Continuing Mounjaro...part 17

[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! Make sure the needle is twisted on tightly. Priming will help confirm if the needle is on securely and not faulty.
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 - 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.
9 - 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
10 - Taking Mounjaro can stop birth control from being effective. If you are on birth control, consider extra protection if you aren't planning on conceiving anytime soon!
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. Try and drink at least 2ltrs a day.
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
15th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5107426-continuing-mounjaropart-15?page=1
16th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5115015-continuing-mounjaropart-16?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 don’t know, but I’d like to know the answer too

I really hope it boils down to the choices we go on to make. I think/hope I've successfully addressed all of the factors that lead to my 4 stone weight gain, and that will hopefully put me in good standing.

The things that lead to me becoming obese were a series of individual things;

Three pregnancies in 5 years.
Depression leading to a sedentary lifestyle.
Going onto meds that cause weight gain.
Enormous portions of carby dinners (far too much pasta)
Using chocolate as a crutch and going through atleast one share bag / bar every night.
Avoiding stepping on the scales for years

Changes I've made (or am making) now;

We're not having any more children, ever
The Depression has been addressed and resolved
I've weaned down off the SSRI and propanolol and I'm almost off it all.
I'm a lot more active.
I've knocked the chocolate on the head.
I'm keeping track of my weight.
I've learned what normal portions look like 🥴

Looking back I can see that at least some of the gain was completely preventable, even if it didn't feel like it at the time.

I consider myself to be fortunate in that I don't have any long term health problems that wreak havoc with ones metabolism, atleast not that I'm aware of.

I'm 11.5lbs away from my goal weight so I'll be going it alone soon.

Fingers crossed.

@BlackFriYay That's brilliant and actually writing it down like that helps. I'm going to do this. I'm going to write down why I've had a problem with my weight. Initially it was postpartum after first pregnancy and low mood. I gained weight and I never lost it I managed to maintain the same weight for the past lot of years. I never really put much effort into dieting etc because when I don't get results I just give up.

I've had some gastric symptoms on MJ so far which are annoying but worth it for now as I'm losing and feel much better

@Forevafatty I take the solgar ones which are 500mg. 2 every day and I’ve not had any issues with constipation.

@BlackFriYay my guess is back to old eating habits. I’d hope though that this journey was sufficient different than previous diets/weight loss and maybe something will stick?

@BlackFriYay @StrawberriesandMango when i try to loose weight I track my weight, keep a diary and meal plan. I think I need to continue these tools into weight loss. I’m fact throughout this I have had a series of mini goals to achieve so I didn’t get overwhelmed, maintenance has to be the final goal doesn’t it. To maintain a certain weight for a prolonged period. Something I’ve never managed before.

I am really hoping that the providers of mounjaro start making a plan for maintenance soon. I wonder if using a private GP to prescribe for maintenance is one way to go? I've never used a private GP, but I will if I need to.

Definitely don't trust the body composition on renpho scales btw. I gained 2lbs of water weight overnight because of the hot weather, and then lost it all the next day. The scales reckon it was fat, and they showed my water composition was way down the day I puffed up.

Just saw some people are taking digestive enzymes and reckon it helps the side effects. Anyone tried this?

Hi @WannabeHealthier, I think the note from Pharmacy2U is just a standard disclaimer that they will only prescribe weight loss injections to people who are starting out in the obese BMI range (with or without co-morbidities). If you are a current patient they will look at your records hopefully.

I have ordered with them previously and received the same message when I went to re-order (however I didn’t re-order with them in the end as they’re too expensive)

I've been taking Berberine but no idea if it's helping.

My musings this morning.

I can't help but think we will be the Guinea pigs of the maintenance plan for GLP1 meds as it's not known what taking them for years on end actually does to a human as of now. I also wonder whether some of us will always be yo yo dieters but with glp1 meds instead of WW or SW etc. So you hit your ideal bmi come off the meds. BMI creeps up you go back on the meds bmi comes down you come off of it and repeat.

@susiedaisy1912 thats my worry, that none of this will change the fact I’ve yo-yo'd for 15 years and I’ll continue to do so. I’m going to try really hard not to gain again and this time I’ve probably spent more time thinking about maintenance than ever before. Maybe that will make this time different.

Maintenance is interesting...for as long as I could remember I was overweight/ obese ...and then I lost 5st with Ww and lots of running and strength training (not heavy but mainly body weight/ hand weights ...not sure if there is anyone else here that got caught up in the BBG craze?) .... I probably maintained for 6months although had already put on a few (but not loads of pounds ....due to wedding/honeymoon) ...then I got pregnant and everything went out the window because my main pregnancy symptom was that I was hungry all the time 🤣.....lost a bit between pregnancies (not loads) .... Then second pregnancy put me near enough where I was before ... So I never really got a proper chance at maintenance... Really in the time I did maintain what was helping me the most was being very active

Yes, similarly here:

COVID - I was working 7 days a week, 12 hours a day and basically inhaled biscuits etc. I was stressed and having a glass of wine most nights. That was chunk one of the weight. Then there was the vaccination program - same again but I hadn't lost the first chunk of weight. Those also meant I was extremely inactive as I was no longer walking to work every day (an hour of walking a day) and also I was busy and things were closed so I was very inactive. Then there was an addiction to crisps. I think I basically need to be cold turkey with crisps or pretty close to it. Then there was a perma addiction to UPF foods which I have massively cut down on. Then there was not getting on the scales for months at a time because I didn't want to know. Whereas if I find out after 3lb it is easy to resolve.

So for me, for the future it has got to be:

1. Commit to continuing to weigh myself every week minimum - need to work out how I create a mandatory accountability mechanism for that. Maybe give a friend some cash Ang they donate it to a cause I despise if I don't weigh myself?
2. Keep the crisps to near zero - maybe permitting myself a bag if I get a meal deal at the office (which is once a month ish) or something.
3. Same on biscuits/chocolate but these are a habit more than an addiction so tbh I don't feel any great sorrow having given them up. So these I think are a) no pudding unless you cooked it and b) if you want chocolate buy the posh stuff where 30g is enough
4. Exercise - I'm back in a place where I exercise regularly (and have been for a good 12 months now) so need to keep this up.
5. My diet is basically fine if I just eat meals and no extras but I do tend towards cheesy carby dishes and I think I need to make sure I intersperse them with some lighter ones. But hopefully commitment one will cover that one.
6. I think I need to remember that there's always something to celebrate and you can't eat out every weekend without considering what you're consuming without then having to be super careful in the week every week. I'm hoping that commitment one will mean I can manage this also.

Also when I did lose weight before while the exercise did help...it was diet that had the biggest effect ....I felt the exercise paid a bigger role in keeping weight off ...but I had already had that as a staple of my lifestyle by the time I hit goal ....but post putting the weight on while I am generally active (not always I do have bursts of being on and off due to less time due to children) ...it hasn't really moved the dial weight wise as the diet discipline hasn't been there ....I mean I ran the London Marathon this year (slowly) and despite the hours put into training the scale did not move (also because I was trying to fuel properly/ the long runs made me starving all the time!)

Wonderful scale victory for me this morning, I've broken into the 9's! I'm 9 stone 13lbs and my BMI is 25.7.

I've worked so hard for this and for the first time in my life I'm proud of myself. I have ADHD and never stick to things the way I have this time.

I haven't felt or looked like this in donkeys years, since before having my eldest son who has special needs. That marks the beginning of when I let myself go.

That sounds like a good plan going forward *Ineffable23 *

Like you, my reason for avoiding the scales was because I didn't want to confirm what I already knew. If I had kept track of my weight through the 4-5 years that I gained I'm sure I would have done something about it sooner, I was enabling my poor choice making by avoiding accountability.

For those of us who are not at the mercy of metabolic disorders or hormonal imbalances, accountability has to be a long term commitment in the 'moving on' part of the journey.

I am one of those of us who had instant appetite suppression with my first 2.5mg… along with a nice dose of nausea. The queasy feeling subsided after a fortnight thankfully as it was pretty debilitating. The feeling of string tied around my stomach stopped. I moved from having to force myself to eat enough calories and nutrients back to genuine enjoyment of food but still without the noise.

As is to be expected I’ve had some weeks with gains but my overall trend is down, if slowing.

After careful consideration I’m now gently titrating up. I took 3.75mg on Friday. And boy did The String return! And some nausea. But I feel more confident that I can manage it. I have some safe easy meals planned. I’m glad for those who have gone before sharing their stories of split doses. It feels the gentler thing to do for me. If it’s too awful I can drop back. If it’s working I’ll stay here until it’s not.

I’m 12lb into a 50(ish) journey. It’s going to take time and I want to build habits for maintenance from the beginning. I want to be able to enjoy food.

@BlackFriYay congratulations! That is an amazing scale victory!

I haven’t seen 9 something since my 20s and the consistent failure to get below 10st in the last 15 years is a stick I have beaten myself with. But I’m hopeful I might (in a few months) see it.

Well done you!

I’m on the stall bus headed to Stallvile. The last 3 days have been a slog. I’ve been going up and down the same pound, then had a little whoosh, and now two days in a row my weight is a little up. I chuck it up to the hotter weather, so hopefully it drops next week.

RE maintenance - it is something I’ve been actively thinking about too, like all of you, although I have a fair while until it’s a real topic of concern for me as still have a ton to lose.

My understanding from what I’ve read so far, is that people who gain the weight back are basically stopping the drug and continuing to eat whatever. I am a firm proponent of “everything in moderation” but I have seen so many people on other forums or TikTok discussing what they eat in a day on MJ and it’s rubbish. Fast food, takeaways, sweets. They’re happy they eat much much less and losing weight but that’s hardly a healthy diet. So, no, I’m not surprised that when they stop the drug they gain it back.

MJ is a tool, not a magic bullet. Yes, it makes it easier to make healthy choices while on the drug, but also helps to establish good habits - like eating three times a day; prioritizing protein, fiber; drinking plenty of water; laying off the less healthy options; portion moderation.

Everyone I’ve read about who has stopped MJ and continues with healthy lifestyle has either lost some more weight, fully maintained, or gained a negligible amount (less than 5-6 lbs).

The thing with GLP1 meds is you need to see it more as a medication for an ailment rather than a way to get slim.

Obesity and Diabetes are two sides of the same coin, both caused by insulin resistance. If you come off the med or reduce quickly, you aren't really giving your body time to recalibrate and regulate insulin production so even when you eat well, you may find your body starts to struggle to process the glucose (energy from food) again and begins storing it as fat. You may need to explore insulin resistance further and find ways to treat it outside of Mounjaro.

Most people can reverse their insulin resistance but rushing off Mounjaro may be counter productive if you aren't making a lifestyle change and have relied on eating your old diets but just smaller portions as inevitably when appetite suppression goes, portion size will increase. Unfortunately some people will really have to strip their diets back to prevent a return to the insulin resistance state (hopefully this is rare, I heard a podcast of a lady who's diet is heavily restricted to healthy fats as her body just does not process glucose well!).

Also, your body will need some time to reset your new 'set weight' point. Studies have shown that it can take anywhere from 1 year to 6 years for your body to adjust to a new weight.

@3wDavid I completely agree.

Since I started MJ 10 weeks ago, I have stopped eating UPF’s, sugar, high carb meals and switched to meals cooked from scratch with plenty of veg, salad and fruit.

I rarely drink alcohol but had a few drinks on holiday and a couple of cocktails on my birthday.

I’m feeling so much healthier and building good habits that will hopefully stay with me through maintenance 🤞

@OnInstagramAsMounjaroJourneyUK I’ve seen the 1-6 years until your set weight changes a couple of times recently. I find it a bit dispiriting that it’s that long. But knowledge is power! if it is to take that long knowing is better as can work more fully on it

Is there a reliable way of knowing whether you're insulin resistant, for non diabetics?

@BlackFriYay I'm interested to know this too.
I was borderline prediabetic a few years back and shoved off without any other information from the surgery other than 'eat less carbs' which wasn't helpful as I then spent subsequent years beating myself up and yo-yo dieting. A little information from them about levels and how to look into testing for other things would have been nice. Seems they just wanted me to go it alone so I wasn't their problem.

I have found the higher the dose the more I can lose. When starting I was losing around 3lbs a week, now I have weeks where I have lost 5lbs a week.

Just wanted to share that I am just back from a 3 week holiday and have lost 4lb while away. I took my pen and used it as normal and this helped me continue to make good food choices. It was also so hot and humid that despite me taking psyllium husk I am bloated and things have 'slowed down'. I'd be delighted if I get a small whoosh when my body realises we're back to the cold weather of home 😂.

I've stayed on 2.5mg as didn't want to move up while away. Flab jab day today and I'm going to move up to 3.75mg. Wish me luck

Lastly, I'd like to buy some spare pen needles for bonus doses but am bamboozled by the choice. Can anyone link to any they've bought that are the right size and are nice and sharp?

Just also wanted to say thank you to everyone for this thread. I read it every day and I always learn something.