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...

ultimately some feel supression on 2.5 some dont, its worth writing off the 1st month on 2.5 as prep rather than a start and that helps you focus and not be disappointed.
i did feel suppression on 2.5 but not as much as i do on 7.5 now, but i know my partner didnt really feel anything on 2.5 . its different for everyone

I think it’s really unhelpful calling it a placebo effect. I am extremely sensitive to meds and always have been. And besides, the conversation isn’t relevant to the OP.

Ok, I am unsure why it’s unhelpful and again sensitivity csn be placebo effect, it is relevant to the op, as she’s thinking her friends can do this on low doses.

Some people are more sensitive to the drug and feel stronger effects on lower doses. Some people need and are able to tolerate higher doses. There is no point in making comparisons with friends or anyone else.

In any case, the OP needs to eat in a way which maximizes the effects of the medication. Also to understand that the goal is not to feel no hunger. Rather to eat healthily and feel full.

It's already been said @Wildgoat that it's just really dismissive of people's own experience, to insist that any effect on 2.5mg is the placebo effect and to deny that it is the placebo effect is to be deluded. You can see surely that denying someone's own experience and calling them deluded would be unhelpful.

It's especially strange to insist that it can only be a placebo effect when in the clinical trials people lost weight on the initiation dose of 2.5mg, more so than those on the actual placebo.

I am sure the OPs friends have had an effect from the start, actual medically induced physical effects, not just the power of placebo. I don't see any point in denying that, or that it's helpful to tell the OP that her friends are just deluded, and in the grips of the placebo effect. Clearly the placebo effect is not working for the OP, and neither is the medication, yet.

Both the OPs experience and that of her friends is very much within the range of normal experiences when starting Mounjaro.

Oh for goodness sake
So my mind invented the specific sensation of appetite suppressant that Mounjaro engenders in people and continued to invent it all the way through my treatment up to 15mg so it was all placebo and confirmation bias?
or, OR, I felt the effects from 2.5mg and they continued until I had lost 3.5 stone and maintained it for 6 months so far?
which is the most plausible??

I was the same OP!

2.5 did nothing
5 did nothing
7.5 I lost 5lb
and I have been on 10mg since August and have lost nearly 5 stone! Some people need the higher doses for it to work.

I don't know why you're so annoyed that the placebo effect can exist and be persistent to varying degrees. No idea really.

Regardless, I'm not saying that YOU personally experienced the placebo effect.
Never once said YOU experienced placebo, never did I say that effects are 'invented all the way through', never did I say 'it was all placebo and conformation bias', so calm yourself down.

I am saying that the placebo effect that take place on any drug and persist through use, and the effect will feel the same through use and at higher doses because the perception and experience of effect is already established from the start. This can happen alongside true medical effect – it's the perception of experience and sensation that persist. Go and have a read up on how the placebo effect sensation persists if you must.

Gosh I don’t understand why people are so upset about placebo effect, it feels just as real as the med effect, and serves the same purpose.

I am not upset. I am not upset about the placebo effect. I am not arguing that it isn't real and something that people experience. I am annoyed at my personal experience being dismissed as the placebo effect and that I am deluded if I think otherwise. I appreciate that you didn't use the term "deluded" @Wildgoat in your responses.

It is especially annoying as we know that prescription medications specifically outperform any placebo effect, as that is a key point in their effectiveness that's tested during clinical trials.

They do, but anyone thinking it works in 2.5 has nothing to compare it to. I simply don’t see it as dismissive.

the fact is 2.5 is not therapetic. There is no amount of sensitivity thay makes it therapeutic, thousands upon thousands have been tested. It is a half dose, the doses are 5, 10 and 15, just it needs half dose increments to ensure the body doesn’t react badly.

of someone feels what they think is the full effect on half the lowest dose, it really is likely to be placebo, they are desperate for it to work and don’t want to move up. They think it works. For these people. They will think it’s stopped working when the placebo effect wears off.

that doesn’t mean it’s any less real to them. It doesn’t mean they don’t have suppression etc, they do, but the meds are not giving them that, their brain is making them think that, from the mere act of taking it.

That someone is me, @Wildgoat. I had the usual effects of appetite reduction, feeling fuller quicker and staying full for longer from the afternoon of the day that injected the first dose. I felt nauseous if I tried to eat past that feeling of total fullness, and I could not eat past that point. It was not down to the placebo effect alone and it is dismissive of my personal experience to suggest that it was. People’s bodies react differently to medication and some people will get an immediate effect from the lowest dose of Mounjaro. They are not imagining it nor producing the effect themselves due to the psychology of the placebo effect.

Some people feel significant effects and lose weight at 1.25mg, some at 2.5, some at 5, some at 7.5, some at 10 or more. Some get to a healthy weight without going over 2.5 or 5 or 7.5, some need 15. The medicine doesn’t work at all for some.

We don’t know (yet) what these different degrees of sensitivity depend on.

It seems a bit silly for someone who didn’t feel effects until a particular dose to insist that anyone who felt them earlier was only experiencing a placebo effect. It is demonstrably not true, as Silence has explained, since even low doses outperform placebo. It is also derailing.

@Wildgoat it seems like you've misunderstood what therapeutic dose means. When clinical guidelines label 5, 10, or 15 as therapeutic, they mean that is the target dose required for the average person to see results. It's the midpoint, not the floor. Another common term is "median effective dose". ED50? You might have seen ED50.

2.5 is an active medication. Because human metabolisms, receptor sensitivities, and genetics vary wildly, an individual's minimum effective dose can be much lower than the population average.

No I haven’t misunderstood, politely. You have.

5mg was the lowest dose in trials to have any therapeutic effect, it was not the median, it was the lowest dose before any therapeutic benefit was realised. no therapeutic effect was witnessed in anyone in the trials of many many thousands,

Thays why there is higher doses, as some people it will not be enough for on the lowest dose hence why the optimal dose can be much higher for some.

I’d have to read the trial data again, but I think the median was at 10mg.

however I can see people really take exception to it being stated as placebo and non therapeutic, and that’s fine.

There are plenty of Tirzepatide trials where patients have been kept at low doses and still see results an order of magnitude more effective than placebo. This is even with 1mg for 26 weeks. Still at that low a dose it is an order of magnitude more effective than placebo.
The point is that the highest weight losses in the shortest time in the trials are seen at higher doses, hence the drug companies concentrate on this. This is because they need their drugs to have the high headline percentage body weight losses, to keep their shareholders happy after investing millions.
But the data is there - even 1mg is a dose an order of magnitude better than placebo.

@localnotail you've confused me. You say you eat too much bread but then say you eat no bread. Can you maybe give us some examples of what you eat in a typical day?
Also, do you count calories? How many are you having and how much of a calorie deficit do you have?

@Wildgoat no that isn't the case. If you look at the trial - are you thinking of SURMOUNT - then you can see that weight loss begins immediately and is tracked against placebo from week 1.

At Week 4, Placebo group weight loss: ~1% of body weight, 2.5mg group weight loss: ~3% of body weight

Anyway I'll leave it there.

I will always leave it, but therapeutic and weight loss are not tje same thing here, therapeutic is to do with rhay the drug does, ie insulin and blood sugar management the fact people started losing weight immediately inc on the placebo doesn’t mean it is therapeutic

Completely normal. For most people 2.5mg does nothing other than start to get your body used to the drug.

I started to lose weight at 5mg but it really kicked in at 7.5mg

There is no shame in needing to inject 10mg to lose weight. Suggesting those who lose on lower doses are deluded - to make yourself feel better about biological processes you have no control over - is unhinged.

Thank you all for replying. Believe it or not, I did read up on the medication before taking it, and also talked to someone who actually prescribes it in their private clinic (not in UK, in the US).

I wanted to hear experiences of real people, not some statistic or a leaflet. Because several of my friends who went on it started to feel the difference almost two weeks in, and started to lose weight soon after. Also, everyone was asking me how I feel - and I felt nothing! No side effects, nothing.

I will continue next month on 2.5ml and then will go on higher dose. Thanks everyone for replying.

Why? If it’s having no effect, why do an extra month on 2.5? It won’t get better.

Agree, another month on 2.5mg is very likely just to be a holding pattern. After 4 weeks on any dose level you reach a steady state where the medication doesn't further increase with each dose. The peaks and troughs are the same. If the medication is not doing anything at all for you, then staying on that steady state for another 4 weeks is not likely to make a difference.

Why??