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:

Its so annoying! I have a short body so it's hard to have much of a waist anyway!
In the past I have just lost all over, but it looks like body and boobs will be the last flab standing!

@3wDavid
Thank you for your kindness and good sense.

@montysma1 You are so right!! I’ve noticed it too. Around my middle and back. I’ll see what it looks like when I reach my goal weight and adjust if I need to. I do need to introduce exercise which I think that will tone me a little. I’ve got Mounjaro bum though, that’s disappeared, which doesn’t make unhappy.

I did my first injection last night. 8 stone overweight so really hoping I succeed with this. Trying to get my head around what kind of diet to eat - I'm figuring high in protein and veg and low in upf, refined carbs and white carbs. But I'm not clear on the role of fats, are we supposed to go low fat or is fat ok as long as we're in an appropriate amount of calories? Usually I'd be using olive oil and avocadoes etc as " good" fats but can I do that on MJ?

@montysma1 I'm the complete opposite! My bmi is 23.7 and I'm tiny around my middle and have no boobs left but my legs feel and look fat and so does my bum. My arms are not as bad but the bingo wings could fly me to Australia ! It's so frustrating that we can't control where the weight comes from.

I don't seem to be able to lose anymore but if I'm honest I don't think I'm trying very hard. I'm focusing on maintaining as I reduce my dose even though I would love to get down to 9.5 stone.

@Watchinghockey good luck on your journey. Too much fat (of any kind) made me sick in the initial weeks so I focused on high protein low carb and low fat. I follow a keto regime anyway so I just went easy on the fat. We’re all different thought so aim for healthy and clean within your calorie deficit and you’ll be fine.

@montysma1 are you sure you need to lose more weight or is that you need to build to muscle to make your arms and legs more in proportion with your torso and then the muscle will burn fat to help maintenance?

As we age we lose muscle anyway and losing weight fast as some of us are doing on Mounjaro can exacerbate that process. There's a risk we end up being 'skinny fat' with a low weight but a very low level of muscle.

Isn't it so strange😅

Good luck @Watchinghockey !

I think you’ll naturally prefer a clean diet when you start as too rich/fatty foods are probably not going to make you feel too good.

Fat in the context of olive oil in your salad/when cooking or avo is totally fine. Fat in the context of fried you need to be careful with as it might give you a dodgy tummy

Thank you. I feel I've underplanned a bit and should have thought more in advance about what I'll eat. My breakfast is always 2 boiled eggs so that's ok and I'm planning to have salad pots with chicken or fish for lunch at work. Evenings are a bit more complicated as my teen son is teaching himself to cook in this school hols and is making the evening meals for the family. I don't want to discourage him by not eating it and he's not aware of the MJ as I feel it's a potentially a poor example for my daughter who's a young teen and has a friend who has an eating disorder. It's all good food as it's cooked from scratch so I'm hoping to just minimise the refined carbs and generally eat less of it. He's a sporty teen with hollow legs so he'll hoover up whatever I don't eat!

@Choux I do a lot of training although much more cardio than weights, so I do have muscle.
I will do more ( it's my husband's actual job to prep elite athletes for strength,😅) I bloody hate weights though, would do cardio all day long!

On my body, it's defo some residual fat rather than being untoned. Not loads, but more than I would have expected at this BMI.

I do think middle age makes fat want to stay on your midde annoyingly.

Thank you! I don't actually eat much fried food at home, ( I mean I don't cook it ) just complete junk like takeaway Mc D or fish and chips if the kids want them which should be fairly easy to avoid and will save me money. So maybe I'll be Ok then.

@bantum
I'm diabetic so my GP prescribes it. I just pick it up from Boots. I'm very lucky that i don't need to pay for it as I have a medical exemption cert due to having treatment for type 2 diabetes.
Anyway you should be able to take your prescription to any pharmacy - and pay as it's a private prescription.
If they dont have it in stock they can order in and have the next day.

I'm back and unsure of what to do. GP won't prescribe as my diabetes is managed with metformin and my blood levels are "satisfactory ". Zava rejected me as I have diabetes so I doubt I can make another account and try again. I suppose I can try one of the other websites and pay extra and not say I have diabetes, but that feels "wrong".

doing my fourth 5mg injection today and going to do another month on 5mg as it's working well for me. which was a relief as 2.5mg had no noticeable effect.

Almost forgot to post!!!
Today is weigh day. Took first 5mg this morning.
SW: 19st 10
W1: 19 st 2.6 -7.4
W2: 18 st 13 -5.6
W3: 18 st 9.7 -3.3
W4: 18 St 6.2 -3.5
Total loss 19.5 lbs
BMI now 38.3 from 41

Kind of gobsmacked to be honest.
I'm off to Spain in the morning so we will see how that goes! I don't drink alcohol - gave it up when I was diagnosed with type 2 diabetes- liquid sugar - and never really missed it so that will be fine
But as for the food...
Hope side effects are minimal #crosses fingers#

@montysma1 yes the term middle aged spread exist because it's a common phenomenon. But losing weight fast also means it's hard to ensure the weight lost is fat and not muscle.

Does your DH have any advice for a middle aged woman on Mounjaro wanting to get to her optimum shape? (Am talking about ME not you! 🤣)

But each pen lasts four doses. Do you mean the guidance says you can stay on a dose for four pens?

Eeks! I got side tracked by the thread on the NHS prescribing weight loss jabs for hours and hours!!

Nearly missed end of thread! 🤣 Well not completely..

@KrankyKumquat try not to worry about it. I think sometimes it's inevitable that you'd gain after any restaurant meal. It's just one of those things. But goes away soon enough so no hard done. I hear you about getting into the 12s. It will happen for sure. Stalls happen. But you just keep going and the weight will start going down again.

I mean the guidance says you don't need to titrate up every 4 weeks, you can buy the same dosage pen for longer than 4 weeks. The guidance says at least 4 weeks. So say you're on 5mg and feel total suppression and you are losing well, but your prescriber emails you telling you to titrate up to 7.5mg. it doesn't make sense as you are doing well on 5mg so no need to go up, but prescribers seem to push people to move up when they don't need to.

Good luck @Watchinghockey and any other new starters

Well done for all the losses today

The guidance suggests moving up a dose every 4 weeks but the better way to do things is to only increase if you need to.

If, for example, I am on 5mg, tolerating it well and losing weight then I could stay on that dose for longer than 4 weeks. If I was on that dose but still struggling to control eating, food noise, etc or not losing weight then I should increase.
There is clinical evidence that increasing too fast just increases the risk of side-effects but does not increase weight loss

I thought the guidance said to stay on each dose at least 4 weeks.