Mounjaro Weekly Weight Loss Injection  

Mounjaro  weekly weight loss injection (tirzepatide) is the most potent FDA approved weight loss agent ever produced with average weight loss of more than 23% of starting weight. It’s the  first and only dual GIP/GLP-1 receptor agonist  hormone that controls both insulin and glucagon secretion. In addition, the GIP hormone controls lipids and fat depositions in the body.  The two hormones in the once a week Mounjaro injection work together as a single molecule. Acting in the brain, stomach. pancreas and bowel Mounjaro controls  appetite, fullness and metabolism.  Mounjaro weekly weight loss injection from Lilly is marketed as a  treatment for type 2 diabetes.  However, Mounjaro, like Ozempic and Wegovy have potent weight loss properties due to the medications affect on appetite and metabolism centers in the brain. The FDA is set to approve Mounjaro as a treatement for obesity soon.

In addition, like Ozempic and Wegovy it delays gastric emptying producing fullness for many hours.  Mournjaro is prescribed  “off label” for weight loss similar to Ozempic while it awaits final FDA approval as a weight loss medication.  Greater weight loss and glucose control  and less side effects are found with Mounjaro as compared to Ozempic and Wegovy because it consists of 2 active hormones acting together.

In the most recent trial of Mounjaro 36.2% of participants in the 15-mg Mounjaro had  weight reduction of 25% or more. This compares to weight loss with bariatric surgery of approximately 25 to 30% at 1 to 2 years and far exceeds the results seen with older anti-obesity drugs of 4 to 8% weight loss after  a year.

 

How Does Mounjaro Weekly Weight Loss Injection  Produce Such Profound Weight Loss?

  1. It directly reduces appetite and increases metabolism by action in the brain.
  2. It reduces glucagon secretion which is the hormone increasing hunger.
  3. It causes individuals to eat less carbs and fatty food.
  4. It increases insulin production, but only when blood sugar is high—which makes the risk of low blood sugar minimal.
  5. Decreases the liver’s production of sugar and increases uptake of sugar by muscle tissue.
  6. It slows down the speed at which the stomach empties food into the intestine. This produces weight loss and is also responsible for the gastrointestinal side effects.

Mounjaro most potent weight loss medication

Research Results Confirms Signficant Weight Loss with Mounjaro Weekly Weight Loss Injection 

The most recent SURMOUNT-1 study consisted of 2,539 participants with an average starting body weight of 231 pounds over 72 weeks:

1. At the lowest dose—5 mg—participants lost 15% of their body weigh..
2. At higher doses—10 and 15 mg—participants lost 20% of their body weight. More than half of the participants taking the higher dose lost 20% of their body weight compared to only 1.3% taking a placebo. Average weight loss = 52 lbs.

Most Mounjaro research results suggest Mounjaro as more effective than Ozempic or even Wegovy for weight loss. Gastrointestinal side effects are lower with Mounjaro than the other drugs.

Comparison of Weight Loss with Ozempic, Wegovy and Mounjaro

The three new GLP-1 medications for weight loss are compared below. Note the Ozempic is presented both at 1 mg and 2 mg doses. The 2 mg dose is from the Wegovy data. In other studies Wegovy produced mean weight loss of 18% of starting weight.  Be careful to recognize different length of studies, starting weights and most important the presence of diabetes in some of  the study subjects.

Weight loss with Oxempic, Wegovy, Mounjaro

                        weight loss comparison of 3 new GLP-1 diet medications

How to Take Mounjaro Injections

Mounjaro weekly weight loss injection is supplied in a box of 4 self inject able pens enough for a month. Each pen is used for a single injection once a week on the same day of the week. Doses start at 2.5 mg and increase in 2.5 mg increments. Weight loss starts after taking the 5 mg pen for several weeks.  It gradually increases as doses increase by 2.5 mg per month. Greatest weight loss is seen at 15 mg weekly. Injections are taken at the same day of the week, usually Saturday morning. Some patients take it at bedtime to lessen nausea. The reason for Saturday morning is that most people eat more on the weekends and the medication is more effective early in the week. Mounjaro can easily be followed on line.

Each month the dose is increased. Here are the doses:  2.5—5—7.5—10—12.5 and 15 mg/week

Side Effects of  Mounjaro(Similar to  Ozempic and Wegovy): What to Do About Them 

Non Specific Side Effects:
Fatigue, lack of energy and tiredness
are common side effect with all three of these drugs. There are several causes including skipping meals which often results in hypoglycemia late in the afternoon ,too much food reduction, vitamin deficiency from rapid weight loss and most important some lowering of blood sugar. Blood sugar reduction would be not unexpected because these medications are used by diabetics to lower their blood sugar. Much of the fatigue is avoided by not skipping meals and having a protein snack late in the afternoon.

Gastrointestinal Side Effects-The most common:
GI side effects are common in people taking these drugs. (72.9%). They included nausea (43.9%), diarrhea (29.7%), vomiting (24.5%) and constipation (24.2%). Less common are heartburn, burping and non specific abdominal pain.  Dose Escalation causes increased frequency of GI side effects especially in the first 2 days of the adjustment. The GI side effects are mostly transient (with the exception of constipation), not serious (99.5%), and of mild-to-moderate severity (98.1%). The GI side effects fall into 2 groups: the specific and more serious side effect and the much more common, mild gastrointestinal pains.

1. Specific GI side Effects: Rare, but on Occasion Could be Serious:

       Constipation is  On Going Problem in many patients: Constipation may last longer than other GI side effects consistent with the more chronic nature of this
condition and the fact it’s often due to other factors. Most commonly, it’s due to the marked reduction of intake of food, especially fatty foods and oils.

       Pancreatitis and Gall Bladder Attacks:  Acute pancreatitis has been reported in patients treated with these medications. Patients are observed for any
signs and symptoms of acute pancreatitis (e.g. persistent severe abdominal pain). Trials have not shown an increased risk of pancreatitis with these medications.

       Cholelithiasis (gallstones) may occur with rapid weight loss with any diet and an increased incidence has been reported in patients treated with
Ozempic/Wegovy for weight management.

 

2. Non- Specific Side Effects Related to Dosing, Food, Eating Patterns

A. Treating GI Side Effects of Mounjaro by Changing Foods

No foods are strictly “off-limits” when taking Ozempic or Wegovy—in other words, there’s nothing to need to worry about that could prevent the medication from working normally. However, there are a few guidelines you’ll want to keep in mind in order to maximize weight loss and minimize side effects. This includes limiting fatty,  fried foods and high sugar foods. Eating slowly and avoiding large meals is another key to preventing GI side effects.

B. Treating GI Side Effects  of Mounjaro with OTC or Prescription Medications- Depends on Type of Symptoms

Nausea: Nausea is clearly the most common GI side effect. It’s often seen in the very beginning and during dose escalation, but for most people it gets less and less significant as time passes.  Studies have shown it’s due the delayed gastric emptying, direct effect of these drugs  in the brain and eating fast or eating large meals especially full of fat and carbs The secret is to eat smaller meals, more frequent and try to stop before you feel full.   Rx: OTC meds like Gas-X, Pepto- Bismol, Imodium and prescription Zofran orally or  Compazine by injection.  

GERD-Heartburn-reflux:  There is a transient worsening or new onset of gastro- esophageal reflux disease (GERD; a known complication of obesity) during treatment for many patients. Rx: Omeprazole, Prilosec- once or even twice a day, for breakthrough pain H2- blockers such as Pepcid AC, Tagamet, Protonix, Prevacid.  

Constipation: One of the most common side effects due to the medication or even more likely the change of food. Treatment includes the usual treatment of constipation. Rx: Fiber such as Metamucil capsules 2-3 twice a day with several glasses of water, stool softeners and/or Miralax. 

Vomiting: This less common side effect is usually transitory and occurs more in the initial phase rather than with higher doses. Often treatment for GERD like symptoms can stop the vomiting. If severe, then the anti-emetics. Rx: OTC products: Dramamine, Bonine, Gravol, Pepto-Bismol, Emetrol, prescription products include Zofran, Compazine, Phenergan 

Other Non- Related Causes 

Clinicians should also consider whether any existing or recently initiated concomitant prescription or non-prescription medications could be responsible. for example, Metformin can cause GI side effects.

C. Treating GI Side Effects By Lowering the Dose of Mounjaro

Given the dose-dependent nature of these GI side effects lowering the dose and/or delaying the escalation is considered for patients unable to tolerate the medications with the aim of achieving a dose that enables patients to gain at least some of the benefits with minimal GI side effects.

If GI symptoms occur and dose escalation is paused or the dose reduced, dose escalation is retried once the patient is symptom-free at the lower dose. Such escalation should be slower than previously used. Many patients with GI side effects are able to achieve the full dose, although the time required for titration  is longer than expected. If patients experience GI side effects with other drugs of this class and are unable to tolerate them, despite best efforts to alleviate the symptoms, treatment should be stopped. Switching to a different class of obesity pharmacotherapy could be considered, if appropriate


Plateaus and Slow Weight Loss: How to Increase Weight Loss with Mounjaro, Wegovy, Ozempic

 1.Take the injections Saturday AM, these medications are more effective just after you take them, and many people eat more on the weekends.
2.Increase the dosage faster if side effects of nausea are not a problem. You still need to reach 1 mg/week for significant weight loss to start and you need a 3. week period to obtain full dose in your blood. (Steady State). Take two doses a week by splitting the dose in half, taking a dose on Saturday and wed. The doses can be the same or different. This often lowers the side effects.
4.Most individuals taking the drug find sweet and fatty foods very unpleasant. So why not simply avoid these. Exercise beginning in the 3rd week is always helpful.
5.Avoid large meals or eating too fast because this ends up filling the stomach up quickly which leads to faster emptying and less fullness and less weight loss. This occurs frequently when skipping meals. Need 3-4 small meals over the day.
6.Avoid drinking water, especially carbonated drinks during the meal because a lot of fluid causes premature emptying of the stomach and defeating the effect of the medications. Best idea is no fluids from 30 minutes before to 30 minutes after a meal. Oils and alcohol have similar effects with high calories as well…
7.Avoid eating dense, high calorie snacks like nuts, seeds, nut butters, and granola. These foods are consumed in tiny portions that can easily slip out of the stomach and be absorbed.   Reference:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189979/ 
8.Chaotic eating, grazing, skipping meals This is often the behavior that caused the weight gain in the first place. Need structure, eating times spaced throughout the day allowing time for breakfast, lunch, snack and dinner. After 4-6 weeks taking any of these medications, the dieter often starts skipping meals because the medication produces fullness and lack of appetite especially during the day. Eventually the dieter ends up with large meal in the evening which can cause premature emptying of the stomach and reduced weight loss.
9.Alcohol causes disinhibited eating and failure to lose weight rapidly.

Who Should NOT Take Mounjaro?

Like any other effective medication, there are certain contraindications and potential risks. You should not take Mounjaro if:
1.A history or family history of thyroid cancer—specifically medullary thyroid ca (MTC).
2.A history of  Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
3.A history of allergies  to any of the ingredients

What is the cost of Mounjaro Weekly Weight Loss Injection ? (Price of all doses are the same)

Retail cash price is about $1100/month
GoodRx coupon is $964
Savings Coupon from Lily:  https://www.Mounjaro.com/savings-resources#savings   $25.00 per month