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'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.

It IS hard to change your lifestyle, but it is possible. I think we make excuses as to why we can't, myself included. I will openly say I don't have the time to go to the gym because I work full-time and I have a 4-year-old (and teenagers). Reality is the gym is open at 6am and closes at 10pm. I could easily find the time.

If I couldn't get the to gym or afford the gym, I could go out for a walk on my lunchbreak, or before work, or after work, or when my DS is in bed...but again I make excuses.

That is stopping. No moe excuse because I only have myself to blame. I have allowed myself to be lazy. It's not just a lifestyle change it's a mindset change.

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.

It creeps up on you @gimmemounjaro, it's happened to me too. Where it went wrong for me was I stopped weighing myself, and it was easy to turn a blind eye to the fact I'd gained a few lbs. I've realised that (for me) the key is to regularly weigh myself so I keep one eye on it all the time. The same with calorie counting. I think now I've got older, it's something I pretty much need to do forever if I want to stay in control and keep the weight off.

I did not take MJ I took ozempic. Myself and a few others on the normal WL board have a thread about this. Although we reported hunger coming back when we stopped I am not sure it was new or different it was just that it hits you very hard as it has been absent for a long time, so it’s a period of adjustment.

You have to learn how to manage it psychologically and tolerate it. I know this isn’t what people really want to hear. I am just being honest with you. Learning to live with a feeling of hunger needs to become more normalised. There are a lot of ways you can manage it - like you would a chronic ailment like tinnitus - distraction, mindfulness techniques. It does actually become more tolerable and normal over time and less bothersome and you get used to it. It doesn’t make me anxious and over eat anymore. I am often low level hungry but not actually hungry, I use a satiety scale to eat until I am full then I will stop. I do not over eat, I do not skip meals. I do not let myself get shaky or have sugar crashes. I learnt about how my body behaves and what it needs. I know how much my stomach can tolerate and how long it will last. It’s like treating it like a car engine or your bank account

there are no long term options for this so it is nice to wish for one, doesn’t exist at the moment. The aftermath is down to you to find something that works

I prefer being a little hungry at times to how miserable I was 2 years ago 5 stone heavier so that’s a good motivation to tolerate it

you have to change your lifestyle forever. You cannot go back to how you were before, ever

This is really glossing over what you choose to consume though. If you choose to consume foods that increase your bodies response to them, like UPF do, you are stuck in a cycle of making yourself more hungry by eating things that are causing the issue chemically. It’s often an addiction. The drugs should be able to help you break the addiction by taking away the desire, after 2 years of taking the drugs you will have changed your lifestyle and don’t eat these foods regularly and don’t miss them or desire them and won’t go back to Them. That is what this tool does for you. If you were epileptic and told to eat keto to reduce your symptoms wouldn’t you do it?

There are so many things you can do alongside managing insatiable hunger, and trust me, it’s hard I know but it’s not impossible. Volume eating. Avoiding sugar and UPF’s. Exercising. Eating mindfully regular small meals with decent proteins and nutrients. I did not become obese eating salads, chicken and working out. Despite any other medical condition I was eating all the wrong foods and not moving enough and I see that now. I was in denial

That is really interesting @Menora and congrats on your 5 stone loss. Could you say a bit more about using the satiety scale, how does that work?

What you say rings true to me about it being a choice between learning to live with the discomfort of hunger and the misery of obesity. (For me also about finding a different outlet when emotions are uncomfortable.)

Thanks for the thread...as this exact question is putting me off starting. I would not like to be on a maintenance dose long term. As some have said...at least it will give me a chance, after so many diet fails I've given up hope otherwise.

Thanks so yes, the scale is below see attached. Never eat past 7. 6 is a good place to stop, you can always have a snack later on. I found that eating past 7 just created a cycle, I would maybe skip a meal then be starving later on, also it keeps the guilt/shame eating cycle going. You need to get to know your body and its limits. I also never let myself get to 3, where possible. This means planning my day around eating to be honest. Always have a snack with me, plan the day of when I will need to eat. I can’t usually make it past 1pm without having lunch so that’s my window. I also like to eat by about 6.30pm. I then don’t eat again till morning and my body has got used to this. I LOVE eating and still enjoy it I just get excited about different things. Like avocados, mango and salmon 😂

I will never be the person who can just wing it and grab food on the go. It’s something I’ve accepted. I always disliked myself for it before, why can’t I just stop thinking about food? I probably can’t, I’m always hungry but I decided to pivot it into a new way of managing it. I know I will get to eat so I always have a meal to look forward to

I tapered dose down gradually over weeks but found everything was the same for a time and then it just wasn't and the hunger was back but unable to fight it.
The change in tastebuds and fatigue has been like a switch. I sleep now and have energy to do stuff and salads taste great again, on mj everything tasted bad and i was soo tired but had insomnia. Today I felt sick and left half my breakfast, egg on a protein pancake. Hoping my body is resetting....
And I indeed did get fat eating salad, salmon and fruit on 1400 calories a day and exercising 300 active minutes a week. I need less than 1200 a day to maintain and when I exercise now my body demands more calories.

Thanks @Menora that looks really useful and I have saved it.

I think I will be able to manage the hunger end with no problem and always having a snack to hand, but I often find I don't know how full I am until a while after I've stopped eating. Did you find that and if so, do you have any advice? Even if I eat really slowly, fullness doesn't happen until a bit later. Maybe it's about estimating a good portion size and gradually learning what that is.

A good way of doing this is to eat mindfully with no distractions, looking at your food and talking to yourself through the mouthfuls about the taste and texture. Don't drink too much liquid before you know if you are full or not, you just have to note your cues. If you don't feel hungry anymore, your stomach feels fuller and if you are just eating because it's there - if you don't know, stop and put it away and go back in 30 mins if you need to. Portion size I always tend to stick to around 500 calories a meal but make sure a lot of this is volume in terms of veggies and stuff. Don't save all the best bits till last as that can make you eat more than you need to, take bits of everything and eat it evenly. You just need to keep asking yourself questions. Do I need this or do I just want it?

fullness is defined by not being as hungry anymore but not feeling strained or stretched or uncomfortable. If you ate so much you needed to widen the waste band of your clothes that would happen in about 10-20 mins so yes, don’t eat the whole thing in 5 mins flat as otherwise you have no idea how your digestive system is going to react. Hunger is not satiated instantly so it might take some tries to see how much fills you but better to try eating in smaller amounts and building up, I might eat my components of breakfast across an hour rather than all in one go.

Thank you @Menora this is so, so useful.

And I indeed did get fat eating salad, salmon and fruit on 1400 calories a day and exercising 300 active minutes a week. I need less than 1200 a day to maintain and when I exercise now my body demands more calories.

That's insane. How tall are you? I am only 5ft 2, and 1700 is maintenance for me. At 1200 I lose 1-2lb a week.

You just need to keep asking yourself questions. Do I need this or do I just want it?

This is so true @Menora . I've started eating more mindfully recently (before MJ). Yesterday I made toast for breakfast, took one bite and realised a) I wasn't that hungry and b) it did nothing for me in taste or satisfaction. It was routine and mindless, so I actually threw it away.

This is a good way of reflecting. In my case (not for all I know) I was basically in denial and lying to myself a lot. Having to be more honest with myself was scary but also liberating too? Deluding myself about what I was eating was getting me nowhere! So saying yes I don’t need it, I want it is fine, but then I can do a deal with myself - if I eat X, would I prefer Y later on instead? I might want to eat the cake but then the next day I know I will not have another cake. That was my weekly cake. It needs to be a really good cake 😂 might go without the cake to have something else that’s bigger for the same calories, within my calorie limits. There isn’t much I do not eat, but for things like cakes and crisps etc I don’t eat them every day, they aren’t part of my daily diet. A birthday or occasion is different

I use your toast example for when I had a domino’s pizza about 9 months into my diet. It smelt a lot nicer than it actually tasted and I realised it just tasted of not much interesting in all honesty. It’s nicer to have a rice bowl or something fresh with lots of different tastes and textures

god it’s quite depressing the lengths we need to
go to to keep the weight off.

Sadly the person who said keeping count of the daily calories, weighing regularly and doing exercise has it bang on. I’m doing all that now and by god it’s hard work. Mostly it’s the 2 hours 10k steps as I just hardly lose if I only count calories.

Im looking out the window, it’s grey, wet and chilly! But it will have to be done! And I’m only doing 1.5 hours today I’ve decided

So I’ve never posted on here before but just wanted to offer some reassurance to anyone coming off Mounjaro. Just to be 100% clear I didn’t have a huge amount of weight to loose and I reached a ‘healthy weight’ quite quickly with the help of Mounjaro. Id initially lost a stone before starting Mounjaro but previous to this I’d just keep loosing and putting back on the same stone. I used Mounjaro to help with the plateau and loose a further stone and a half which came off quite quickly with only the starting dose of 2.5ml and then 5ml for a month. I stopped when I reached a BMI of 24 and wanted to see if I could continue loosing weight (I want to be well within a healthy range not just on the cusp of healthy weight and overweight) in my experience the first week was testing. My appetite was definitely increased but I decided to use that time eating at maintenance rather than in a calorie deficient. The extra calories definitely helped me keep on track. The second week has been easier and I have introduced MCT oil to try and help with the cravings. I’d say it’s definitely doable but just takes slightly more willpower, especially during the summer hols!! I’m still loosing, albeit a lot slower than I was on MJ so it can be done.

I think the biggest lesson I’ve learned on MJ is that by declining some cake or a biscuit, I’ll be ok, I’ll feel satisfied by what I do plan to eat and I won’t be missing out and most importantly I don’t need it.

I think calorie counting, weekly weigh ins and meal planning are going to have to be long term tools for me.

I got fat because I let myself eat too much, indulged in all the sweet things and drank too much. I also got lazy especially when short of time so self care is an investment, meal planning, prepping lunches, etc. I must not give myself the excuse to slip back into those bad behaviours.

I’ve definitely learnt I don’t need all the extra stuff and I was also completely kidding myself about my calorie intake - totally and utterly.

Of course it only works when you're on it, the same as any other medication. You can't expect it to keep working if you're not taking it anymore.

But if your comment is implying that it's not useful/ not worth having, then that's not true at all. It can change people's lives if they approach it in the right way, and also, for most obese people, the recommendation is that this is treated as a long term/ lifelong medication, the same as medications you'd take for any other condition.

They can change your life for sure. They did mine.

but is a level of delusion about staying on them forever when prescribers are not going to do this, not in the near future, if ever. So you need to prepare yourself for that. I get frustrated by so many posts just entrenched in that this is it now, you will never experience hunger again, the end and that’s that. You need to prepare yourself for if that’s not possible

Part of it for me, is I need to get into a mindset of feeling okay with being hungry. We fear being hungry.

@Menora there has been a shift in prescription protocols since you were on it. More and more prescribers are recognising that for many with biological/medical obstacles to losing weight, it will be a long term drug and there have been quite a few prescribers who have changed their stance and are willing to prescribe it long term, as per Eli Lilley's recommendations. You are right though, that it's not given that we will always have access: shortages etc will happen so there does need to be a plan b.

I'm not sure 'deluded' is fair. 3 months ago, no one in the UK was at maintenance on MJ and prescribers were saying they'd cut people off when they hit BMI 25. Today, many/most are saying 22-23 and 2 years maintenance support, with individualised plans. Who knows where we'll be in another year?
Things are changing very quickly - new meds are being trialled, existing patents will end, research about maintenance is being undertaken, non-specialist medical staff are learning more about obesity and becoming enthusiastic about the potential of weight loss drugs, regulatory bodies are reviewing their guidelines, evidence about broader clinical benefits is being gathered.
Yes we can prepare but we can also be a little optimistic that finally we may have some good news.
I'm not sure who believes they'll never experience hunger again but plenty are hoping they'll never experience being clinically Obese again maybe?

@KrankyKumquat it isn’t just the prescribing it’s many factors. Shortages (which hit whilst I was on Ozempic very badly), personal finances and health. Say you get gallstones after 2 years, you will have to stop taking the medication most likely. Gallstones can be common with weight loss. I had a gallstone issue. You also have to be prepared that on a low dose you will still feel hungry, it will not suppress your appetite like a high dose will.

It is more that I see people who just started it already planning to stockpile it for life and yesterday even someone saying they didn’t care about risk of infection from using a vial way past its best. Lying to prescribers standing on scales holding books and shopping different pharmacies. All this will do is make it harder to access for other people. And if any of this is rational thinking or behaviour then I am pretty saddened by it. Where is your own responsibility to make changes and learn to cope. Being optimistic would mean preparing yourself for other eventualities too