Starting Mounjaro with BMI 27/28

[NotALotToLose]

Keen to hear experiences of any Mounjaro users who had a lowish starting BMI. Obviously this only includes people who have other health concerns. I have high cholesterol so pharmacy were happy to prescribe to me with a BMI of 28.
I've lost 4lb in week one which I'm very happy with after many other unsuccessful attempts to get back to my previous size.
Any advice for those of us in the 'not a lot to lose' camp?

I started end of October at 11 stone 7 lbs

52 five foot 3 (and a half)

high cholesterol bmi was 28

today I weigh 9 stone 12 bmi 24

I started with BMI 27 (high cholesterol), 5 foot 2. It's been slow, only 4 pounds in a month, with no loss in last 10 days.

I had to cut my dose from 2.5mg to 1.6mg as the side-effects were overwhelming and was making my food choices less healthy than without MJ (protein drinks, carbs).

I've managed to stick to a calorie deficit of 500 a day despite only having a low dose so I guess the weight will come off at some point. I feel a lot less hunger than pre-MJ, but also tend to suddenly feel weak and have to eat, so I don't see how I can cut my calories more than I have already, even if I do up my MJ dose a little more.

I think it's a fair question to ask views of those with a lower starting BMI. There probably won't be the large week 1 weight loss, and 2lbs a week ongoing that some of those with a higher BMI have. Also not sure that the clinical trials showed whether side-effects were more severe in those of a lower starting weight, so interesting to compare on a thread.

Op. I started at 31 bmi, I am now 26 bmi and on the highest dose I’ve been on. I’m tall. I will continue to 23 bmi, then stay on a maintenance dose.

I think it is clear and obvious if you fall into the prescribing guidelines set then your starting weight and required dose isn’t correlated.

as said, many people start at 28 , and yes some have reactions, others do not, some who have a starting bmi of 40 or higher have reactions, others do not.

you are able to get prescribed due to you falling into the prescribing criteria.

if you did not, then yes maybe there would be a reaction, but you do. And not just, so don’t worry yourself.

@ThatCoralShark why are you trying to shut down discussion of perfectly reasonable questions? Do you also go on the BMI 50+ thread telling them they are within the prescribing criteria etc?

You weren't the BMI that OP has stated when you started. I am, and I'm interested in the discussion.

If you are short, female and a BMI of 27 or 28 (and so overall have a relatively low weight for MJ) then you probably weren't represented to a large degree in the clinical trials.

I don't think I've said I'm worried at any point. I'm delighted actually! I'm just interested in how this drug works on people like me as opposed to the millions of threads about much higher starting points. I'm not smug or worried just curious.

It will work in the same way, as dosage isn't dependent on weight. Side effects also don't correlate to weight, effectiveness doesn't correspond to weight either. None of the research trials produced any results that indicated that. They had a range of starting BMIs, for example the recent SURMOUNT-4 trial had participants with a starting BMI of 27 with a weight related health issue (excluding diabetes).

It will be much like any other weight loss programme, that doesn't use medication. So, you are not going to be able to create the large calorie deficits that someone with a much higher TDEE (due to having a BMI of 35, 40, 50 etc) can create. As a result you are unlikely to get the initial large weight losses that can happen for that group, on any calorie controlled diet.

There was a thread a while ago that was created as a group for people with a BMI in the 27 to < 30 range, but it's dropped off the board as it didn't get a lot of traffic. You might be able to find it if you Advanced Search for it.

OP how have you found it in terms of side-effects? You don't mention any? Mine were pretty bad but I do also have quite a sensitive stomach anyway.

Hi, I am 5 ft 2 and only have a stone and a half to two stone to lose. Also high Chol. I am intersted in this thread and would be great to stay on here as my BMI is also lower for support ?. I started on Friday , felt very unwell cold, aches, headache , sick but food noise def better. I am feeling better today . A little worried for my next dose as I have a very busy weekend also worried if I will lose at all as in the past slow loser and peri.

@Tinydancer123 you're same height and similar weight loss aim to me, and I'm post-menopause.

Support on this thread would be great, I like the January starter thread but finding it a bit hard to relate to sometimes in terms of the big losses some people are having, and how much higher a lot of people's calorie allowance is. I'm aiming for 1200, I don't think I can manage on less.

That sounds good your side-effects are lessening by day 2? Mine went on for about 4 days, I lowered to 2mg for my second dose as I couldn't risk it with work. Just had one day side effect on 2mg.

Are you doing weights as well? I just upped my hand weights from 2.5kg to 4kg and it's definitely working me harder! (Though only do them 10 mins a day, am aiming to increase).

Hi, 5ft 2, starting BMI of 27, with high bp and cholesterol. I've lost 2 stone, currently a bmi of 22.8 and now maintaining successfully. I lost at a rate of roughly 1lb a week after an initial loss of 4lbs in week one. I was fine with the comparatively slow loss as I'm 51 so didn't want my skin to suffer too badly. It has been great for me, bp and cholesterol now normal. Good luck if you do decide to proceed.

Hi , great we can support each other. I was ill from Friday late evening till Sunday. Today I feel cold, but the side effects are managable. What were the side effects for you? I am glad they have eased. I am a teacher so took the does on a Friday, however this meant my weekend was a write off. Next weekend I am very busy so very concerened.

Clalorie wise I am also aiming for 1200. Weights I follow Caroline Givran and I am currently on 6 kg...... but even my 5kg were very hard going. I wonder how I will do all of my workouts this week !
How much did you lose the first week ? I am worried as I have followed fast 800 and 1200 before , SW and nothing has worked !

dose !

Congrats on your loss! Did you go up a dose every month?

@Tinydancer123 I lost 1.5lbs the first week. But that was more than I had managed in the preceding 6 months so was happy with that! I lost half a stone by myself in the summer but then went on holiday, winter came...managed to maintain the loss but not lose any more. I tend to put on and lose the same half stone every year since Covid and make no progress with the bulk of my weight.

My side-effects were cold, severe nausea (vomited), insomnia, moderate constipation, acid reflux, very thirsty. It was complicated though by having an actual cold at the time of first dose so not sure how much was due to that. I've done 4 shots - 2.5mg, 2mg, 1.6mg, 1.6m. For doses 3 and 4 I had mild side-effects for a day on dose 4, mainly insomnia due to thirst, and some nausea just in morning after shot.

I've only lost 4 pounds in the 4 weeks but I really need to up my exercise. I usually walk a lot, but the weather has been putting me off. I've stuck to the 1200 calories pretty well and have got my snacking habit in hand so I think even my small dose is helping my self-control and hunger.

I've heard a few people say about the Caroline Girvan programme, I'll have a look.

I am exactly the same last summer I lost half a stone and then it went back on. I needed to lose more than the half a stone but was happy with the loss. Now feel I need to really get on topof this . Well done on the loss this is fantastic ! The side effects are very similar ro mine, minus the sick. You poor thing. i am just not sure how to handle next weekend but will see how the week goes. Are you going up to 5mg ? who do you use to prescribe ?
Exercise wise I find her 30 min workouts really good. x

ps also the same with walking /weather and we lost our dog so I am not as active.Sadly whilst teaching I do not get that many steps in - I need to aim for more !

@Tinydancer123 I've bought 2.5mg again for the second month. I'm going to aim to increase a little in next few weeks. I'm using medexpress.

I'd rather be able to eat healthily and have only a little suppression than have major suppression and nausea and only able to stomach carbs and protein drinks. So am not in a rush to increase from a small dose.

@Dunkou I agree and I think I will follow the same path. Do you think my second dose will hit me less hard or was it the same on the second ?
When do you order , when you have two weeks left ?

I really don't know how tough you'll find the second dose. I reduced to 2mg and was still pretty green the morning after the dose. I work from home so was able to just get on with it, I'd have struggled being out of the house.

From memory it was a lot better by the afternoon, it was just a rough nights sleep and feeling sick the night of the dose and morning after. I've been taking Nexium a couple of days before dose I'm not sure if it works or not. Also eating very plainly day of and after dose, had some dairy last time that might have been a mistake.

I ordered early on as I knew I wouldn't move up but I'll leave the next pen until week before I need it.

@Dunkou thank you so much for sharing. If I take it Thursday night - unsure if I can inject on day 6 - I heard someone had that may help for the weekend.
If not will take early Friday and hope I am well by sat.

You can inject a day early but be aware the overall effect will be stronger as not as much of the first dose will be out of your system than doing it after 7 days. You can also delay the dose a couple of days but I guess that just moves the issue along to when you are working.

Of course, I will stick to the sametime on Friday and hope for the best ! So much to consider !

Side effects have been minimal for me. I felt a bit queasy on day 2 after 1st jab. Nothing serious, some burping but nothing sulphurous! I have felt very cold in the evenings though, even when the house is 22 degrees, I'm still chilly.
But I'm eating very clean, lots of veg, not drinking and exercising a lot - proper weight training with a PT.

I still get hungry at meal times but the amount I eat is less than a child size portion. I feel really full very quickly. Like Christmas Day full!

Sorry to hear side effects have been rough. Where are you injecting?

@NotALotToLose glad you're escaping the side effects mainly!

I injected stomach first time, and moved to thighs after that as read it gave less side effects.

I'm next jabbing on Wednesday so fingers crossed I've built some tolerance to side effects by now as it will be 5th dose. I'm not drinking alcohol, no spicy food or grease, drink loads of water, have rehydration sachets. In theory it's all in place.

I do have naturally low blood pressure and wonder if that plays a part, as MJ can lower it even more.