Dp is not losing weight on Mounjaro

[CupOfSoup]

I need to lose about 4-5 kg to be my ideal weight but that is all that's left for me.

Dp needs to lose 30-40 kg still and is obese and qualified for Mounjaro. He is a tall man, about 196cm, and all his weight is on his belly. His arms and legs look normal.

He used to drink far too much so he has completely stopped drinking. He's eating less than he was before but still a fair amount though his BMR gives him a total of around 2170 calories

He is 6 weeks into Mounjaro and he has not lost 1lb. Despite not drinking at all in that time (and I think he was easily polishing half to a full bottle of wine a night).

He is now so low about it he won't even talk to me about his weight. Is this normal though? Should he have seen some weight loss by now?

So he’s still only taking 5mg dose? The initial doses aren’t therapeutic m, they’re to get the body used to the medication and minimise side effects. Lots of people don’t lose weight until they are on 10mg, 12.5mg or even 15mg. It’s not magic, you have to work with the appetite suppressant to manage a calorie controlled diet.

there’s absolutely no need for him to feel low, this is inline with lots of others experience

Ah thanks so much! I will tell him this. He seemed to think it would be very quick. Yes he is on 5mg dose at the moment.

I just don't want him to lose faith as even cutting down all the drinking was a massive step for him!

I don't think that's usual?
I started at 11st9lbs and first week I lost 5lbs! And I don't have alot to lose.

Is he having food suppression? Is he tracking and limiting his calories?

I’m on 5mg (3rd dose tomorrow) and I haven’t lost a solitary pound. I haven’t gained anything either which is a bonus.

He's not tracking his calories. Try as I might to persuade him, he does not want to do this. He is definitely making healthier choices (loads of fruit and vegetables, yoghurt for breakfast).

He says he doesn't feel any different though he's definitely grumpier 😂

The injections themselves are not magic. He does need to still make changes, which starts with looking at his lifestyle. What exactly is he eating? I don't calorie count but I am careful about carbs. How active is he? Does he drink a lot of water?

I read the glucose goddess, ultra processed people, the obesity code for starters.

He needs to understand how this medication works, in order to maximize their effectiveness.

He's definitely doing the right things and I reckon he's cut out about 500-750 calories a day from his old diet. He's also walking the dog a lot more. He's on the right path. I think it might just start coming off - took me 6 weeks to start losing weight this time. (We are also both in our 50s!).

I'm now on 12.5mg.

I lost zero weight on 5mg and only 2lb when on 7.5mg. I too was very disheartened!

However...in total I have now lost 24lb...it started to shift (slowly) at 10mg and in 8 weeks I've lost 22lb (which, with the 2lb earlier gives me 24 in total).

I'm a 60 year old post menopausal female though, so assume my metabolism is shot to shit!

This. He needs to be in a calorie deficit to lose weight. It sounds like he has already taken some really positive steps, but without knowing how many calories he is consuming he's making everything more difficult for himself.

@justsaxy I believe the Obesity code is not the right book here. It puts all the blame on Insulin however Mounjaro increases insulin secretion , proving that the insulin theory doesn't have a shred of truth.
All the weight loss drugs that do work stimulate insulin production.
@CupOfSoup if your partner is not losing weight, he is overeating. Mounjaro works by regulating your appetite though several hormones and physiology such as slowing down stomach emptying. It doesn't impact how calories are processed. Eating healthy can be calories dense. He might need a higher dose if appetite is not affected.

@CupOfSoup I don't like tracking and counting calories, so I do totally understand what your DP is feeling about that. But, whilst taking Mounjaro, I did track for about a week just to check what my calories were on a typical day. It was so I could check if it was too low or too high, and adjust if necessary.

I agree with the PP about Mounjaro being a long-haul process where you might not get immediate results. In the clinical trials, women lost more weight than men too - losing 11.5% to 27.6% of starting weight for women compared to 8.8% to 18.9% in men. It also makes sense to me that a larger person might need a higher dose of Mounjaro to start getting the effects, so he may well find that moving up to the higher doses makes a difference. Is he going to be ordering a 7.5mg pen next?

Was he eating enough to steadily gain weight before? If so he might still just be eating enough to maintain now, even though he feels like he's eating less and being healthier. If he was in a calorie deficit he would lose weight, unless there's some drug he's taking or medical problem he's unaware of.

If he could just track his calories for a week (without adjusting what he eats) he'll see how many he's eating and then will know more about what's going on.

I was gaining weight quite quickly recently and although I knew I was binging, I didn't think it was so bad. I had a moment of clarity, tracked my calories, and realised that although I wasn't eating much junk food or sugar, I was still eating about 2500-3000 calories a day just in bread and butter, cheese, and big portions of dinner. Crazy when I look back but I've always tended to overeat. Dropping to under 1500 calories feels like severe deprivation in comparison, and I'm only losing a pound a week but at least it's going down.

He thinks he's eating healthily but is he really? Lots of things that are often perceived as "healthy" are very high carb/calorie.

Things like jacket potato, fruit, muesli, porridge, fruit juice, rice, pasta etc can be worse than you think.

It would be worth him tracking just a few days to see what's going on.

He probably just needs to be patient while he works his way up to a higher dose. Many people don't get significant effects until they are on 12.5 or 15mg, and a big man is probably more likely to need a big dose than a small woman.

Meat and eggs are very high satiety and nutrient foods for relatively low calories and they reduce stomach bloating.

Assuming he is not veggie for ethical/religious reasons I think upping the meat content of his meals and eating the protein first then fruit (if having) last should help.

I haven't lost several pounds at a time, but I've been losing small amounts very steadily and they have added up to over 2 stone over 4 months. I can't understand why it's not more, but what I like about Mounjaro is that it takes away those obsessive thoughts, so I'm able to get some perspective and just think it'll happen soon.

Does he have suppression, where he just doesn't fancy eating much, or is he able to eat the same quantities? I can only eat small quantities as otherwise I feel really ill. I also feel full for much longer, so eg if I ate at breakfast time I would still be full by evening.

Check his calorie deficit. It's not enough to guess, and my maintenance calories were lower than I thought.

I think that if he is a big tall man he might need a higher dose for it really to register and start to lose the weight. So don't get discouraged, keep injecting through the weeks and upping the dose.

I am on week 6 and have lost over 16 pounds, suppression has been there since day 1. I appreciate I am a smaller female however.

It is really important to watch what you are eating, i focus on high protein and low carb. I dont really eat fruit, yoghurts etc due to the high level of sugars, but plenty of veg.

If he is eaten less than he did before, as well as moving more he should have lost weight. I think they say a lost of 3500 calories, whether through eating less or moving more should result in a weight loss of one pound?

It's possible he's still eating too much.

My BMR for my starting weight was 2,500 calories a day. In reality, I've been eating at most 1,200 since the start (often less!) and still only losing 1-3lbs a week not insane amounts.

He may well be eating too much, but he's obviously eating and drinking a lot less than he was, so there should be a weight loss of some kind.

Does his pharmacy have someone he could email for advice?

It doesn't work for everyone. Some people are immune to it. But he needs to work out his tdee, find out what calories he needs to lose weight and stick to that. If the mounjaro was working he should be able to do that easily.

The problem is he may have cut 5-750calories out per day but he may have been eating 5-750calories more than he needed to maintain very easily.

He’s still eating far too much. 2000 calories would be for a 30 year old bloke who goes to the gym. The older you get the lower your BMR.

Tell him to focus on eating more protein, basically protein will give him more bang for his buck calorie wise. Fruit like bananas and apples should ditched they are just turned into sugar by the body. The best (and probably only fruit he should eat) fruit is berries. As for Veg he should avoid veg from below ground and stick to only above ground veggies.