When you stay on a low dose so you can eat more...

[CanILeaveMyJobPlease]

I've read a couple of threads where people have made comments such as "gone back down to 5mg as couldn't cope with not being able to eat enough on 7.5mg" or "I don't want to move up from 2.5mg because I won't be able to eat enough".

As someone who (probably unhealthily) is finding themself addicted to the feeling of full suppression and absolutely loves not wanting to eat, I'm really curious about this.

Why do you want to eat? (now I've just written that, I feel a bit stupid for writing this question!! But I'll leave it as maybe the answers are more varied than I think!) And what do you mean by "I couldn't cope with not being able to eat enough"?

(Just trying to make sense of my own unhealthy relationship with food and hunger. I'm at maintenance now so towards the end of my mj journey. But scared to start coming down the doses and I cannot understand how it feels to want to eat more and not chase suppression)

Thanks. I can't imagine how talking will help. Maybe.

Thanks.

My BMI is currently 19. I am happy with this. I am maintaining. Twenty years ago when I had bulimia, I wanted to be stick thin. I wanted to be anorexic (which I know makes no sense) but I couldn't stop myself eating so did not manage to be anorexic (so I felt a fat failure which made my bulimia worse...). I wanted to see my bones. I actually didn't value my life that much so telling me starving myself could kill me, didn't bother me. I wanted to be skinny at whatever cost (thank god these wl injections weren't around then because I'd have definitely got my hands on them, and I don't think I'd still be alive now if that had happened. I 100% would have starved myself to nothing.. )

I don't have that mindset now. I am happy with my current weight. I've just never had this peace in my mind before and it's incredible. Honestly since I can remember, my brain has calculated the calories in everything. Constant number numbers numbers in my head. I thought about food every minute of every day. Now, when suppression is good, that doesnt happen. I have peace. When I'm not hungry it's incredibly calming and I can actually have head space to focus on other things. As soon as the hunger creeps back in it's like instantly the brain starts going into overdrive and I'm back feeling starving, wanting food and freaking out about calories.

Maybe I can stay on GLP1 for life. But that just doesn't feel healthy.

I think your way is unhealthy. Both physically and mentally.

I want to eat, because that's 'normal' and healthy. I just don't want to overeat. I am 4 months in and so far only taken 3 doses of 5mg. I'm not chasing total suppression, nor rapid weight loss. I am using mounjaro to support me to eat in a healthy deficit to lose weight at a steady pace. This way I avoid all the risks associated with rapid weight loss such as gallstones, pancreas, loose skin and hair falling out. Staying on a low dose allows me put in place all the healthy lifestyle changes I know I need to do, but struggle.to.manage without the medication. I also don't want unpleasant side effects. I will.stay on 5mg for as long as I have this perfect balance of being 'normal' with regards to appetite etc

I LIKE food. I LIKE enjoying delicious food. At the moment, I sit in front of a plate of food and just cannot be bothered with it. That’s a horrible feeling!

I think this is the bit I don't get! I don't like food that much, even though without GLP1 I just want to eat and eat! So with GLP1 I feel happy because I don't think "that's a horrible feeling", I think "this is a greaaaat feeling"!

Mmm.. How interesting! I would like to read more on these different mental approaches to food.

How long have you been on it?
Agree with the PP who remark on warning bells re disordered eating.
have been on MJ since November last year, increasing very slowly and even skipping the odd week here and there. currently on 7.5 but probably inject every other week maintenance. Will see how it goes may/may not continue/titrate down.
Currently not interested in a higher dose. I don’t want to go back to being repulsed by food as I was in the first few months. There is an impulse there for me but I know this is the ED part of my head and I shouldn’t give in to its madness.

To do this, I practice gratitude. I like my body now for the first time in years - I am down probably 4 dress sizes. I am reprogramming my brain to think of myself as “a thin person” and that helps too - as a result I tend to make “healthy” choices, I’m more mindful of what I feed our family, I find it easier to have the discipline to stick to what exists of my plan (its pretty loose tbh - I don’t eat breakfast and try to stick to an eating window, snacks ideally fruit/nuts). I also now have the ability (most of the time) to actually feel full and to stop eating.

However I have lost weight too quickly (though I didn’t weigh myself once) and my hair is falling out. I am now trying to focus on increasing the quality of my nutrition further and introducing weight training this week

7 months in it is a joy to enjoy food, to feel satiety, to feel like I have control. I enjoy treats etc, and I’m not worried about binging. I used to binge terribly at night due to stress/ADHD having been a restricter for years. this was the main driver of my weight gain and the main thing I wanted support to break. I LOVE that I don’t have this problem at the moment, and I feel no shame about getting support from MJ if I feel it slipping. But currently I don’t need more than this. I especially do not want the fatigue side effects back.

Thanks girlJulian

How did you come off it? Was it scary? Sounds like mentally you have a healthier mindset now. How did you attain that?

Who is prescribing to you please with a BMI of 19

Several suppliers will support maintenance at 19. I'm with oushk and they do. My BMI is 29 currently and I'll be aiming to stop around 22 I think. But on my maintenance call they said 19 is the lowest they will go currently

perfectly normal feeling of hunger has you terrified of losing that control and you immediately drug it away.

mmm.. yeah I think this is true.

I thought I was 20 yes recovered from bulimia! But I guess my head is still not fully recovered. Can it ever be?

I'm open to getting help, but I sort of don't feel that bad. I'm nothing like what I was 20 yes ago. I am genuinely happy with my weight. My mind (on mj) is peaceful. But maybe i still have some residual issues I need to sort out. Food for thought ..

I haven't been entirely honest with my supplier about my current BMI (because they've been great and I didn't want to have to switch). However I know that's wrong so I plan to switch to Pharmulous this month who accepts people with a BMI of 19 for maintenance.

That's really interesting thanks. Especially the dopamine fog thing. I think I may have that.

OP, there is a reason why you are asked when they prescribe if you have ever had an eating disorder. Sounds like yours has reared its head again and it’s not merely a residual issue. You have an ED. Unfortunately it is often the case that they never really go. If you are barely eating it will have serious effects on your health, your hair will start to fall etc. Don’t fool yourself it’s a ”different approach”. You need to wean off the drug.

it’s very wrong that it’s continued to be prescribed at this level at low BMIs.

Thanks. I do want to come off it. It's just really scary and I don't know how to because I am scared of feeling hungry. I really really really don't want to end up eating and eating again and putting all the weight back on. I can't tell you how peaceful my mind is on mj. Calm. I don't want to loose that

Thanks for all the posts and replies. Sorry I haven't replied to every one. I have read all of them and it's been incredibly helpful and given me a lot to think about. Thank you so much.

Oh I really don't! I just recognised the old mindsets coming back and told myself I had to stop, so I just stopped cold. I actually haven't put any weight back on. I told myself I used to be so good at dealing with hunger and I could be again, which is just another ED coping mechanism unfortunately -- remember the "hunger is good but I'm even better for resisting it" feeling?

You're clearly showing some disordered thinking that suggests your ED has taken a new form: lying to the medical professionals to obtain medication, panicking about feeling hunger (a normal bodily feeling you should be able to feel!), undereating enough to feel too tired to exercise (and chasing that feeling), wanting to stay on the jabs permanently because it allows you control, fear about having the crutch taken away from you. If I were your doctor I'd be very concerned, and I think it's worth speaking to them. There's no shame in having a condition triggered by something that is - almost by design - tapping into previous elements of that condition, but you do need to be careful not to let it get worse.

I was asking OP because I suspected she had lied to get the prescription, which is the case.

I just recognised the old mindsets coming back and told myself I had to stop, so I just stopped cold.

Wow! Well done! 💛

As I’ve said on a thread I started, MJ hasn’t worked that well for me. That might be because I didn’t like some aspects of the suppression I got on higher doses. There were a couple of days a week when I scarcely ate as I just didn’t think about food. On the other days, underlying nausea meant I mainly wanted to eat carbs or really bland, easy to swallow food like yogurt. I could stomach apples but not really any other fruit and no veg. Even more of an issue was that I wasn’t drinking much. Yes, it is healthier for me to be reducing my weight as I was obese and am still overweight but it is not healthier for me to be dehydrated and eating a really limited diet. There was also the issue that the limited calorie intake meant I was constantly knackered and really reduced the exercise I was doing. And how I interacted with the family.
I am back down to 2.5mg and today I ate plain Greek yogurt with banana, blueberries, strawberries, chia seeds and a smear of honey; a protein bagel with cottage cheese and a side salad; chicken casserole with broccoli, cabbage, peas & a dollop of mash. And I had an apple. And drank 2.5l of water. My calorie intake will be much higher than yours but I feel my body is benefitting from all of the fuel that I put in it today. I also did a spin class and a Pilates class. That would be unthinkable had I still be on a much higher dose.

Treatment for eating disorders always involves talking therapy. Always.

I hope you are beginning to recognise how seriously disordered your thinking and behaviour have been. You are lying to your prescriber about your BMI, and probably about your history of ED. BEAT will give you sensible, non-judgmental advice.

My friends who were on them said they hated having no energy, couldn’t exercise, low mood. So they went down to less suppression so they could eat more food but still in a controlled way. Slower weight loss but they just weren’t functioning or happy on higher suppression

My bmi is 20 ( been around this weight for 6 months) and I’m on 10mg. Been on mounjaro a year. I really don’t want to come off it but I’ve just had a massive telling off by my gp for being on it. Told me the providers don’t care about my health and insisted that mounjaro shouldn’t be used for maintenance. I recognise a lot of what you’re saying. I’m scared of coming off it as well

Thanks! Glad it's not just me and that you get it!

It's a bit confusing because there are quite a lot of people on YouTube etc.. who 'seem' to be knowledgeable, who are saying people should stay on it for life. But then others say you shouldn't! It's hard to find facts and reliable information (and I'm not convinced GPs know much more than anyone else as these meds are fairly new)

This is exactly how I feel about remaining on 2.5.
I'm only a month in and still getting good suppression and just hope this continues but I appreciate it's early days yet.
I'm early 60's and short in height.1 month in I've lost 6lbs which I'm happy with.
Are you still going to continue with 2.5 for the time being?

I didn’t want full suppression. I was doing lots of weighted exercises and I need to be able to eat a good amount so I can work out. I also didn’t want to be on MJ for longer than I need to.
I used MJ for 4 pens, 1 was 2.5 and the other 3 was 5mg. Apart from the first 3 weeks on 2.5, I didn’t experience full suppression at all. I had ‘food noise’ but when I’m eating, I can feel when I was full so used that to still be in a calorie deficit. On the 4 pens, I lost over 23% of my starting weight and finished with a BMI of 24.8.
I’ve been off the Jab since early February and because I never had full suppression whilst on the jab, being off has not made any difference. I’m now a BMI of 23.5 so still losing weight without the jab because I’ve just been using the same coping strategies I used to manage hunger when I was on the Jab. It’s worked well for me.
I don’t see the feeling of hunger as bad, just that now I want to consciously fuel my body with good and nutritious food when I’m hungry.
As others said, you don’t want ED to be rearing it’s head again so seek help before it gets any worse