Three weeks on MJ 2.5ml - no effect whatsoever? Really upset

[localnotail]

Hi - so I have been on Mounjaro for three weeks now, 2.5ml - and, as title says, I feel no different in any way! I'm not a big eater anyway, though I'm obsessed with bread and sometimes eat too much of it, but my weight gain (25kg over 2-3 years) was mainly due to menopause and antidepressants. I walk a lot - average 10k steps a day - so I'm not inactive.

I had various other issues with extra weight, and failed many times to lose it through dieting, so after a lot of deliberations I decided to go on weight loss injections - especially as a lot of my friends done them, and were really happy.

So after starting it, and after being on MJ for three weeks now, I still feel hunger - I skip breakfast (I was advised that interval fasting works well with Mounjaro) and feel so hungry by lunch time I feel like I could pass out. In the evening, I feel hungry again. I have not lost even a bit of weight. I watch what I eat, I eat small portions and dont have sweets or bread.

Is this normal? I asked my med provider and they said my body is adjusting. But I was expecting to feel at least a little different? My friend says she felt no hunger at all. What is going on?? Will it get better or should I give up? I already got a next 2.5ml pen, so have to do it for at least another month...

Well everyone responds differently to medication and the first 4 weeks on 2.5mg are the treatment initiation dose. It’s not intended to produce significant weight loss although some people do experience that. Other people need to move up the doses for the effects to kick in, so you can’t decide it isn’t working for before you have been all the way to the maximum dose for 4 weeks on that, with no effects.

I would have suggested moving up to the 5mg dose, but you seem to have already decided to do another month on the 2.5mg dose. Was that what your provider recommended?

Can I also suggest tracking exactly what you’re eating, and eating breakfast if you are that hungry by lunch time.

Does nobody read the information about mounjaro?

The medication is started at a very low dose so as to build tolerance and avoid side effects.

Whilst some people report suppression of appetite at the initial doses they are either “super responders” (ie very sensitive to the drug) or experiencing a placebo effect.

Work your way up the doses every four weeks as needed until you reach a dose which has a positive effect.

Then when that wears off you move on to the next dose.

Some people even find no effect until 15mg.

Personally I felt positive effects at 7.5mg and then moved up as needed when this decreased.

I didn't really get positive effects until 10mg. I did lose weight on lower doses as the side effects played havoc with my digestion and I had to really think about what I ate.

In my head I have decided it's all the people who say they got strong effects at 2.5mg who are deluded. It's a sub-clinical dose - that has to be placebo effect. But smile and nod and be prepared to have to shell out a lot more money before it starts 'working'.

My side effects stopped at the 10mg mark I went up to 15mg before price rises- I'm now on 5mg as a maintenance dose. And poss placebo effect 😊

The 2.5mg dose is pretty much to introduce your body to the medication. Some people have weightloss immediately but others dont. The idea is to give your body a chance, at a low dose, to get used to it.
I was fortunate that 2.5mg worked for me, I lost 5 stone and only got to 7.5mg, 5mg was fine I only used 7.5mg as I ordered a pack which had the next dose and went back to 5mg.
2.5mg for another month may cause some effect for you but you'd be better moving to 5mg.

Some people just respond better than others to lower doses. I lost more than 5 stone on nothing higher than 3.75 and mostly 2.5, but some people unfortunately do need to go up the ranks before they see any weight loss. Just keep going up each month as needed. You do have to be prepared to invest in the higher doses.

@Beyondjourneysend genuinely was not a placebo effect for me on 2.5mg, some people really do just respond immediately to the medication. No way I could possibly convince you of that, but it’s not deluded to recognise my own experience.

Yes it's perfectly normal.
You may not experience any therapeutic effects at low doses, but if you started at a higher dose your stomach would probably be very upset indeed. Be patient and give it time. Don't skip breakfast, that's not helpful and obviously not working. Plan your meals, aim for TDEE minus between 500-1000 calories (maybe start with - 500 while you're working up the doses) and aim for 1g protein per kg of body weight. If you plan your meals you'll feel much more in control and that really helps with the mindset. The benefits of the medication will follow.

It's not delusion, placebo effect is real and so is the actual effect of the drug. I felt strong increase in appetite suppression after moving up every single dose including starting from 0 to 2.5. Each time the effects reduced significantly towards week 4 and I moved up. But the effects were real. Just because you didn't experience that doesn't follow that other people can't have either!

I definitely had the physiological changes you would expect on 2.5 outside the appetite suppression, evidenced when I got Norovirus and threw up recognisable food from like 36 hours previously 🤢

To be fair, the placebo effect is psychological, so it is a delusion. The results (in this case) are real, but the cause is not the biological interaction of the medication. The poster is simply saying don’t let other people’s experiences negatively affect you and to continue on her own journey.

In this world of vast pseudoscience, the placebo effect should always be treated with caution.

Did you maybe not do any reading on the meds before you started?

2.5 is initiate treatment, it is half a therapeutic dose and used to get your body used to the drug. You need to move up to find your optimal dose, could be the 2.5, could be 15, you won’t know till your body is on it. Like any other med where your doctor finds optimal dose.

if you’re not losing weight you’re eating to maintenance. So to lose weight you need to reduce by 500 a day to lose a pound a week.

Ok, placebo, delusion, whatever. But the claim that everyone who experiences effects on 2.5mg is deluded is false. Having experienced the effect of Mounjaro at all doses I know what the appetite suppression effect feels like and so I know I had it at 2.5. If it was placebo effect I wouldn't have been able to replicate the specific effect of Mounjaro from my imagination as I'd never experienced it!

I agree with you. The mind is incredibly powerful and can cause physical symptoms, if you beleive it is working, then it can do. A lot of these people then feel it wears off or stops working, it doesn’t just the placebo effect wore off. But that doesn’t mean it’s doing nothing to the body, it will be, just not a lot.

peopoe tend to stay on the 2.5 due to either fear or cost.

I take this for diabetes. I noticed no difference in blood sugar control until I was on 7.5. Very frustrating but shows that some people don’t respond to lower doses

Placebo is a real effect - it means something works just not by the mechanism you'd expect.

The point that Didimum is making much more kindly - is that OP is upset in a way I recognise as I was upset too when tons of people turn up saying that MJ works from the get go at sub-clinical levels. And the way I coped with it is to dismiss that experience as non-relevant to me.

I'm really glad it worked for you without having to go for higher doses but not relevant to me, and not relevant to OP.

Op you don’t need to do 2.5 for another month. Thay would be silly. You can either do two injections each week so you’re moving up to five, or depending on expiry date just keep the 2.5 for later and buy a 5 now.

2.5 had no effect on me. 5 is when I started losing and 7.5 is when it fell off.

Skipping breakfast clearly isn’t working for you.

Instead, plan and stick to three small, high protein meals. I also have a snack in mid-afternoon so that I’m not ravenous for supper and don’t overeat. This works - I’ve lost a third of my weight.

Regular high protein meals will keep you full for longer and keep your blood sugar even. Personally I have coffee with almond milk and chocolate protein powder for breakfast. Other people have eggs, salmon, avocado, chia…

It is normal and healthy to feel hungry as mealtimes approach. The MJ helps you eat sensibly, feel full, and stay full. The goal isn’t to not eat or to eat as infrequently as possible. It’s to eat in a healthy, sustainable way.

Pause the bread.

You probably need to go up a dose. Some people respond strongly to low doses. Some people don’t. But even if you do go up, you need to find a healthy eating pattern.

For Mounjaro to be successful I think you have to treat it as a marathon and not a sprint. It’s a long term project/treatment. I’d order a 5mg pen and start that once you’ve finished your current 2.5mg pen. If the following month you need to go up to 7.5 you could order another 5 and add the 2.5 to it. Everyone is different on when effectiveness kicks in and also when their current dose becomes no longer effective and needs a boost. Some people can stay on 2.5 and some have to go up to 15 for continued results.

I’d buy a 5 pen for next month and just save the 2.5 pen for later.

If it was placebo effect I wouldn't have been able to replicate the specific effect of Mounjaro from my imagination as I'd never experienced it!

You would, because that ongoing psychological effect is still partly placebo.

We know that Mounjaro significantly outperforms placebo, from the clinical trial data. It's really annoying and dismissive to be told that clear physical changes from the start are just down to the placebo effect and that people are actually just deluded.

Anyway, none of that helps the OP who is not experiencing the placebo effect nor the actual effects of the medication.

@localnotail I would either do two 2.5mg injections from your 2.5mg pen each week to make a 5mg dose, or buy a 5mg pen and start that. Your unopened 2.5mg pen will last till the expiry date printed on it, so could be used towards the end of your weight loss process to taper down to. @ShrankLastWinter 's diet advice is also very sensible advice to follow.

No, because it's not a psychological effect when I feel a specific type of fullness after eating that is not the same as a full tummy from volume or eating a large meal, or when I get 2/3 of the way through a meal and have to stop immediately. Those effects are Mounjaro effects and I have never experienced them before being on Mounjaro. I experienced them from 2.5mg onwards: that's why the initial effect could not have been placebo because I had no reference point for what Mounjaro fullness feels like before taking it
If it was placebo effect I would have felt 'full' similar to normal fullness or just not felt as hungry between meals or not thought about food as much, because those are all feelings I have felt before. You can't correctly imagine a sensation you haven't experienced before, so the immediate effect couldn't be placebo.

What you're saying DOESN'T rule out a placebo effect. If someone feels a noticeable effect at 2.5mg, that could be due to the drug – but it could also be expectation, attention to bodily changes or other psychological factors. The key point is that once a person had noticed an effect and formed a belief ('this drug affects me this way'), that perception can persist.

If fact it often carries forward – sometimes even reinforcing itself – because the person is now primed to expect and recognise those same sensations. Experiencing similar effects at higher doses doesn't prove the original response wasn't placebo. It just means the experience became consistent. The presence of an effect alone doesn't tell you its source, when both drug effects and expectation effects can overlap.

I think you don’t understand the sheer strength of the placebo effect. It’s been proven it is so strong it actually impacts brain signals and it causes physical symptoms. The mind really is incredibly powerful, as you beleive it is working, you will sense feelings of fullness etc, all the things you expect.

it’s hugely unlikely a tiny dose has the impact of the lowest therapeutic dose, and it is likely why some people think it stops working, it doesn’t.