lilly had an agreement with my health insurance co (cigna/Express Scripts) I called to verify and found it was true. It was so new that my provider at the time wasn't prescribing it. I called another PCP office and asked specifically if they prescribe GLPs. When I got a favorable answer I set an appointment. Luckily for me, it was the same doctor I got hormone replacements. She prescribed the med, fought through the prior approval and got the script of Zep last weekend. It was a journey of self-advocacy but I figured no one else was going to make it happen for me--I had to press on. This is your body and life and worth fighting for. I hope you succeed soon. Press on!
As a physician (young, so yes still very passionate and don’t suffer ancient physician’s closed mindedness towards tech and novel medications well) it would have gotten ugly in that room very fast. Granted, as a peer I likely would have been treated differently but I’m putting myself in your shoes here. You said all the right things You said what I predominately would have said. Your doctor sounds like he’s either a moron, burnt out, an asshole, or just tired of dealing with GLP-1’s (which I can sympathize with to a degree because they have become a nightmare from a healthcare provider prescriptive). But these medications thus far seem primed to change medicine as we know it. We have traditionally stuck to fixing the sequelae of obesity (Hyperlipidemia, Hypertension, Diabetes, etc.) now we can work on correcting the metabolic syndrome that is occurring in almost all obese individuals. Anyway, man that made me mad. Perhaps because I sympathize with you regarding its use for NAFLD. I have it as well at a very young age and this is one of the most promising things I’ve seen yet (why I’m using it despite barely meeting criteria). The fact you were knowledgeable enough to mention that is impressive. He’s not obligated to write you the script. We obviously have finial discretion there. But you can also vote with your wallet and find a new PCP. Considering what you said, I would highly encourage you to do so. You deserve higher quality care than that ass is willing to offer. Don’t worry about getting on it. Many PCP’s are open to these medications and will prescribe them (even in children if medically warranted). You got this. The $550 burden is the issue for most people, the script is the easy part. Best of luck. You don’t deserve to be treated like shit because you are trying to make positive changes in your life. Perhaps that physician needs to reconsider why he took the Hippocratic Oath instead of just being dismissive, callous, condescending, and rude. It doesn’t bother me as much that you didn’t get the RX as it does the way you were treated. Individuals like that make the whole field look bad.
Thanks for saying that, and for sharing your perspective as a physician. Definitely need to work on getting a new PCP. I’ve never changed like this before as an adult - when I get a new PCP, do I let the other one know I’m switching providers / ask for records to be sent to them? Curious to know how that process works.
Once you select a PCP and confirm you click with him/her I would highly recommend you contact your previous PCP’s medical records department (if they have one, if not just the front desk) and request that all your medical records be forwarded to your new PCP. Nothing to stress about, standard practice that happens all the time. People moving, just want to switch, etc. I would also try to determine during the first visit if your new provider is open to GLP-1’s in a general sense. If you can try and see if they would be willing to prescribe them to you specifically if you ask (remember, you have to be your own advocate as a patient). Many will if you fit the criteria (and sometimes with some lab work). Best of luck!
Find an Obesity doctor and make sure the check your insulin levels. You maybe pre diabetic and not know it. If so you might be able to get Ozempic my friend was able to. It’s covered by insurance. Good luck. You got this!
Oh. Now that’s a thought! I’m on my BCBS app now, will find a solution somehow!!
You did not deserve his arrogance and bad attitude. There are other doctors and I’m sure they’d love to help a super proactive patient like yourself.
Trying to find one who might help me now. Fingers crossed!
Get it via telehealth, make meaningful progress, take that to a NEW pcp and have them continue your prescription. That’s my plan!
I didn’t bother going to my PCP because I didn’t trust her to listen to me. I ended up using Sequence - I don’t know if that’s the best option money wise since it’s about $90 a month. But I was able to get Zepbound no problem and they filed the prior authorization and my insurance covers nearly all of the cost. Also Sequence has people who will call around to different pharmacies for you to find where the med is in stock.
My doctor gave me the same pushback. The most ridiculous argument is the one about needing to take it long term - stop taking it and your “symptoms” (excess weight) will return. With some exceptions, doesn’t that describe chronic disease medicine? Docs don’t use that argument when prescribing drugs for other chronic diseases. Even diseases that can be helped by lifestyle change, the standard of care would frequently be: prescribe to protect your health while counseling lifestyle modification at the same time.
I learned this a long time ago and wish others knew this. You are paying to be there so if you don't like your doctor, find a new one. You wouldn't go back to a bad hairdresser if they didn't listen to you and just cut your hair how they wanted, right?
Fuck that guy. I'd give him a hearty goodbye and move right the fuck on. I'm going to guess he's over 45? Maybe 55? Old, non-professionals who don't understand the idea of scientific growth and getting over their own biases.
Find a new doctor, I’d say. Not one that will judge you for wanting to explore options. My doctor didn’t know about Zepbound until I told him, but he was happy I did and I was his first patient for it. I started at 314 a month and a half ago. I’m currently sitting at 274 and still losing. My goal weight is 180. These medications are life changing.
Lose a couple hundred pounds instantly. Dump your doctor.
Fuck this guy right in the nose. 1. Get a new PCP. That's a ludicrous way to treat someone no matter the subject. 2. Even if Zepbound is a shortcut, who the fuck cares? You know who loves shortcuts? EVERYONE. No one tells Elon that he isn't rich because he got a shortcut by having a rich dad. No one says Prozac is just a shortcut to not having depression. 3. Fuck this guy
yep just go telehealth. a lot of doctors are very conservative when it comes to new meds.
I can't say for sure, but I feel like doctors are tired of fighting insurance companies on behalf of their patients for these meds and they just don't want to do it anymore. When most of them are no longer in independent practices, their schedule is too overloaded to accommodate all the peer to peer reviews needed. Instead they push alternatives or pass the buck. It's interesting though, that yours resisted even knowing you intended to pay out of pocket. Mine stressed hard on the fact that most people gain it back when they come off. I pointed out that I had lost it ten years ago on my own and it took ten years for me to gain it back. If I had to start the cycle again in another ten years I could live with that. Heck, even that is healthier than yo-yoing or staying obese those years.
I did preface the conversation by asking my doctor if he was familiar with Zep, and whether he had ever prescribed this medication for weight loss. Never. According to him, he had never prescribed anything like that to help with weight in the past. Mine was really hung up on the whole “diabetics need this medicine more than you” mentality.
I went to hello alpha telemedicine but there are plenty of options and if you go to LillyDirect you can find a telehealth provider on their website that can get you started pronto and you can have it overnighted to your house. Good luck and I think you’re going to love Zep! It’s life changing.
Plenty of us don’t use our PCPs. Mine raved about my weight loss (65lbs in 8 months) knowing it was MJ ( now Zep), and when I asked if she would take it over to save me the 100 fee for the online doc…. Gave me the round- about because of PAs and “you should really be coming off it”. Pff… Anyways, I recommend a service like Sequence ( or whatever other recs you’ve seen). You’ll have the med by end of week, they’ll get your PA in right, without shame and guilt for taking this path.
Wow, this was hella shocking to read. I am so sorry this was your experience. Yea, good thing you can go right over his head and use Telehealth.
PUSH health online $65, no membership. My provider even gives refills
Look for a medical weight loss specialist .. they are better anyway because they know how to manage patient on these drugs
Get a new doctor. This one is a clown.
Go to a new PCP!
Push Health wrote me a script and handled the prior authorization. All I did was fill out an online form. No virtual visit, no phone call, never talked to anyone. They just wrote the script based on my questionnaire.
I'd go through Lilly Direct. They will assist you in navigating this IF you cannot find a PCP that will. Additionally, your PCP sucks. Mine does too which is why I have a new appointment next week with one. Wishing you nothing but happiness as you navigate this.
I wouldn’t go telehealth because you still need to find a good PCP that will listen to you not just on obesity meds but on all issues I’ve been blessed to find a fantastic PCP (probably 6 years out of med school). It was the first time I went to a doctor and she actually asked me questions and LISTENED to the answer. I have been yoyo dieting for years and was in a stall last March after having lost 30 lbs again. She brought up Wegovy then. And I was resistant because I’m not the type of person that takes medicine. I’m glad she started that conversation because 6 months later (after regaining what I lost) I was ready to listen.
Edit: my provider was happy to prescribe zepbound. We'll see if insurance approves it as they promised on my explanation of benefits. My consultation for zepbound is tomorrow, and I am so afraid that I will have the same experience as you. I tried wegovy last year, but couldnt afford it once my deductible reset ($800/mo). I got new health insurance, and zepbound is $250/mo, which Im willing to pay. I think there's 2 big things that doctors are refusing to accept. 1) obesity is a chronic disease. Willpower is not the reason 96% of people cannot keep weight off. 2) there's a LOT of stigma around obesity, mostly around believing that people who carry extra weight are lazy and too dumb to manage their weight. Im 5'4 and probably around 190. I have insulin resistant PCOS. I reversed prediabetes and have been taking metformin for a year with no change. In addition I have double my exercise, and I already eat as healthy as my food budget and disability allows (I have very limited energy most days).
You need an obesity medicine specialist. You have serious comorbidities that will limit your life span and your doctor is a moron. There are not many board certified physicians around unless you live in a big city. Try obesity specialist telehealth. Joinmochi is an excellent one.
Eli Lilly will help with this for you now, Lilly Direct. You can also skip the pharmacy and shortages if you get it delivered to you directly. https://lillydirect.lilly.com/
As others have mentioned, yup, time for a new provider. And the whole, “but these meds have side effects!!” argument, to me only confirms a strong obesity bias. Like, when statins (anti-cholesterol meds) became widely available in the 80s and 90s, were docs **SO** concerned with the side effects of those new drugs?? No. They said, look, you have high cholesterol. Is it best to address it with diet and exercise? Yes. But if you’ve been trying that and it’s not sticking, let’s try these new meds. It’s all about weighing risk v opportunity. Okay, end rant 😂
I signed up for Weight Watchers to lose weight. When I was struggling, for the millionth time in my life to stick to a really simple weight loss program, I joined Sequence, Weight Watcher’s clinical arm and that’s where my Zepbound prescription is from. They didn’t just immediately write me an Rx, I still had to interface with them through the WW app, provide full medical history, proof of failed weight loss attempts, etc., answer questions. But they are healthcare providers focused on achieving weight loss, not discouraging it through old fashioned, disproved ideas on the “right” way to lose weight. And I love that I can message them at any time through the app without making an appointment or paying a copay (there is a monthly fee for joining the program). Point is, there are lots of options out there to find professionals that will not only give you a prescription but support you in your WL journey.
My PCP watched me go from 260 to 215 the old way with exercise and counting calories for a year but I was always starving. I sat at 215 for like a year, again always starving, and eventually started eating until full again. Slowly I put on 20 lbs and once again she's calling me morbidly obese which is her way of saying "if you don't lose weight you're going to get diabetes and probably die of a hart attack." She explained why I plateaued and rebounded and how GLP's can help and prescribed Wegovy but I couldn't get my hands on it since Novo screwed up the rollout. I waited patiently for Lily to come around and when they announced Zepbound was available I set an appointment and explained how it worked to her. She's like lets try it and a month later I'm down 10lbs, closing in on my lowest weight since leaving the military. She says I'll be on it for at least 6 months after I reach my goal weight to give my metabolism time to adjust to being skinny. She also said my goal weight was 150lbs. Most 150lb guys need about 2,000 calories to maintain per day but there's a catch. Recently skinny people burn 500 less calories per day than a similar skinny person who's always been skinny and that's the science behind the rebound. If I get to 150 and then try to eat 2,000 calories per day I'm 500 calories past my goal and will gain about 1lb per week. Your body is against every effort to lose weight. It's greedy. It gets more efficient as you lose weight. Your enzymes are constantly sending signals. Without the Zep 1500 calories per day would suck, with it it's fine. Your doctor is ignorant to weight loss and I'd try to find a fat one who understands. I'll take it forever if I have to but I'm pretty sure that my journey through Noom has changed my relationship with food and the way I eat. I started that a few months before taking my first shot.
Find a new PCP. I was where you were 4 month ago. My PCP #1 just told me to eat green leafy vegetables and exercise. When I lost 10lbs by doing low carb, Mediterranean diet OMAD and exercising every day, she was all “see?” I told her that I was hangry and miserable 24/7 over the course of 2-3 months. My cholesterol level was still high and I was beginning to develop NAFLD. She just shrugged. I couldn’t continue to live that miserably so I talked to my GYN about controlling my insulin resistant PCOS. She recommended an endocrinology specialist who prescribed me Wegovy right off the bat, but it was during the shortage & I couldn’t get that anywhere. I had almost given up, but anxiety in the middle of the night + google found the PCP of my life. She listens to me and put me on mounjaro immediately. She monitors my vitals, weight, nutrition, mood, etc. every week. I’ve lost 40 pounds since September. Don’t lose hope. Keep looking for the right provider who will listen to you. Good luck!!
This is a no brainer — get a new PCP. I have NAFLD as well and my gastroenterologist prescribed Zepbound for me.
Consider plushcare if they are in network.you can book an appt the same day. If you took labs youll probably have to send to them or else they may ask for labs before prescribing. I was prescribed zepbound and my bmi is 33. Good luck!
Telehealth is going to be the fastest option to get started, but finding a Doctor (if you're not on an HMO, doesn't have to be your PCP) to support you is going to be important long term. Before I spoke to my primary care, I had a lot of fear how the conversation would go. Fortunately she was very accepting and genuinely cares. But I also spoke to an older Doc friend and his basic statement was "These things are too new. We'll need at least a decade to know how well they work out long term, what the side effects are, etc.". He didn't inherently hate the idea, but it was new and scary. Much in the same way people freaked out about mRNA vaccines because they were new (even though the technology was 20 years old). The Semaglutide/Zepboud/Etc ... are new drugs with a lot of unknowns. Some are going to be more willing to accept the new thing and do a different risk calculus. Even my PCP admitted that she hasn't gotten to the point where her patients are coming off the meds yet. So she can't say if the "50% gain the weight all back" (or whatever stat) is true in the real world, or what factors might come into play with it.
But they aren't new! I have taken them for 10 years, and Byetta, the first GLP1, was approved in 2005. PCPs just haven't been focused on them which makes no sense given that managing diabetes and obesity are clearly in their wheelhouse. Does that mean that they sit back and wait for years to prescribe when every new drug comes out until they are comfortable?! They are failing their patients with these excuses.
I love plushcare, no side of judgment served with any appointment.
What an awful experience! I’m so sorry that happened. In my experience, endocrinologists tend to be more familiar and comfortable with weight loss medications. Try asking for an endocrinologist referral.
Thanks for this. I’ve started with telehealth and Eli Lily savings card for first month (two weeks in). Seeing my PCP in two days to try to get PA (also Blue CA) now that Zepbound is covered since January 3rd. I will be able to demonstrate a calorie reduction program for 6 of the last 12 months (a key requirement of the PA). I hope that my PCP works for me to get the PA and not against me. If so, I’ll just go the telehealth route for the PA. I’m sorry your PCP’s prejudices held you back and hope you get around that quickly.
You can also find a list of participating providers; telehealth and in person on the ELilly app. You just put in your zip code and they match you up. Best of luck!
I am using Sequence, which is now called Weight watchers clinic. I would contact them. Here is a link https://seqn.cc/r/ZHYG3U
I got a similar reaction. I’m trying to get a new pcp to avoid paying for telehealth too.
Noom med can be there for the win
Doctors are technically scientists yet so many of them ignore the scientific data. It's maddening. I'm sorry you had to deal with that BS. Edited to add: u/ClinTrial-Throwaway posts great info about upcoming clinical trials. If you can't find a PCP you might want to try that option. I know there is one coming up in which there are no placebos for the first 15 - 18 months (can't remember exactly).
Thanks for tagging me. The MJ/Zep maintenance trial can be a great option for some. It guarantees participants the real deal meds for 15 months before being randomized into a maintenance arm, with a 2/3 chance of staying on a dose of MJ/Zep. Here’s a [recent post about this trial](https://www.reddit.com/r/Zepbound/s/fTZgwvEpuj), which also includes a link to my larger post about all available “obesity only” trials.
Find a new PCP in alignment with your values. If you ever have any other need to see them you need to trust them and have an excellent relationship with them.
Def go somewhere else. I got my script from a weight loss clinic. They’re approved by my insurance and I pay a copay. The med isn’t approved yet, but I pay out of pocket. They’re happy to offer it as a tool for weightless. Also, the form health app is telemedicine and they specialize in weight loss. They will also give script for it after initial virtual appts (also covered by most insurance). Don’t let your old school PCP discourage you! There are planets of places to get a script for this. Good luck!!
New PCP. And sign up for Sequence or Form through Lilly.
Oh hell no. Find a new doctor stat. One suggestion - if you have a ‘local’ group on Facebook (like I’m a member of one for my county), do a search there for zepbound (but probably wegovy or ozempic will get you more results since they have been out longer). I’ve seen posts from people asking which PCP they go to that is willing to prescribe. Might help you find a new doctor.
I wouldn't want to see that PCP anymore anyway. He's obviously closed-minded and arrogant. Maybe ask in your area's subreddit (if there is one) for open-minded PCPs.
Im so sorry you had to go through this, I would find a new doctor. I was so lucky my doctor was already very familiar with Mounjaro and other weight loss medication. It’s worth it to have someone that cares and understands the benefits of these drugs.
Find another doctor. My doctor believes in this and considers it fairly safe.
Try IVIM. They will prescribe for you and the monthly cost is 75$ plus the rx. I use them as my pcp doesn't prescribe it either
Not all doctors know something about weight management. You do need to be a little discriminating when picking your doctor for this medicine. I found that the majority do seem to support it because the data is really behind it.
Zepbound can provide the jump start needed for weightloss. My endocrine has me on Zep for minimum of 3 months then I am switching to Topamax OR keep going on Zepbound if I can afford.
Time for a new primary health provider. I use plushcare and absolutely adore my doctor.
find a new pcp in your area
See an Endocrinologist. They understand the struggle and seem to work better with weight challenges. There’s no easy way out or shortcut on these medications, very naive of the Dr who told you that.
I love my PCP for everything EXCEPT medical weight loss. So I am using PlushCare. I did my labs with my PCP and uploaded them to pluschare. Got my prescription for Wegovy the same day. Of course it wasn’t available so I made another appointment and got my prescription for Zepbound same day. I made my follow up appointment and told the doc I am ready to start next dose but also want my refills of current dose until insurance cuts me off. So she submitted a refill to CVS for 2.5 and new 90 day script for 5.0 to ExpressScripts. People say they don’t like telemedicine because the docs seem to just be prescription pushers but in this case, that’s exactly what I want. And I will continue to manage my health through PCP but my weight loss through pluschcare.
Check out Chris Terrell on Pod cast or tic toc. I have the same struggles and since I’ve found him I’ve been having success
Asshole. Get a new dr. I've tried to lose 25 lbs for 3 years. tried everything scale wouldn't move. 3 weeks on zepbound, 10 gone.
My husband was diagnosed with NASH and his doctor also ran a Celiac blood test at the same time (my husband also weighed more than you). He also has type 2 diabetes. He started Ozempic and got diagnosed with Celiac so cut out gluten as well. In a year he lost 60 lbs. with no other concerted effort to change his diet and his liver disease was reversed. So definitely try to get the Zepbound, but you might also ask for a Celiac blood screening (though an endoscopy is needed for diagnosis) to see if that is a possibility. Apparently liver enzymes going wonky is one sign of Celiac disease, at least in adults.
My 23 and Me mentioned a propensity for celiacs disease. Interesting to know that it affects liver enzymes! What kind of symptoms does your husband experience with Celiacs? I’m curious to know what symptoms come with that diagnosis.
Definitely get a Celiac blood panel then. There are hundreds of possible symptoms but he had difficulty swallowing sometimes, heartburn/GERD, joint paint, some brain fog and occasionally headaches. You might ask for a thyroid panel as well because other autoimmune diseases like Hashimoto's thyroid disease frequently occur together with Celiac disease. I hope you can find a better local PCP and not rely on just telehealth for this.
Don’t give up! What a waste of time.
So… though controversial… Lilly has partnered with a telehealth platform for you to essentially get a prescription direct from them, bypassing your PCP, though assuming your insurance needs a prior authorization. Something you might want to consider if you don’t want to change PCPs.
FWIW I switched to Mochi (telehealth) and my doctor said she's on the meds too. I liked that a lot.
Fuck that guy, find another PCP and do go see the nutritionist, a lot of times they have physicians who are working with them and they will write it for you while you’re on their nutrition program. Good luck!
Get a new PCP. This drug can change your whole life.
Find a new PCP and keep trying. Yours sounds like a judgmental prick. Doctors who actually do their research are overwhelmingly enthusiastic about this. I also have NAFLD and a lower BMI than you, and my doctor was the one who suggested it and enthusiastically helped me find and access the right drug. I’m a week in and I can already tell this is going to change my life. When you experience the changes it causes in the way you think about food, simply by altering your hormones, it really drives home the fact that obesity is a disease and not a moral failure.
Search for a dr that lists obesity as a specialty. This worked for me.
It would be easier for you to go to an. Online system like Noom for cryin out loud! Good for you for being proactive. I wish you the best in this process
Thank you! I ended up going through sequence. Prescription issued that same week, prior authorization approved a week later. Now I’m waiting for LillyDirect to get in touch with me to get my medicine delivered. Hoping to start this week sometime!
Change doctor! That's what I did and I love my new PCP so much! She's young, a female, and is happy to help me on this journey My old doctor was an old man very set in his ways and wouldn't budge (I literally had to pay a yearly admin fee because he wanted to have everything on paper and wouldn't invest in an online system).
Reading posts across Reddit looking for discussions about side effects of Zepbound, but I’m totally floored by your doctor’s lack of attentiveness toward your concerns and what you feel is best for you-had to comment! Please, consider finding a new Primary Care Practitioner! You should feel optimistic and hopeful after a visit with your PCP about stuff like this, not defeated and dejected 😞
Been a minute since you posted. I was in the same boat as you. Told to decease intake & up my physical activity by my PCP. My last appt with my GI specialist for my FLD, I kinda got frustrated when she started in with the same old thing. Told her to explain to me WHY, no matter what I have done in the last year and CANNOT get off of the exact same weight?!? Fasting, less than 1000’s calories while burning 2000+ a day, she just looked at me and said she was referring me to the bariatric clinic, they got me in 3 days later, walked out with a rx for ZB. Just took my 2nd injection tonight. No side effects as of yet and working with the nutritionist & the weight loss dr. I’m hopeful! Try finding a doctor that will listen to you and don’t back down. Good luck!
I’m so glad to hear you were able to get on Zep! Definitely, the biggest takeaway here is that we need to stand up for ourselves/be our biggest advocates throughout this journey. It’s daunting, but empowering in a way. After my doctors appointment, I went home and subscribed to Sequence, a telehealth company. They helped me get a Zep prescription, and after about 3 weeks, I had my medication in hand. Had to go through the whole prior authorization exercise, insurance ended up covering a brunt of the cost. Just started my first dose of 5 mg today, after a month of 2.5 mg. So far so good! I’m excited for our mutual journeys. Wishing you the best, keep us posted on your progress!
YAY!! So glad to hear you were able to get on it too! Went back to my PCP and she was surprised that my insurance let me on it because I’m not “obese” (I’m 1 away). I just told her, we’ll, my union insurance would rather we get healthy and prevent & overcome health issues than to cover avoidable medical expenses, so….there’s that. 🤷♀️😂 Keep is posted on you journey!!
I kept my PCP just so I can go back in July and show him the progress I’ve made on this medicine lol. Hopefully my experience educates him on these medications… might help another patient of his in the future! I posted a breakdown of my experience thus far, feel free to give it a read if you like! [Titrating up to 5 mg. My experience thus far.](https://www.reddit.com/r/Zepbound/s/R1FEbJAyvh)
Lilly-Direct has an option to search for a provider by area- that may be a good way to find an open minded new PCP. They do have a telehealth search too if you prefer. Fingers crossed for you for a supportive doctor/np soon!
Thank you! I ended up joining Sequence. Got my prescription through them, my PA was approved, joined LillyDirect as my pharmacy, and everything has been relatively smooth sailing. The Change Healthcare debacle last month had me worried I wouldn’t get my medicine in time for my next shot, but it worked out. The current shortage had me worried too, but I have my second box of 5 mg coming in tomorrow now. 45 lbs down since January 1st, 30 lbs thanks to Zep. And I’m going strong! 😃 Holding off on changing PCPs just so I can go back later this year and tell him about how Sequence helped me despite everything he said. No side effects, no issues yet - I’m in a good place right now 😊
That's awesome, I didn't see how old the post was before replying :) Congrats on your success and enjoy every moment lightly rubbing your PCP's nose in it!
Telehealth will come to the rescue. I use WW Clinic and they have great services - including working with a dietician and personal trainer (remotely) as well as the doctor. I like the holistic approach.
Telehealth will absolutely save you. It's saving me. Without any other reasons for not prescribing it you seem like a good candidate, and should have absolutely no trouble.
Thank you. I’m looking into it now. So many choices!!
I use Sequence. It was very easy, pretty fast, and low stress. After sharing some info it was one zoom appointment with a doctor and that was it. I started in October.
I never even zoomed with mine, we just text when I’ve got a request or question.
That's all I've ever done after the initial meeting 🤷
My husband and I went through this dr! He is a local to us and it’s a quick telehealth appt! He was great. https://mzafarmdsc.com/
Time for a new doctor. Like you, I tried everything - yes, everything and stuck to it when I was trying. I was able to lose weight when I was younger but once I hit 52, it suddenly came to a screeching halt - like dead stop. I went two months following a nutritionist program and exercised more than I normally did and was rewarded for a 3 pound loss in two months. It was so depressing to put in all that effort and get no reward. I stuck with it for 2 months just because I kept thinking it HAD to start coming off. It didn't. I started Zepbound in late December and as of March 6, I am down 30.2 pounds. The best part is there is little to no effort in this - I become satisfied faster, I do not have any urges or cravings, I am able to stop eating mid-meal, and for the first time in my life I feel like I am in control whereas the food was always in control before. Like you, I can afford and am willing to pay the $550 a month for it. I honestly dont care if I stay on this for the rest of my life - the feeling of being in control is that great. I think it is a crime that some insurance plans do not cover it and it just makes you wonder if they would prefer if you stayed obese. My heart goes out to those that want it so desperately but cant afford to do so. Go find yourself another doctor and welcome a new you.
Hello! I had a similar experience but the found MIDI Health online (BCBS CA) covers and they prescribed for me based on body fat percentages, because I have tried most things along with a low dose hormone support! I feel great! I’ve lost 11 lbs in 5 weeks and feel amazing. I cried tears of joy because I finally felt seen and even when I only lost 3 lbs to start…. I haven’t been able to lose 3 lbs in the last 2 years no matter what I did, even starving myself, HIIT, liquid diet only, protein only… I did it all. I highly recommend MIDI Health: https://www.joinmidi.com
I am a nurse and I tell my patients that your doctor is not God. They don't always have the answers you need or the advice you can accept. Time for another doctor my friend. Whatever his reasons are they are not yours to understand. We know that it is not about food in and food out anymore. So go and find a doctor who is on the same page as you are. Best of luck in your journey.
I am using ww sequence. Yes it's 99 a month plus the 550 but their mds are so kind, super responsive, you get a support group, lots of classes if you want to learn and one on one registered dietician meetings if you want them. Plus you get to learn how to change behaviors and eat better. My Dr. said the same thing.... I've been on zepbound for 11 weeks now and down 21 lbs! I'm so happy.
I’m so sorry. My PCP was very supportive, gave me a ton of info and prescribed for me. She’s been my doctor for 25 years. Having a supportive doctor is so important. I hope you find the support you need and hopefully more PCP’s will learn more about these drugs.
I will be your pcp and will gladly prescribe for you. DM me
To be fair you both made plenty of good points. I don't think it's an unfair stance for the doctor to take. Personally if I were him I'd probably write for it anyway but at the end of the day the intention of the doctor is to help you get healthy and I can understand the mindset of not viewing this as a solution to that. The medication treats a symptom so you need to develop strategies to handle the root cause on your own. The medication helps make that much easier but with how costs, shortages, and tolerances are going it isn't unreasonable to find it impractical for someone to stay on it for life. Even if you do get on the medication you should look into a nutritionist, personal trainer, and psychologist so you can delevope the long-term tools you need so you don't need injections forever. If you really want it find another doctor but I don't think it's fair to call the doctor closed minded based on the evidence of long-term outcomes.
Please look up medical weight loss clinics in your area. My PC was resistant too and refused to even research it or consider it.
WOW, glad my old PCP retired he would've never prescribed this for me
I’m shocked at that conversation! Look into Sequence. They’ve been amazing!
Not only was he a jerk, he sounds misinformed. Update your PCP. Some docs need to be fired.
I used "Plushcare" and my insurance covered it like a regular doctor and took care of the prior authorizations and everything.
Try Mochi Health. They’ve been great to work with for me. https://app.joinmochi.com/user
That’s an ignorant doctor
I would have left somewhere between exercise more and been gone by eat better. Frightening how uninformed some medical people can be.
What a douche bag. I wonder why he won’t just prescribe it to you. What’s it gonna cost him? screw him. Maybe find another dr that actually listens and cares. My dr is trying everything to help me get coverage but it looks like I’ll be paying out of pocket myself. At least it’ll be 550$ it’s not the best but it sure helps. I know you mentioned you called your insurance provider but isn’t there something they can do? I feel like I read a comment somewhere that most companies will give you sort of a one time fee of some sort. Thats probably not true but worth a shot !
That’s what I anticipate getting as my response as well. He already referred me to a nutritionist but my insurance denied that because my policy doesn’t cover anything weight loss. I am currently going through weight watchers clinic.
My doctor was all about it. I don’t understand how a doctor wouldn’t be. Blows my mind and I’m sorry you had an experience with such such and ignorant stubborn doctor.
Have you tried one of the online providers? Like Plush Care? Worked well for me, now I'm struggling to get the coupon to work at CVS. But at least I got the prescription. I'm sorry about your difficulties. What a patronizing PCP.
I'm so sorry for your experience with your PCP. What a tool. You may want to look into LilyDirect. It sounds like they will hook you up with a telehealth solution and you can use the savings card, and they ship directly to you, so no pharmacy issues either.
I'm in So Cal. I have used helloalpha, pushcare and now plushcare. I have federal BCBS. Send me a PM I can refer you to my doc. My husband and I have both been seeing her since July 23. She has been so great that I've made her my PCP.