Increase dose in Maintenance, or take a break?

[mjuser]

Hi all

I started MJ late September, and lost enough to get my BMI down to 23 by the start of January. I never increased my dose from 2.5mg, and stuck with the 7 day dosing schedule, had no side effects and weight loss was was consistent throughout. I was really lucky.

Due to my lifelong history of obesity, I decided not to come off it. By the time I hit target, I had little appetite suppression, but great food habits and no food noise. So I stayed on 2.5mg and increased my calories by 250 a week until I found my maintenance intake - lost a little more weight in the process but I felt like I was in complete control.

BUT THEN...the food noise started creeping back. I upped my dose a tiny bit, to 3mg, then to 3.5mg and 3.75mg but it just seemed to get stronger, and although I haven't gained significant weight (still bobbing around in the 5lb window I set for myself to maintain), it now feels really bloody difficult, and I'm constantly having to fend off sugar cravings and general greedy thoughts!

I know I'm still on a low dose, and that technically anything under 5mg isn't considered therapeutic, but I am so fed up with paying money for what feels like miserable denial, instead of the total freedom from the cake demons I had before.

So now I'm torn. Do I up my dose (feels like 5mg isn't going to even touch the sides right now tbh)? I keep reading that other people bring their levels down to maintain, so I feel like I shouldn't be going up - and what if this keeps happening, and it keeps wearing off and I have to keep going up?

Alternatively, I have read some accounts of people stopping for a few weeks then restarting and they get a sort of reset and it starts working again. I'm tempted to try this as I'm getting basically nothing from it right now, so it's not as scary to come off it for the short term...

If anyone has any experience of this I'd love to hear it. I.e. the drug becoming less effective AFTER reaching a healthy weight. Or if anyone has stopped and restarted - did it work better afterwards?

Sorry for the long post - just thought I'd try and pre-empt any questions about the "journey" so far.

Well done on your loss and I’m sorry that you are now struggling. I have read about people increasing dosage in maintenance, particularly on the American maintenance subreddits. I have also heard about people having a break, restarting and not having any effect at all until higher doses so be wary of that one.

Sorry, I’m not sure I can be of more help and really do sympathise with the return of the food noise. The thought terrifies me!!

Thank you. I have read that too, about it not working so well second time around, but I suppose I'm hoping that because I'm still under 5mg, that won't happen to me as I wouldn't be dropping so much.

Also I'm sure I read on this board that someone who's 15mg stopped working was advised to take a 2 week break and restart. I might have to see if I can find it, and ask them how it went.

It's not the end of the world moving up, I suppose. Just annoying!

How long has your hunger been going up? I just had an 8 weeks stall and increased hunger (I stayed at the same dose). I have been bouncing around 2lbs up and down but the last few days the suppression seems to have come back. I’m at a weight I was for a long time previously and this happened to me when I was dieting without ozempic too. I would up your dose and then see where you settle and then give yourself a little while at that dose before trying to go down again.

It’s difficult to know what to do isn’t it? I reached my target of 9 stone 7 about 4 months ago now. I’ve stayed here ever since, give or take the odd fluctuation lb. I eat 1500 + calories a day

I’m on 7.5mg and this gives me what id call a normal appetite. When I tried to go to 5mg, I had food noise

so I’m debating bow on dropping down to 5mg again and riding it out. I’m lucky that I never had to go above 7.5 and I’m not totally opposed to taking a maintenance dose for a long time if need be but I’d prefer that dose to be 2.5 if possible

Have you spoken to your provider to see what they recommend? I'm with oushk and they have great maintenance plans and a video consultation for starting maintenance.
Though you say you have sugar cravings and food noise, have you given in to them and have you gained weight? Have you worked out and eating up to your maintenance calories and still drinking lots of water daily and focusing on protein?

I have insulin resistance, now on 10mg and it's doing a great job finally at stabilising my sugars, but my worry is also when I start maintenance if the unstable sugars and symptoms will go back to pre mj. Even on the lower doses I still had symptoms of feeling faint, shaking hands, dizzy and ravenous after day 5 until I started 10mg which I've been on 7 weeks now and it's keeping me stable all week long. My bmi is now 27.3 so hoping to start maintenance end of May hopefully

I haven't really gained weight. I still do at least 80g protein and 30g fibre a day as priority, and I drink 3l of water. But I have definitely had some shit food too - when I was trying to find my maintenance calories I ended up with about 500 "spare" after healthy meals, so didn't stress if I had the odd piece of cake or a few biscuits, as it kept my weight stable.

I have been wondering if sugar deadens the effect of MJ - I was low carb all the way through the weight loss part, and only added carbs after reaching target. This is definitely when the food noise started again. But it's really hard to get 2000 calories in without carbohydrate.

I'm thinking I might take a couple of weeks off, use every last bit of willpower I have to get back to proper low carb, and then start back on 2.5mg. Then at least I will know.

Thanks for posting your experience, I can’t help as I am still at the weight loss stage, but it does concern me when I don’t have that goal to focus on anymore, what is next.

Reading your post reminds me of Christmas, where I stuck to my dosing schedule but ate, in moderation, Christmas food - some treats, yule log, crisps and I was surprised as the Christmas period progressed how the cravings were starting to come back stronger and stronger. A bit like stopping smoking, then have one, that leads to two and before you know it you are craving cigarettes and a smoker again. I never increased dose but it felt that it took most of January to get back into the swing of things.

I see similarities in your post and it makes we wonder if I can ever go back to having just one cigarette……

That's exactly how it feels, yep. Although for months I felt like chocolate had no allure. That's what was so magical about MJ for me. Over the years I have lost tons of weight on low carb, and after the first week it totally removes sugar cravings etc. But (obviously!) I always gained it back, because the second I had anything with sugar in it, my body reacted like it was bloody crack and demanded more and more till I was fat again.

I really thought Mounjaro had ended that cycle. I stayed low carb way longer and to a much lower weight than I ever previously achieved without it. But I supposed it also lulled me into a false sense of security, thinking I was now "normal" and could have a slice of toast without falling off the wagon. Wrong.

I went up to 5mg then took 6 months break. It doesn’t seem to be working now I’m taking it again. Feels like body is used to it x