Would I be unreasonable to try Mounjaro at a BMI of 27?

[Lorrrrrre]

With the likes of MedExpress now offering mounjaro to anyone with a BMI of 25+, WIBU to take it? I am 5ft 6, 12 stone, so not hugely overweight. I’d like to lose 2 stone so I can be comfortably in the healthy category for BMI. I also want to get a handle on it before it spirals out of control. I had my baby 3 years ago and just can’t shift the weight, finding time to exercise etc is really difficult and I find I have no willpower and snack a lot on bad food as I’m always rushing around. I’m hoping mounjaro will kick start better habits for me.
My family and partner are firmly against it, saying it’s lazy to use it and should only be for very obese people. My friends who have used it themselves are much more supportive. I’d have to hide it from everyone apart from a select few friends if I did take it as everyone would be so judgemental.

Has anyone used it with success for a similar weight and BMI? How long did it take you to lose?

Eating well can reduce side effects for a lot of people, but there will be a minority of people who just get really bad side effects and there's nothing they can do. There will also be a minority of people for whom the drugs have no effect. I couldn't tell you the reason, but that's what the research has found.

I had a good chat with a GLP clinician that might reassure some people on this thread. She said there is no harm or worsening of side effects if you do take the medication under BMI 30, the main reason why it is not indicated for people of a lower BMI is because of the risk of misuse / abuse ie people losing too much weight, eating disorders, going into an underweight BMI.

It’s more the risk benefit balance. People with a high BMI have much more benefit and so will accept higher risk. Side effects will vary from individual to individual regardless of BMI but the risk benefit balance of taking the medication will very much change.
I work in drug safety, I’m not a fan of these drugs….

Why not, out of interest?

What are these high risks?

I don’t work in this industry, it should be noted.

From my own research online and from speaking to clinicians, it seems that severe side effects of the medication are the same as those from rapid weight loss (for example pancreatitis or gall stones), and that the risks associated with mounjaro are more to do with rapid weight loss than the medication itself?

I am prepared to be told I am wrong, this is just based on information I have received from the prescriber, clinicians and online sources.

I've gone from 12'3 to 11'10 in 4 weeks. Weigh in tomorrow and I think i will be down another lb. So fairly slow. But as I say, I've not been able to get below 12 stone for aaaagggges, so this feels amazing. I've been eating so well - healthy, small portions, but the difference is it has felt so easy without constantly feeling hungry and being tempted by stuff in the cupboards. Including rose wine!

Oh and I also jab on a thursday - added benefit of reducing temptation over the most difficult days of the week

I didn’t say high risk, I said higher risk.
the types of side effects seen are too broad, that rings all sorts of alarm bells. If you take it in a medically managed environment these can be picked up early. This is my opinion (that taking them is not risk free and it should be directly related to the risk of staying overweight) but is based on my professional experience

What sort of broad side effects are ringing alarm bells?

The FDA FAERS database or the EMA Eudravigilance database has them all.

What did you mean when you said you are not a fan of these drugs?

Do you mean they way they are being prescribed (ie mainly through private pharmacies) or you don't think they should be used at all?

Or presumably the MHRA Yellow Card scheme in the UK. These are databases of reported adverse events. Not databases of confirmed side effects. Here’s what the MHRA Yellow Card database says about their data - “It is important to note that reported adverse reactions have not been proven to be related to the drug and should not be interpreted as a list of known side effects”.

They shouldn’t be used outside of a medically managed environment

I have a friend who is a dietician who expressed a lot of concern about people's ability to manage their diet well on them. She pointed out that people are losing weight at the same rate as people who have had bariatric surgery but without any of the support you get when you have that through the NHS. So her concern was around malnutrition (from being in significant calorie deficit for so long without diet support) rather than the side effects.

Yes this is the same as I’ve heard, it’s concern about rapid weight loss / nutritional losses rather than side effects themselves.

the thing is the majority of big name pharmacies are just businesses. Let’s be completely honest, they titrate everyone so quickly to make more money and give limited support.

Don’t be so ridiculous.

@JT1987 the pharmacies can't increase your dose unless you want them to, and they are following the standard dosing guidance by suggesting 4 weeks on each dose and then moving up. That's because the most weight was lost on the 15mg dose (if tolerated) and so if you are obese looking to lose weight then that's the most appropriate titration schedule. With the obvious caveats about tolerating each dose level.

The support that I have access to from the pharmacies that I use is at least the same or better than the "support" that I get from my GP for my long term NHS prescriptions.

To me a "medically managed environment" sounds like an in-patient setting, with round the clock monitoring. That's surely not what @foxychox is suggesting, or is it?

There are some people who react badly to WLI - but they'd know from the first try, and then whilst unpleasant (gastro issues) they aren't dangerous and they do wear off if the person stops taking them.
The more serious side effects as people have already mentioned are side effects of losing weight rapidly. For some people those risks may still be better than the health risks of being very obese. For those at a lower weight, it's not a sensible risk, but then I don't know anyone who has started WLI at a lower weight with the plan of losing weight very very quickly. Its also much harder to lose weight rapidly if you're at a lower BMI, our bodies just don't work that way.

Definitely not, regular review by a clinician is what I meant. Thanks!