Doctors/Nurses/Dietitians/healthcare professionals, what are you real and honest beliefs about the whole weight loss injection moment we are having?

Very similar to this (started at BMI 30) and I'm microdosing Mounjaro (because I always overreact to medication) and have lost 1 stone in six weeks eating much the same as I was before. Losing weight when you are peri seems to be almost impossible but this unlocks it somehow.

It will absolutely change your life . I went from 122kg to 64 in 9 months. Unlike you I was already in the grip of comorbidities. I was pre diabetic, have horrendous IBS, High BP, fatty liver.. having injections for knee pain and that was just the physical stuff. Add to that a deep self loathing and it was a pretty miserable life .

I have swapped the bp and diabetic meds for a maintenance dose of Mounjaro since reaching goal in November. I cannot wrap my head around those who are obese preferring to remain so when the KNOWN side effects of obesity include stroke and death .. as opposed to a remote possibility of as yet unknown side effects despite the drug being in use for over 20 years..

Being obese is just so bloody uncomfortable. Your legs rub and it causes sores. Getting in and out of a bath is a mission.. being sidelined at work because. ‘fat =stupid’ (is often subconsciously done because this view is ingrained) .. generally being over looked or having to make self deprecating ‘jokes’ because of size embarrassment..

why would anyone want that .. and even more interestingly, why would posters like @Cityandmakeup get any sense of joy from finding my new found love of life in my now healthy body (that costs the NHS nothing) came with a ‘price to pay’. ? I can only imagine them to be the sort of person who took great enjoyment from putting obese people into that ‘stupid fat woman ‘ box and now has fewer people to take the piss out of …

It will absolutely change your life . I went from 122kg to 64 in 9 months. Unlike you I was already in the grip of comorbidities. I was pre diabetic, have horrendous IBS, High BP, fatty liver.. having injections for knee pain and that was just the physical stuff. Add to that a deep self loathing and it was a pretty miserable life .

I have swapped the bp and diabetic meds for a maintenance dose of Mounjaro since reaching goal in November. I cannot wrap my head around those who are obese preferring to remain so when the KNOWN side effects of obesity include stroke and death .. as opposed to a remote possibility of as yet unknown side effects despite the drug being in use for over 20 years..

Being obese is just so bloody uncomfortable. Your legs rub and it causes sores. Getting in and out of a bath is a mission.. being sidelined at work because. ‘fat =stupid’ (is often subconsciously done because this view is ingrained) .. generally being over looked or having to make self deprecating ‘jokes’ because of size embarrassment..

why would anyone want that .. and even more interestingly, why would posters like @Cityandmakeup get any sense of joy from finding my new found love of life in my now healthy body (that costs the NHS nothing) came with a ‘price to pay’. ? I can only imagine them to be the sort of person who took great enjoyment from putting obese people into that ‘stupid fat woman ‘ box and now has fewer people to take the piss out of …

I would prefer to get it via my GP, and would happily pay to do so, but even with a BMI of 49, I don't qualify. I am not diabetic ( according to last Hba1c ) or have any other diagnosed health conditions ( blood pressure is fine ), take no medication, other than the very occasional paracetamol, I don't have any digestion issues, no reflux, no IBS etc, rarely if ever ill, maybe get a cold once every 18-24 months if that, needed antibiotics twice in the last 20 years, for surgery related phlebitis and insect bite cellulitis. I am menopausal and know that I need to act now, before my weight causes me serious issues. I have tried unsuccessfully in the past to lose the weight, I am not an emotional eater, I enjoy healthy food, am a good cook, I just don't feel 'full' very often and certainly not for long ! I think that this medication could help me achieve a substantial sustained weight loss, along side a healthy diet and exercise.

On this thread, there has been confusion re and/or posters unaware of the potential to lose substantial amounts of muscle mass and bone.

On other threads, I have seen posters who claim to "know all the side-effects" positively shrieking when some of the well-known major adverse affects (eg gastroparesis) listed on the packaging inserts are stated...

Etc.

This substantial muscle loss can be largely attributed to the magnitude of weight loss, rather than by an independent effect of GLP-1 receptor agonists,

@pirateshirt it was this bit that made me think that it was about the actual amount of weight lost ?

@pirateshirt could you explain what information we are not getting if you think that would be helpful to people? What is it that we are not being told that we should be being told? Thanks.

Thank you @MereNoelle , you sound similar to me regarding appetite and portion size. I am considering using it to reset my appetite, whilst eating a healthier diet and starting to exercise. I do know if I remove the rubbish carbs from my diet, my appetite does reduce so hoping a combination of the two might be the key to a more sustained weight loss. Have a lot to lose, around the 10 stone mark !

No, it's to do with the rapidity of loss (also occurs in bariatric patients). If people have the right support and information, it can be minimised, but so many people do not have much support or information, judging by these threads.

@Dymaxion it depends, the level of support varies according to what people want. Some companies offer coaching and lots of other access to varied support. They all will give out detailed information about the medication and how to support taking it with an appropriate diet and exercise.

Some do, some don’t. You can ‘shop around’ and choose an approach that’s right for you.
Personally I didn’t want any of that… as i said above I already strength trained 3 x a week (and ran 5k twice a week) so had the exercise side covered, and I knew the theory behind eating well, it was just the ravenous hunger/food noise meant I ate too much. MJ helped me to reduce my portion sizes.

What sort of ongoing support do people get from the private companies prescribing this medication ? Do they get nutritional advice, such as a minimum amount of protein you need to be eating ? Advice on exercise ?

Hope I've not lost too much muscle - some is inevitable with any weight loss, you can't purely lose fat. My muscle tone has never been an issue though, just that since I had kids it has been hidden by a load of fat which wouldn't shift. I always knew the importance of weight bearing exercise. I first joined a gym with my dad when I was 18, 31 years ago and remember him telling me about how beneficial weight training was for women long before I read about it online. I intended to have a private Dexa scan in a year or two anyway even before I heard of mounjaro. And I might take HRT, am seeing if my periods have definitely stopped at the moment.

@Dymaxion I need to look more into it but at the moment with this morning info it does feel a little bit like sour grapes.

@Icebreakhell Thank-you I will totally take on board what you are saying about contact GP first.
At the moment I'm nervously toying with the idea. I'd love to be able to drop 3st and get back to a healthy weight. For the first time in years

@Icebreakhell can I ask what my GP would be able to say about a private prescription that is nothing to do with them? The online prescriber has my full medical history, that’s reviewed by a doctor, so what would be missing there that a doctor at my GP surgery would pick up? My GP surgery don’t even want to see me for the prescriptions that they issue, so I can’t see why they’d be prepared to discuss a private prescription.

I also don’t have a “local pharmacist” and also can’t see why talking to someone at a pharmacy would be any more helpful than the process carried out by the online pharmacy.

It feels like the research is comparing apples and pears. Someone losing a couple of stone on a traditional calorie deficit diet loses 10-30% non fat mass, someone who loses six stone using WLI loses 25-39% non fat mass. Do you see what I mean ? the fact that they mention it is most likely attributed to the larger level of weight loss as opposed to the mechanics of the medication, means they are unlikely to be comparing like with like ?

As a registered nurse who is on Mounjaro with 20kg to lose I would advise speaking to your GP before you start; this is especially important if you have other medical issues and/or are taking other medications. At the very least people should consult their local pharmacist.

For me personally, not far into the process, I think it’s a brilliant drug. It’s calmed down the feelings of being constantly hungry and deprived I get while dieting. You can eat healthily if the dose suits you but you’ll probably get some gastric adverse effects if eat oily fatty foods. I feel better, all my bloating and longstanding IBS has disappeared. I’ll accept the low risk of later effects if it improves my cardiovascular risk, which to me is far more imminent a concern.

I think some of the sceptics are people who won’t grasp the complexity of food dependency, which is an addiction like any other and should be thought of as such. Those of us who yo yo with dieting our entire life are rarely going to manage our weight long term with the tried and tested methods.

As it said:

on WLI, 25 - 39% of total weight loss
with regular dieting, 10 - 30% of total weight loss

It's just something to bear in mind. Especially, as people have been shown to regain when off the WLI, so presumably would go back on them, and round and round, and it could lead to premature sarcopenia.

Also don't people who are obese tend to have a larger amount of muscle mass anyway ? So as they lose weight the necessity for that additional muscle mass is reduced and so it isn't as much of an issue ? As long as they exercise so strengthen the remaining normal amount of muscle ?

But what's the muscle and bone loss compared to eating any other calorie deficit?

Or what's the muscle and bone factor for someone at 9st who's never been overweight.

Compared to someone at 9st who's lost 4 stone on a diet vs on a WLI diet?

This muscle and bone loss does worry me. A few years ago I lost on a diet and going by my scales I seemed to loss a load of muscle rather than fat.

@pirateshirt That Lancet article suggests that it is the amount of weight lost that is the critical factor, which makes sense, if you lose 10 stone you will lose more non fat mass as opposed to if you lose 2 stone ?
It would be interesting to see a study carried out where people are given enough protein to eat and do weight training, whilst using WLI and see what the difference would be ?

There looks to be an increased likelihood of muscle and bone loss with weight loss injections, which is something people should receive advice about and it should be one of the factors considered in prescribing decisions. Risks can be mitigated though, through diet choices, vitamins, and exercise (really important).

I'm a registered nurse and podiatrist. I couldnt lose weight for 30 years. Went through loads of diets. I've been on mounjaro for 4 months and lost 3 stone. I have 2 stone to go. No side effects at all and feel great.
I feel better than I have in years.
Emotional bingeing was my problem.
I've had counselling for that since and I'll be on a 2.5mgs maintenance dose when I've lost all the weight for as long as I need to while I work on my emotional eating problems.
I've had no side effects.
So many of my patients and friends are on it. But anyone who is thinking of doing it should seek medical advice first. It isn't suitable for everyone.
I'm 63 and had to lose weight for joint pain and osteoarthritis.

I weight trained 3 times a week pre taking Mounjaro, and continued to weight train 3 times a week while taking it, so I’d be interested to see what my muscle loss is like. I certainly don’t feel any less strong.

No, it's not the same.

Per a 2024 article in The Lancet Diabetes & Endocrinology, studies suggest that muscle loss on GLP-1s ranges from 25 to 39 percent of total weight loss over 36 to 72 weeks. In contrast, non-Rx caloric restriction studies have shown only a 10 to 30 percent reduction in fat-free mass. The authors also add that the decline in muscle mass on GLP-1s is several times greater than what’s expected from natural age-related muscle loss.