I’ve hit a stall and I really don’t know what to do

[LifeOfAShowGirl]

This is going to be long, I’m sorry, but I’m just looking to vent more than anything.

I started Mounjaro a year ago. I’ve lost 7 stone 2 pounds so far on it, and an extra 2 stone before that. I feel great.

im on 12.5mg.

but I’ve really hit a stall now. I’ve noticed my appetite has come back, I’m struggling to stay within my calories (1600 a day) and I’ve been maintaining, not losing for a while now. I’ve lost a stone since April.

since April though, I’ve been through a lot of stress - I sat professional exams, my mum and dad were both really unwell, and I also underwent surgery myself. So I do think that that side of things has had an impact on things. I’m really trying to put some effort into my diet now, and getting myself back to the “clean” way I was doing things before my exams.

I just feel really down about it. I’m spending a LOT of money on this each month, and I feel like I’m failing. I’m going to get back to the gym etc starting today, since I wasn’t allowed to go for a while because of my surgery. But what do I do? I’m not going to move up to 15mg yet, because I’m off on holiday and I want to give it the best chance to actually work. Because im very aware that when I hit 15mg, im done and there’s nowhere else to go if it doesn’t work for me.

You're not failing, at all. I think you've identified all the things have contributed to your weight loss being slower recently and have taken steps to change what you're doing. That doesn't sound like failure to me.

I'd give yourself time to get back into the gym, and to get back into the way you were eating before and see how you go over the next couple of weeks. And if you feel you need to move to 15mg then I would do so. That was the dose level that showed the most weight loss in the clinical trials, so there's no reason why it wouldn't work well for you.

I think I’m just nervous to go up to 15, because then you’ve got the ceiling haven’t you? If it doesn’t work for you, where else do you go?

I know I’m definitely not going up this side of my holiday because I don’t want to deal with potential side effects etc while abroad! But I think it’s just that mental thing of hitting the highest dose

Op, I’d suggest after 9 stone loss that 1600 hundred cals a day is now too high to lose weight on, especially if you’ve not been active due to surgery and your mind maybe not as focused on your consumption. Our cal requirements reduce as we lose weight, and lack of activity reduces our energy output further. It is also very easy to underestimate our cal intake , and say hit 1700-1800 or even 2000 , averaged over a week, without realising.

the drug clearly works for you and the drug doesn’t stop working, that’s why it’s approved for life, I think what’s happened here is your cal intake is now not right for weight loss coupled with lack of physical activity.

on 15, it should be fine, don’t worry but I’d focus on calorie intake, and becoming active again,

You could try doing a dose between 12.5 and 15 by counting clicks on a 15mg pen, so maybe 13.75mg and see if that makes a difference. Then you’ve still got a step up if you need it.

Becoming active again is definitely my top priority, but I have to take it slow because of my recovery.

according to multiple TDEE calculators, I should be losing on 1600. Not 3-4lbs a week, but 1-1.5, which is where I’d say I want to be. I’m not keen to go much lower than this because I’m skirting with being at a level where it’s not possible to get the things I need.

Oh this is a good idea for when I’m back from holiday. I just don’t really want to mess around before I go 😂

Ok, but the fact you’re not losing tells you something is wrong, either the tdee is over estimated or the cals intake are under estimated. or a medical issue.

When we eat in a deficit the body burns fat or muscle to fund the additional energy that we use, but don’t consume enough cals for, this in turn makes our bodies lighter, as our fat or muscle is being burned to fuel us through that deficit.

If you are not getting lighter over an extended period it says one of two things, either 1/ we are mistaken on our consumption or our tdee or 2/ we have a signficant medical issue which means co incidentally every pound lost is replaced by fluid.

If you’re sure it is not a calculation error then I’d say a trip to the gp is in order now.

I’ve literally said in my OP that part of my issue is that I’m struggling to stay within my calories.

I only had two stone to lose for normal BMI, started averaging about 1500, then 1400, and have just gone to 1200 to lose the last few pounds. Even with food tracking and weight calories are at best, a guess. So I need some wriggle room in case I eat more. And TDEE calculators never worked for me. As an active 50 year old at menopause I apparently have the metabolism of a bed bound elderly patient!

It definitely is about calories (before someone gets me!) but it’s also about where those calories come from. Are you reaching protein and fibre goals? Protein should be about 1-1.5g per kg you weigh. Fibre is about 30g.

Protein fills you up for longer and would hopefully help you stick to your calories. It’s also useful for when you stop (if you are planning on stopping) as the hunger will come back.

It is normal to plateau for the last bit. Your body is fighting the weight loss (you could read about set point weight- not universally accepted, but lots of nutritional scientists support it).

I’m trying as hard as I can to get my protein but some days I just find it impossible. My nutracheck sets it as 118g a day, which is hard unless I’m eating pure protein at every meal!

I was chatting to someone the other day who said he thought it was all over when 12.5mg stopped working for him but after moving up to 15 mg he has lost a further 3 stones and it is still working five months on.

There is also retatrutide coming along in the future.

I would move up to 15mg.

Lose what more you can and then even if you stop losing and maintain that is still a big achievement.

If you regain some if/when you stop mounjaro then it is still better than having never tried it and lost so much.

I have also had a gp suggest to me that as with some other medications ( non weight loss) the body can respond well to a complete break and then restart so that might be a future option.

Yes I think 15mg will be an option I explore when I get home. It’s just a scary thought that it’ll stop working. Nobody really told me that was a possibility

Yes I think 15mg will be an option I explore when I get home. It’s just a scary thought that it’ll stop working. Nobody really told me that was a possibility

What's your BMI now and how much further do you have to go?

BMI is 36. I’d like to lose another 4 or 5 stone I think.

A stone since April is really not that bad. Just under 1 pound a week (depending when you’re starting from in April) and after such a big loss is probably quite normal. I would go up to 15 after your holiday and see if it kicks in starts things again.

It’s since the end of April - about 15 or so weeks. It just feels like a pathetic loss compared to the six stone I lost in the 8 months before

It's not a pathetic loss at all. Weight loss inevitably will slow down, as you lose weight and your TDEE lowers as a result and so your daily calorie deficit gets smaller. The way to increase the weight loss is either to reduce your calorie totals, and/or to increase your exercise - particularly strengthening exercises as well as calorie burning exercise.

I also think there's a mental shift to be done to accept that the larger losses you might have had at the start aren't going to be happening any more, and that's ok. Any loss is heading in the right direction, maintaining is ok too, and the odd gain week here and there isn't a disaster either.

Yeah I do think it's mainly mental. I think something I've struggled with is seeing women who have lost a similar amount of weight as I have, going from being visibly overweight to looking normal. I feel like I still look massive

For comparison, it’s taken me a year to lose 2 stone.

I’m on 15mgs now. I am stubborn with calories, protein target and exercise a lot.

it just takes time.

To lose 7 stone in a year is mind blowing. To have lost 9 stone in that time? That would be too much, that’s a massive loss.

I don’t think it’s too much, I was high 24 stone in January of last year and I’m now high 15 stone!

You’ve done brilliantly, OP - you must feel like a new person 👏👏👏👏

I understand the fear though - I’m like you, I know I need the MJ to curb my appetite, no matter how many new habits I’ve acquired.

I’ve lost 4.5 stone since last October when I was 16.5 - got another 1 ish to go before I maintain. That will bring me to a BMI of 25 , which with my frame and being 55, I will be delighted with.

ive plateaued on 7.5 for about 5 weeks. Just gone up to 9mg from a 10mg pen and can feel it’s giving me the oomph I need.

i didn’t want to go straight to 10 to avoid side effects, and like you, want to stay away from 15 as long as a I can.

good luck and don’t lose track of what you’ve achieve,

and, as a PP said, there are plenty more developments on horizon for weight loss meds. You won’t be high and dry xxx

i try and make my meals mostly protein and veg. Veg and salad are so low calorie that it means you can eat substantial protein.

I don’t really eat much in the way of ‘carbs’ anymore. Obviously lots of things have carbs in, but I mean pasta, rice, bread etc. I do occasionally, but not every day.

So every meal is meat/fish with veg or salad. I have Greek yoghurt for breakfast, which is fat (but good fat).

I've been on 15mg for 5 weeks now, I've struggled to eat throughout and I was prediabetic at the start and the doses all wore off quickly for me, including 12.5mg which only worked for 7 weeks for me.
I was even stupid enough to do the bonus dose on Friday and I feel like I've recently jabbed as im still super suppressed today, so much that I'm forcing in 700-850 cals a day and that's while im at work and expending more cals than at home.
So try not to worry about where else you can go after as many stay on 15mg for many months and it works well for them. For me I'm going to delay my next dose and go down to 12.5mg asap then continue tapering down as I'm bmi 24.2.
I lost 1.7lbs last week due to lack of food, which is not to be proud, esp at 9st 11lbs.