Struggling to loose any more weight

[fudgesmummy]

Hi all,
I have been on Mounjaro for 11 months now.
Started at 2.5 and slowly worked my way up to 10 by September.
At Christmas I had lost just under 4 stone but I am now struggling to loose any more.
I am having to reduce my BMI to have life changing surgery but need to lose at least another half stone, preferably more before I will even be able to go on the waiting list.
The drug has reduced my appetite to such an extent that I find it hard to eat enough but I’m still not losing anymore weight.
It is making me feel increasingly depressed and despondent that I will never be able to have the surgery I desperately need.
I would be very grateful for any advice or insight on the situation.
Tia

I think people are probably going to ask what your daily calorie total is, and what your daily calorie need is (TDEE) to see if you are actually in a significant calorie deficit. Do you currently track your calories?

You've been plateaued for about 2 months, is that right? What was your starting weight/BMI and what weight/BMI are you now?

Use tdeecalculator.net to work our your tdee and log your food on myfitnesspal app to track your food and macros. Reducing carbs will help.

You need to cut your cals, you are consuming to maintenance I’m afraid,

"... I find it hard to eat enough..."

This is probably the reason you're not losing

It’s really not. That’s not how the body works or anorexics would he fat.

I’ve been effectively plateauing for some months, though for me it’s not much of an issue. Can you exercise? What are you doing physically at the moment?

I’m at goal now after loosing about 10 stone. Whenever I had a plateau I went back to basics and asked myself:

• how many calories should I be eating, how many am I eating?
• an I drinking 2 lts water a day?
• am I getting enough sleep
• am I eating too much salt/carbs and as a result retaining water?
• Have I done too much exercise and retaining water to heal achy muscles?

Usually the answer in my case was not enough sleep and not enough water, upping both of those would result in the weight loss restarting.

Is there a reason you’ve not gone up the doses? I see you have some suppression but it sounds like increasing up to 15 and seeing how that goes would be sensible.

@SilenceInside
No, I don’t track my calories, perhaps I need to start doing so.
At the start I was 18st 11lb with a BMI of 48.1
I’m now 15 stone with a BMI of 38.4
I am only 5ft 2 ins tall

@PermanentTemporary @InfoSecInTheCity
I walk with crutches and have to use a wheelchair when I’m out so I am completely unable to exercise at all. This has been the case for coming up to 2 years now ☹️
I do drink a lot of water
I hardly sleep because of the constant severe pain I am in at night.
@FurForksSake
I find it nearly impossible to get an appointment at my surgery, when I have spoken to them about not losing anymore weight there has been no suggestion of upping my dose. I get the feeling they don’t really know much about it.
I get it prescribed on the NHS.
I will try and get an appointment to discuss increasing my dose

Thank you everyone for your replies

Definitely track your calories and speak to them about increasing the dose. It’s designed for you to go up to the maximum of needed.

Sometimes I’ve found upping my calories for a week and then going back to a deficit have moved things.

Are you seeing a physio? I’d recommend it particularly finding a sympathetic and knowledgable private physio and if possible hydrotherapy, even just walking in the shallow end of the pool would get you a little bit more mobility.

Are you able to do any type of seated exercise or is your pain too bad? It might be worth seeing if you can find a local pt or physio that can help you to get some sort of gentle exercise and movement into your day that is manageable for you. I don't know if your Dr would be able to help with this too?

I would say that you probably were in a decent calorie deficit at the start due to carrying the extra weight. As you’ve lost weight, your daily calorie need will also have reduced due to carrying less weight. So now you are no longer in a calorie deficit which has resulted in the plateau. As you are quite short and less mobile, then your daily calorie need is probably going to be fairly low. Using an online TDEE calculator your TDEE would be around 1800 cals, so you’d be looking at around 1300 cals a day to lose 1 to 2 pounds a week. But it may need to be a bit less than that given your mobility.

As has been suggested, I’d say track your calories. I use Nutracheck, it’s a brilliant app and very easy to use (I also use it to track my protein and fibre intake). I’m 5 foot 1 and my calorie allowance is only 1200 a day which is hard to stick to.

good luck

100% track calories, I’ve needed to from the start and if I stop doing it, I gain. I use MyFitnessPal.

But it does... that's why people can break a plateau by cycling / increasing their calories

You do need to track your calories, at least for a few days to figure out how many you’re eating now and how that compares to your TDEE. When you started you were 4 stone heavier, your body used more calories just keeping you alive than it does now. As your weight decreases so does your calorie allowance.

As others have said you need to calculate your TDEE based on sedentary lifestyle and deduct 1000 calories if you are aiming for a 2lb a week loss. A healthy loss is 0.5-1% a week so that is 1.05-2.1lb per week.

Also if you are tracking calories you can track macros so make sure you are eating high enough protein and carbs to a reasonable amount (lowish ideally). It really does matter what your calories are made up of, there is lots of scientific evidence behind this.

I used a guessed age but at 5ft 2 and 210 lb your TDEE is 1861 so that would be your allowance to stay the same weight. If you want to lose then you should aim for less than that. Don’t cut by 1000 you’ll be trying to exist on carrot sticks and the memory of food and that’s miserable. Aim for 1300-1500 calories a day of high quality food - lean protein, good fats, complex carbs, fibre.

Honestly I am really not going to sit and explain how the human body works but I can assure you you don’t gain or maintain weight as you eat too little.

The TDEE calculation is absolute rubbish for me, as it says I can maintain at 2487 calories a day. Ignoring exercise, 1730 calories a day.

In reality, since my mid 40s - when I started perimenopause and HRT - I put weight on as soon as I go above 1400 calories a day. Hormones have a massive impact.

Obviously if your deficit calories are too low then you cant cut by 1000 but if your maintenance is 2200 say, then 1200 is fine

I cant cut by 1000 as it would take me to 400 so obviously not a great idea!!

Although you’re probably eating a lot less, what sort of foods are you actually eating?

If you can focus on eating mainly protein like fish and chicken with salad and vegetables and completely cut out processed carbs, you’ll probably find things start to get moving quite quickly again. That’s what worked for me.

Thank you everyone for your replies.
I obviously need to track my calories.
Today won’t be difficult, all I’ve managed to eat is a small cheese scone, a packet of skips and 4 rich tea fingers.
Dinner was oven chips, peas and a frozen fish in batter.
All I managed was a couple of chips and a spoonful of peas, I just couldn’t physically make myself eat anything else.
This is how it is most days, it’s just so miserable.
I feel sick with hunger

It’s not a great amount, but it’s quite high in fat and salt and low in nutrients.

Could you have a bowl of Greek yoghurt with raspberries for breakfast
Small snack of carrots and hummus
Small lunch of cooked chicken and salad or maybe some soup
Another small snack, maybe an apple sliced up with peanut butter
A small dinner something like salmon, green veg and brown rice, keep it small for it for me manageable.
Then a protein shake in the evening?

You need to push through with the eating, making healthy choices.

Are you drinking enough? Making sure you are getting 2-3litres of fluid in over the day is really important.

If you can’t eat then I’d suggest protein shakes, but it is a bit mind over matter and prioritising protein, fibre and nutrients over anything else. If you can’t eat much it’s got to be nutritious or you’ll end up with all sorts of deficiencies and feel worse.

Try eating your 3 meals starting with a proper breakfast. I like Greek yogurt with blueberries and honey, or fruit and fibre, or bran flakes with raspberries and oat milk.