I’m finding working back down the doses so scary.

[Icanthinkformyselfthanks]

I’m only 5’2”, I was just over 190Lbs; this morning which was my one year Mounjaro anniversary I weighed just over 116Lbs. It is such a massive, massive change. I have previously lost over 50Lbs twice and put it all back on again and more. I shall soon be 63 years old, I can’t do that again. Mounjaro felt like my last chance saloon, the final frontier; the end game. I accept having to take this medication forever, hopefully in time it or another iteration of it will become vastly more affordable.
I hadn’t anticipated how challenging I’d find this stage. Losing the weight mind wise was straightforward. You lose you win, you maintain, you try to accept, you gain you cry. Now I’ve set myself a 5Lb buffer between my goal weight (120Lb) and the weight I aim to head towards if it’s a special occasion (Christmas/holidays) 115Lb. We’re off on a 3 week cruise holiday just after Christmas so I’d like to be at 115Lb when we board.
I had got up to 15mg, I’m presently on 12.5mg and aiming as I go down the doses to stay at each dose for two months. I’ve just ordered a 10mg pen. I was always a bit apprehensive moving up the doses but that pales into insignificance compared to my apprehension going down.
If you have been on this journey moving down the doses I’d be so grateful to know what I might expect and especially how you understood where your maintenance dose is. I really haven’t seen much about people’s experience with this.
Thanks

Sorry this doesn't answer your question. I just started.

I i'm curious how you lost 50lb without it
And also what was it like going up? Is your plan to be on low-dose forever?

@RoundandSad , the last time I lost 50lb without Mounjaro I intermittent fasted. I still fast but to a much less severe extent, I had previously only eaten 4 meals a week, I ate once every Tuesday, Thursday, Saturday and Sunday.
Going up the doses posed no issues for me and I think I will need to be on at least a low dose forever.

There’s a thread specifically for supporting people in exactly this position, check it out

I’ve been in maintenance for 6 months, I’ve slowly come down from 10mg to 2.5mg.
I continued to lose weight in the first 4 months and found going down was really easy.
I have found the last month a bit more difficult, the combination of a holiday and moving into winter, which I always find a bit hard, has meant I’ve been drinking a bit more wine and eating more (warm carbs food) and have put on 2.5kg.
I have gone back to 5mg and will continue at 5 until I feel I’ve got back to my target weight. I’m hoping that by addressing any weight gain quickly, I can keep on top of things.
I currently have no intention of stopping WLI.

4 meals a week 😱

If you're comfortable having a pen open for more than 30 days and using a syringe then buying 15mg pens and dosing 10mg is a much more cost effective way. I'm dosing 12,5mg from a 15mg pen but I have the safety net of going up again if I feel I need to. If you're planning on staying on it long term you don't actually have to titrate down - you can maintain on 15mg if that's what works for you. I appreciate the cost is crazy though.

4 meals a week? Yeah that's fucking nuts, sorry!

So the good thing is if you’re going down doses at goal weight you can always go back up on a maintenance programme. I was with Boots my entire year to goal but switched to OUSHK as Boots refused to offer me maintenance and I just didn’t trust them.

I don’t know if you have the intention to come off entirely but I know I can’t. My allowable calories is only just over 1000 on maintenance, there’s no way I can do that on MJ since I didn’t manage it for 40 years.

Im too short, too old, too insulin resistant, too (slightly) hypo thyroid to do it so I’m just aiming for the lowest dose possible.

I still save money on food and alcohol even on the stupidly expensive £284 a month but ideally I want to get to the lowest price.

And we need to bear in mind this is also short term. Pills and cheaper MJ is coming so worst case scenario I’ve only got a couple of years of this cost.

I’ve been fine, I went to 10mg, lost 6 and a half stone. I did one extra month of ten, whilst reverse dieting, so increasing cals by 100 odd a week, then I moved to 7.5, keeping increasing cals till I stopped losing, then moved to 5, where I have been for 6 or 7 months, with a totally stable weight.

the increase in cals, the slow one, with the slow reduction in meds, off set each other, so it felt the same throughout. And if I have a week away , holiday etc, I just slightly increase my dose, when I come back, like move from 5 to 5.5 and the weight falls off.

i get the apprehension, but you will be fine.

Frenchfrychic

how is the reverse dieting doing for you. ChatGPT talked me through it a few months ago and was convinced I could get up to 1200 calories with gradual increases.

I was initially very sceptical as I never had any food issues, I basically ate only 1400 calories a day for more than 15 years and put on 6 stone 🤦‍♀️ (with lots of intermittent joining of bloody weight watchers and slimming world - where obviously I put on weight)

@LaurieFairyCake , it’s worked brilliantly for me to be fair. I lost a few pounds as I settled ie titrated down on the medication and up in the cals, which was good as gave me the buffer, and then I settled where I don’t lose or gain really. I feel the same in 5mg as I did on 10. I guess due to the increased cals.

Sometimes I go down a pound, sometimes up a pound and a half (unless been away) so weight is really stable. I can eat a surprising amount to be honest. I go out for dinner every couple of weeks, drink wine, and it seems to have no impact, I’m up a lb or two ghe day after, then the next day back to normal and it can trigger weight loss, like the day after that I’m down another pound. But it goes back up, I get hungry for meals, eat a healthy portion, and don’t really think about it again.

i eat about 2000 a day, but I do work out,

@Itscoldouthere , thank you that’s reassuring.

@LaurieFairyCake , I’m also short, old and hypothyroid. I’m as certain as I can be that I had/have insulin resistance issues. I don’t think I can ever stop taking this.

@PumpkinTwistyWindToots , which supplier allows us to stretch doses in this way please?

@PumpkinTwistyWindToots , I read the Obesity Code by Dr Jason Fung who is very well respected. It is a legitimate fasting protocol for weight loss.

@Frenchfrychic , thank you.

Oushk are pretty easy going about gaps between ordering and they have an official maintenance plan I think, I haven't checked it out but I understand you can order less frequently and pay a small standing charge to do so? Not sure

Of course you'll lose weight fasting to that extreme. But it's no more scientific or a 'protocol' than any other type of VLCD. It didn't fix your insulin resistance did it?!

@PumpkinTwistyWindToots , I wasn’t advocating for it; just answering the question honestly. And no apparently it did not fix my (undiagnosed) insulin resistance.

I’m trying 2.5. I never went higher than 5. I’ve lost four stone.

Sorry, I didn't mean to be as snippy as I sounded (not at you anyway)
I cannot believe anyone 'well respected' advocates for anyone to eat 4 meals a week for longer than a week at the most. That's eating disorder behaviour.

4 meals a week is really concerning op, that’s nearly starving yourself. Yes you will lose weight, but many people would be binging after that, the blood sugar fluctuations would be enormous making insulin issues worse. It also sounds utterly miserable

I'm with Curely. It's subscription but you can pause, skip a month or change the delivery with no problem.
I'm buying the 15mg but only using 7.5 each time now. I'm more or less ready for maintenance but would like to gradually lose another 7lbs as a buffer. I'm half way down a pen and have another one ready so I will skip buying next month and then review.

I don't think I'll ever buy less than a 15 pen if I can avoid it as it works out cheapest per mg and I don't have an issue with using one pen for over 30 days or even over 60 so long as I keep it refrigerated

Hi, I'm similar to you, 5ft 3" I'm at bmi 22.9 9st 3lbs though today I got measured by nurse and I'm 1cm shorter, gutted!
I made it all the way upto 15mg in mid August at bmi 25, but the step up from 12.5, when previously suppression had worn off after only 7 weeks, was far too strong and I was like a zombie and could only eat 750-900 cals a day for the whole month and lost 6lbs. Stupidly I did the golden dose too, all of it..I then already had another 15mg pen in fridge, as I assumed it would settle after the first 2 weeks like the others but it hadn't. I then started doing 12.5mg doses from it, it was still super strong, after 2 of them I did 3 x 10mg doses, still too strong..which shocked me, I had no idea what was going on. I then did 3 x 8.5mg doses from the remaining pen, which were ok, I was still losing and suppression worked fine. I then had a 10mg pen and did another 4 x 8.5mg doses from it, after trying 7.5mg which i was hungrier on, but 8.5 was fine, then I have 1 more 8.5 to go and another 10mg pen in fridge and a wegovy of 1.7mg, which I wanted to move on to due to 10 months of hair loss and being exhausted from day 1.
Anyway to explain all this, basically don't worry tapering down as suddenly when I got to 10st bmi 25, suppression was a lot stronger and I do believe my prediabetes was resolved and all the weight loss means I was more sensitive to insulin, so I didn't need the higher doses anymore. I'm going to try wegovy next then I have the 10mg pen to do either 7.5mg or 5mg or a mix of whatever doses I'll need at the time, trial and error! I'm hoping to stay on a low maintenance dose before stopping in spring. All is going well so far and I'm suppressed enough to stick to low cals but I wouldn't worry if I had to eat more. I'd rather get to 9st but I'm not desperate.

I know what you mean OP, it can mess with your head! I have been in maintenance for a few months and dropping down the doses slowly and also questioning myself. Last week I had lots of food noise and definitely overate. This week feels much more normal - hungry, but managing my calories just fine. I'm constantly asking myself if it's because I'm on a lower dose but it seems like it's just natural fluctuations.

All of which is to say, I've got no real advice but you're not alone! Maintenance really is a tricky game after all.