Maintaining weight loss after coming off injections without going above 5mg

[donotknowhowtofeel]

I reached a comfortable weight for me in December having never gone above 5mg and have been maintaining (more or less) since then. Initially at 5mg and then at 3.75mg. I've just titrated down to 40 clicks of a 5mg (so 3.3mg). I'm terrified of going off it completely though as all the research seem to suggest that the weight comes back on if you stop. I was wondering if the research was for those who needed much higher doses and then had trouble maintaining, or even for those who never went on higher doses at all. For context, I exercise consistently 5-7 days a week (hot yoga, weights, walking), and eat (relatively) well and mostly plant-based, drink a few glasses of wine on weekends, but do not track (and that has been the greatest joy of MJ - not needing to obsess about everything that passes my lips!).

Anyone have success titrating down, and stopping yet maintaining (esp when you didn't go up beyond 5mg)?

I can't spot anything in the trial data that suggests that those on 15mg regained the most and those on 5mg regained the least, the documentation refers to the average weight regain across everyone that was swapped to a placebo instead of continuing taking Mounjaro. I know it's tempting to think that those that "needed" 15mg are the ones with the most issues and the most likely to regain the weight, but I don't think that's how it works.

Regardless of that, individual outcomes will vary a lot. There's some evidence that exercise helps with reducing regain, so that's in your favour.

I don't get the terror, tbh. You won't regain all the weight in a few weeks if you suddenly start to gain, and you can restart Mounjaro if you are with a maintenance friendly pharmacy. Then you can get on top of the weight gain, regroup and try again.

Thanks for that helpful response, makes sense. I think the terror as such is this - I love being a healthy weight, not worrying about getting to pre-diabetic stage, getting into all my clothes (I lost about 10kgs, didn't actually change dress sizes just stopped bursting out of the ones I had!), and enjoying life/food in moderation and without constantly having internal conversations about food/weight/self-worth. I could titrate down to nothing and see how it goes, I guess. I'm more worried about having all the internal food/weight noise start up in my head than actually putting on a bit of weight.

I do understand the relief from not having the constant internal dialogue about everything food and weight related.

I wonder whether Foundayo might be worth considering in your situation if you're eligible for it. It's a lot cheaper and it may be enough to keep on top of the food noise as well as keep the weight off. Or stick at 2.5 or 3.33mg Mounjaro for a long term period until you are very habituated to staying at a stable weight.

Thanks, I will check it out!

I lost 4 stone on mounjaro. I went up to 7.5ml I’ve been off the injections for 18 months now and maintaining ok. I do 3-4 gym classes a week and just have to be super super careful what I eat. I weigh myself once or twice a week to keep a check on my weight and adjust my eating if it starts to creep up.

As soon as I weaned off the injections my hunger came back rapidly, even though my stomach must have massively shrunk. I only eat 2 meals a day - lunch and dinner, to keep the calories down and my stomach growls all morning 🙈 but I have to push through and ignore it! And I avoid eating out very often as that’s a big pitfall in weight creeping back up. It’s hard but not impossible to keep the weight off.

I never went above 5mg and lost 25kg. Im verry happy now with 1.75mg a week. Lower than this and the food noise come back.
i am exercising 3-4 times a week though and try to focus on protein.

Hello, I'm reading with interest.
I had a gastric sleeve in 2015 and lost about 6st of the 11st I needed to lose and just couldn't get down more until discovering ozempic in 2021. I lost a bit more but the side effects were pretty rubbish. I tried mounjaro early 2024 and have been on and off it ever since. I'm finally at target and maintained mostly for nearly a year.
I'm not convinced I'll ever be able to maintain the weight loss without it. I'd been yo yo dieting from 10 years old and the disordered eating is too ingrained. On mounjaro I eat pretty well, mostly for fuel and I'm not very very active. I never feel that overwhelming compulsion to over eat that a gastric sleeve couldn't even take away.
It's daunting the thought of being on it for ever tho (and expensive). My issue is that you have you pretty much get a pen each month on any plan and because I inject 5mg every 10 days I end up with too many pens. I worry tho if I take a break they won't prescribe again as BMI is now 23?
Where might be best to approach for a maintenance plan. Has anyone been on mounjaro longer than me. Most of the research points towards it being fine to keep taking I think.
Thankyou

Bear in mind, OP, that there aren’t a huge number of formal trials - Google could only find 2 for me. I think I’m right in that in both of those, people stopped the jabs abruptly rather than tapering down.

Real world clinical experience is that tapering down is the way to go, plus all the things you already know - keep up the exercise, limit sugar and processed foods, plenty of protein etc. The majority of people do need some sort of ongoing intervention to keep the weight off, but that could be a different medication, nutritional or lifestyle coaching, a personal trainer, a support group…. Whatever works for you, basically.

Also remember that, within any group, there is a range of responses and you can’t always predict at the outset what will happen to any individual. All you can do is try it, and be prepared to change the plan if you start struggling.

OP, I just asked AI whether the amount of regain was related to the highest dose used during the weight loss phase. It was not - but it WAS related to the amount of weight lost. People who lost more regained more - but also regained quicker.

My personal theory is that the more excess weight someone has, the higher the probability that they have a food addiction or binge eating problem. I speak as a binge eater - my regain after any period of weight loss has always been very rapid. Apart from this one, that is, cos I’ve done/am doing the work on both physical and psychological drivers of my eating.

Try Swift - can get a pen every 8 weeks so that will help. I make a 5mg pen last 8-10 weeks. My BMI is 23 (I’m very muscular).