Mounjaro at lower BMI

[roundrobyns]

Has anyone tried Mounjaro who is a lower BMI ie 26/27? I’ve seen that prescribing criteria has changed with some providers so I am now eligible to order it. I’m a small frame and an apple shape so I carry all my weight on my tummy and look bigger than my weight suggests, and I worry about the impact on my health. I would like to lose about 15kg. I struggle to lose weight and stick to a diet so I’m hoping this would give me the extra help I need. But I am scared a bit of the side effects. If anyone has any experience would be great to hear it.

I have managed to move around to different pharmacies easily with a BMI of 26 & no other health conditions. I started at 38 and have kept my previous boxes as proof.

I just wanted to come on and say Voy accepted my request for mounjaro with a BMI of 27 and no additional health conditions 🤷‍♀️ must say i am quite shocked as I thought it would be rejected but it has been shipped today!

First ever prescription of mounjaro? You’ve never used it before?

if so are you one of the ethnicities which permits 27 with no health conditions?

@Thelankyone Voy have very recently changed their prescribing decision making to allow off label prescriptions for those with BMI higher than 25 but less than 30, with no weight related health conditions or qualifying ethnicity. They can do this because all their prescribing is doctor-led, and so they are not bound by the GPhC guidelines alone as they would be if it were only pharmacists making prescribing decisions.

I don't personally think this is appropriate, but they obviously feel that they can justify their decision making to the CQC whenever they are next inspected. Off label prescribing in this way is legal, but there is supposed to be clear signposting to the patient that this is happening, and there should also still be a clear medical reason for the prescribing decision for each patient. I am not sure that having an online consult then it being approved on review is sufficient to demonstrate that, but Voy clearly do.

For example, it doesn't sound like @WorriedMum210721 is aware that this is off label prescribing, even though the online consultation form has a section at the end indicating this and asking for consent.

that’s very interesting. I got my prescription through Voy with a BMI well under 30 and no medical conditions and I couldn’t understand why, I’ve been worried it was a mistake and they’d rescind! They didn’t make it clear at all that it was being off label (as in, they certainly didn’t sign post me clearly if they did!)

No they didn't make me aware it was off label at all. Just had a message saying it was accepted and just sounded like this was normal 🤷‍♀️. I am white British.
I do not intend to use it for long and I am aware of the side effects and will immediately cease use if the side effects are severe. Before I use it I will do some further research. Thanks for the information shared.

That’s interesting I wonder how many more will do it.

I got it from Voy at 27 bmi a few months ago. I told the truth on the application and it was prescribed “off label”. I was about to 11stone at 5ft 3 and similar shape to you. I was on it from Nov- Jan and got down to 9stone ish. I’ve maintained it since. feel so much better, have joined the gym and am more active. It’s the best thing I’ve ever done.

To add, I have no health issues and am not in an ethnic minority at risk.

Following. I'd lost 9lbs without WLI so thought my chance had passed.
My BMI around 28

@Catontheradiatorcan you share how long were you on and what dose and a rough idea of how much weight lost. I am on 2.5 and having side events and wondering whether lower would be effective. @JustBeach what dose did you stay on for the three months and did you taper off?

• side effects - no idea what side events are

I started on 2.5mg last July and lost almost a stone within 4 weeks but I felt terrible. Came off for a month and went back at half dose for a few weeks then went down to 0.83 and I’ve been maintaining at that since. I’ve lost 1.5stone in total. Feel amazing and confident in myself again. I’ve always calorie counted and exercised (lost 5 stone in my early 20s and kept it off for 20 years) but perimenopause is here and I truly believe it affected my insulin, hormones and blood sugars. Weight was creeping up and up despite calorie control and exercise. The microdose has been brilliant for me.

Thanks @Catontheradiatorthat’s given me something to think about.

@cautiouslyoptimistic3i stayed on 2.5 throughout, I tried 3.75 one week but felt really nauseous so went back down to 2.5. The second month I got a 5mg pen and click counted to get a half dose - so I only bought two pens and lost nearly 2stone. Worth every penny. I’d already lost some myself, but just could not get below 10 - I’d get close and then bounce back up. I had no side effects on 2.5 and have kept it off in the 6 weeks or so I’ve been off it. It’s reset a lot of my bad habits. I feel bad saying how easy it was to lose the weight. I still enjoyed my food, but was full after a normal portion , completely stopped craving chocolate and crisps (my biggest downfall for binging every night) and craved healthy food.

I was BMI 27 or only just 28 with no other health issues. I am short and also had an apple shape. They asked for my waist circumference which was in the category for health issues so that probably was another factor in being prescribed. I wasn’t expecting that question but I then found the NHS has it as guidance alongside BMI for health risks.

@cautiouslyoptimistic3also, I didn’t taper off. I did intend to have a 3rd pen just gradually tapering off but I didn’t bother in the end. I got down to the bottom of my goal weight range (half stone ) and just didn’t feel the need to carry on. I’m maintaining by calorie counting (only roughly as after 30 years I have a decent idea what things are!) and weighing a couple times a week. If I got out of my half stone range I’m happy in , I’ll cut back on the calories. It’s so strange allowing myself to eat maintenance calories after decades of trying to eat below to lose weight. After I stopped I did put 2lb on, but I think that was just extra food and also I started the gym. My weight has hovered around this since though.

Thanks @JustBeachreally helpful to hear your experience. Well done on reaching goal and enjoying life post MJ.

I'm in same boat. Have about 15-20lbs to lose. My BMI is 25ish (I'm 5'3, 10st 8lbs. Been looking on Voy, Med Express and Superdrug websites. They'll all give me it, but 'off label' as BMI is below 30. Just trying to decide between Wegovy or Mounjaro??

That's amazing! Did you get Wegovy or Mounjaro??

Pls can I detail this thread… I’ve got 5mg in its way from voy, I haven’t used it since May last year. They said 5mg is fine but I’m starting to change my mind and think I’ll do 2.5 for the first pen. do I just click half way around? That way I get double the amount of jabs? It’s been so long I can’t really remember. Thank you

To come back and update: I have ended up ordering Mounjaro so I should receive it in the next day or two. I had to do an extra call with a clinician before they dispatched the order which they said was for everyone BMI under 27, it was straightforward though and mostly explaining it was off label use and side effects to look out for, and I had to weigh myself on the call. I’m feeling a little nervous but hoping for minimal side effects and a boost to getting some weight off for summer 🙏🏻

Thank you to everyone that replied!

Good luck. My advice for what it's worth is avoid overeating or particularly fatty, stodgy foods and alcohol just to minimise chance of upset tummy or indigestion. A fish supper and half a bottle of wine on or shortly after jab day is asking for trouble. Do let us know how you get on. I recommend reading Food Noise by Jack Moseley too as it was very interesting to understand more around the science and stats around WLI.

How are you getting on now OP? Im similar to you and starting my MJ 2.5mg tomorrow, nervous and excited!