Failure. What advice would you give?

[margaerysmittens]

Please don't be too unkind. I am feeling somewhat low already.

I'm a woman, 53 and not quite 2 years into meno. Been on mounjaro about 2 years, maybe a bit longer. Brief stint of ozempic (I think) before switching. At first it did wonders for weight loss, suppression, I lost about 5-6 stones and my self esteem soared and general overall health seemed improved. Never went higher than 7.5.

I'm on the short side, 5ft1, so every pound shows. I felt slim and small and I loved it. I could even buy kids clothes 😂

Over the last year something has changed. I've been gaining steadily even still being on weekly jabs. I've stopped counting calories. I think honestly I was tired tired tired of "dieting". I'm not overweight (yet) but I have gained about 2 stones and it won't be long until I'm overweight. My lovely new clothes are all too tight. I feel "chubby".

This week I tried to "diet" and found I couldn't in the same way I did before. I don't know if I trust myself to recognise true hunger signals. I feel utterly depressed at the thought of restricting food again.

I'm not lacking knowledge. I know all about bmr, tdee, protein, fats, general nutrition. I know about being active and the 80/20 "rule". I don't love exercise, being honest. I joined a women's gym about a year ago and I strength train with a group but I don't love it, I tolerate it for the benefit of heath/bones (it does nothing for weight loss). All the "motivational" chat that goes on in our group chat actually makes me feel worse....about the women who show up, are consistent bla bla are the successes. I think some people just don't love exercise and don't experience the same "high" from it that other people do? I'm fairly active, part of a walking group with weekly walks.

I feel I've lost my spark, my motivation. It's not only the weight gain. Recent ish ending of a rel (not a great loss, but still), kids flown the nest and so on. Work OK but like exercise I don't love it. About 2-3 months into hrt patches (which shouldn't cause weight gain).

I have a holiday coming up in Feb and usually that would be motivational but it's not.

I can't afford to go up beyond 7.5, not an option. Do I buy ready meals and stick to a really rigid calorie controlled plan, knuckle down and just tolerate it? I "know" how to diet but I'm panicking that I "cant". Is there something I may not have thought of?

No judgement from me, I totally recognise what you're going through. Been on mj for over 2 years now. First year was easy, then much harder. I think for me it was diet fatigue. Even with the mj old bad habits started to creep back in.
I did go up to 15mg although I resisted it for a while it was the only way I could get the last stone off.
I'm in maintenance now - recently so titrating down (on 12.5mg currently). I've actually put on a few pounds and I know this is because I am eating crap again. I still don't eat much but I'm eating the wrong kind of food. I wish I had an answer for you but I just wanted to say that you're not alone.
I'm going to try really hard to get my exercise in and really focus on eating heathly. It is very frustrating but I am absolutely not going to let myself slip back.

That's really tough, OP, I feel for you. It must be so disheartening.

I know there have been a few people on the long running threads with more weight to lose who have tried a hard reset - ie coming off MJ completely, letting it clear their system and starting again. With varying success I think.

I would also say that just because you've been told patch HRT "shouldn't" cause weight gain doesn't mean it might not in your individual case. This has been true since the early days of the pill - women's systems and responses to artificial hormones are too varied and nuanced for anything to be 100% true. But the weight gain goes back further than the HRT so it's hard to know.

My last point is a bit more tough talking: you say you can't afford to go above 7.5 and this is probably your biggest problem. You've been on MJ for a long time and 7.5 is quite low. (I lost 6.5st going up to 10, currently maintaining on 5, I'm in my mid 50s and post-meno) . Yes, there are people who lose loads on 2.5 etc but there are also just as many who have to go all the way to 15. I'm going to challenge your thinking on this. Right now you might be spending less, but you're seeing nothing back for it. And you've now got ground to make up. Which makes 7.5 a bit of a false economy.

I don't know what the answer is - it makes a difference whether you're with the cheapest provider already, and what your plans for maintenance were originally (come off or stay on). If your plan was to come off then funding the higher doses actually makes more sense financially than sticking at 7.5 and going nowhere for longer.

I hate calorie counting and am not a natural exerciser, BTW so I'm with you 100% there. I do weights at home and love walking far and fast. I think you either need to make the MJ work for you again or come off. I don't see the point in paying out loads at the same time as struggling with healthy eating so much that you might as well not be on it at all.but

These things can be a constant battle. I was talking to a good friend of mine about it. She looks the type who is totally in control of all aspects of her life, but we both agreed it was far from straightforward. The only way I really manage to keep control is to keep my eating really simple and regular, so I don't have to think about it too much. Having exactly the same thing for breakfast and lunch every day and then a small portion of whatever for dinner (obviously you can do lunch instead of dinner). Some people only have one meal a day but that wouldn't be enough for me!

I can relate although I have only been on mj for about 2 months.
Spent my whole adult life battling food noise but managed to stay a healthy weight through healthy but restricted eating and exercise. I’ve found it more of a struggle the last few of years - had to stop sports during Covid and never really got back to where I was, menopause hit, and emotional eating meant I put on weight which I just can’t shift. It’s only about 4 or 5kg but I hate myself at this weight.
I hoped a low, affordable, maintenance dose of mj might be a long term solution and the first 6 weeks on 2.5mg were amazing! Not thinking about food, not eating out of boredom/stress! But that initial high has worn off and 5mg isn’t doing anything for me.
I’ve got an unopened pen in the fridge but am thinking what’s the point of starting it and feeling very down that I am going to have to continue battling for the rest of my life.

Have you considered switching to tablets if the cost of higher dose mounjaro is too much? I have also been on it for a long time and muddling through maintenance. I've put on 10kg from my lightest but I wasn't keen on my lightest anyway. I would like to drop 5kg though. I've tried stopping and that didn't work but the ongoing expense of the dose I need to maintain is a stretch. So I'm going to give Foundayo a go as I can do a higher dose for a lower price. I've not started it yet so I can't report back, but I'm hoping it will work well enough for a bit of loss and then maintenance.

Well done on what you've achieved so far; don't overlook that. As you've said your logically mind know exactly what you need to do but it's being overridden by your emotional/subconscious mind, so that's the part of you that need working on now. Start at the beginning. How was food regarded in your childhood? When and why (if you know) did you begin overeating? Once you can identify why your mind thinks food = happiness or comfort or security (or whatever) you can begin to change that way of thinking. But you need to figure it out first.

This is my take on going forward with WLD.

As a former severely obese person, (bmi 49) I’m about 18 months into this and I’ve concluded that over eating or eating the wrong stuff is definitely a choice I have to take ownership of.

If you were an alcoholic and had managed to get sober, you’d presumably accept that staying sober would need constant vigilance for the rest of your life?
This no different as your mindset understands that one drink will escalate into two, three and before you know it, you’re falling down drunk and a mess.

You have to accept that maintaining a slimmer figure is a long term control issue. The WL drugs only help to get the initial excess weight off but if you take your foot off the gas when you reach maintenance, you will undo all your efforts.

There is no more access to an ‘all you can eat buffet’ for a week on holiday. That’s the equivalent of “just one drink at the Christmas party won’t hurt, will it?”

I think @Lhori has the right approach here. Work out a basic eating plan and stick to it. You get to design your own plan, but if you say “ah feck it, I’m going to eat this entire Chinese takeaway by myself”, you have to accept the consequences of that choice. So, that means you get straight back on your boring food plan the very next day.

I must take full responsibility for my eating from now until the day I die. I hope improved WLD will make this easier but I’m no different to a recovering alcoholic taking it one day at a time! 🤷🏻‍♀️

Have you tried changing up your exercise? I’m in London so fortunately have a lot of options on Classpass, but I find the only thing that keeps me motivated to exercise a lot is by having variety. As soon as I find that I can’t really be bothered to turn up or that I’m not really seeing any results, I switch it up and try a strength class at a different location.

The hard thing for most to accept is.. if you want to stay slim, there is no end to the “diet”
It’s a lifelong change, no end date
No temporary way of being.
Resisting temptation is a daily effort.
Strength training mixed with cardio definitely should be changing body composition

The thought that I'm going to have to stay on some form of this expensive drug for a long time and perhaps for the foreseeable is really annoying, as is the likelihood that I'll have to go up to 5 mg for a month to winch the last 1.5 kg off (2.5mg seems to be my maintenance dose now, it's no longer a weight-loss dose).

I don't have any really good advice to offer except maybe to suggest finding a new provider and making use of discount codes to go up to 10mg for three months to try to get things under control. Just be careful as some of them offer you a really cheap initial month (my provider, Voy, does this) and then charge like a wounded bull for subsequent pens.

Hope things pan out for you though, & no judgement here at all. Sometimes life is just unfair.

My advice would be to not think of it as a binary failure or success. Managing weight is an ongoing process that has ups and downs. When things change then it’s just a question of adapting.

I would agree with reconsidering whether you can find a way to move up from the 7.5mg dose if it’s doing nothing for you. Are you buying from the cheapest supplier? Can you get a higher dose and count clicks, to make a pen last longer if that works out cheaper?

I’m 55 and 5’4”, and I’ve lost six stone. My highest dose was 7.5mg, and I’m now on 2.5mg for maintenance. I’ve maintained for six months, losing one whole pound in that time!

Sadly, I think I’ve accepted that I’ll need to watch my weight for the rest of my life. I’m socialising again, with drinks and meals out occasionally, but to make room for those, I’ve given up breakfast and most puddings and treats.

When I look at my estimated TDEE, it makes sense: I’m averaging roughly the calories I need to maintain. The problem is that it feels like so little! It’s around 1,780 calories, including daily exercise and dog walks, compared with a baseline of 1,478.

I’ve had to rethink my whole approach to food. I think part of me expected to go back to something closer to how I ate before losing weight, but I can see now that wasn’t realistic.

I understand saying you don’t want to diet for the rest of your life. What’s helped me is thinking of this as the way I eat now, rather than a diet with an end date.

Everything else is so much better- my fitness, my relationship, my knees, work- that, for me, it’s worth the adjustment. But there’s no shame in finding that difficult or deciding it’s not for you. I just wish maintaining meant I could eat more than it seems I can. That’s the bit I’m learning to accept.

I’ve maintained for about 20 odd months, on five mg, down from ten where I lost most of my six or so stone, my weighr fluctuates by 1 kg either way,

the reality is fne drugs don’t do the heavy lifting, when the initial diet phase wears off, and real life settles in, you need to do the heavy lifting, the drugs just make it much easier they kill the cravings, manage your hunger, via their various mechanisms,

we can all push through and over eat. So you need discipline. I basically have cheat days once a fortnight when I’m socialising, where I eat and drink as I please, the rest of the time I stay in a healthy eating regime, and working out. The medication makes it feasible for me to do that, I’m not sitting feeling deprived or hungry or having overwhelming cravings, if I feel like eating something I can simply ignore it.

if you want to get back down you will need to diet again, it’s that simple. I know you can’t afford to go above 7.5 but maybe a few months at ten will give you the push you need,