My doctor won’t prescribe Zepbound. Here’s why.
People with other chronic diseases don’t run into nearly as many obstacles as we do when trying to get help to control our weight. It’s something I think about a lot these days. And, it’s led me to make some adjustments to access the most helpful healthcare professionals I need in the here and now.
If you’ve been overweight for as long as I have, you know that even healthcare professionals with good intentions don’t always understand our challenges. They also often don’t know how to adequately help us achieve our weight loss goal.
Things have gotten a little better since 2013. That’s when the American Medical Association recognized obesity as a chronic disease that requires treatment. It’s still a struggle to find a doctor who understands what we’re going through, though, and how to help.
Trying to bond with a new primary care doctor
Today was my first appointment with a new primary care physician. After eight years, my previous doctor decided to leave her practice and transition to working in a hospital setting.
While I was happy to see my former doctor follow her dreams, the timing was bad for me. After months of research, I was finally ready to have an in-depth discussion about weight loss medication options. Specifically, I had researched the new class of injections such as Wegovy (semaglutide) and Zepbound (tirzepatide).
I was hospitalized last year with a serious ailment and losing weight is part of what I need to do to stay alive. I spent a year trying to do it the old way: a restricted-calorie diet and exercise. However, now that I’m in my 50s, losing weight is tougher than it used to be. I haven’t been able to make a significant dent in my weight loss goal. I need to find something to kickstart the process or I risk cutting years off my lifespan – and I certainly don’t want that!
When I found out my PCP was leaving her practice, I decided to find a new primary care physician as quickly as possible. I would start the weight loss injection drug conversation with her.
I live in a small community and was lucky to find a young doctor who has tons of positive online reviews. When I walked into the office, everyone was friendly and the place was spotless. I was optimistic that maybe I’d found a partner to guide me on my weight loss journey.
My appointment didn’t go as planned
I had hoped that I could have an in-depth discussion about weight loss with my provider – which I did. I had hoped to walk out of that appointment with a prescription for Zepbound. I didn’t. My doctor won’t prescribe Zepbound.
Related reading: Everything you need to know about Zepbound
Weight loss isn’t one of her specialties
I got good vibes from the doctor and I know she’ll be a great partner in my healthcare going forward. However, she didn’t want to talk about weight loss injectables just yet — mainly because it’s not an area of her expertise. She wasn’t aware that the FDA had approved Zepbound, Eli Lilly’s medication, in December.
‘Your insurance won’t cover Zepbound’
As we discussed the GLP-1 and GIP classes of weight loss injections, I could tell that her resistance may be more about the rigamarole of the healthcare system than the effectiveness of the drugs themselves.
She told me that insurance doesn’t cover them. Mine does with prior authorization. She told me that even when a doctor goes through the time-consuming prior authorization process, the medicine isn’t approved. Yes. I know that’s unfortunately true. But I’d love for my doctor’s office to give it a go without assuming what my particular insurance company will say. I understand her point of view, though. She told me her team has spent a lot of time trying to get some of these drugs approved for patients and they don’t have a good track record. A doctor should be in the business of keeping you healthy and not mired in paperwork.
Medication shortages
When I pressed why she was resistant to Zepbound, she also told me that because we live in a more rural area, the pharmacies don’t carry the medicine and I’d have trouble getting it. That might be accurate. Wegovy, Novo Nordisk’s class of medication has experienced sporadic nationwide shortages but Zepbound is readily available as of now.
Qsymia was recommended over a GLP-1 drug
Instead of snagging a Zepbound RX, the doctor gave me some information about Qsymia. It’s a once-daily pill that combines phentermine and topiramate. She told me to think about it and call her if I decided I wanted a prescription for it. The doctor didn’t rule out Zepbound in the future for me but wanted me to truly compare the options before making a choice.
The more I research Qsymia, which was approved by the FDA back in 2012, the more I am convinced that it isn’t the right option for me now. Changes in mood are a side effect of that drug and one that’s a deal-breaker for me. I work really hard to have a bright and optimistic outlook. I don’t want any chemical possibly dimming my love of life. I draw that line for myself.
My next step: Telehealth
I also decided that it isn’t fair to burden a small-town medical office with monthly prescription requests and occasional prior authorizations. While it would be amazing to have a doctor’s office that has the time and expertise to do that, it’s a tall order.
My next step is to pick a telehealth program. These companies make it easier for individuals to connect with endocrinologists, registered dieticians, and other weight-loss specialists online. The Form Health homepage is open on another tab in my browser right now. I’ll look there first simply because it’s recommended right from the Eli Lilly webpage (maker of Zepbound). But there are many other telehealth companies specializing in weight loss and weight management that I will consider.
The wrap-up
What was your experience like getting a prescription for Zepbound/Mounjaro, Wegovy/Ozempic, or Saxenda/Victoza? If you’re about to start this conversation, what will you do if your doctor won’t prescribe Zepbound?
Email me a note or post over at the Shots to Shed Pounds Facebook page.
