Obesity as a Disease - Medication

Yeah I heard about that alright. I'd say it'll be a few months before the modified pen becomes available.

In better news, Irish Life Health have announced that they will start partially compensating customers for the cost of weight loss injections. They haven't said how much they're going to pay back yet, but I'm hoping they'll confirm before I have to renew my VHI health insurance in November. If ILH start covering it, you can be sure Laya and VHI will follow suit over the course of the next year.

From my own cost perspective, I have decided to go with Pllsorted in the UK for my next order. They will take on patients that are already on Mounjaro and are therefore no longer over the BMI 30+ criteria. They're £254 for your first order of 15mg Mounjaro and then go up to £309 a month after that. I'll get the pen delivered to Border Parcel Motel in Belcoo, and then pay £10 to get it forwarded to Dublin. That should avoid any customs concerns.

I realise it will be out of the fridge for 2/3 days but I've used pens for longer than four weeks out of the fridge in the past and they've been fine. I've discussed it with my GP and he said it was fine to do, in that it wasn't dangerous, but that I might find that the efficacy of the medication might reduce around Week 6/7. I'm not making this as a recommendation - everyone should discuss what they're doing with their own prescriber. I'll shop around again in November/December to see if I can get a cheap pen again from another UK provider.

Well, McKeagneys are £319 plus £15 delivery, and Corrys are £340 including delivery for the 15mg pens. So £254 plus £5.99 for delivery to Belcoo and another €10 for delivery to Dublin is going to make a big difference. Doing the calcs online that's a €75 difference.

I don't care which pharmacy I get it from. As long as they are registered as a pharmacy here or in the UK, I'll buy for the best price. The medication is the medication, no matter who you get it from (understanding of course that it needs to be a registered pharmacy).

I actually got a code from someone on Reddit, which I need to use before the end of September.

I would have to show previous proofs of purchase from a pharmacist alright. I can’t see any problem with you requesting 7.5 if you can prove you were on 5mg for four weeks. That fits witch the manufacturer’s dosing guidelines after all.

Depressing, isn’t it??

Honestly I'm quite nervous to come off it or titrate to a really low dose. I actually love being able to go into a Spar or supermarket and go "meh, I don't really want any junk, maybe I'll just get some strawberries". Or pass the shops altogether. And I like being able to be flexible with mealtimes, whereas before I'd be very hungry coming up to a mealtime and get really p**sed off if I had to eat late. Now it doesn't matter if I don't get to eat lunch until 3, or if we have something on the evening and only get a small snack. The thoughts of having to white knuckle my way through cravings again. Ugh.

I will start titrating downwards if/when I hit my goal weight. And I understand that as long as I stay on the right dose of the medication, the hunger will return and I'll eat more but I won't put weight back on. So I shouldn't fear the hunger as such. It's a natural bodily function. What I fear I suppose is that the right dose for maintenance might only be 9mg/8mg/7mg and I'll have to fork out between €150-200 a month forever more. Now, I'll do it, I'll sacrifice other spending to stay a normal weight. But it's depressing.

Still, I do know that other medication is coming in 2026, and it's in tablet form so it should be significantly cheaper than the injectables, and perhaps that would work for maintenance. I can live in hope.

"It's sounds like as well as medicating weight loss you are medicating a bad diet also. Eating when you are hungry will not make you overweight, eating junkfood specifically when you are hungry will make you overweight."

I do know what I'm supposed to do Jackboy. A lack of knowledge on what are the right foods to eat has never been the problem.

Before meds I made reasonably good choices for my main meals. Lots of fish and meat, wholegrains, olive oil. I particularly loved a roasted pepper and squash salad with feta. My portion sizes for breakfast and lunch were well within recommended guidelines. My trigger points were always on the way home from work, about five hours after I ate lunch. I would be properly hungry, and would have a long commute ahead, and would pass loads of shops. Some weeks I'd "be good", some weeks I wouldn't be. Some weeks I'd have taken fruit in my bag, but just didn't eat it. And then I'd have a normal portion dinner, but after I put the kids to bed I had a habit of eating more junk.

I am diagnosed with ADHD. One of the issues with ADHD is that we don't process dopamine properly, so we're always on the search for it. That is why people diagnosed with ADHD have a much higher chance of being alcoholic, gambling addicts or obese. We have a higher chance of dying in an accident as we are more likely to pursue dopamine through risky activities (and also we are terrible at assessing risk). The dopamine I get from junk food without meds is off the charts, and I expect way way more than the average person. I know this because I have been this way since before I could speak. I would steal money from my parents and hide the junk food. As an eight year old I would search the house for the treats that my mum had hidden, and eat them in the shed. This isn't just your "oh sure don't we all love a bar of chocolate? And sure if you want to enough, you can just stop". It's way beyond that.

I know that people who don't have ADHD are like "oh here we go, an another excuse for why people can't just be disciplined. Blaming it on a "condition"". But if junkies could take a weekly injection that made it 100x easier to give up and stay off crack or heroin, wouldn't it be recommended? Or alcoholics? Or gamblers? Mounjaro reduces the dopamine I get from junk food. I still need dopamine, but I've had to find healthier ways to get it.

And let me just head off the "medication isn't what you need, you have an ingrained terrible relationship with food and you need to go to therapy, not take injections" at the pass. If my problem with junk food was purely psychological, then Mounjaro would have done nothing. The medication has balanced something in my brain, and I finally feel what a normal person feels around food. And it's wonderful. And I'm very very reluctant to give that feeling up. Perhaps you are right, I could come off the medication and up my protein and fibre and I'd feel exactly the same control I feel while on the medication now. But forgive me if I'm a little sceptical around that.

Something non-related to weight loss…

I was diagnosed with lipodema about three years ago, after my mum got diagnosed with the same thing. I'm only at Stage 1, so the appearance isn't very noticeable, and it's really only on my legs, not my arms. But it's always been quite painful - like, not all the time, but if I knock my leg off something or if the dog jumps up or a football hits off them or whatever. I noticed the other day (after my son lay down over my legs) that I haven't felt pain in them for ages. When I googled it, it seems that lots of people with lipodema are being prescribed GLP1s - not for weight loss (lipodema fat is notoriously resistant to calorie deficits and I can see that my legs have not reduced by much even though I've lost 25% of my body weight) but to reduce inflammation. It must be that - my legs aren't as inflamed as they used to be.

Anyway, I just thought it was an unexpected win I would share.