Should I move up a dose?

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I’ve been on Mounjaro for nearly a year. I did a month at 2.5, probably about 4 at 5, 4 again at 7.5 and now I’m heading into month 3 of 10mg. In that time I’ve lost 7 stone 1.7lbs.

I feel like this is a good loss for a year, but also that it’s slowed down a lot over the last two months. I am tempted to move up to 12.5, but I’m also aware that there isn’t much further to go in terms of dosages when you hit the final ones.

I will drop a large amount of weight the first week of my menstrual cycle and then slowly gain it over the month, before a big drop before my period and then the same cycle again. This has happened for 2-3 months now

What should I do???

Have a good look at your daily calories. You have lost a lot of weight and you probably need to reduce what you are eating to continue to lose . Maybe that would be a better approach than upping the dose?

I’ve reduced them down - I’ve gone from about 2100 daily and still being in a deficit to now being at 1500 daily. It doesn’t seem to have done much

Depending how old/active/BMI you might need to go lower. If you are not losing you are eating too much to lose

I’m reasonably active - gym 4-5 times a week, 10k steps a day. I can’t go much lower without it impacting my day to day.

7 stone is amazing!

I know nothing about WLI but what does ‘slow down’ look like? Healthy weight loss can be slower and fine. As long as it’s in the right direction…

How much more do you need to lose?

The NHS says I should be somewhere between 7 and 9 stone ish to be at a healthy weight.

I personally think that’s too light for me and I’d like to stop at 10-11 stone, with a view to spending at least a year maintaining on a lower dose before slowly coming off.

I’ve only lost about a stone in the last three months

7 stone is amazing, perhaps not strange that you’re in a slow phase for a while.

Whether to go up or not would depend for me on how much there still is to lose. You said your target weight, but not how far off that you are?

FWIW I’m having the same menstrual pattern as you now I’ve lost nearly 5 stone and am at BMI 25. I think it’s because I’ve increased my calories to let my loss tail off. I’m now losing more slowly and there’s much more of a down and then up round my period.

im 4-5 stone off my goal, depending where I set that

Back of a fag packet maths!

I’m rounding. About 5 pounds a month, a little over a pound a week. Perfectly healthy and sustainable loss. Is it vaguely consistent? 5 pounds per month? Or has it tailed off? I know the monthly gain and loss must be frustrating, I get hormonal issues! But getting into boringly sustainable eating is important.

I wonder if you are disappointed because if you lost 7 stone, 4 stone must seem like it should happen quickly and you’d get to a ‘normal weight’ in a matter of weeks. I eat LCHF and at the beginning it’s really quick. I always think the last bit is going to take x weeks and it takes 4x weeks!

I do think that’s part of it. Pre-Christmas it just seemed to melt off me. Had a bit of a stall for a couple weeks post Christmas, the next two stone came off easily and then the last stone has taken three months. It’s just getting draining now

I think that's an ok rate of loss - it was bound to slow down a bit.

For comparison, I have lost 7lbs in the last three months - I was starting to lose the faith but it's now back to 1lb/week which feels fine.

You'd still have 15mg to go to, and Eli Lilly reportedly have higher doses in trials at the moment. Also other similar drugs such as Retatrutide are in trials. It seems rather misjudged not to go up to 12.5 because you fear ending up with nowhere to go, when there will still be another dose up.

I've also read so many times about people finding one particular dose is markedly less effective for them, and things start moving again when they increase the dose.

Yeah this is also a good point, I did flip between 7.5 and 10 for a while as it did feel like 7.5 was more effective for a while. I’ll give 12.5 a go and go from there

...the last stone has taken three months. It’s just getting draining now

But that's just your life now isn't it? Maintenance will be even less satisfying than slow(er) weight loss. So perhaps as pps suggest, reaching acceptance of your current situation will be more realistic and better for your mindset long-term?

I’m not entirely sure what you mean?

im still 15 stone 9. Dangerously obese. I don’t think it’s unreasonable to be annoyed that despite everything (paying monthly for a medication, calorie counting, going to the gym) it’s still slow

I agree with this. Probably time to bite the bullet and go up a dose. Alternatively, you could consider a re-feed where you increase your calories for a few days.

But also, 1lb a week equivalent is still good going! It just feels slow after the earlier periods of more significant loss.

Sure, you can be annoyed, but it doesn’t alter the situation. I was thinking about how we have to find a new normal in our relationship with food, and it won’t always involve weight loss at a satisfyingly fast rate. So acceptance of a reasonable, if slower, loss might benefit you more longer term.

Have you calculated your tdee and deficit calories? I have to eat less than my deficit for 1lb a week continuous losses. Lost 4.6lbs last month and 5.5 month before and I'm now bmi 25 and 10st 1lbs. They do say weight loss is mainly through diet. Exercise helps build muscle which burns more fat but diet is the main influence

If it were me I would stick to the current dose. 1lb/week is a good rate.

If you want to lose another 5 stone then at 1 stone per 3 months that will take you 15 months - i.e. you would be at goal weight by October 2026 if you maintain your current deficit.

I tend to think that it takes a lifetime to put on the weight and so we shouldn't be disappointed if it takes a little while to come off. This is a drug that realistically we will be on for the rest of our lives, and when we are years down the line in the maintenance ohase, the weight loss phase will seem like it was such a short time.

But you could increase if you want to do so.

I think I’m going to go up a dose because I want to lose another stone by September

You’ve lost really well and know what you’re doing, but the loss has tailed off anyway, and for quite a while. I think it sounds sensible to increase dose and get yourself down to a healthier zone. Of course reviewing exercise and calories is part of that, but given how much you are planning to lose in total, it’s not surprising if you need all the doses. Good luck!! Keep us posted on how it goes?

I will do!! I’ve recalculated my calories and been at that level for a while now, it’s not a huge surprise I was maintaining but I don’t know why My calories just didn’t come to mind at all. But that extra push of the next dose would be nice

1500 sounds like a pretty good deficit at 15 stone with all the exercise you do! I expect you’re already making sure you have lots of protein and water? Hopefully next dose plus a bit of time will see you into a better loss rate again.