Continuing Mounjaro...part 6

[ObsidianTree]

Please note: Mounjaro can only be taken if your BMI is above 30.

Pointers for newbies:

1 - For taking your first dose you need to twist the pen a lot to get to 1! The instructions say prime each time you take a dose, but actually Eli Lilly have confirmed you only need to prime for the first ever use of a pen. (The video posted says every use, but this isn't true!)

2 - When injecting, hold down the button until the number goes back to 0. Once at 0, keep holding down the button and count to 5 with the needle still in so no medication is lost!

3 - Your first dose may not have an immediate effect. For some people the effects build slowly. It could take 3 or 4 days to notice anything, it could take a few weeks. Some people don't feel the meds working until they get to 5mg. See titration chart which shows how the medication builds up in your system.

4 - 2.5mg isn't a therapeutic dose, meaning you aren’t meant to lose on 2.5mg. You need to start on 2.5mg to get your body used to the drug and gradually introduce it into your system and get used to any side effects.

5 - Not everyone loses a lot in the first few weeks. Don't feel discouraged if you don't lose a lot initially. Again, you might need a higher dose to start losing. Also, inches can be lost without anything showing on the scales. Start your journey by taking measurements and check them as you go along.

6 - If you do lose a lot in the first few weeks, please don't assume you will continue losing at this rate. The first few weeks it is usually water weight that is lost, after than a good weight loss is about 2lbs a week. Some weeks you might not lose anything, but this is ok too…again, taking measurements might show inches lost instead.

7 - Constipation, coldness, nausea, diarrhea, headaches, aches, are side effects. There may be be other side effects also. Read info here :

www.medicines.org.uk/emc/product/15481/pil#about-medicine

8 - Once you take your first dose you can choose to keep your pen in the fridge or somewhere else. It's up to you.

9 - Don't reuse any needles as this could risk infection. If you damage a needle or one isn't working, you can buy a pack of about 100 spares. https://www.chemist-4-u.com/carepoint-pen-needles-31g-4mm-pack-of-100?gclid=Cj0KCQjwiYOxBhC5ARIsAIvdH51rLZBVFQxuvS7mDJooegtK8BMiyT0PwREMRHhH_1atfQIo8TEbsmkaAkA0EALw_wcB

10 - Protein is important as eating less protein can cause muscle wastage and hair loss. Try to have at least 100g a day. There are protein supplements you can take. Myprotein have a good range. Ask for a referral code if you want to buy some.

11 - Some natural sources of protein:
https://www.bbcgoodfood.com/howto/guide/best-sources-protein
https://www.medicalnewstoday.com/articles/321522#high-protein-foods

12 - You can use supplements, some that people use are magnesium(for sleep and constipation), protein(to reduce muscle wastage), collagen (skin elasticity), aloe vera(for constipation), electrolytes.

13 - Drink lota of water. Water helps with the weight loss. Drink at least 2ltrs a day. Preferably 3ltrs.

14 - Don't be afraid to feel hungry. It is entirely normal and healthy to feel hungry. Just eat something. Treat it as an opportunity to start good habits around hunger. Eat a nice balanced snack or a meal if it's a meal time. It's ok.

15 - Does it makes any difference where you inject? yes it does! Drugs get absorbed at different rates depending on injection site

In order of fastest absorption, it goes:
• Tummy
• Arms
• Thighs
furthet reading about injection sites and the effects: https://www.medicalnewstoday.com/articles/316618

16 - Abdominal side-effects are much easier to control with smaller meals. For example, having 4 small meals in the day vs 2 big meals can have an improvement in nausea and burps.

17 - You can track your calories / protein on apps such as My fitnessPal, Carb Manager or Nutracheck. Nutracheck is quite useful and easy to find foods /build recipes.

18 - Some of the places you can order from are:

• MedExpress £149.99 - Sometimes there are codes that can be used for a discount. Ask for a code on here or do a Google search to try and find one.
• Voy - £114.99 for first month then £229 after. Need a referral code (ask on here for one if needed)
• The Family Chemist -£149
• Simple online pharmacy - £159 2.5mg £179 for 5mg
• Bolt pharmacy 2.5mg £125, 5mg £179. Or starter pack with 2.5mg and 5mg pen £319
• Asda £184
• Boots £219
• Chemist4U £179

19 - If you want to switch suppliers, make sure you have pics of your Mounjaro box with your name and dose. This will come in useful when other suppliers ask for evidence.

1st thread:

https://www.mumsnet.com/talk/weight_loss_chat/5007744-mourjano-starting-soon?page=1

2nd thread:

https://www.mumsnet.com/talk/weight_loss_chat/5028495-continuing-murnjaropart-2?page=1

3rd thread:

https://www.mumsnet.com/talk/weight_loss_chat/5037623-continuing-mounjaropart-3?page=1

4th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5044316-continuing-mounjaropart-4?page=1

5th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5048290-continuing-mounjaropart-5?page=1

Thread for newbies just starting out:

http://www.mumsnet.com/Talk/weight_loss_chat/5057475-mounjaro-and-wegovy-newbies-april-2024

My dh has taken both boxes in from pharmacy2u and not realised it’s discrete packaging.

lol.
when I received it last month he was already at work lol

I did my first gym session since moving up to 5mg and felt really dizzy. Low blood sugar. I mostly do weights but some box stepping cardio made me feel grim. I had a chocolate cookie afterwards. I had no issues on 2.5mg.

On the plus side my PT remarked on my weight loss for the first time.

My husband knows I'm doing it but my postie knocked with my 7.5 this afternoon and was asking "is this medicine?" So I said yes. He asked "does it go in the fridge". Yes. "Funny, I've got a couple of houses on my round who have medicine delivered but this box looks bigger than theirs". This was all in front of my husband as he saw the ring notification so came downstairs which is right by our door so heard the entire exchange. Something to be mindful of for those wanting to keep it private.

I was pleased it wasn't in front of my eldest who came home from school today saying "I want to lose weight" ☹️ he's 7 and definitely doesn't need to! I'm really careful what I say in front of him and we sit down to eat our evening meal together and I really do try to model healthy habits such as everything in moderation, veg and lots to drink etc etc so I'm hoping it's just one of those things kids say.

Had an email back from MedEx after my order earlier just asking me a few more questions about my starting weight and when I started taking the 2.5. Hopefully a good sign, I didn’t expect anything from them til next week to be honest

Try the tracking again later, it can take a while to register.

This is exactly my experience, including the chase email today!

I think I may need to leave all the Facebook forums!! They are driving me mad. There are some really disordered behaviours with the focus on the speed of the weight loss like it's a crash diet!

I've been off with flu this week so have really fallen down the internet rabbit hole this week. There's a real difference between the American way of looking at this drug and the way some people here are viewing it. Lots of Americans are now in maintenance and it's interesting to read about their exit strategies, with many of them recognising it may be a life long drug. Prescribers here really need to prepare for this as they can't just switch it off when people reach a healthy bmi! It's needs to be done so carefully! I'm hoping there will be more evidence based guidance over this soon as it's so vague and is making me anxious. I know full well that my menopausal metabolism isn't going to suddenly reset when I hit a healthy BMI.

The menopausal thing is such a tricky one. In the old days, when half those incredibly slim women suddenly became plump despite no other change in lifestyle, it was just accepted. Now there is so much focus on being slim for health and the sort of internalised fat phobia that MN is full of, we feel pressure to fight this, even if (as is obvious to many of us) that might mean excessive calorie restriction and potentially nutrient deficit. But the odds are stacked against us once we come off this drug.

@izzy2076

Unfortunately the drug companies (like the weight loss companies!) don't really want anyone to keep the weight off successfully so they are unlikely to do any studies on how best to do this other then stay on a maintenance dose for life!

There was one study that was useful though from one of the universities about how exercise can help, you can find it here:
https://www.medicalnewstoday.com/articles/exercise-helps-keep-the-weight-off-after-stopping-glp-1-drug-treatment

I worry about this too. I hope they approve it for lifetime use if we want that.

I also don't think I will be magically fixed of the reason I gained weight in the first place. I am pretty sure I have insulin resistance and I don't believe I will be fixed of that if I come off MJ.

On another topic, I have noticed more places offering discounts. Zava discount codes, Voy codes without referrals... I wonder if this means the prices might start going down already. Or better deals etc

Insulin resistance though does improve as you lose weight. That is what Metformin helps with. Despite all the tutting about fat people bringing T2 on themselves, the vicious cycle of insulin resistance making weight loss harder/weight gain easier, so people who are already at risk of T2 then becoming heavier is often ignored.

Wouldn’t it be great if it was easier to get insulin resistance tested and treated?

@lurkylurk I'd be quite happy with taking a maintenance dose for life (say every two weeks) if it offsets the risk factors that accompany being obese. It's just that the NICE guidelines haven't caught up with the fact yet that these drugs aren't a cure and they are still advising a two year limit, which is madness and goes against what the manufacturers themselves are saying about it being a life long drug.

The lack of advice around this worries me. Being menopausal, I know my weight gain is due to a hormonal imbalance that will never be fixed with CICO and willpower. The same for a lot of people with obesity.

@Wonkypictureframe totally agree with you on the testing for insulin resistance thing!

I am so grateful for how balanced and sensible these threads are. The advice and support shown here is invaluable.

Too many discussions around weight loss focus on the shamefulness of being fat and the desire for speedy weight loss at the expense of health. All of these things just feed the horrible and complicated mess that is obesity.

That's a long winded way of saying a big thank you to everyone for all that they're sharing here.

I have been really hungry this week on 2.5mg. really not sure if it actually injected or if the bonus dose of 3+ has raised resistance.
BUT the amazing thing is I'm ok being hungry. Haven't fallen back into old snacking habits. I have never gone this long (6 weeks) without a sugar binge. It's remarkable.
I think I'm going to try a slightly higher dose from the 5 pen without doing a full 5. Maybe 3. I haven't lost any weight this week but I'm down a stone since I started so can't complain at all . I'm now on the cusp of a healthy BMI and I am really hoping to see the scales hit the 8s for the first time since I was 17. I do need to start going to the gym and exercising and that may help with the loss but fitting it in is just so difficult.

@Losingmymind85 I think it's good not to cancel out the food noise completely! A reminder that this isn't just a sticking plaster and that we still need to listen to our bodies!

I’ve really enjoyed being on here and the focus on health. Lots of people clearly very clued up and educated.

Whoop. Managed to get it sent to the post office down the road.
Ill collect Monday 😄

I agree with what others have said - these threads have been so helpful. I can’t imagine struggling through this journey without the information and support here. Thanks everyone!

I agree! I'm definitely coming off the fb forums and come on here more often!

I would just like to add another reason why I want to stay on this long term. The effect on my peri symptoms! Previously, I've only been able to cope with 2 squirts of hrt as a third would mean instant bloating and boob pain. Now I can slather it on. Mood is stable. No awful PMT. No hot flushes. More energy. Sleep is also better after the first month of insomnia. I don't know if it's helping the hrt work better or if it's doing a better job than the hrt!

I'm on day 7 of my first 3.75mg dose and still feeling good appetite suppression/reduced food noise. I'm assuming it's the increased dose, but I also did the injection in my thigh last time for the first time. Not as nauseous the last few days.
I may push back a day and do the next dose Sunday. I'd brought it forward twice as I started on a Wednesday.

I started this with over 5 stone/30kg to go to the top of a healthy BMI and 6 stone to where I'd like to be. I've still got 4 stone to go until my BMI drops into normal. It feels like a long slog and not that long ago in my head that I was in that range (actually about 6 years!), so thinking of it taking until the end of the year is hard.

However, the time will pass anyway. That's what I keep telling myself.

@izzy2076 I think it's definitely doing something.

I'm wobbling on the edge of peri menopause, insomnia and anxiety were really starting to take hold. But now I'm feeling so calm and am sleeping like a log. The overall impact is incredible.

Everything just feels balanced.

@MountKilimounjaro yes. I think there's a lot more to it than just suppressing appetite! My hormones have never felt so settled. To the point where I would use this for HRT alone! I take citalopram for PMDD and I honestly forget to take it and will come off it. It's a real education in the effects of hormonal imbalance.