Help overcome a weight loss stall

[Mollydolly2]

I started Mounjaro in September at 117kg (I'm 160cm tall) and have now lost 28kg which I'm really pleased with. My goal is to lose another 20–25kg.
From the beginning I had very strong appetite suppression with virtually no side effects, so I increased my dose quite slowly. I did one month on 2.5mg and then stayed on 5mg until June, when I moved up to 7.5mg because my weight loss had slowed.
The problem is that since December I've only lost around 7kg. I'm still losing, but it's painfully slow compared with the first few months and it feels like I've completely stalled. It's becoming really frustrating and disheartening.
For context, I eat around 1,200–1,300 calories a day, keep my carbohydrates very low, don't eat ultra-processed foods, prioritise protein and generally stick to the same healthy routine. I haven't relaxed my diet, so I'm struggling to understand why my progress has slowed so much.
Has anyone else experienced this after an initial period of really good weight loss? If so, what helped you get things moving again? Did increasing the dose make a difference, did you change anything with your diet or exercise, or is this just a normal part of losing a significant amount of weight?
I know losing 28kg is a huge achievement and I'm grateful for that, but I still have another 20–25kg to lose and I'm worried that Mounjaro has become much less effective for me.

Hi OP

A stall is frustrating, but it sounds like you are still losing weight albeit slower than you would like.

Are you definitely eating only 1200 - 1300 calories a day? Maybe you can go back to tracking to double check. It is boring, but for me, even though I would say my diet hadn't changed, I was sneaking in an extra biscuit at work, or a celebration from the tin, or an extra spoon of yoghurt, or an extra drizzle of oil in the pan. All of which over the week add up.

It also sounds like you are at 7.5mg. If so, could you consider increasing your dose if you are struggling with appetite and food noise. I reluctantly did this last week, and this week has been such a relief as I feel less like I am having a battle in my head about food again and have been able to stick to a lower calorie diet.

Have you taken measurements? Sometimes, especially if you have upped your exercise, your shape changes but the scale remains stubborn.

Also - in a heatwave you retain more water, so that could account for the last month or so. Make sure you are drinking at least 2-3 litres a day.

Good luck - and remember to stick with it. Slower losses are better than no losses (and also better than gaining!). I know in the past I have thrown in the towel at a stall, regained the loss and then bitterly regretted it.

You've lost a fair bit of weight and you're still losing albeit around a kg a month. Double and triple check your calorie counting as that seems on the low side for that rate of loss, but it's normal for weight loss to slow down the more you lose.

I've lost 8 stone in two years and have had a couple of stalls. Something that's worked for me is changing things up. Like you I can only eat 1200 - 1300 calories if I want to be in a calilorie deficit so there's not a lot of wiggle room. The stall before last I switched to intermittent fasting and had two meals between 2pm and 8pm and that got things moving. The latest stall has been fixed by switching back to three meals. Basically I think my body needs the odd shock.

I've really upped my exercise game and I can see a lot of shape changes which aren't reflected on the scales and I have definitely been retaining water in this heat.

Definitely go back to weighing and tracking as well. It's really easy for portion sizes to grown when you're not paying as much attention to weights

My journey is very similar in that I started MJ in September and have lost over 4 stones and want to lose another 1-1.5 stones.

My weight loss has also slowed considerably in the last few months with the same gain and loss in the last 6 weeks. I’ve moved up the doses slowly in increments of 0.5mg since the start and I’m moving up to 4mg for my next dose.

I look at it this way. I’ve been obese for the last 20 odd years (was a healthy weight until my mid thirties) and I think it’s pretty unrealistic to expect to lose all the excess weight within a few months at a constant rate. I’m ok with it taking as long as it takes and I expect the weight loss to have periods of stalling. It’s normal.

I think you need to readjust your expectations, increase your dose incrementally and just keep plodding along. Trust in the process and you will get there.

It’s unlikely you’re eating 1200-1300 cals a day and losing that slowly at your height and weight, unless you’re chair or bed bound.

if you’re losing 1kg a month, that’s half a pound a week, which means you eat in a 250 cals a day defecit. To lose a pound a week, you need to eat in a 500 cals day defecit, so the easiest way is to reduce your cals by 250 from what you currently eat. As it’s likely you under estimate then I’d aim a little higher.

the meds don’t make you lose weight, if you’re not getting sufficient suppression to eat in a defecit, then I’d up the dose till you find your optimal one.

If you read the accompanying leaflet that comes with the medication you will see that it is recommended to increase the medication every 4 weeks. I followed the instructions and continued up th 15mg where I stayed until I had reached goal. This way it took me from April - January to lose 8.5 stone. With the vast majority coming off from July to January at the hightest dose. I lost very little between 2.5-7.5 with only really noticeable loss at 10 and upwards .

I think there has been a lot of nonsense written on these boards to make women feel somehow guilty for using WLI and then if you do - encouraged to stay on the low doses as if that’s somehow more acceptable. So many myths !

1. NO ONE is meant to lose weight on 2.5 mg it’s a therapeutic dose to see how your body reacts to the jab.
2. The antagonists react to the neuro pathways in your brain. This is the ‘food noise’ that some people have noticed diminishing. They also control your blood sugar. This is important. If you are seriously overweight or obese then you’re almost certainly insulin resistant. Like me. You will have to climb the doses to the top. To get to goal before you are bankrupt from the cost .
3. It’s better to lose slow and steady or you will put it all back on. Complete nonsense. Doesn’t matter at what speed it comes off as long as it comes off and stays off. If you are highly insulin resistant and are determined to stick in the low doses losing 2lb a month then good luck. It’s going to cost you a fortune and take forever . Much more financially savvy to increase the dose to lose 6-8lb a month then titrate down once at goal.
4. Once you are at goal you should have miraculously of trained yourself into healthy ways and will be able to remain slim if only you use some will power . Again. Total bollox. If you were insulin resistant when you were fat you before you took the drug. You will STILL be insulin resistant when you are thin. Stopping the drug like stopping any medication designed for a fault in your bodies chemistry - will simply see the symptoms return and you will get fat again. This applies to those of you really struggling with weight. So BMI 30 +. One of the reasons so many people report amazing losses on 2.5mg 5mg etc is that they are almost certainly not insulin resistant. So can probably lose a stone and keep it off. Sadly for us fatties it’s not the case. I have maintained my weight on 7.5mg for 18 months. It’s expensive but seeing as it’s cured 3 really dangerous obesity related conditions, it’s a price I’m happy to pay .

Have you checked your current TDEE?

I agree with you but a couple of small corrections. Yoire only supposed to increase till you find your optimal dose. For me that was 10mg. But due to cost many people try to make it work on lower doses, which is very valid.

secondly 2,5 is not therapeutic, 5mg is the first therapeutic dose. 2.5 is a half dose to get your body used to it. The doses are actually 5 10 and 15 and the .5s are half dose step ups.

I've stalled too, I'm on 5mg going up 1 click a week as I'm very sensitive to the meds. I've stayed the same for about 6 months but I've been in hospital for most of that time so no exercise or control over my food much. Now I'm home I'm going to get back on Nutracheck and I've been back at the gym and I'm hoping to see the scales start moving again. It's true that you may be eating more than you're guesstimating unless you are already tracking your calories? Good luck I know it's disheartening.

you could potentially try changing injection site if you’ve stuck to the same. I get significantly higher effect if I jab in my arm instead of my stomach.

Another thing I tried when I had a stall was taking the weekend off from being in a calorie deficit. I didn’t go mad, but I ate what I wanted. It seemed to kickstart me losing again, for what it’s worth. All things you can try before you go up a dose if you want to.

@Mollydolly2 there’s a couple of things working against you. First of all, you’ve lost 28 kg - congratulations btw! - so that means your TDEE will have come down significantly. For the same daily calories you eat, your deficit will now be much lower than when you started, hence your weight loss is reduced.
Secondly, our bodies don’t like us losing weight. With a significant loss, our bodies can reduce our base metabolic rate by as much as 500 cals a day. The TDEE calculators don’t take account of this, so their predicted TDEE can be over by this amount. We need far fewer calories to maintain at a given weight than someone who has always been at that weight.
So everything works against us!
You may need to try going down a few more calories unfortunately.

Lilly say in the patient leaflet that 2.5mg is not a therapeutic dose but trials didn’t actually show that. Doses as low as 1.25mg showed weight loss after accounting for placebo effect. The issue for Lilly was that low doses didn’t give high percentage body weight losses. When they were trialling this drug, they needed to have a higher percentage than existing drugs for it to be a commercial success - to get those headlines and keep the shareholders happy. Hence they wanted people on the highest dose they could tolerate.
Their current guidance of course says go to 5mg after a month but then to only increase on the advice of your healthcare professional.
I’ve personally had to go up to 12.5mg but my OH has lost 4st and never gone above 3.75mg.