Continuing Mounjaro...part 15

[ObsidianTree]

Please note: Mounjaro will only be be prescribed initially if your BMI is above 30. If you have additional health conditions you can get the medication with a BMI 27. (Prediabetes, high blood pressure, high cholesterol or heart problems)

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 - Some people find that they don't need to go up a pen dose each month if the current pen dosage is working well for them. If you are unsure when to go up, speak to your prescriber.

8 - The move up from 2.5mg to 5mg can be quite a shock to the system. Some people chose to take 3.75mg dosage for a few weeks to ease the transition.

9 - If you are having bad side effects after titrating up or you are struggling to eat your calories each day, your dose may be too high so should consider lowering your dose. Speak to your prescriber if unsure.

10 - 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

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

12 - 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

13 - Protein is important as eating less protein can cause muscle wastage and hair loss.
Some natural sources of protein:
https://www.bbcgoodfood.com/howto/guide/best-sources-protein
https://www.medicalnewstoday.com/articles/321522#high-protein-foods

14 - 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.

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

16 - 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.

17 - 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
further reading about injection sites and the effects: https://www.medicalnewstoday.com/articles/316618

18 - 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.

19 - 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.

20 - Some of the places you can order from are:
MedExpress:
2.5mg and 5mg. £149.99. 7.5mg £169.99, 10mg £189.99. 12.5mg £209.99. 15mg £209.99 Coupon codes no longer working!
The Family Chemist:
2.5mg and 5mg £149. 7.5mg £169, 10mg £169, 12.5mg £194, 15mg £199
Zava medical:
2.5mg £139, 5mg £139, 7.5mg £169, 10mg £189. 12.5mg £204. 15mg £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, 15mg £199
Asda:
2.5mg and 5mg £179. 7.5mg £189, 10mg £189, 12.5mg £204 15mg £204
There are others not listed.

21- You will still be prescribed Mounjaro when your BMI falls below 30. However, it may be harder to move suppliers once you BMI is below 30 if you wanted to move.

22 - Worried about your supply being cut off when you get to a healthy BMI? Below is some info on some places maintenance plans.
The Family chemist :Would consult you as approached healthy BMI to discuss maintenance under close supervision(if you started with family chemist)
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 and does offer maintenance
Zava:Once healthy BMI will stop prescribing this treatment
Med Express: BMI 25 and cut off.

23 - 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
14th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5102149-continuing-mounjaropart-14?page=1

Thread for newbies just starting out in July:
https://www.mumsnet.com/talk/weight-loss-injections/5101435-mounjaro-july-2024

Video on how to inject:

I also see @Slimstar13 's point and have also seen posts of faking bmi etc. I don't at all think everyone does it and for some I understand why but she is entirely correct to point out that it isn't correct and I feel a little unfair and very unsupportive to her to suggest she finds elsewhere to post just because she was honest and aired her concerns.

We all have to be much more aware that what we post might seem to us like a bit of advice but someone could take it as medical fact which we are not qualified to make, and do harm.

I admit I’ve taken a step back as I hate all the chat about faking BMI and stockpiling. It’s horrible to read (for me)

Context is everything.

Do you really think embellishing my BMI by less than 1 point to switch provider's is that bad? 🙁

I was already on the medication and would have still been on the medication, perscribed at my then BMI regardless. It was about changing provider whilst at BMI 29.2.. not me trying to obtain drugs to take below BMI 25. I wasn't even upping the dose, I was just buying a second 7.5mg pen.

I feel like I'm being lumped in with irresponsible abusers of the medication and that makes me feel quite sad and not want to stick around and read any more.

I've really enjoyed being a part of this community throughout the months so thank you for everything Obsidian and the rest of you. You've all made my MJ journey super enjoyable ♥️

@BlackFriYay defintely a non-issue embellishing by 1 point to get it cheaper. This is expensive stuff.

I will remove the information about splitting doses in the starter post. Don't want to upset people for stating what others do.

It's up to the individual if they want to split doses etc. People aren't doing it to be reckless, if anything they are being sensible and trying to avoid strong side effects. Asda recently emailed saying if you can't eat etc then you should go back down doses etc. I certainly split doses when 10mg floored me so I chose to split the doses so I could build back up gradually.

I think people have their individual reasons for doing what their doing and we shouldn't judge others. I haven't seen anyone on here say they are doing anything extreme like is seen on Facebook all the time.

Yes I have seen people say they lied a bit to get another pen etc, but considering pescribers cant seem to make their mind up on their maintenance plans I can see why it's happening. For those that started right at the beginning and are now in limbo as to whether they can stay on MJ when they get to a healthy BMI, it's worrying for them. I'm sure most of us can say they would not want to get cut off when their BMI reaches 25 and wants to be able to go come off the drug at their own pace if they have to. Which also explains why some of us have built a bit of a stock pile.

The way people eat is up to them. I haven't seen people on here saying they live on junk food so think thats unfair judging us on this. You cant judge people if they happened to have a takeaway as a one off! Everything in moderation is fair and we shouldn't judge people for that. Mostly I think people are very sensible with their eating on here.

As far as I'm concerned we are all trying to do things as sensibly as we can and we should continue to support each other.

I’m not going to get into a conversation about how many BMI points is okay to fake because that’s a path to madness.

Ultimately, we are all responsible for what we post and also our reactions to posts. if I read something on here that makes me feel sad/angry/happy/pleased, that’s on me. It’s not the responsibility of the poster to gauge our emotions.

We know if we’ve posted stuff that is potentially dangerous nonsense (and I imagine if people recognise that in themselves then it makes them feel defensive and that’s when they start to insinuate that some posters are perhaps not welcome on this super supportive non judgemental thread - can anyone see the irony?!) and I guess people don’t like being reminded of it.

We all have the same goal, but we’re not all on the same journey.

Yes i have had a few days off eating higher calories and its been successful for me and that's despite it being unintentional wagon falling half the time rather then deliberate and controlled. I wouldn't say i was eating unhealthy either just normal 'high' carbs (i keto when i diet) but i certainly indulged, pastry and chocolate featured.

The real trick is getting back into the groove and being strict and deliberate about that. MJ certainly helped at all stages as i just didn't feel i had the same capacity that i used to. Its difficult to binge eat if you have to stop in the middle of the first slice of cheese cake. I did enjoy big portions but regretted more then usual as felt full for ages. Lean from my mistakes. If you do this, then plan out a day or two of lovely meals, in moderate portions but enough where you will still feel like you are spoiling yourself.

I had some of my favorite meals, bangers, mash, red cabbage and peas, I had rice with my curry, I ate gelato at the new italian place round the corner from us. Not what someone would typically think of as unhealthy but it was great not to have to think about my choices for a while.

I have a posh event next week with an expensive dinner included. I have been focussed on losing as much weight as possible before hand but i do plan on enjoying myself fully, even ensuring its the day before my jab so i won't feel very suppressed.

@AgathaMystery and @30not13 You're right. I didn't mean it to come across as saying people aren't welcome here. People are welcome and we should be able to have these discussions. I was trying to say that it's unlikely this thread will never have things said that other people don't disagree with and you probably won't find that anywhere else.

Personally I find the constant voucher codes clutter. 😉 But as with any thread and forum, if a post doesn’t interest you, scroll by.

This is now a very busy thread. Back on thread one when MJ was new and had been out for about two weeks it took us ages to go through a thread. We were all new and learning and sharing together.

I think we fly through 1,000 posts in less than a week now?

People are doing what they can as they are adults. I’m sure most prescribers are doing it as a tick box exercise anyway.

@FlappyFish yes this. I think it would be impossible to have these threads where everyone is happy with every post.

I've not outwardly indicated stockpiling but I've ordered a 10mg / 12.5mg combo from ZAVA with a code and will be staying on 5mg till after holiday as I'm losing 2lb a week on average.

I've got my 7.5mg pen from medexpress that expires in 2025. I'll order from where the best deals are to stay ahead although am running out now.

Please don't take it to heart @BlackFriYay and others. I've been following this thread for ages and it's nothing but super supportive.

@ObsidianTree does an amazing job of keeping the first post up to date and other than that, we're all adults.

Maybe there is a small word of caution that people who are here for a quick fix or to cheat but that's on them. Not us.

Sometimes people will say things like ‘if people mess around with it we’ll end up with greater regulation/face to face appointments’ etc, as though we’ll all see that as a bad thing. Actually I’d welcome more ongoing support/regulation, as then we wouldn’t have to make our own decisions regarding things like titrating up the doses more slowly.
For example I’m on week three of 5mg and am experiencing almost complete appetite suppression; it’s a challenge to eat. I don’t want to go up the doses yet, but I would rather not go against the dosing schedule without professional guidance. I’d love to have someone qualified to ask! It would also help massively with maintenance.

@ItsAlrightDarling can you ask your prescriber about what to do? In asdas email last weekish they said if you can't eat then perhaps you should go down a dose. I wouldn't go up to 7.5mg if you can't eat on 5mg etc.

Has anyone got that email from Asda? I never got it weirdly, but it's good information and would help support the advice we give on here!

Yes I’ll email them before ordering my next dose and see if they’ve got any advice. I’m with MedExpress at the moment.

I did want to post about my NSV earlier but got caught up in the drama 🤣

I should really wait until Saturday when I do a weigh in post, but can't wait!

I am 1lb away from my lowest weight on keto back in 2020/21! (13st 3lbs) When on keto it took me nearly a year to get to that weight. As with keto, when you have a day off and eat carbs the weight goes back on quick and once you eat carbs its so hard not to keep eating them! So a lot of weight ups and downs in that year! On MJ it's been about 6 months. Counting from Jan before MJ when I lost a bit on keto.

Once I get below that weight, I will be at my lowest since before having my first born who is nearly 11!

I guess my next mini goal would be to get to my lowest when I did a shake diet in my 20s which was around 11st 7lbs. First time I have felt it's achievable! Thank you MJ!

Has anyone else not set a goal weight?

I've been overweight since I was about 13, so no range of "normality" to aim for.

@ObsidianTree

That's amazing! Are you planning on doing keto to maintain? I lost 4st doing keto but stalled.

I'm trying to at least do IF and after September will ramp up both. And get back to running. I'm still too heavy to run yet.

@30not13 I've set a goal, in fact I've had 7 mini goals as otherwise I think I'd have felt overwhelmed. My goal weight isn't what I was in my 20s and trying to be through my 30s though, I figured I needed something that was much more realistic.

Mine changes every time i type it. I think i would be happy with anything below 11stone so just aiming for that currently. I think it really depends how much you have to lose and its healthy to think in mini goals that are achievable in a time frame that is relatively soon rather then thinking 6month, a year, two years as that can be disheartening.

@30not13 no goal weight for me yet. A bmi of 25 which I haven't had for 20+ years is my main goal.

Then I'll assess 😀

I didn't start with one as it does seem like a mythical thing getting to a weight you could never even imagine!

I think I will aim for BMI 23 as that's what I am allowed to get down to due to my ethnicity. So that's about 11st for me.

I haven't set a goal weight. Starting at over 18 stone it was too much to contemplate the amount I need to lose to get into a healthy weight range.
I'm just going to see what happens.

@30not13 I haven’t set a goal weight either. To be in a healthy BMI range, I would need to lose 7 stone and that is just incomprehensible. I don’t think I have ever weighed that little since the day I first stood on a set of scales!
I am not a huge believer in BMI though as I am a fairly muscular build but we shall see.

I don’t really have THE goal weight…I have many goal weights I’m striving for but not sure if they’re all doable/reachable.

For example, I started at 107.2 kg, right.

My first goal was 99kg.
My second goal is 95 kg. (Getting closer)
My third is: 89 kg
My next: 85 kg (yay hello OVERWEIGHT!)
Next: 80 kg

I’ve not been 80 kg in 15 years!!!

I want to believe MJ and I can do it, but I’ve not seen that number in sooooo long!

If we want to get real aspirational, my next goal would be 73 kg (juuuuuuuuust squeezing into the veeeeeeeery end of the HEALTHY BMI).

And if we’re reaally going for it with the big bold dreams, my ultimate end goal of all goals would be 65 kg. Which I’ve not been since high school!!!

Realistically, I am chuffed with any and all changes, I have been around 90-89 kg in the past 8 years, constantly losing the weight only for it to pile back on. I feel like once I get back down to that, I can really see what is possible for me.

My overall goal weight is lower than I will be ‘allowed’ to get to on MJ, so I have an MJ goal weight and a ‘doing it on my own’ goal weight. I’m setting mini goals in the meantime though (next one is below 70kg), as it helps me physiologically. I am also rewarding myself when I hit a goal, so for example I had a pedicure when I lost a stone!

@Slimstar13
Whilst I sympathise with your concerns around misuse this is an area of developing research. Research on Semaglutide suggests that rapid stepping up through the doses may not be the best approach for maintenance of losses. Similarly, titrating off the medication appears to better a hard cut off.

I think if people are making rational decisions to take the lowest effective dose of a weight loss medication that is very different to someone underdosing on something critical for health like blood pressure or heart medication.

I agree that hard cut offs around appropriate BMI, contraindications like eating disorders, maximum doses make perfect sense. However, people should be able to choose the lowest effect dose of a non-critical medication.
https://easo.org/is-coming-off-semaglutide-slowly-the-key-to-preventing-weight-regain/