My partner has small vessel disease (GP and cardiac depth no very clear on this but it's the best we have for now) and is doing his level best to deal with being quite seriously overweight. He read the other day that the MHRA hafd given green light for use of wegovy for weighloss struggles, and considers it particularly useful for people with heart based 'issues'.
He approached our GP to request a change of medication from rather grim Orlistat to Wegovy only to be told point blank our health board trust wouldn't approve it unless he goes back on their weightloss programme which is quite frankly not fit for use, poorly run by novices who haven't a clue how difficult loosing weight is. He has been on it before, was told he could participate by email because his shift pattern at work made it impossible to get to the classes but his emails were never answered.
Any thoughts about a way through the mire to get the treatment which could help so much with his struggle and protect his heart. Using the weightloss group email address rarely gets a reply and thete is no tel number or contact name
Thank you for reading this rather long post
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LilySav
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I’ve only done general reading on both these drugs and they both have side effects.
It can’t be easy to eat sensibly and exercise whilst also on shifts, and specialised “diets” aren’t always the answer as I’m sure you know already.
The NHS Eat Well plan is a sensible eating plan and combined with exercise like walking - and walking in the countryside or woods or parks is really great - might be helpful?
Shifts, inc long night shifts are so bad for health and well being but at the moment, there's no other option. We are eating very sensibly but weight loss feels so slow when there's a lot to lose. We try to be mobile when he's not working but again, the excess weight makes it all the more difficult.
The lack of real understanding at how difficult it is, is a real blot on the NHS as far as I'm concerned. The last 'fat club' (you see how negatively we perceive it!?) was run by 2 skinny young ladies barely out of their teens ...it just felt inappropriate and insulting to people who really want help. Box ticking at its finest.
I have SVD. Diagnosed in 2014 and I didnt know what it might mean. For ten years it was harmless and only this year is it raising problems. Just makes ageing more prevalent.
I was stunned that I was deemed overweight. I am shrimp sized and have been underweight for years. But sure enough I am now over weight for BMi purposes. So I have very slowly edged diet and booze. I lose one old pound every two weeks. But the loss has now gone on for 8 months and I approach good BMi. That works for me. I make the effort to exercise a little more than is comfortable. I rarely drink beer. Keep wine and spirits low. My bank balance is growing in line with my weight loss.
I dont think anything can be done with SVD.. Just accept my memory is now pants.
Unfortunately, even though many NHS weight management programmes are outdated and not fit for purpose if you want to change to more expensive or different options of drugs it is usually necessary to jump through the hoops to get what you need.Yes. going to the programme is pointless for many and costly if time is required off work to complete it , but for some the combination of both , no matter how outdated the programme in certain areas can be , can also improve the results you get on the original or new treatment and to the care provider can save them a lot of money which is often at highest priority to the health service.
In the case of weight management injections they do not work alone after an initial period of rapid weight loss they only work long term by following diet and weight management changes as well and learning how to adjust your calorie intake in a way that doesn't make you feel starved when you finally stop the injection. That is another reason they expect you to join their programme or have evidence of going to another private weight management group or course because they want you to get as much chance of the injection method being successful for you first time, rather than you needing multiple courses on the injections costing more money and affecting your long term health.
The same is true when trying to get improved or more expensive treatments for every health condition in the public health services across the World, not just the NHS.
You'll find yourself doing pain management and getting medications unfit for purpose for years before getting the most successful options or surgeries. Everyone gets put on the Statin with the most known side effects first rather than more tolerated versions , even though it could end up putting patients off taking the statin medication altogether.
Many people have side effects to betablockers , they really aren't a definite solution for lots of heart , pain or anxiety issues but they are always tried first despite the potential distress to the patient.
It goes on and on.
You need to try the more basic and cheaper options first to create proof for your doctor or Primary Care Provider that they won't work. It's that physical proof alone that allows them to sign off on giving you a more expensive treatment, test. or surgery, because they must follow the prescribing permission regulations that are passed down by the Health Service you are treated under. The doctor can't prescribe something without following these guidelines of doing the basics first even if they want to , their request is denied if they do or they can get sanctions or punishments from the health provider is they don't follow the rules.
It's frustrating for a patient and a good knowledgeable doctor or care provider, particularly if the system means you can wait months or years for a treatment , and even for a severe illness or pain problem that could have solved your problem straight away and without causing a growing list of symptoms caused by deterioration.
But you can also understand why it's necessary in both the state funded service, and also at a speedier care rate in a private care system to do this.
Especially so in relation to weight management, because why would you or your care provider spend money on costly treatments that may have side effects on all patients straight away when it is more common for standard, cheaper. and natural options to work in most cases. Often costing the patient less money as well as the care provider.
As a patient jumps the hoops for any care they need from pain management and infections to Recurrent or chronic health issues they need to get copies of all tests and dates of using other treatments both unsuccessful and successful from the doctors surgery and keep a copy of them for future reference too. Only by doing this can you speed up the care options you get in the future and not be forced to jump the same hoops again and again if you get recurring health issues.
You can then thrust the evidence in any doctors or specialists eyeline to prevent yourself delays and get the most appropriate care.
Just wondering , does the NHS in England allow people to sign up to the free NHS Type2 Path to Remission Programme that provides the soup and shake diet free and a more up to date weight management diet and menu plan, testing and app and chat support for after the initial shake programme for up to two years alongside taking the standard injection. That could be worth researching as an option to consider.
I feel your pain. I’ve gained weight slowly over the last year due to feeling continually fatigued and not having enough energy to go walking (which is something I’ve always done. I went to see my gp in January explaining how I was feeling and worried I was gaining weight and I was seriously considering going to Turkey for weight loss surgery. He could see how upset I was and said he would refer me to the Weight Management Service who could possibly prescribe the weight loss jabs. He also resume to mental health.
After about a month had passed I phoned Weight Mngt to find out if they’d received my referral, which they confirmed so I asked how long would it take to get an appointment and she replied 3 years. I felt so dejected. After about another 2 months I phoned them again to enquire and was told 2 years this time. Again 2 months later I phoned again and was told 3 years again. Then out of the blue I received an hospital letter invite to make an appointment. I had that appt which basically was researching my background and lifestyle etc. at the end of that meeting I was told he would discuss my case with the WM team and he’d let me know the following day. The following day I received a call back saying I’d been accepted to start their 20 week program which starts in September- I don’t know what this will involve but at least I now feel supported and someone is listening to me. Good luck.
I genuinely hope it's a better programme that my partners, which involved the 2 'young ladies' runn8ng the programme going through a book which in all honesty was like a children's colouring book. If you can stick with it ( as the previous reply suggested) they can't turn you down for better, more appropriate help later on. In my experience, these groups work for very few and my partner like you was considering surgery as a last resort.
At the moment, its a week by week process of making good food choices and suffering the side effects of Orlistat when we don't.
Thanks for your reply and I hope the programme starts you on your journey.
I don't understand how drugs can make you overweight. The energy to lay down fat has to come from food. If a drug could help you gain weight I would love to be on it. All the experts tell me to eat more but it's impossible as I eat all the time anyway. I do have IBS though but before I developed that condition I was always skinny as a rake despite eating like a horse. I love food though. I weigh 51 kg and am over 80. The stroke team's food consultants advice was to put on muscle but that is hard for me because of my age.
as Blearyeyed your partner has to tick the NHS boxes if they wants to get their box tickedif that's the only way to get what they feel is best for them they needs to be seen to be putting in the spadework - they can't see all the stuff he is trying at home, and need evidence of commitment - think of it as being present for roll call and saluting
giving constructive feedback during and after the weightloss programme would be a good way to help them gather evidence of the need to change their approach - I.e. suggesting more appropriate and flexible methods rather than telling them what they do wrong, explain why something is unhelpful and suggesting alternatives
Hi fishonabike, he did sign up for the weightloss programme offered almost 2 years ago. He managed to get to the first 2 sessions but work commitments made the next one impossible. He was told he could carry on via email but his emails were not replied to. I'm trying to advocate for him because he simply hasn't got time or energy around his work patterns.
yes, I read that in your post, but the programme might have altered during the intervening period - these things are carried out under contract and the contract may have been given to a different provider - he could check k that before refusing it
if "they" want to achieve their targets they should be making it possible for your partner to achieve his, so they ought to be providing an approach which can be tailored
also just registering and showing willing may be enough - they need "bums on seats" and results to keep their contract, he needs to attend to get wegovy, there is a common interest🙂
I too have asked for the Wegovy injection as it states it benefits those who seriously struggle with their weight and have heart problems amongst other diseases inc diabetes . I was point blank refused. To save face ,as I felt embarrassed to be asking , I said that I would investigate getting it private . I asked a number of questions as to whether I would be suitable with my illnesses and medicines, he point blank would not talk about it saying that I would have to ask the questions of the provider , didn’t even point me in the right direction for a private provider . It would have been a disaster if I had gone on the internet for it if I had not read about the dangers . I haven’t done anything about it yet , I am giving diet another go , trying the 5:2 diet and fasting for 18:6 that gives me a fasting window of 18 hours and 6 hour window of eating in the evenings . It does seem to be achevable which is always a bonus . I have lost 5lbs in 2 weeks so far so better at the moment than the Slimming world diet.
Hi junik53 , since posting this morning, we've discovered that the health board inthe next county can prescribe Wegovy ...another instance of NHS post code lottery. I hope the 5:2 etc method works for you. Would you keep me posted?. A bit of mutual support may help. All the best, LilySav
I have asked but have been told to I had to be referred to the weight loss team , that was last November, you can’t phone & get through to anyone just have to wait ! I did look at buying it myself which I think is my best option even if it gives you a kick start, several pharmacists do a programme 1st month approx £170 dose goes up monthly same sort of cost Asda have deal on 1st month but maybe an option if you can afford it !
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