Continuing Mounjaro...part 14

[ObsidianTree]

Please note: Mounjaro will only be be prescribed initially if your BMI is above 30 until you get to a healthy BMI of 23 to BMI 25

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. Also below you can plot the effect of your doses.
https://glp1plotter.com/

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 that 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, vomiting, headaches, aches, are side effects. There may 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

Also there is a 5th dose in each pen. To extract it you can either try a hard twist or use an insulin needle.
https://medbasic.co.uk/bd-micro-fine-30g-1ml-syringes-needles

10 - Protein is important as eating less protein can cause muscle wastage and hair loss. Try to have at least 100g a day.

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

11 - 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), psylum husks(fibre for constipation), electrolytes.

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

13 - 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.

14 - 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

15 - 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.

16 - 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.

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

Zava medical:
2.5mg £139, 5mg £139, 7.5mg £169, 10mg £189. 12.5mg £204. Zava offer refer a friend discount of 15% off. Ask for a code on here.

Simple online pharmacy:
£149 2.5mg, £149 5mg, £169 7.5mg £189 10mg

Bolt pharmacy:
2.5mg £149, 5mg £149. 7.5mg £169, 10mg £179, 12.5mg £199

MedExpress:
2.5mg and 5mg. £149.99. 7.5mg £169, 10mg £189. Coupon codes no longer working!

The Family Chemist:
2.5mg and 5mg £149. 7.5mg £169, 10mg £169, 12.5mg £194

Asda:
2.5mg and 5mg £179. 7.5mg £189, 10mg £189

There are others not listed.

18 - Worried about your supply being cut off when you get to a healthy BMI? Below is some info on some places maintenance plans.

MedExpress: Once at healthy BMI continue on maintenance dose for 6 months and then step down medication and monitor loss
The Family chemist :Would consult you as approached healthy BMI to discuss maintenance under close supervision
Curate: up to 2 years
Cloud: up to 2 years
Boots: Cut off at BMI 23
Asda: Cut off at a healthy BMI
Pharmacy2u: Will supply for maintenance
Bolt:Individual assessment once BMI 22
Zava:Once healthy BMI will stop prescribing this treatment

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

6th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5057916-continuing-mounjaropart-6?page=1

7th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5062935-continuing-mounjaropart-7?page=1

8th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5068850-continuing-mounjaropart-8?page=1

9th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5074054-continuing-mounjaropart-9?page=1

10th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5080755-continuing-mounjaro-thread-10?page=1

11th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5085436-continuing-mounjaro-thread-11?page=1

12th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5090788-continuing-mounjaro-thread-12?page=1

13th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5096704-continuing-mounjaropart-13?page=1

Thread for newbies just starting out in June:

https://www.mumsnet.co
m/talk/weightlosschat/5082791-mounjaro-june-24-starters

Video on how to inject:

Wow this thread moves fast!
Not been able to read the last few days due to work and life and have fully caught up this morning.....has taken me 2.5 hours.

As someone said, this thread is like a bible! So much valid and helpful information. Thank you everyone.

I was particularly interested in the protein chat. I find it a real struggle to reach 100g.
I'm trying to eat as normally as possible now. I've done keto in the past and really loved it. I felt great, I enjoyed it and the weight fell off.
HOWEVER, as soon as I started to introduce the "forbidden foods" the lbs just kept creeping on. Then Christmas came, my father got sick and died and it all fell apart.

This time round, I'm trying to eat more normally with the hope of keeping it up when I reach my goal. I know that protein is important to a point but I simply cannot have all my calorie allowance in protein. I want to enjoy other things too.

I've a long way to go, having "only" lost 10lbs in 5 weeks on 2.5. I'm still delighted with that. I simply cannot face the questions and judgement around the fast losses.

I've a 5ml in the fridge and am going to step up to 3.75 this week to see how I go.

I am absolutely terrified about how maintenance looks. I dont want to be on this drug forever..........I doubt my finances will allow it. I'm using money allocated for savings every month and dont want to continue that indefinitely!
I want to train my mind and body to be able to do it without the drug. Just need to think like other slim people (she says hopefully!).

Sharing a Voy code if anyone wants it.

https://joinvoy.com/r/U-bGZ0yk9ZRm

Also a Zava code if anyone needs one.

There’s no better gift than the gift of good health. Use my code and you’ll get 15% off your first order at ZAVA: REFJZZFF
www.zavamed.com/uk/?utm_medium=referral&utm_source=refer_a_friend
Maximum discount value: £30

So I've taken my third 2.5mg and ordered my 5mg pen. Zava have sent a load of questions about my liver function. Bloody annoying as it's no difference to last order just a different doctor. Now it's been put on hold and I'm waiting to see if it's sent out today. I needed it tomorrow as someone will be home and it's then the weekend.

Anyone else been put on hold pending medical questions and did it get resolved quickly?

I wanted to upload a screenshot of this but Mumsnet says I have no photos 🤔

Anyway with all the talk about a maintenance dose when you teach goal, Voyager says this on their app:

Deciding what to do. It's safe to stop the medication at anytime or reduce the dose gradually. It's up to you how you'd like to transition back to life with the medication.

I notice on reddit mounjaromaintenanceuk that MedExpress is being discussed again. There may be hope

Just done my 8th jab.
Currently on 5mg dose with a 7.5mg in the fridge.
I’m following the protocol of moving up each time I need a new pen. I will re-assess when I get to 10mg.

I have a lot to lose so want to get up to the tested therapeutic doses ASAP.
My initial GW is higher than some of your start weights! But I haven’t been 14 stone for over 20 years and I’m tall at 5’9.
BMI calculators say I should be 10stone something to have a normal BMI but I weighed over 10 stone when I was 11 years old! 🥴

SW 17.10
CW 16.8
GW 14.0

Currently using ZAVA - here is my referral code if anyone is looking!
REFUM535

What insurance was this for?

I think life insurance takes in the risk at the time so don't need ti report changes.

This may be controversial but looking to build a little stock...I currently seem to be living box to a box, like I can't get to the point where I have 2-3 boxes at the ready. I'm with medexpress, so ordering every 2 weeks. But they are spenny. I tried zava but my request was stuck on processing for the past 3 days, and I can't be dealing with the slowness. Anyone recommend any other provider? And could I have 2 on the go?

Isn't 5mg a therapeutic dose?

Also interested to know who doesn't notify the gp as I don't want mine to get arsey with me having two suppliers.

Is 'spenny' expensive? Anyway, I'm going to try the same and get my first 7.5 from Medexpress, for the last time, and move to Oushk at the same time (good attitude to maintenance as per yesterday's post) so will be a pen ahead (I hope) as I'm thinking there's no way systems will be so efficient that 2 pharmacies will compare notes about simultaneous orders. I'm entirely confident that my GP will be totally disinterested in how much I'm being prescribed!

Also re the 1lb weight loss. I've made peace with mine now as I'd have to only be eating around 900 calories a day to get a deficit to lose more each week. I'm really not prepared to eat so little and risk not having a healthy functioning mind and body.

Haven't been on here in over a week so checking in. Due to take my 4th 10mg tonight. Losing 1lb a week on 10mg. Contemplating staying on for another month... I've been quite a slow loser so 1lb a week is quite good for me.

Just for info. For anyone wondering about the provider Pharmulous. I have just received my second pen from them with no issues. Free delivery and sharps bin included if you want it.

I am absolutely terrified about how maintenance looks. I dont want to be on this drug forever..........I doubt my finances will allow it. I'm using money allocated for savings every month and dont want to continue that indefinitely!
I want to train my mind and body to be able to do it without the drug. Just need to think like other slim people (she says hopefully!

I think a lot of us can relate to this.

Yes but the largest % losses were seen at 10mg and 15mg doses in the trials so if you have a lot to lose (like me) and there is a potential restriction on how long they can prescribe for, I’d rather crack on.

Just listened to a very interesting podcast from Zoe (most recent one) which interviews Dr Louis Aronne who seems to be at the forefront of research on obesity and on weight loss drugs. Very interesting on why eat less, move more doesn't work physiologically once you have been obese for any length of time.
.
Two main take aways on drugs: 1. more efficient drugs leading to greater weight loss (circa 30% of body weight) in the pipe line. 2. The vast majority of people on weight loss drugs that get to their goal weight will, over time, regain the weight (5/6ths). His view is that once the damage to the various pathways is done, obesity is then a chronic disease and he thinks that continued intermittent use of the drugs is the way to go.

He did also say that there are animal studies suggesting it is possible to reverse the damage but this is yet to translate into anything for humans.

I hope I haven't misrepresented him, but it is worth a listen.

@Ivytheterrible good point.

In the trials did they record things like appetite suppression and the correlation with weight loss? Or just recorded the weight loss?

Just wondering if people should be moving up even with good suppression in that case, or if the trial participants found little or no suppression or suppression waning and that's the reason they lost more at higher doses.

Also what's the correlation between calorie consumption on each dose and weight loss in each dose. Maybe they lost more as they started eating less as they thought jeez this drug isn't working as fast as I'd like better cut my calories some more 😂

It's a complicated minefield really. Move up or don't move up. Stick at the dose and risk no weight loss. Etc etc

I need to read the research 🧐

Thanks to all of you on here for all of the information - it’s a VERY different place to the FB groups 😂
Am on day 1 of my second 2.5. Had a great first week with minimal side-effects and a loss of 7lbs😱!

SW: 16st 12lbs
CW: 16st 4lbs!!!!

Woke up fairly hungry this morning and usually meet a friend for breakfast (which is always a 7 piece cooked breakfast plus toast! 😩) so was a bit worried I would cave BUT (for the first time ever!) I ordered a 4 piece without toast! No cravings for bacon, beans, toast none of it! Cannot believe it!

where has this wondrous stuff been for the last 40 years of my life?!? 😁

Here’s my Voy code if anyone is looking for one - £85 off for you and a discount for me👍

joinvoy.com/r/U-JEMB7cPnsU

Yeah have a read of the research. Originals and summaries are all widely available online.

I suspect the answer is ‘it depends’ as we are all different and we can see on these threads how people respond very differently.

I’m quite a ‘big’ person, some may say statuesque! Tall and broad as well as fat! When taking anti-depressants a few years ago I had to titrate to a huge dose until it had any impact on me so I wonder if this could be the same.

I've still got another 5 pen in the fridge as I've been sticking with that as I'm getting excellent appetite suppression but may move up to 7.5 to see if that makes any difference to the actual weight loss

Just to add to the protein chat! I increased my protein a good while ago when weight training. I find having eggs for breakfast, a couple of baby bels for snacking, a protein bar ( fulfill salted caramel is yum), protein pudding / yogurt, tuna or chicken salad for lunch, and some kind of meat for dinner normally gets me there! I appreciate not everyone wants to eat processed bars / puddings but it's gets me my sweet fix so win win! Expensive though - I buy the bars on Amazon. They're really filling and delicious!

I fully appreciate this will be harder on a reduced appetite!

1. The vast majority of people on weight loss drugs that get to their goal weight will, over time, regain the weight (5/6ths). His view is that once the damage to the various pathways is done.

That is thoroughly depressing. 😫

It was a bit. Just have to hope we are in the sixth that don't! The rate of regain was relatively slow if I understood him but seems to involve the body desperately trying to get back to the previous weight.
However, he did say there were long term benefits in reducing the likelihood of diabetes even if the weight was regained.
My hope is that, as more is understood about the chronic nature of obesity, we will be able to access the drugs to use on and off as he suggests rather than having to get obese again first.