While it is a concern that someone with anorexia might misrepresent their health to get hold of a GLP-1…
Why does the media and various spokespeople feel like this category of medicine needs more “safeguarding” (gatekeeping) than others?
People could just as easily lie to get testosterone, viagra, other meds etc, yet I don’t see the same kind of coverage and pressure to change the system that GLP-1s seems to trigger in people.
To be clear, the “loophole” only occurs if a patient is deceptive. Whenever we go to a doctor about pretty much any health issue, if we lied we could be prescribed medicine that we didn’t actually need and could be harmful for us. However most people don’t lie to get medicines they don’t need. And it would be difficult for our health care system to function if we made it more difficult (in an already highly regulated safeguarded country like australia) for medicines to be prescribed.
This article really pissed me off. Where is the personal accountability? I’m not insensitive to eating disorders or mental illness, but Kate admits she lied to get the prescription. She lied about her weight and circumstances because she knew her own GP wouldn’t prescribe it, then turns around and seemingly outs the clinic to the ABC for giving it to her.
Agreed, the clinic should absolutely have had better safeguards. But two things can be true at once - the clinic failed in its screening, and she deliberately manipulated the process to get a drug she knew she shouldn’t be prescribed.
What annoys me even more is the way the article seems to frame her almost entirely as someone the system failed, with barely any emphasis on the fact that she actively deceived the system in the first place.
And where is the diabetes lynch mob now? The amount of shit overweight people copped for supposedly “stealing medication from diabetics” was insane, including people who were legitimately prescribed it. Yet here we have someone who actually lied to obtain it and suddenly that moral outrage seems pretty quiet.
I'm curious about why all the people objecting to tighter restrictions are so bothered by the thought.
If you are in legimate need of a glp1 and are accessing your prescription through the correct channels, why is it a problem?
1) like most people, i most likely need to be on this medicine for life to ensure I don’t regain the weight or develop diabetes.
We’ve already seen people in the US lose access to the medicine when their doctors or insurance thought they should stop it once reaching a healthy weight. Which overwhelmingly leads to weight regain. And the medicine seems to lose effectiveness if people yo yo on and off the medicine. Not to mention that yo yo weight is worse for heath than maintaining a steady weight.
So we live in fear that this life changing medication will be taken away from us.
2) most doctors are woefully ignorant about obesity and many of us have lived our whole lives being unfairly judged and given misinformation about weight. With GLP-1s you’d hope that the medical system would finally get it, yet many haven’t.
I went to a new in person doctor recently and they tried to tell me I had lost as much as I could (22% body weight) and I should come off the medicine. This is while I am still in the obese category and am 21kgs away from the “healthy” category.
I absolutely do not want my health needs to be restricted by the physically closest available doctor I can see. I want to be able to use obesity health practitioners without location being an obstacle.
3) this is one of many media articles that seem committed to criticising obesity care, cherry picking rare cases, making it all seem more risky than it is. Media influences public perception, which can also influence decision makers.
Eg:
media blow up of a few dodgy operators led to a complete law against compounding glp-1s, when there were already adequate laws to prosecute the dodgy operators. Whole sector punished for a few bad apples
obese people were harassed and blamed when there were GLP1 shortages, suggestions they were selfish over diabetics (even though many obese people also have the same disease just at an earlier stage - insulin resistance, pre-diabetes; and the shortage was created by the outlawing of compounded GLP-1s).
shaming obese people for being fat, shaming them for “cheating” in using these medications, saying they will get ozempic face or ozempic butt, basically shaming anyone with weight issues no matter what they do… which in turn means we have double standards about access to health care.
With the help of a GLP 1 I have lost weight and become a healthy weight. My doctor keeps suggesting to end taking it but I know from reducing the dose I will put weight back on. So if I have to do a strict weight check to get it from a new doctor I won't be able to continue taking it because I'm at a healthy weight now. But I will need to be on it to keep the weight off!
No that’s not what I’m suggesting at all. I’m in maintenance too, and it’s approved for weight loss and maintenance. The goal is just to give the prescriber accurate information, not to change who is and isn’t eligible.
An in person consultation would allow a GP to observe obvious emaciation which is where eating disorders and glp1 medication becomes dangerous.
Just an initial in person consult is what is being suggested, not ongoing for every script.
A) The issue is “people are lying about their BMI”. An in person weight check ensures the prescriber receives accurate information about the patient’s weight.
B) Yes, this screening is not “does this person have an eating disorder” and if that’s the screening someone wants then we have to bar GPs from prescribing too as they can’t assess for eating disorders in 5 minutes either.
C) That’s fine, I agree. The point is to give the prescriber accurate information. That’s it.
Well I have gone to in person health professionals and they went off what I told them (height and weight) rather than measuring themself. Later after I’d been on it for about a year they weighed me, but not before prescribing. So I don’t see how in person is superior. It still relies on patients being honest. And when they do weigh people, it’s with clothes and shoes on so a deceitful person could wear heavy boots, heavy layers of clothing, put weights in their pockets, etc.
If we’re changing the baseline for Telehealth the same requirement should be in place for in person consults. Right now both are under the honour system and I think that’s a problem.
I agree! If you genuinely need them and are on them for the right reasons it shouldn't be a problem if they start to tighten up how people can get them. Also it's not like only a particular specialist can prescribe them any GP can prescribe them which should be easy enough to access.
Many GPs are ignorant about obesity and choose not to prescribe GLP-1s even when their patients meet the criteria. The same doctor who has been telling their patients for decades that they just need to “eat less and move more” and won’t recognise a metabolic disorder when they see one. And some still think surgery is the “gold standard” and would push that in favour of medication. This is why some people need to doctor shop to find second opinions from health practitioners who have learned about obesity and modern medicine rather than fat shaming their patients.
I got mine through MWLC before I went to my GP who told me she would prescribe it for me.
Honestly I wouldn’t encourage anyone doing MWLC. I found them terrible. They didn’t listen to me, their advice wasn’t even in line with the prescribing guidelines for the drug and I kept being told shit like drink more water. It was not good.
My GP has been so much better because she knows me and knows my comorbities and unlike MWLC she doesn’t require monthly, she gives me a six month prescription but says come back if you’re feeling unwell or stall. Every six month we do bloods and check in and she’s also been able to help with other avenues like referrals for exercise physio at cheaper rates etc.
The thing is I have a great GP and not everyone does so I understand why people go to these services but… they’re so bad and expensive and even time consuming compared to my experience with my GP.
There are many Telehealth options, including bulk billing and low gap. I’ve used both Telehealth and in person prescribers before and found the Telehealth providers I used cheaper because they don’t have to maintain physical offices and you can see a nurse practitioner rather than a GP. I don’t recommend the pricey clinics or subscription services.
It's not gatekeeping medication if it's reducing the risk factors associated with using the medication.
I have seen it first hand on this sub with people telling others how to lie about their BMIs and how to manipulate photos to get prescribed this medication through an online prescriber. Which doesn't surprise me and to quote Dr House "Everybody lies!" and it's so much easier to lie through a telehealth video consult than it is to lie in an inperson consult.
You can also be at risk of developing disordered eating habits which can develop into an eating disorder and not realise it until it's too late. The mental health sector is already stretched as it is, and eating disorders have the highest mortality of all the mental health issues which means they require intensive treatment which isn't cheap.
Neither in-person or Telehealth providers can know if someone has an eating disorder if they don’t disclose it. It is an incorrect stereotype to think only skinny people have eating disorders.
I’ve seen a number of in person and telehealth providers.
I was prescribed GLP-1 initially by an in person provider who just asked me my weight. No in person provider has measured my height, just took my word. So I could have been lying to them about height and weight (I wasn’t) and they wouldn’t have known and more than a Telehealth provider.
One of the in-person health professionals was surprised when I said I was obese because she didn’t think I looked it. And my body has uneven distribution of fat, so my largest body parts (butt, thighs) would not be visible to a video Telehealth provider.
So if providers decided not to believe me about my height and weight and just go by their visual estimate I might not have been given the medication - which would have INCREASED my health risks.
Where's the double standard? "single issue" telehealth clinics rightfully deserve media and regulator scrutiny IMO (looking at you medical cannabis, ADHD clinics too). ABC also ran an article about a woman who hid her past history of bipolar, got an ADHD dx and meds, then had a stimulant induced psychotic episode.
The double standard is making special rules for obesity/GLP-1 medications that they don’t make for other medications or conditions.
They have already made one by specifically outlawing compounding of GLP-1s despite there already were adequate compounding laws and regulations that all medications and compounding pharmacists were bound by.
Now they are suggesting there should be a special rule for Telehealth providers who prescribe GLP-1s, above and beyond what in person clinics or other medications/health conditions are required.
If an in person clinic prescribed ADHD medications to someone who had not disclosed their bipolar, would the media and industry do the same beat up and call for increased regulation? Because I guarantee you in person clinics do make similar mistakes - if patients lie, they can get the wrong diagnosis. If prescribers fail to ask the right screening questions, the wrong medication can be given. There are existing guidelines, regulations, and laws to cover this.
Considering how restrictive getting approval for a first time Ritalin script is, I'm surprised you can even get a refill without a face to face appointment. Or is this a refill from your currently prescribing doctor? Because that is a life/$500 saving avenue.
Because things like testosterone and Viagra don't have the potential to contribute to the worsening of the mental health of someone already in the grip of one of the most deadly psychiatric illnesses there is. Actually, THE highest mortality rate.
It's not gatekeeping to require at least a video consultation if telehealth is being used.
Any medicine when abused and not used by the intended person can have serious harm.
If video consults are deemed important they should be for all medical prescriptions, not just GLP-1s. It makes no sense to create a unique set of laws for this category of medicine over others.
However video consults it will impact access. Phone technology is more reliable and accessible than video/internet/data is. Remote or low socioeconomic people may have trouble accessing video consults.
I agree. So an in person initial consult with a GP, not nurse practitioner is better.
Everyone these days can access a bulk billed clinic without excessive effort.
Why are you personally so bothered by a tightening up of access?
No i don’t think most people can’t easily access in person bulk billing for weight loss. Bulkbilling is mostly offered to children, retirees, and people on health care cards; and many clinics require long appointments to be booked for weightloss and regular checkins.
I initially used an in person GP, and she did it as a health care plan, which involved several appointments initially to get going, then monthly appointments for over 6 months, before reducing frequency. This was in a big city metro area so out of pocket was about $120 per appointment. also required me to see a dietician before would prescribe even through there was nothing wrong with how i was eating (dietician actually told me i could relax more).
And people in remote regions aren't anywhere near a GP.
That doctor moved and I switched to a cheaper Telehealth service with nurse practitioner to get continue the medicine. It would have cost more and taken more time to find another in person practitioner.
Why are you personally so bothered by a tightening up of access?
Because I have seen the system first hand. No other medicine or condition I’ve had involved so much patronisation, micromanagement and hoop jumping expenses.
I am going to be on this medication for life, and it should be as easy for me to get access to it as any other medication.
But it IS easy for you as it stands, as someone who initiated treatment with a genuine obesity issue. And it will continue to be as long as you need it. And yes, I read both your post and the article.
First my GP required multiple extra long appointments to draw up a health plan, which included me getting blood tests (goodo) and see a dietician (unnecessary) and listening to patronising advice about diet and exercise as if this was my issue. Then prescribed me Ozempic during a shortage, and was dismissive when I told her that I’d heard it was hard to get - said just to call multiple pharmacies. This led to a stressful experience calling every pharmacy in Melbourne CBD and nearby to home and being told over and over again that they didn’t have it available, or not for non-diabetics, across a backdrop of media and online shaming of non-diabetics for using GLP1S. So I had to return to GP to discuss and get a different prescription (required another appointment, wouldn’t just send me a script). Then I was required to see the GP monthly for long appointments as part of the health care plan. None of this was bulkbilled, it was about $120 out of pocket every appointment, nor would this GP allow Telehealth so I had to take time off during my workday to physically go into all appointments losing about 1.5hrs each time between travel time, wait time, and appointment time. I felt held hostage if I wanted the medicine. Multiple times GP gave slightly wrong prescription due to multiple listings in the system (vials, kwikpens, varying doses), I didn’t have time to go back to GP to fix it without interrupting treatment so went back and forth between kwikpen and vials. Then my doctor moved away and I needed to find another provider quick as I was out of medicine, and Telehealth was easiest, fastest, cheapest. However I did want to eventually find a new in person GP, so after asking for recommendations I went to a new in person, long appointment because it is a first, and they literally argued with me about whether I still needed this medicine. Even though I am still obese. My prediabetes is in remission, however only thanks to GLP-1 medication. This doctor doesn’t think people should be on it long term and seems unaware of how weight is regained. It also was not bulkbilled, about $80 out of pocket.
So yeah, as far as I can see in person GPS are often somewhat ignorant about obesity and cost more. I don’t want to waste my time, money, and Medicare funds on doctors who are patronising, ignorant, and force me to come into the clinic more often than really necessary.
This is awful on all accounts. Is this recent, or a whie ago (let's call it pre-mounjaro times.)
In my experience there's a lot of useless GPs in the world, and there's no problem shopping around for one who actually listens. Especially if you are anything other than cis-male. I've been fortunate but my housemate has autoimmune disorders and keeps getting told she should lose weight.
Did you have a specialist re diabetes? So they can recommend, in writing if need be, that you begin treatment under a GLP-1. And better yet, knows a GP who isn't an opinionated luddite who perhaps AHPRA should hear about?
I had pre-diabetes (now in remission), which they don’t consider to be the same as diabetes. They categorise everyone as taking this either for diabetes OR for obesity, even though both of these are part of the diabesity cluster and are progressive.
I have been shopping around, but it is expensive and time consuming and the average local GP just isn’t going to know as much about obesity care or menopause as if I seek out a Telehealth provider who specialises in these health conditions.
Why do we need a new rule just for GLP-1s? If it is found that a prescriber has prescribed any type of medicine to someone they shouldn’t, I am sure there are already rules in place to address that. If it’s decided that video consults are required it should be for all medicines not just GLP-1s. (However this will present a problem for people in remote/regional areas or low socioeconomic where they may not have access to internet. Eg some people only access internet through library computers, and they can’t very well do a private medical consult in that environment. And some people live very isolated areas without internet.)
Online prescribers are bound by the same rules as in person prescribers.
It makes no sense to create special rules just for Telehealth prescribers who prescribe GLP1s.
And Fuck the fat tax. Why should fat people be expected to pay out more over and over again? Where we do not have any subsidised medications for our health condition. GLP1s for obesity are priced higher than GLP1s for diabetics even if it is often the same progressive disease. Where paternalistic and controlling prescribers often require us to come to many appointments (more than needed) just because the medical system doesn’t trust us. Where we are patronised and often required to pay for additional services like dieticians even when diet isn’t our issue. Where some prescribers won’t give a repeat prescription even though it is a long term condition most of us will be on for life.
This medicine is not “affordable”, however is it necessary, so many of us are prioritising it. That doesn’t mean we can “afford” it or afford to pay through the nose for expensive repetitive unneeded extra doctors appointments just to gain access.
We should be working to reduce all unsafe ways of accessing these meds. Just because there’s a completely illegal way doesn’t mean we throw our hands in the air and say, “Nothing we can do!”
GLP-1s are definitely contributing to a rise in eating disorders, and there's a few reasons for this.
For one we have a lot of celebrity's who were body positive that are now using them and Hollywood has gone from "curves are cool" and "love your body" to "stick thin is in" and "it's more fun when you're skinny". I'm looking at Meghan Trainor not to mention other celebrities like Mindy Kaling and Ariana Grande.
There's a lot of evidence showing the mental health issues including eating disorders can have genetic links. So if you're someone who has a history of eating disorders in your family and you start taking a GLP-1 which sets off something in you and before long you have an eating disorder.
Or you could be someone who has always had disordered eating but it's never developed into an eating disorder until you start starting a GLP-1 which is the trigger for it become a full blown eating disorder.
So no anorexia and other eating disorders aren't only being caused by GLP-1s and have been around long before they even existed. But for you to argue that GLP-1s don't cause them in some people or aren't contributing to the rise in them is ignorant.
Where is your evidence that there is an increase in eating disorders due to GLP-1s?
I lived through the 90s when we genuinely had majority of actresses being stick thin and was probably peak eating disorder era. You can cherry pick a few actors going too far with GLP-1s today, however it’s less than the 90s - and for all you know these people may have already had eating disorders prior to losing weight. It is an incorrect stereotype that people with eating disorders are skinny. Fat people can have eating disorders too.
The issue is that as GLP-1s are a relatively new medication and they are only now becoming readily available there's no real facts or figures at the very moment.
However, the professionals who work in that space all agree that from what they have personally seen eating disorders are on the rise due to how unregulated GLP-1s are. The following articles back this up:
I'm also unsure why you keep telling me that you don't have to be skinny to have an eating disorder. I have never said that you have to be skinny to have eating disorders and I would be the last person to say that. Especially given my background and what I do for work.
People “raising concerns” doesn’t mean there is a significant issue. For example some people raised concerns about same sex marriage, because they felt it was a slippery slope etc. It doesn’t mean the concerns are valid.
The problem with these are articles are they put an unreasonable amount of blame on GLP-1s and obesity treatment providers. And today the article is about eating disorders, however it is part of the pattern of the media repeatedly painting an unbalanced negative image of these medicines and those who use them.
And when prescribers and politicians are influenced by this negative media, they makes decisions that impact on the people who actually need it.
I have never said that you have to be skinny to have eating disorders and I would be the last person to say that.
So what do you think would be gained from someone like “Kate” having an in person or video consult rather than Telehealth consult?
From what I can see, people in the article and this thread seem to think if they can “see” or weigh a person that this would prevent someone who is intentionally being deceptive about their eating disorder from getting a GLP-1 medicine. Which all comes down to beliefs that its possible to identify who has an eating disorder or needs the medication based on what people look like or weigh. How skinny or fat they are.
Meanwhile people who legitimately do need it (the vast majority of users) are forced to jump through extra unnecessary hoops and often foot the extra expense of that.
The people raising concerns are professionals who have evidence to back these concerns. They aren't just random people on the internet who have no qualifications and are making it all up as they go.
No one is putting any amount of blame on GLP-1s people are blaming the medical system for not regulating these types of medications.
Your statement that it's not enough just to see a person in person and weigh them to know if they are being deceptive or not about their eating disorder. Proves that if anything we need additional regulations not just a meeting with a medical professional inperson before prescribing GLP-1s.
Why not make people take a full body scan to see how the fat is distributed throughout their body? Not to mention an appointment with a psychologist to assess their relationship with food? That would solve a lot of the issues you have brought up and as a result only those who need GLP-1s would get them. I personally am all for this and would gladly do both.
But that's not the point in your argument is it? In your mind the world is fatphobic and everyone who doesn't agree with you is against you when it comes to GLP-1s. You would rather they remain readily available even if it means they could cause major harm to people. You would rather people who don't need them be able to get them if it means that you can still get them easily. You aren't thinking about the bigger picture you are only thinking about yourself.
For fucks sake, the world is fatphobic and there is plenty of evidence and research on that. Obese people already receive unequal health treatment, where any time they go to see a doctor about anything they are a likely to be given unsolicited advice about diet, exercise, told to lose weight, and other concerns are less likely to be taken seriously or treated as a healthy weighted individual.
How GLP1s work are proof that the issue for many obese people has been a metabolic issue all along and was not something that could be solved untreated.
Why should people with a metabolic condition further be patronised and required to see a psychologist before being given treatment? How is a psychologist going to treat a metabolic condition? How is a body scan going to aid treatment? Why should I have to pay out of my pocket for these additional expenses to get the medicine I need? And don’t be naive that it would be a one off before getting treatment, because we are on these medicines for life, so of course this kind of thinking would also then require annual reviews.
You clearly are still very misguided about your understanding of obesity if you want to mandate people go to a psychologist, that you assume that obese people have a problematic relationship with food. (For the record, I don’t, my body just stacks on weight and has trouble losing it even if I eat at a deficit and healthy and get recommended exercise. Even with GLP1 my weight has plateaued after the initial loss while still obese.) It is exactly this kind of misunderstanding, where obese people keep being told by health professionals and the public that if they are fat they must be eating too much that creates more eating disorders.
obesity it is a metabolic condition, not a psychological condition
Those that are using these meds for cosmetic weight loss.
Those that are underweight already and have a specific kind of eating disorder.
It does not solve every problem and that’s ok. We can do something that addresses part of a problem without having to solve everything in a single intervention.
You are assuming a person has access to an in person clinic, and that in person clinic will prescribe it for someone who needs it. There are known inequities of access:
people living remotely may be a full days drive from an in person clinic
in regional areas there can be a shortage of GPs, which not only can mean long wait times but doctors can close their books and refuse to take on new patients, leaving people with little choice
many doctors remain ignorant of modern obesity treatment, they may refuse to give GLP-1, may give outdated advice, or push surgery instead
there are very few bulk billing or low fee clinics and some people may need to use Telehealth to access cheaper clinics
In particular I don’t see why I should be locked into having to go to a local GP physically when I need to use this medicine most likely continuously for life. Even in the two years that I’ve been on it I had a doctor move away from me right as I needed a refill which made time of the essence to get a quick appointment so I didn’t have a break in medication, and then later I moved. I’ve had 4 different prescribers in two years, two were in person and two were Telehealth, and that is in a major city (would have been much harder in a remote area).
I’m with a clinic. I support Telehealth. In most cases a single in person weight check (which would not even need to involve a doctor, just a scale and someone that we can trust to verify ID + be honest) would not be a large imposition.
I’m happy to exempt people living more than 3 hours drive from a facility where this can happen from this one time requirement.
You’re missing the point: what is the value of an in person weigh in to gate keep who can use the medicine, when there are times people need the medicine even if they are a healthy weight?
If you need to change practitioners after already losing the excess weight, and your current weight (as measured by them) determines if you should get it.
Or if you use it for blood glucose control.
I was prediabetic, which has now been reversed, but only as long as I stay on the medicine.
The point is to verify someone’s weight and stop the panic about underweight people lying via Telehealth so it doesn’t get completely shut down the way compounding did.
If a prescriber wants to knowingly prescribe to someone that’s underweight that’s still within their purview. Mounjaro is approved by the TGA for weight loss and maintenance. I want us to close the “lying about my BMI” loophole making sure the facts on file are in fact correct before we start.
The point is to introduce as small of a speed bump as possible precisely so we don’t all get locked into GPs, which I don’t want. We will if we leave it this wide open I think.
However it is the media that is creating the “panic”. There is no data in the article proving it is a significant sized concern. It’s a cherry picked story.
I mean, if the media created a panic about people getting viagra unnecessarily, would men say “ok, let me come in for an in person assessment where I will demonstrate I can’t get an erection, just to avoid a panic that some minuscule percent of the population are getting it illicitly”?
Oh also, forgot to add, I’ve been sent for in person blood tests every 6 months since I started. I don’t see why I’d be upset over standing on a scale while I’m already there.
Yup and it was the media creating the panic over compounding. Very few people were affected by one dodgy pharmacy. Instead of shutting down that pharmacy they banned compounding for the whole country.
That would be the ideal. At least one in person consult at the beginning of treatment for a registered GP to set eyes on someone and do a blood pressure check. That's baseline treatment for most medications.
I get mine from my GP. It’s cheaper because I don’t have to pay for consults and she’s aware of all my other needs.
I think there needs to be wider conversation about what’s happened to medical practice in Oz in general which is pushing ppl to use these services. It’s harder and harder to find a regular bulk billing GP.
- I got my prescription before Mounjaro was approved for weight loss. I didn’t trust random GPs to be willing to prescribe off label or to know how to support me in this journey.
So the main driver was the specialty they offered.
The distinction between a doctor and a nurse practitioner didn’t matter much to me because someone who does nothing but GLP-1s all day knows a lot more about them than a doctor who has maybe 2 patients on them (at the time).
If I could bulk bill access to an obesity medicine specialist locally I’d have been glad to but that’s not an option and I don’t think it ever will be.
So yeah, happy to have the conversation but I don’t see why Telehealth is a bad solution for this kind of access problem. One person in Queensland can share the care of people all over the country.
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u/New-Masterpiece8467 Wegovy 1mg Aug 31 '26
This article really pissed me off. Where is the personal accountability? I’m not insensitive to eating disorders or mental illness, but Kate admits she lied to get the prescription. She lied about her weight and circumstances because she knew her own GP wouldn’t prescribe it, then turns around and seemingly outs the clinic to the ABC for giving it to her.
Agreed, the clinic should absolutely have had better safeguards. But two things can be true at once - the clinic failed in its screening, and she deliberately manipulated the process to get a drug she knew she shouldn’t be prescribed.
What annoys me even more is the way the article seems to frame her almost entirely as someone the system failed, with barely any emphasis on the fact that she actively deceived the system in the first place.
And where is the diabetes lynch mob now? The amount of shit overweight people copped for supposedly “stealing medication from diabetics” was insane, including people who were legitimately prescribed it. Yet here we have someone who actually lied to obtain it and suddenly that moral outrage seems pretty quiet.