Coming off/ after mounjaro

[Cerialkiller]

Can't see any recent threads on this topic so maybe this could be a useful resource for some people.

I've decided to stop or at least take a break from mounjaro for a week or two after finishing 7.5pen and losing 25lb. It's been really great for me but I have noticed a pattern of getting a sore throat weekly after the jab and after this long I can really deny it as coincidence. I had throat surgery last year and I have a post viral cough that isn't shifting after 2 months so I'm coming off to see if it helps. I may start again once I'm better.

My next jab is due today (fresh 10mg in the fridge) but I'm not going to take it.

So naturally I am concerned about my cravings coming back and gaining weight as I would be anyway at goal weight. I can't afford to do this long term so this was always going to be a question for Mumsnet it's just earlier then anticipated.

So. Those that have successfully lost weight and come off mj, can you tell me how you are doing? Are you gaining weight? Continuing to lose? Struggling with cravings? Do you feel different then when you were heavier? All the gory details please.

I wonder if using a company that offers support alongside the drug helps.

I do wonder if that helps prevent eating too little on the drug.

I had a very traumatic event last year that caused me to eat next to nothing for a few weeks (like a slice of toast each day) - I lost about a stone.

I gradually increased my food intake the following couple of months but it still was reduced - yet that stone flew back on with another for good measure!

That's why I'm focussing now on nutrition (especially protein) and exercise in the hopes that won't happen again (I also suffered an injury during that event so had to stop exercising which won't have helped, I lost a scary amount of muscle mass in a short period of time).

So to sum up 😂 my feeling is that we need to try and not cut calories TOO much and keep up good nutrition and exercise in the hopes that our bodies won't switch on 'eat everything in site as you have been starving me of calories and nutrition' mode!

@MadameMassiveSalad yup, back to square one
is there anywhere that will give maintenance doses? I couldn’t see any. - not that I need to worry about that atm tho😣

I worry about this too. I just hope that the price will come down once there's more competition from other drug companies.

How long were you on it for?

My initial plan when I first made the decision to go on MJ was to only do it for a month to kickstart my weightloss and form better habits as I was in a rut, but I quickly realised that won't work and it's a long-term thing. Were you on it for long?

A family member (not on mumsnet) lost a lot of weight on ozempic last year and has kept nearly all of it off.
I've been picking her brains as I'm on MJ and curious. She says:
She tapered off slowly.
She didn't go to high doses.
Calorie counting is key key key. Don't just rely on suppression because when the hunger comes back you're just going to intuitively overeat.
No more unhealthy food and crap takeaways - ever.
Gin and slims are now the only alcoholic drinks she has.
She now also exercises a few times every week.
What she said that I found interesting is that she now has the body she wants - but she is now eating like slim friends and family members. I totally get where she's coming from with this. She's had to rewire her thinking with food completely. Lunch is cafes is now always soup (not a massive cheese toastie) etc.
If you go back to how you were, the weight will pile back on.

I came off MJ 3 weeks ago after losing 2.5 stone. I haven't had any increase in hunger from my pre MJ levels and am sticking easily to my maintenance calories. My weight is currently 1lb less than when I stopped.
I’m aware it’s going to be a challenge and I’m in it for the long haul in terms of calorie counting etc. I managed to instigate a good exercise regime while taking MJ which I have continued, and plan to stick with long term.

Yes. Some pharmacies are now doing maintenance. There's a thread on Reddit on the ones who do. Search uk mounjaro maintenance.

I think there's so many variables and it really depends on why we got fat in the first place. I think for those who have been slim all their lives and have suddenly gained weight due to lifestyle changes, it may well work as a reset. I think for those of us with biological obstacles like hormones, insulin resistance, pcos, adhd etc it will be much harder as it's not brain training that's needed but a bio intervention.

Reading through the comments on here it just sounds like these drugs work when you’re on them and then you regain what you lost (and then some..) when you stop taking them. Is there not any aftercare advice from GPs?

Like any diet, if you go back to eating what you were eating before you started taken them then obviously you would regain the weight. Again, like any diet, you have to make sustainable long term changes to keep the weight off.

I've only just started but I am the same - my weight gain has been the classic - eating too much, drinking too much, not moving enough. I love food and drink and I am lazy.

I am using my time on Mounjaro to make a whole lifestyle change, not a temporary diet.

But I don't have a food addiction (just an obsession) which makes that easier. I also have a husband who is happy to take on the same lifestyle so I have support with the eating and exercising element.

It's not a miracle drug, it's the same as any diet, like WW, Slimming World etc If you stop and go back to your old ways the weight will go back on. It has to be a complete lifestyle change.

What she said that I found interesting is that she now has the body she wants - but she is now eating like slim friends and family members. I totally get where she's coming from with this. She's had to rewire her thinking with food completely. Lunch is cafes is now always soup (not a massive cheese toastie) etc.

Exactly @wickerpram I saw someone describe their normal diet as their slim friends 'treats'. And that resonated with me massively! I have the 'treat' diet every day!

Typically it is not necessary to start at the very beginning.

The titration starts low to see if you have side effects and to minimise them if you do.

Once you have found you tolerate it well you will likely be able to start midway up and see how you feel.

Even if you did have side effects at the start they are generally way less next time they if you have a break

It's the same with lots of medication as your body and brain is already familiar with it

I listened to a podcast the other day with a Canadian doctor (obesity specialist) who uses these drugs, amongst other things, to help her patients. She said the biggest mistake she sees people making is thinking this can be a quick fix / reset, because most people will need long-term, if not lifelong treatment. MJ and the others do not address why someone is obese in the first place, or the thoughts and behaviours that got them there. So just like other approaches to weight loss, if you revert to old ways, the weight will go back on again. Her patients have specialist help with their diet and exercise, they all have a lot of therapy too, and yet they still need the medication long-term.

I do feel a bit naive for thinking this will work without all the extra support, but ploughing on regardless. 2.5mg hasn't done much for me, -4.3lbs in 4 weeks, but I'm moving up to 5mg this week. If that doesn't have any effect I think I will call it a day as I'm a bit scared now of ending up even bigger after reading some of these posts.

MJ and the others do not address why someone is obese in the first place, or the thoughts and behaviours that got them there.

@gimmemounjaro I think that is the 'danger' with some of these treatments. Similarly, I know two people who had gastric bands and regained all their weight.

I do feel like MJ is a reset for me. I'm not hugely overweight (2 stone, really). I also know the reasons why I am overweight—I like too much of the good stuff, drink too much wine, and am so lazy. These are all things I am working on while on MJ and don't intend to revert back to because I need the lifestyle change for more than just weight; I need to reduce health risks, too, and I can't just keep ignoring that anymore.

The reason I became overweight is that for a period of time I ate and drank too much and moved too little. There wasn’t really anything deeper to it than that. So I didn’t feel like I needed to address the reasons I gained weight particularly.
Now off MJ I am confident I can stick to my pre weight gain diet and exercise habits.

For some this is true but for many Obese people, it's much more complicated than simply changing your lifestyle. This belief feeds into the blaming of fat people - they just need to stop being lazy and greedy and a bit uneducated about healthy food options and they'll get and stay thin.
If you take medication to stop having epileptic seizures, everything's fine. When you stop, your seizures return. No one suggests this means the tablets don't work and it's all a waste of effort and money. Instead, we accept we need to take epilepsy tablets for life. Yet we don't think the same about weight loss meds, I wonder why that is? Could it be due to society's views about why fat people are fat?
Hunger is a physical state, and the message we're hungry is created by a complex set of hormones, peptides and other chemicals. We can no more tell ourselves we're not hungry, when we're experiencing the feeling of hunger, than we can convince ourselves we're hungry when we're faced with a meal we really don't want, or that we've not got a headache, or a cold, or high blood pressure when the tests and symptoms tell us otherwise. Many people who are Obese have an insatiable hunger which is a symptom of a disease caused by metabolism, hormones, endocrines, a combination of all these or something else. For them, weight loss medications will be needed for life. We're so lucky such effective medications have been discovered and are available to us but we still need to move the conversation on so that those that need them long term can get them and aren't expected to simply go cold turkey and to have learnt some nebulous and life changing lesson from the experience of using injections for 6 months.

Apologies, I didn’t mean to shame anyone and am aware some people will need the medication for life (and believe they should be prescribed that on the NHS). My point was really just that yes, if you stop taking it and go back to eating the way you ate before, the weight will go back on. So there needs to be a long term maintenance plan. For some that will be medication, others will do it with a lifestyle change.

Morning @angel1977 and I'm sorry I wasn't able to continue our conversation last night. I've been thinking about what you said over night and I'm so sorry things are so tough for you at the moment.
All I can add now is that I think a conversation with your GP would be a good place to start. I'm not an expert but clearly something very odd is happening to you and you can't carry on like this. I don't know your medical history obviously but wonder if you could ask for tests to try to find a cause of your insatiable hunger and maybe a referral to a specialist (endocrinologist perhaps?).

I think MJ could realistically be a quick reset for people who have mostly been a normal weight through their lives and have recently gained, maybe due to a pregnancy or whatever.

But for the rest of us, I am a bit sceptical about MJ's longer term effectiveness if you come off it, given that health professionals seem to think of it as a long-term treatment. I am also overweight because I eat too much and don't exercise enough (isn't everyone) and knowing that has never really helped - the key is probably to figure out why I adopt those behaviours when I know they make me fat and I don't want to be fat, which is much more complicated.

I'm afraid I also think that lifestyles are very difficult to change - your lifestyle develops that way for a reason, it fits with your family circumstances, work, your age, physiology and hormones, your character, likes and dislikes, your stress levels and reaction to them, where and how you live, how you were brought up, disposable income and time etc etc. I do have a chance to overhaul things significantly soon, when hopefully both DC will be moving out of the family home, so a big change of circumstances which should help to shake things up.

I'm sorry to be negative - obviously some people definitely do achieve longlasting success and your experience @HungryBeagle is great to hear. Fingers crossed for that result for everyone, including me - I'm still going for it with MJ although maybe more in hope than expectation!

I think at the very least it gives you a chance at staying at a lower weight long term, which is a chance that you may not have had otherwise because you were struggling to lose that weight in the first place, if you see what I mean? (I mean a collective ‘you’, not you personally by the way).

Great post @KrankyKumquat

And thanks @wickerpram, your family member's advice is really useful.

@HungryBeagle
Sorry Beagle I was feeling frustrated and snapped a bit (your comment was simply the one i chose to tag). However, many of us are now talking about maintenance and I'm seeing a lot of comments about how being on MJ is about learning to eat less/better and exercise more. I wish it was this easy - I've been doing that for 50 years and still ended up obese. I hate the thought of not being able to afford this drug much longer and knowing that I'll end up back where I started like some have described on this thread. Obviously I'll try my damndest to ensure this doesn't happen (I've never lacked willpower or knowledge or determination) but fear it may be beyond my power.

I think at the very least it gives you a chance at staying at a lower weight long term, which is a chance that you may not have had otherwise because you were struggling to lose that weight in the first place, if you see what I mean? (I mean a collective ‘you’, not you personally by the way).

Yes, that's definitely true. And for many (including me for now at least) the money is worth it when some people do manage to keep it off.

I have lost a significant amount of weight before, twice, and put it all back on again. It seems so crazy now, like how could I let that happen? But it did, and I know that's a very common experience.

@gimmemounjaro @HungryBeagle
Yes, i keep telling myself that maintaining a healthy weight and losing a pound or two of regained weight every month must be easier than losing 4 stone or more. My other hope is that the longer we're on MJ, say 2 years, the more chance that all the physiological set points which drag us back up to higher weights might adjust themselves down.