Which glp-1 to start? How does this all work?

[amistillsexy]

So... I've just weighed myself. I weigh over 21st. I have thought about my weight all my life, and started diet after diet to no avail. I weighed this amount last year, and started WW, lost 2 stones slowly, then life got in the way and I stopped tracking, so... here I am again.
I can't continue like this, and for the first time, I'm considering injections, but I'm totally confused by the 2 different types, and the doses, not to mention how to buy it!
The cheaper one seems to not be as effective - is that the case? But the more expensive and 'punchy' one comes with more side effects? Is that true? How do I know where to start? Also, is, weight loss just going to happen, or will I still have to track my points/calories, etc? How does it feel when you're on the injections?
Do I need to speak to my GP first? I have ME/CFS/long covid, which affects how much I can do physically, but no other health issues.
Please, weigh in with any advice/recommendations for me. I'm looking to you experienced lot to set me on the right track! 😊

I’d definitely start with your GP.

I was 22st when I started Mounjaro. I didn’t bother with my NHS GP. They don’t prescribe weight loss injections unless your BMI is over 40 and you have 4 out of 5 specific serious weight related health issues, so it’s not something that they would be able to advise on.

You would be looking at a private prescription for either Mounjaro or Wegovy, from an online pharmacy. Mounjaro is more expensive but more effective and has fewer side effects. It mimics two hormones instead of the one that Wegovy does. Wegovy is cheaper but a bit less effective and with more side effects.

Don’t worry about doses. For either medication, everyone starts on the lowest dose and you take that for 4 weeks, then you can move up a dose if you need to, or stay on the starting dose. You would move up a dose if you aren’t really losing weight and not having much effect from the medication.

Some people calorie count and track, I generally haven’t and have just reduced portion size and cut out snacking as a result of the medication. You have to be in a calorie deficit to lose weight, the medication doesn’t make the weight fall off you on its own. But it’s easier to be in calorie deficit due to the effect on appetite and on balancing your blood sugar so you don’t get sugar highs and lows.

I’ve been on Mounjaro for 18 months now, and I feel totally normal. It’s a bit odd at the beginning, in the first few weeks. You can get digestive changes and feel a bit out of sorts but that should settle down and level out.

I'm happy to do that, what makes you suggest it? Do you have experience to share?
Our GP has posted on their website that they aren't currently able to prescribe it, so basically, 'don't make an appointment to ask for weight loss injections, as were not giving them'.
So, I feel it would be an embarrassing waste of time!

@SilenceInside your view of the nhs GP is what I have been led to believe, based on my GP's statement on their website.
Do you mind me asking, since you started at a similar weight to me, did you have a similar experience to mine with other diets prior to starting injections? And how much weight have you lost in 18 months?

Yeah, don’t bother with a GP appointment, especially if they have asked people not to. They won’t be able to prescribe you Mounjaro. They could refer you to the specialist weight management service but that may have a long wait just to be referred. Then you have to work through the tiers of support which involve various attempts to support weight loss via diet and coaching. Then after months of that without losing weight you may reach Tier 3 where they might offer Wegovy instead of Bariatric surgery, depending on what your local NHS service offers.

You don't need to speak to your gp. Go to monj.co.uk. All the providers they mention are proper regulated pharmacies and you can look at discount (usually first order) and ongoing prices. Choose one and complete the online form honestly. They may want you to books short online appointment so they can see you weigh live or just have a chat. You'll have to pay when you complete the form but if they reject you they will refund. All the prescribers should have information about each option (wegovy and Mounjaro mostly) and so you can compare how they work, price and effectiveness based on what's most important to you. They have transformed my life and I hope that you have a fantastic experience too

I have been obese my whole life pretty much, and have been up and down like a yo yo with my weight, but always getting that bit heavier after each downwards attempt. When I got to 22st I had essentially given up for a fair while and just ate everything I could get my hands on.

I have lost just under 11st so far, and have another stone left to go.

Hope it’s ok to join in- I’m on my first week MJ, am a similar starting weight to you OP. Is going well so far. Had one or two loose bowel movements and that has been it. It’s definitely helped me to reduce calorie intake and stop snacking. Less food noise about sugary food which is my usual vice. I can’t see a change on the scale yet but not really expecting to as only 5 days in. I’m hoping to stay as low a dose as possible for as long as I can. Not sure how realistic that is though!

Wow! Many congratulations, you must feel so happy and relieved getting on top of this.

If you’re going to start WLI, the GP is the place to start. You can get your bloods taken as a baseline. Does your GP mean no NHS prescriptions?
People use either a private prescription from their GP or go through a pharmacy that can prescribe WLI. If costs are an issue, weygovy (aka ozempic) is cheaper. Mounjaro is considered to be more effective but more expensive. If you weigh 21 stone, if you lose 2lbs a week, you will be down 104lbs in a year so you will need to factor in the cost of the injection for a year or more until you reach maintenance and how you will keep off the weight. It’s not a quick fix, you will need to be in a calorie deficit and it is important to do regular weighted exercises to help maintain muscle mass.

No one gets a private prescription from an NHS GP. You also just can’t rock up to your GP and ask for “baseline bloods” for a medication that they’re not going to prescribe.

I’m not UK based, I didn’t know that. I pay for GP visits in my country and for prescription medication up to a monthly limit. I get my bloods done annually through the GP. She prescribes MJ for me and I pay for the medication privately as it’s not covered by any public scheme. Apologies for not being fully au fait with the UK system.

Wow, @SilenceInside that's phenomenal! If I could achieve that type of loss, I'd be over the moon! 😊

You absolutely can. Just be realistic about the timescale and as you reach goal weight consider switching to a provider who supports maintenance. I've found the mental switch to maintenance harder than losing as I've always been focussed on being too heavy and self blame/successfully losing on mj but actually being a weight that's a healthy bmi, not slipping or chasing more loss. That's a different game and one I need support from mj to manage but I'm getting there. You will too.

@amistillsexy I also wouldn't worry about being physically active. Weight loss is mainly down to diet, as that's the easiest way to create a calorie deficit. You may find that as you lose weight you can become more active in your daily life. Some people also find that Mounjaro helps with chronic conditions as well as with weight loss.

I also agree that the Monj price comparison site is useful to check costs for Mounjaro. There is also a linked site called iGovy for Wegovy price comparisons. Be aware that you often get a large discount for your first order with a pharmacy but for subsequent orders you pay the full price. You can swap pharmacies each order if you want to, in order to get another new customer discount each time. Also, some suppliers operate a subscription service, so check what you are signing up for and how to cancel if you want to swap to somewhere else.

You would need to plan for being on it for 18 months to 2 years plus which is what I realised when I started out. It's definitely a long haul process for me. There is a long running thread in this section for people with 10st or more to lose, which is my main support thread. It's a great place where we all understand the issues with having a lot of weight to lose and being in it for the long run.

Yes, it's like getting a golden ticket if you get a GP appointment here!
I know my GP won't do my bloods, as they were done within the last 12 months. That's what eventually led to the diagnosis of ME/cfs/long covid. I was seriously ill, and they have no idea what caused it or what it was. My bloods were all perfect, in fact, my levels of vitamins, iron, etc, were impressively high.
So I'm not worried about my health apart from the weight and fatigue, and I'm hoping the fatigue will lessen when I'm not carrying so much weight!

@CrispinWhispers do you mind me asking, what made you choose mj over Wegovy? And are you paying monthly or on subscription?

This is the 10st or more to lose thread:

https://www.mumsnet.com/talk/weight-loss-injections/5452050-mounjaro-10-stone-or-more-to-lose-thread-10?utm_campaign=thread&utm_medium=share

There are quite a few of us now on there who have lost similar amounts to me over a similar time frame. We all lose at different rates though, and the rate of loss definitely slows down as you get nearer to your target weight.

It's good to hear they've transformed your life as well.
I'm surprised that I'm only reading good things. I was expecting more mixed reviews, tbh!
I've looked at monj. Co. Uk. I hadn't thought of switching to make use of sign up prices, but of course that will make it cheaper.
Do the different providers give different levels of support, do you think? Because I'd rather pay a bit more and get good support and advice, than pay less and be left to flounder!

Of course- from what I have read MJ can achieve a higher percentage weight loss overall. However I expect they are both good and it’s probably
more about what you do to change your habits whilst on the medication as much as the medication itself. I used the online pharmacy Voy. I didn’t ask GP but am aware in general GPs are not offering unless you have a host of weight related health conditions which I don’t have, so I didn’t bother. No harm in you enquiring I suppose as GP eligibility could change from area to area

Thank you. I'll take a look. I did lose a lot on WW years ago, and I remember finding it really slowed down towards goal, then being very hard to maintain! I suppose this is the same.

I was just going to comment as @SilenceInside says, come join us @amistillsexy amd @CrispinWhispers on the 10st+ to lose thread. Everyone there understands the challenges of a long journey ahead of you and also what you’ve been through living with significant obesity.

I started mounjaro on 23rd March last year, I was 24st 9lbs at 5’ 8. This morning I was 15st 13lbs.

It depends what level of support you want. You can use your local pharmacy if you want face to face. These online pharmacies offer additional support https://monj.co.uk/mounjaro-support-help-providers/ . They'll all give you the information you need and to be honest it's common sense. Eat good nutritious food and balance protein, carbs and fat, exercise if you can especially weight bearing exercise and aim for a steady gradual loss rather than anything extreme. Contact them if you're worried about side effects but for minor things like constipation I just popped to my local one for treatment

@amistillsexy I just started wegovy and chose it because I'm cheap and because I have so much to loose (more than 10st too) that i want to do it slowly without anything that kills my appetite too much. It seems M gives a bit more suppression. I need to refigure my eating habits and I hate being rushed.

There is going to be a new max Wegovy dose and studies have shown (they all vary a bit) that the average person will loose around 20pc as opposed to 22 on M. I think people generally exceed that on either medication. I'd still be very obese loosing just that. I need to be half my size.

On W I don't think I have eaten enough so far. I do worry about not getting my vitamins and proteins in but it's early days. I felt very strong supression.

To be honest joining the thread of people who started the same time as me was all the support I needed. We all swooped experiences and tips. It was a little community. The 10 stone or more thread sounds the same. The medication will support you but it's no different to any other diet apart from it takes the pain away. Just avoid greasy food. I suffered after 2 slices of thin veggie takeaway pizza!