Continuing Mounjaro...part 18

[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)

Mumsnet does not allow promo codes. Please do not post any. If you want one, ask and someone will PM you a code or there are now threads on the promo page that have codes for Mounjaro.

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.
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 - 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.

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 - 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!

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

13 - 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

14 - 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

15 - 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.

16 - Drink lots of water. Water helps with the weight loss. Try and drink at least 2ltrs a day.

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 your 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: Now saying they support maintenance upto 2 years.

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 to 9th thread, get link from thread 10

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

17th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5122095-continuing-mounjaropart-17?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:

Well done everyone on the losses and those struggling, keep on! I’m starting to think about weaning down. I’m not sure exactly at the moment but although in the early days I thought I would want to be on this forever, I am struggling with the tiredness and lack of appetite. I have my last 7.5mg dose next week and I have a 10mg pen arriving (ordered before I realised the suppression was too strong for me). I think I’m going to do 7.5mg then 5mg doses from the new pen and risk it going over the 30 days.

I’ve lost 2 stone and have 1st to go to GW. I want to get to the point where I can comfortably eat 3 healthy, proportionate meals a day. At the moment, I feel no hunger at all for most of the day, force myself to eat something at lunchtime and then usually can’t stomach anything in the evening which means my calorie intake has dropped pretty low recently and I’m afraid it will really impact my metabolism if I keep it like this.

Hopefully titrating down will mean I can eat a bit more and hoping that will get me close to the final stone off and then I might do 2.5mg every 8/10/14 days to come off. Anyone else starting to think about stopping?

Do you use plant based milk for your protein shakes or water and why? I prefer the taste with milk and feels more filling but thought they might be a reason why some people use water instead.

In regards to meal plans, I've actually used chatgpt this week to help me write it! I do double check the macros on MFP.

If you use a prompt such as "write me a high protein, low carb weekly meal plan for x calories. Include at least x grams of protein. Ensure it does not exceed x carbs and x fats. Include lots of fresh veg. Do not include foods I do not like such as xyz."

On the topic of what we're eating, one thing I tried a few weeks ago and have made many times since is a sort of quiche made with a wrap. It kept coming up on my insta feed. I was really sceptical if it would work but it does!
You grease a Victoria sponge tin, put a wrap in it, add four eggs and a couple of tablespoons of cottage cheese and whisk them together (this can be done gently in the wrap) and then add fillings. My favourite combo is red onion, ham, tomato & spinach. Top with grated Parmesan and then bake at about 160 degrees for 35 mins.
I tend to have half with a salad and then put the other half in the fridge and either snack on it or take it to work for lunch.
It makes a nice change from the endless poached & scrambled eggs or omelettes.

Weigh day for me and I’ve lost nothing this week 😭

I go on holiday in a couple of weeks and can’t decide what to do about injecting. I get the worst side effects (4-5 days of bad diarrhoea every week) so I definitely don’t want that while I’m away! But I also don’t want to come off completely and have to start at the beginning again? Has anyone who gets bad side effects gone away? What did you do?

@ObsidianTree Even with my meal plan I'm lucky to get to 50g of protein, I'll keep trying!!

@Mounjarojourney Its really sad as they were brilliant for my first 5 orders. I think they've got more than they can handle right now.

Thanks for the link. Listened last night when too hot to sleep. I agree, it's worth listening to - some good revision of what a glp actually is and does, why dieting/exercise is not so simple, a heartening lack of scare stories and sensationalism. Slightly depressed by the idea that weight gain after MJ is effectively inevitable, regardless of effort and motivation. I started this journey without any intention of staying on MJ long term but this seems very naive now and life-long use appears to be the only viable option. I suppose the best outcome is that a maintenance drug will be developed which is both cheaper and better targeted.

I am at a very similar point with 1 st to go and near the end of a 7.5 pen. I think my plan is is to stick with 7.5mg for a few weeks until I am within 5 or 6Ibs of GW and then titrate down to 5mg. Also as I am with MedExpress I will have a chat with them and see what they suggest. I don't expect to be on the meds long term though.

Another still waiting for MedExpress too. Might shop around a bit today to look for other options.

I've had a bit of a post holiday whoosh 🙂I'm now 189.8lbs. Feels good to be in the 180's.

@ObsidianTree @KrankyKumquat I listened to it a couple of weeks ago and agree that the weight regain rate without a maintenance dose is depressing but do have some thoughts /musings:

1. Of those that stopped taking mj and maintained weight loss (around 16%), were there any shared characteristics? I would be interested both in what they did while taking mj as well as what they did before and afterwards. Eg what had led to obesity in the first place (medication, emotional eating, poor diet, insulin resistance, bingeing etc.)? What support did they have to address these issues? Did they implement an exercise regime (including strength training) while on mj and did they maintain it afterwards? Did they lose the weight fast or more slowly? Did they change their way of eating while on mj or just use the suppression effect to eat less of what they usually did? If they did change their diet, to what and did they maintain it afterwards (ie did their habits change)? None of this was reported in the study so I assume this data wasn't collected.

1. Weight regain is, in large part, due to the physiological response of the body in an attempt to get back to a previous weight (set point theory), which remains a theory as yet, though many of us have seen stalls at previous weights which tends to support the settling points hypothesis. I have seen on American reddit a number of posters who have been advised by doctors/endocrinologists to continue with maintenance dosing of various types for two years after goal, at which point the body accepts that this is the new set weight and stops trying to sabotage maintenance.

It would be great to have large scale rct studies to look at these questions but can find no indication that these are being undertaken. It is unlikely they would be undertaken by the manufacturers given a business model would favour lifelong use, but given the human and financial cost of obesity, it would be helpful if this formed part of a preventative health study.

My hope is that the many of us on here who are forming new eating habits and exercising more will be in the 16%!

I'm hoping the set point maintenance time theory is accurate. I'm planning to keep on once I reach my target in the hope that my body decides that it is my new set point. I will of course be carrying on with good eating habits, exercising and keeping a very close eye on any gains too. I'm trying not to be disheartened by the statistics.

@Everdecreasingcircumferences i hear you, we are a ND family my eldest competes nationally at sport very fit but still needs the hit of a Pepsi max & some haribo to help her at stress points. I’ve bought some lime sweets and chewy mints just 2-3 in the evening with a cuppa tea or a mini crunchie bar is enough of a sugar hit to satisfy my hit now and I keep 100-120c from my allowance for it. I hope you can hit your work deadline.

I view using this drug that for whatever genetic reason my body was resistant to insulin and MJ has altered that. I’ve always known how to eat healthy and exercise well but was obese. Using this drug was the missing key for me. If that means using it longer term in some form of maintenance plan, I view it like my mum use statins despite eating a low cholesterol diet for years to maintain her health. Hopefully a cheaper way of accessing it long term at low dose will emerge.

To add reading the research in Andrew Jenkins book “why we eat too much” helped me understand it wasn’t me being crap but my body constantly fighting against me.

I guess our main hope is our body resets to the new set point we get to. If we are able to stay on it for the full two years. Or, the guidance changed by the time we get to 2 years and we can stay on for as long as we want. Or as you say, a maintenance dose/drug is created that we can take for life

That would be just the icing on the cake (that no one wants to eat ha)

We can do our own research 😁

I think all we can hope is that we can attempt to stay on the drugs for 2 years after goal weight in the hope that our bodies accept the new set point (if this is possible)

Just watched this and found it interesting. However, I’d just point out that the slightly depressing conclusion that people would likely regain the weight if they do not remain on it (or semaglutide) has been slightly disproved since. He cited the Step extension study looking at 300 people over a year after the study. I’ve posted before a study released a few months ago that followed 20.2k semaglutide patients and 17.8k liraglutide patients that showed that 56% of patients maintained their weight loss a year after taking it (and indeed half of those continued to lose weight); of the rest something like 18-19% gained the full amount back and the others about 25%.

The graphs suggested that it was the people who lost less/took it for shorter periods who experienced the most regain, so I inferred that if you have lost a significant amount of weight, over a longer period (ie taken 12-18m to lose 4-8 stones) you were less likely to regain. I infer that these results can be extrapolated to those of us now on MJ.

Ie. I would hate anyone to watch this and find themselves thinking… what’s the point? In traditional diets the evidence is that 80-95% of dieters regain all or more weight within one year. The charts in this study show only 18-19% regained the full amount. Obviously the data in this study was not available to the chap being interviewed here.

Anyway, I’ll bugger off now…

This is the same for me. I think I have insulin resistance and mj has solved that for me. Before MJ the only diets that worked were the very low carb ones. Which were unsustainable for life so I always put the weight back on. I have tried diets where I reduced calories but still eat carbs and I lose no weight. So think that indicates insulin resistance.

As mj helps this I am reluctant to go it alone as I think this could be a reason why people might regain when stopping. Mj might help your body use insulin instead of store it as fat(I think!) but I doubt it will cure you for life.

If I have to stop MJ and do all I can to maintain but I'm still gaining weight, I'll be going right back on MJ. I think I may attempted to get an appointment with an endocrinologist consultant to try and get backing to stay on for life (based on my thyroid issues). Or just hoping, eventually UK will allow maintenance for life.

@CautiousLurker thanks for that. This is encouraging. You don't happen to have a link to this research do you? Thank you 😊

https://www.epicresearch.org/articles/many-patients-maintain-weight-loss-a-year-after-stopping-semaglutide-and-liraglutide?

Thanks. I'll have a read

hello! I've been reading the thread since pretty early, only my second post, but it's really a great space and fab to see the journey that we're all on. I've been on MJ since late may, it's going slowly due to a month until mid July being taken up by anniversary / festival / holiday excesses... now on 7.5g and the first jab hit me like a ton of bricks. basically the same as for many of us. I was wondering, though, does anyone have any experience of going onto oestrogen while on MJ? I'm also ADHD (DX but currently unmedicated), and have a history of PND / PMDD etc which has meant excessive reactions to hormones in the past. I'm sure it'll be ok, not going to worry too hard about slapping the patch on! all power to us all xx

hello everyone, I have not had any time to read on here yesterday, so I am really behind. Will get to it later today, promise!

We're celebrating my little peanut's 2nd birthday today, so lot's of cakes and prosecco and treats incoming over the weekend with friends and family. But I have no appetite for these things generally, so not overly worried. Also hoping that maybe going a little off piste on the diet and calories will have that re-feeding positive effect a lot of you have mentioned, and get the weight loss going again!

In other news, I was very stressed and busy yesterday, had a healthy lunch after my moan here, and then just some watermelon wedges and cucumber salad for dinner, so ate less than I should have. But today, finally a tiny little move on the scales in the right direction - 92.75 kg. It's negligible and I can't let myself get too happy about it, in case tomorrow I'm greeted again with 93...BUT it is something! I'll take it. Ideally, I would have wanted to be 1 kg/ 2 lbs down compared to this time last week, and my loss is only 250 g / half a pound - but whatevs, there's always next week! Hope it just continues on the downward trend again!

Ok, I'm off to go back 10 pages and catch up now.

Fingers crossed the half a pound turns into a whole pound by tomorrow x

I do use that "what I eat" thread, mainly to hold myself semi-publicly accountable. I track everything in Nutracheck anyway to make sure I'm in a deficit and admittedly, I have had a couple of days where I know I haven't eaten enough, because I just can't face it. I think it's important to note that everyone is at different stages in their journey with different levels of suppression, and some are experiencing nausea and other gastric side effects that may affect what they are eating, and when.

Personally, I'm thinking longer-term towards maintenance, and trying to eat 3 meals and a small snack per day, with a focus on whole-food protein and fruit/veg. I'm not there yet with fruit and veg as I'm finding that a bit tough on the stomach at the moment, but it's improving.