I need a higher dosage but have just received lower dosage one. What to do?

[MercyMeMary11]

It wasn't a mistake but I have been rushed off my feet. I have lost 12lbs on the 2.5mg but in this last week (week 4), I have plateaued. I renewed the 2.5mg in a rush and now it's just not working

I really need to start the 5mg but I have just received a new 2.5mg.

Any advice please?

You’ve lost 12lbs in 3 weeks and you say the 2.5 isn’t working because you’ve plateaued in week 4?

Why do you think you really need to start the 5mg?

Keep taking the 2.5 and see what happens then go up after this pen.

That's not a plateau. You've lost 3lbs a week on average which is excellent. You could double dose the 2.5mg pen and order another in 2 weeks but I wouldn't TBH I would try to continue on 2.5

5 is 2.5 twice. easiest is to inject yourself two times.
but is the 2.5 providing the appetite suppression you need.
because you still need to eat healthily.
there are long plateaus with this process, you need to be patient; eat well, drink water, and exercise.

Just go up after this pen if you need to, and watch what you are eating/adjust food intake as you lose weight.

Lots of people get sick going from 2.5 to 5mg - it is the only time that the dose doubles. By counting clicks you could take slightly more than 2.5 and order your next pen a week early.

60 clicks is a full dose (on the uk Mounjaro quickpen) so you could take one full dose and a few extra clicks on a second injection to take a little more and titrate towards 5mg rather than just double your dose in one go.

If you’ve lost 12lbs in 3 weeks, it clearly hasn’t stopped working! A plateau is generally 4–6 weeks with no loss.

It’s normal to have the odd days/week where the scales don’t move, or for the medication to feel less effective at times. Hormones, food, exercise, body response to previous weight loss and more can affect things.

Personally, I’d stick with 2.5mg for now, get the basics right and see how the next few weeks go, paying attention to how your body responds to different types of food and eating patterns.

For your next pen, if the price difference isn’t much, I’d get the 5mg. You can take 2.5mg from it, but have the option to increase later if you need to.

Weight loss isn’t a linear downward line with weekly losses, even on MJ and your total loss for the first month is very good.

How much do you want to lose overall? If you have a lot of weight to lose - say more than 5 stones, then you’d expect higher losses in the first few weeks anyway.

A plateau is when you haven’t lost anything after about 4-6 weeks so this is definitely not a plateau.

Stick with 2.5mg for the next month and only consider moving up to the next dose if you haven’t lost anything in that month.

I've actually started putting weight back on now. That's why I'm concerned.
It wasn't an even 3lbs a week.
It was 7lbs in week one
4lbs in week two
1 lb in week three.
0lbs in week four.

Now I've gained a pound.
So the 2 5mg doesn't cut it anymore

I am fortunate in that I have had no adverse side effects.

Is it an idea to inject 2.5 mg twice?

Why are you concerned?

You’ve lost 12lbs in 4weeks

Drink more water, watch your calories, increase your exercise etc

@MrJollyLivesNextDoor I'm concerned as I'm spending a lot of money and my appetite isn't being suppressed any longer.

With your tips I may as well just go do it without the MJ.

Moving from 2.5mg to 5mg is the only time you double the dose. I moved up slower and would recommend that, IF you want to move up. I think I did 3mg, 3mg, 4mg, 5mg. I was using a 5mg pen though so it was easy to work out via clicks. I moved to the 5mg pen after the first month, but kept with 2.5mg for sometime- so ended up with several more weeks and it was cheaper than just buying a 2.5mg pen.

I'm not sure if the pens allow you to click past the number 1 setting? You could always use an insulin pen to up the dose.

The simplest way of doing 5mg from a 2.5mg pen is to do two normal injections. Change the needle inbetween. The pens don’t turn past the 1 position.

That sounds like a good idea.
I mean I do need to drink more water and do exercise too but I don't want to waste my money on MJ at a level that it's effect is waning.

I agree with pp that one week of no loss after a significant loss over 3 weeks doesn't constitute a plateau. A small short term gain could be water weight, or anything really. If you're eating in a calorie deficit, it's not fat.

However, 2.5 isn't a therapeutic dose long term for a lot of people and although many stay on it successfully and continue to lose, there's nothing wrong with going up to 5 on schedule. I did, and still only got as far as 10mg as my highest dose, over a year. So I hardly raced up through the doses.

You can jab twice to get 5mg, your potential problem will come when you use the pen up twice as fast. I get my MJ in person from local pharmacy so I don't know how easy it is to communicate with and explain to an online pharmacy why you need to get your next pen early.

And I know you've had no SE so far, it is true what pp have saud that 2.5 to 5 is the biggest jump and the most likely point to experience them other than starting in the first place.

Most online pharmacies will let you reorder after two weeks, so the OP should be ok timescale wise to order a 5mg pen in time.

Oh, that's good. Online ordering is an unknown world to me. 😁

You definitely haven’t gained a pound in fat, it’s more likely water retention!

If you weigh daily, you’ll see fluctuations up and down a couple of pounds all the time. It’s normal.

From your flippant responses and seeming lack of knowledge of ordinary dieting protocols, I’m guessing you’re not seriously obese and struggled unsuccessfully trying to lose weight for years? 🤔

12lbs over 3 weeks, even if nothing has shown on the scales in week 4, is not really a plateau - and therefor not a reason to speed on up to 5mg. The reason to increase is because you are no longer getting the appetite suppression by day 6. If you rush through them too fast, it is actually counter productive as eventually you can be on the higher doses and reach that plateau there.

I’d press on with 2.5mg for now, expect to lose 7lbs approx on this pen, but ask to go up for your next pen if you are feeling it is less effective on appetite control. I am still on a maintenance dose having started Wegovy initially and then transferred onto Mounjaro after my initial 2stone loss. I lost 6.5 stones in 15months - so slowly and steadily after the initial huge loss - and have been on maintenance dose for 2 years. I have PCOS, hypothyroid, post menopause etc so am keen to continue to be on it as long as the budget allows and in the hope that by the time I retire in 10+years a form of it will be available on the NHS. I admit to also be a little nervous of putting it back on if I come off completely - which is rather nuts as I’ve maintained within a 5lb range for the full two years, despite several holidays, Christmases, and a really active social life now where I eat out often. My relationship with food and my body changed significantly I think precisely because I took my time. I can’t bear high carb/sugar foods now because I simply did not eat them at all for more than two years, though I still love a bit of decent chocolate!

TLDR - don’t rush. It’s not just about the weight-loss, it’s about truly changing your mindset towards food/your body and developing a healthier lifestyle so that it stays off.

@KrazyKatty miaowww! How very unkind of you and how wholly inaccurate are your assumptions.

@AnonyMumAuDHD I have had a tough time recently this past month so haven't been as diligent as I need to be
Also so many social events. I want to do better this summer so I need to plan better.

Which is why your weight loss has slowed down.

Be more diligent and things will start up again!

Or just order a 5 pen, which is obviously what you are hoping people will say so just get on with it

Honestly it will come. When you start a new job you don’t get it all perfect straight away. You learn by trial and error, monitor how the systems work, work out how that works with you and tweak.

Erm, if your bathroom activities have slowed down that can appear to be a gain or plateau, so make sure you are drinking lots and get some easy to digest fibre in you (fruit or lots of green veg with supper).

Are you using any fitness apps? I forget which ones I tried, but there are some where you can monitor your water and 5 a day intake, where you can log your 10,000 steps a day and any exercise you are doing so that you can see the link between how much/which activities seem to prompt a weight shift, and some have recipes depending whether you are doing 5:2/OMAD/Keto etc together with mindfulness medications to help you relax and focus [stress can impede weight-loss, as can lack of sleep if that is one of your stress indicators].

Can’t emphasise enough that whilst, at the moment, you will be focused on the scales each day - what you need to be focused on in the longer term is sustaining steady weight loss and preparing for maintenance. If you lose it and revert to old habits you will regain it, just as you would on any diet. I personally felt it was far too much money to spend to not be invested in the long term outcome.

Sorry if that sounds patronising - not meaning to be, but I spent the best part of 25 years yoyo dieting so I know that desperate to lose weight now feeling! Maintaining without much effort for two years has been liberating. :)

OP you shouldn’t change MJ off the back of one week. Very few people have a straight down line, especially if you’re pre or perimenopausal. Having some weeks of no gain or even upwards is normal. The general rule is to wait 3 weeks before assuming it’s a pattern. I “gained” 1.5lb this week according to the scales, I definitely haven’t, I assume it’ll be water retention, I’ve kept my dose as it is and will see what it says next week. I’ve actually just upped the dose!

@AnonyMumAuDHDcan I ask what you mean by the link between slowing digestion and stagnation of weight loss?

That's helpful @AnonyMumAuDHD.
I am getting a new phone soon and so can put some of these apps on it. My life is full on with disabled dc and work and other dc but I knew I had to start on MJ to get going after years of my weight just going up and up. However there's a bit more space this summer to put some good practices into place.