Decision making for moving up a dose

[Tammy214]

I am a fairly new member, have read through the threads but its not answered my question, apologises if i missed a good thread (please point me in that direction).

I am on MJ, first injection. I am wondering about peoples decisions on moving up dosage. From what i can see mostly people are moving up if they havent had significant side effects or issues.

For those of you who stayed on the same dose for a number of months without any issues of major side effects, what motivated you to stay on the same dosage and not move up automatically?

This question is more for the future, I have started 2.5, I have a 5g pen in stock so i will be aiming to move up, but i am not sure how far i want to go to acheive the loss i am aiming for (4 stone).
For reference, i am aiming to lose the weight and come off the drug at the moment, for me i think that might be the right path.

Good luck on the weight loss. I have been on it for 11 months and moved up very gradually. After a month went up to 3.75 for a couple of months, then 5 for a couple of months then 6.25 and then 7.5mg.

Partially because I didn't want to risk bad side effects which I had read others had from going to the next dose in one go and because I didn't want to lose weight too quickly.

I have lost about 5 stone doing it this way. As you get used to it you start to feel when you might need to.go up.

Obviously everyone is different and given the cost implications some people may want to lose a lot quicker then I have.

Generally, people move up the dosage strengths to get maximum appetite suppression. If you feel it’s working miracles at 2.5mg then there is no need to go any higher is there? Some people increase dosage only to suffer side effects so many stay at a lower dose. It does feel as though the culture is to move up through the different strength pens almost “automatically” until you reach the maximum, but my advice is to listen to your body.
For myself, although I found smaller portions were filling me up for longer, I didn’t really notice any real appetite suppression until about 10mg, so although I moved up to 12.5 I never made it to the 15 pen as I felt there was no need. The weight was coming off, (over 5 ½ stone in 7 months), I had little to no side effects so the 12.5 pen was ticking all the boxes.
Now slowly working down the doses to come off it completely. Good luck with your journey!

I started mid January and on 10 mg. I’ve lost just over 4 and 1/2 stone. My aim has always been to stay in the lost dose I need while still losing weight. There are times when I didn’t have as much motivation or a busy time so I have stayed on a dose for another month when I could have increased.

" I have started 2.5, I have a 5g pen in stock so i will be aiming to move up"
@Tammy214 I guess my first question would be why are you aiming to move up? There are plenty of people on here who have successfully lost a lot of weight on 2.5mg and have never moved up. You really need to give it a full month on 2.5mg and see how the weight loss goes. If you don't lose any weight then fair enough, think about increasing the dose but I wouldn't assume that you will need to, at least for quite a while.
Do bear in mind though that the injections can't do it on their own. You still have to do the work, whether that's calorie counting or just changing the types of food you eat, but eating appropriately is key. The injections just help you to do that.

I've been on 2.5mg since the first week of September and have been losing weight at an average of 2.2lb a week. I don't want to lose weight any faster than that, and I'd rather not pay the extra for a higher dose or risk side effects.

I have felt that the drug is having less of an effect on me these days, and if that carries on I will probably increase my dosage in the next couple of months, but when I started getting a but stricter about my nutrition and actually eating enough, I stopped wanting to snack again, so it might be longer.

I didn’t move up, I hated the appetite suppression in the early weeks, it was terrifyingly strong. I have stayed on 2.5mg for well over a year and lost 7 and a half stone so far. I eat well, 1500-1600 calories a day, sometimes more. The majority of my diet is healthy, I still feel hunger and have an apetite but I do think these are normal things to feel.

I made the decision quite early on that I didn’t like that intense initial suppression, and I would try to stay in a place where food noise and cravings volume was turned down enough to let me stay in a calorie deficit long term.

If I felt the effects were waning, (they do some days or even some weeks), I would wait 2-3 weeks, refocus on the basics - protein at every meal, minimal UPFs/sugar/sweeteners, eating mindfully, plenty of water, perhaps track calories and macros in an app too, and then reassess.

Following that for the last 18 months I never needed to increase beyond 3.75mg (which I only increased to after my first pen because provider implied I should move up after 4 weeks at 2.5mg). I have dropped down to 3mg as getting closer to normal BMI now happy to take the last bit slowly and haven’t noticed much difference,

I will drop to 2.5mg, probably end of January as I remember last year with the Christmas treats and eating out of a routine the cravings came back and it took most of January to get back to pre Christmas effects (without a dose increase).

I’ve been on it 8 months and have lost 5 stone and am still on 2.5 which I have every 10 or 11 days.

I don’t have appetite suppressions in I can eat a big meal but I have no wish to overeat and I don’t have the urge to snack. So its like it’s changed my brain and the way I think.

I have another 3 stone to lose and am happy to lose it slowly so hope I will do the rest of it on the lowest dose.

I've been on Mounjaro since end of August - my aim was to stay on 2.5mg all the way through. But in the 4th week I was getting urges to snack, so decided to move up to 3.75mg (6 weeks) to minimise side effects.

Another reason for deciding to move up, was learning that 2.5mg isn't a treatment dose, and my whole reason for deciding to take Mounjaro was get support for the insulin resistance that I've had for for years and hba1c that had recently strayed into diabetic territory.

I may still increase further, but I will take my time to move up doses (by 1.25mg) and not just automatically every 4 weeks.

I stayed on 2.5mg as I lost at least 0.5kg each week with no hunger between meals.

Thank you all for replying, very much food for thought.

I purchased the jabs a month before i started (i like to be prepared and planned) so i hadnt started before i ordered the 5g dose. I like the idea of being a month ahead, just because thats how I am and the first pen is the start of the treatment but its tritation so it felt like it would be a primer before the 5g and fully starting.

Am aware that people have different senstivities and therefore for some the 2.5 is enough. I am aware also of my own tendancy to be competitive even with myself and to want the proceed quickly to get the best result in the quickest time (not always a great trait).

I am obviously not relying on the drug itself, there is a whole support plan, and the excercise part i started slowly a few months ago which i had lapsed and i get back on it next week. Strengh excercises are in the plan as is other things that support the meds as its a process, especially if , like me your aim is to eventually come off it.

The question comes from a place of research from personal experience, as an overthinker I have read everything i can about it including medical journals and white papers. it doesnt however include the lived experience just clinical results.

must admit i kind of assumed i would do cold turkey not taper, but that is something i need to think about

I did one pen on 2.5 and have been on 5 ever since (7 months). It’s not working as well now so I’m toying with moving up for my next pen but it’s also quite a jump in price.

Even though I stayed at 2.5mg I’m tapering down. Currently on 2mg. No way would risk cold turkey!!

If you’re prepared to go over 30 days with your 5mg pen, you could take eight 2.5 mg doses from it - 49 days

I am aware also of my own tendancy to be competitive even with myself and to want the proceed quickly to get the best result in the quickest time (not always a great trait).

You perhaps need to rethink what your definition of "best result" is when it comes to medicated weight loss for obesity and health. However much we all want it quickest is not the "best" outcome!

The best result is consistent healthy weight loss of 0.5-2lbs/week (depending on your starting point), discovering how your body responds to different types of foods and ways of eating, improving exercise routines, then success at maintaining long term. It is not a quick journey for most of us.

2.5mg since May, started feeling like the effects weren’t there so went to 3mg for the last month, it feels like that’s tapering off now too though, but I’m happy I was able to stay on it for so long!

it’s often overlooked but you don’t have to use your 5mg pen as your next one, it’ll like have a 2027 expiry anyway so you can always get another 2.5mg and use that until you feel ready to go up.

for me personally if I was losing 1-2lbs a week then I didn’t see a need to go up. I introduced exercise fairly quickly so it might be that that was contributing to weight loss as well but losing slower has benefits like potentially reducing loose skin (which is worse when you lose weight too quickly), making it more likely you’ll keep it off long term, and frankly preventing some awkward conversations in the early days.

Still on 2.5 and it's still working after 9 months. It's the calorie deficit that makes you lose weight, not the dose so if you can stay in the defecit easily then don't move up. Don't chase suppression as it may never arrive or fluctuate.

I'm nearly 5 stone down.

yes success criteria , i have already got that in my plan as thats the first thing i thought of. My best result isnt necessarily just about the fastest weightloss.

My diet is always something i focus on due to my own dietary needs.. I also dont have an issue with the idea of maintaining, mostly because i know the reason for the weight gain and since that lifestyle has been changed , however i need help shifting the backlog of weight.

Thank you for that reminder about the expiry date!
I do think i will move up to 5 but i will take more care in the decision ofter that pen to see, I will wait until atleast my first 5g dose and decide what to do after that and make it a decision not just go up automatically.

so the answers here have been helpful

This is something that makes sense, i feel many are chasing suppression only. But there are many facets to the drugs impact that have to be considered, and we are all different and have different requirements

Not to hijack the post but how do you go up to 3mg is it less clicks of the 5mg pen… wise ones please advise as I think I would rather 3mg than 5mg as my next step.

i also wanted to add (cant edit my post) that I am curious about suppression working without a colon, even though technically it shouldnt because the secretion is in the small intestines, I havent see information on research on people with my condition. So it could be I need to have a high ish dosage but have to balance that with potential side effects, am sensitive to some medications.

So one of the reasons i dont see this as being a longterm solution is the lack of colon and how the medication especially the supression might create issues in restricting my diet further. This is fine for short term , but longterm it might be a struggle to balance dietary needs

no worries, am curious too!

You can use this chart to work out the clicks

1. Go to the column with your pen strength
2. Go down the rows to find the dose you want
3. Go to the left to find the clicks or ml (syringe) dose