Nervous about starting Mounjaro with BMI 27.8 and existing health conditions

[Kittyberry]

In a nutshell, I am nervous about starting the Mounjaro I have been prescribed by a provider - at my GP suggestion - although she cant prescribe on NHS as I don't meet the criteria (this hasn't been fully explained aside from the restrictions of the Health Trust)

I'm post meno, Underactive Thyroid on meds, hypertension on meds and high cholesterol on meds.

My BMI is 27.8 and I need to lose 5-6 kgs which I have tried to do for over 2 years using calorie/in and out deferential and increased exercise - in my sednetary job is a challenge but I do try.

I am really worried about side effects - indigestion and a bit of constipation and a touch of nausea is acceptable - but I am dwelling on the pancreatitis, gastroparesis and a complete life threatening allergic reaction to the injection....if it was a tablet I wouldnt' be AS worried.

I guess in my head it is because my BMI is 'relatively' low compared to the 30+ and more, and a few friends I do know who are on WLI report only minimal manageable impacts.

BUT because my BMI is not massive and my goals are lower- I worry it puts me at increased risk of side effects of the more significant type.

I have no evidence for this really, its just my belief.

The provider I'm using didn't think it made me at higher risk but then - they would likely say this.

I have sent them my full medical details and photos ( front and side views in close fitting clothing ) and a photo of my bathroom scales - passport - the whole lot and my GP will be sent a notification.

I am prescribed 2.5 for 4 weeks and then a poss increase to 5..but Im wondering if that is the dose for a BMI in excess of 30 - should I be 'calibrated down' ??

I just don't know anyone who is at a BMI of 27 who uses this although obviously- Diabetics doubtless are or could be - but I also guess the diabetic body uses the medication in a different way.

I really am keen to lose this weight as after 2 years of effort, a diet plan, pilates, and sensible diet apart from literally one glass of red wine - maybe once a month - and a few nuts - thats as extravagant as it gets.

GP has rechecked my Thyroid every 6 months in 2 years and it is absolutely at the correct level with daily meds..but she (and I) are worried that my knees are now aching and hips are stiff and really wants me to give it a go - if I can afford to do so- which I can with some special discounts around right now.

Is 2.5 too much I wonder and what is a general view on the importance of the on the low side BMI - does it make me vulnerable to the more significant side effects?

Any advice/thoughts/experiences welcome

The dose doesn’t depend on your weight, it doesn’t increase based on your weight. Everyone starts at the 2.5mg dose for 4 week. Whether you move up to 5mg depends on how you’re responding to the medication which doesn’t relate to your weight. So it depends on if you’re getting the appetite suppression etc and losing weight well, and if you’re experiencing any side effects. You would stay on the same dose if it’s working well for you. You’d move up if you weren’t getting any of the suppression etc.

Side effects don’t depend on your weight. At all. Although I don’t see how me saying that as well as your GP and the pharmacy that supplied you is going to make a difference to whether you believe that!

There’s a thread in this section for people starting with a BMI around 27, it’s got lots of people posting on it. It would be a good place for you to ask these questions of people who started in a similar situation to you.

My starting BMI was over 30 but my current BMI is 22 now I've reached my goal weight. I've experienced minimal side effects, a headache the first week and occasional constipation and nausea. Most people don't experience significant side effects.

Side effects are really rare, and you’re already taking meds, never heard of anyone taking a massive allergic reaction, do you have healrh anxiety?

I’ve been on over a couple of years, my bmi is 20, I’ve been maintaining for about 14 months or so on 5mg, I felt immediately better when I took it.

‘my stomach started shrinking back, my blood pressure started dropping, took about 5 or 6 months to come off those brutal meds totally, my doctor checked and reduced each months. I started at bmi 32, by the time I was bmi 27 I was on 10mg, when I hit goal i titrated down to 5mg.
]id say do you really want to just lose that small amount, if your weight is causing high bp, which it did with me, its better to get more into the healthy range,maybe aim for bmi 23, see how you feel;

My knee pain is significantly worse after losing weight with mounjaro. It hasn't helped any of my pain in any way so that is a possibility. The dose is the same no matter what weight you are though.
Side effects for me have been awful hair loss (still happening though i eat at maintenance now, had bloods checked and all fine).
A bit of nausea in the early days and conatipation a handful of times. Not really had any other side effects. The major
side effects are rare

How you react to it does not depend on your starting dose.

I have never managed to get over 5mg as it was so effective for me - I started at 16 stone.

My BMI is now 23 and I continue on 5mg with good effect and zero side effects.

Lots of people have started MJ on lower BMIs, myself included. The kinds of risks you’re worried about are really rare; and possibly less likely to happen as you have less to lose so may manage to stay on a lower dose for longer, just don’t rush up the doses. Slow and steady.

27 really isn’t an unusual BMI to start at, it might be for the NHS, but it isn’t privately.

I started at similar BMI, I have lost 3.5 stone and now BMI 20.8. I lost most pf my weight on 2.5mg, went up to 3.75mg but never higher, down to 2.5 again but need to reduce more as still losing. Have had good suppression all the way through. I'm 5ft4, started at 12stone2, now 8st9.

I had a bit of nausea for first few weeks, constipation at first too but I have always been a bit like that. After 5 months I feel completely normal with regards to any stomach things, have been the same for a few months.

My side effects were probably in the middle with regards to other people on the Nov 25 thread on here.

Its the best thing I've ever done.