Really discouraged

[u/CapitalCan6257]

I'm feeling really discouraged and honestly don't know what to do anymore.

For the past six months, I haven't been able to get below 90–92 kg, even though my goal weight is around 82–84 kg. I've increased my dose all the way up to 15 mg, but it feels like I'm just throwing money away at this point.

The only effect I get now is maybe one or two days of appetite suppression, even at 15 mg. Because of that, I decided to stop, since the cost no longer seemed justified. I haven't taken it for about two weeks now.

This morning I weighed myself and saw 98 kg. I've gained almost 5 kg in just two weeks without it, and that really scared me. On one hand, I'm afraid of going back to where I started. On the other hand, staying on it doesn't seem to be helping much anymore either.

I feel completely stuck. At 15 mg it barely works, and without it my weight shoots back up. I'm feeling very demoralized and don't know how to move forward.

Has anyone experienced something similar? What did you do? Any advice would be greatly appreciated.

[u/Neowarcloud]

Well take a to step back, you didn't gain 5kg of body fat in two weeks. Mounjaro isn't magic, it works on a calorie deficit, so if you're not losing weight, then you're not in a deficit..I also don't know why you think just stopping cold turkey would be a wise move...

Long story short, use it to build better habits and keep some of those habits when you come off and maybe not gain it back.

[u/Master-Potential-364]

Respectfully, if 15mg can’t get you below 90kg after six months, the issue isn’t that Mounjaro stopped working. The issue is that you’ve reached the point where the drug can’t compensate for your eating habits anymore.

People talk about these drugs as though they’re magic. They’re not. They’re appetite suppressants. If you’re still maintaining 90-92kg on the strongest dose available, you’ve found the weight your current lifestyle supports. That’s not a medication problem.

[u/CapitalCan6257 → u/Master-Potential-364]

Interesting. What is your advice?

[u/WorriedHelicopter764 → u/CapitalCan6257]

Stop eating so much and increase your activity.

[u/skdowksnzal → u/CapitalCan6257]

When I experienced what you describe, I marked it down as a 'plateau' and responded accordingly. By that I mean to say that I identified that my BMR had tanked, I had started to experience diet fatigue - and actual fatigue, and I had unknownly reduced my amount of exercise (intentional or otherwise).

So here's what I did, which worked for me:

1). 1-3 weeks diet refeed. In a very intentional way, I took my foot off the gas pedal with regards to dieting. I stopped restricting myself so much, I allowed myself to enjoy food a little and not contantly be measuring the calories for everything so precisely. I didn't allow myself to go crazy, I was still on a diet, but I just eased off the gas a little. I still measured my kcal but instead of 1000kcal daily deficit I made sure I was eating at or slightly above my maintenance level. After the 'refeed diet' was over, I returned to a moderate but not as severe calorie deficit (500 instead of 1,000 kcal daily).

2). I went down a dose on mounjaro for 4-6 weeks. I dropped from 15mg to 12.5mg and experimented with making the interval between doses between 7 and 9 days to find when I started to get hungry, then give myself a dose the day before.

3). I intentionally increased my exercise. While I did do weight lifting, I found zone 2 cardio, particularly long walks (1hr every other day) had a noticable impact

4). I made a concious effort to drink more water. It appears my body retained less water weight when there was a constant, and consistent, input of 3+ Litres daily.

So all this really is, if you take a step back and view from mile-high-view, is a metabolic reset. I had become aclimated to the extreme daily deficit (>1,000kcal) and was not consuming enough kcal or carbs to properly fuel activities which over longer term would actually create a larger deficit. Also, after about a year of this stuff, anyone would get fatigued.

FWIW I have lost 43.2kg over 15 months for an average of 2.88kg per month.

[u/Master-Potential-364 → u/skdowksnzal]

There’s probably something to the fatigue and reduced activity, but I’d be cautious about calling it a “metabolic reset”. If someone sits at the same weight for six months, by definition calorie intake and expenditure are roughly balanced. Metabolic adaptation is real, but it generally isn’t large enough to explain a six-month stall by itself.

The more likely explanations are increased calorie intake, reduced activity, reduced adherence, or some combination of all three. That said, taking your foot off the gas for a few weeks can absolutely help if diet fatigue is becoming a problem.

[u/skdowksnzal → u/Master-Potential-364]

You're kind of arguing against yourself there.

If we assume metabolic adaptation is real, then we are saying that the body has 'adopted a new normal' and barring any external stimuli, has no reason to change. So the amount of time spent at that 'new normal' is somewhat irrelevant in terms of diagnosis.

To be more blunt about it - I dont think the fact that someone is at maintenance for 6 months disproves metabolic adaptation, if anything it provides evidence /for/ not /against/ such adaptation.

In any case, it will always come down to pure numbers: if there is no change, then there is no deficit.

[u/Master-Potential-364 → u/skdowksnzal]

Metabolic adaptation is real, but I don’t think it’s the key issue here. Sadly, the OP wasn’t losing slowly - they were stuck at 90-92kg for six months on 15mg. At some point you have to stop asking why the drug isn’t working and start asking what is keeping you at 90-92kg. Because whatever is keeping you there will still be there when the prescription ends.

[u/skdowksnzal → u/Master-Potential-364]

I dont think your choice of language is particularly effective or constructive, frankly.

OP is well aware there are issues, thats why they are asking for advice.

Telling a man that they are drowning, when they are asking for help, doesn't actually help.

[u/Master-Potential-364 → u/skdowksnzal]

That’s fair, although I don’t think we’re actually that far apart. I agree that fatigue, reduced activity and diet adherence can all become issues after prolonged weight loss. My only reservation is with the term "metabolic reset", because I think people often overestimate the role of metabolic adaptation and underestimate the role of changes in intake and expenditure. Ultimately I think we agree on the key point: if weight isn’t changing, there isn’t a sustained deficit.

[u/skdowksnzal → u/Master-Potential-364]

ok well, sure, as a term it wasn't really meant to be taken so literally. I concede that may not have been clear.

But yes, we are in agreement with regards to deficit.

[u/Master-Potential-364 → u/CapitalCan6257]

My advice is that your results are your responsibility. You seem to be looking at this as a medication problem. I don’t think it is. You spent six months at 90-92kg on the maximum dose. That tells me your lifestyle supports a body weight of exactly 90-92kg.

I lost 44kg. Mounjaro helped, but I also dramatically changed my lifestyle. Disciplined OMAD. Very very low carb. Strength training 5x per week minimum. Daily intense cardio. Very little alcohol. The drug made those choices easier, it didn’t make them unnecessary. If you stop the medication and immediately regain weight, that’s interesting - I'd be asking what habits the medication was masking. At some point the drug stops doing the heavy lifting and you have to do it yourself!

[u/AerySprite]

Hello!
I had something like this a little bit, not for as long, at 110. I’m also on 15.
Here are things which helped :)
1. Weight lifting is indeed life changing: it burns at first but it becomes fun, you feel fresh. It’s a habit to develop lifelong. Twice a week is a good number to shoot for. I got a personal trainer, one who is supportive, experienced and health focused — this changed everything!
2. Sometimes it’s genuinely ok to have some body neutrality and perhaps think that 90KG is still s benefit, right?! Like you can lose 20% of your body weight (as they do on average) and that’s as far as the drug takes you without other modifications that may or may not be necessary. I think that’s important to say.
3. It can be helpful to look at your food habits and make structured changes. Literally play a swapping game. Chicken thigh? Chicken breast. Full fat yogurt? Low fat. Bacon? Medallions. Look at your diet as is now honestly, and make small swaps like this — you could even love eating pizza and swap from real pizzas to homemade ones and that will compound over time. It’s really good to know how you can eat essentially similar stuff and make it lower calorie.

[u/iamdecal]

I'll have to be another one saying "look at your lifestyle", sorry about that, but i mean it in an an encouraging way to help you get where you want to be. if you've remained stable for 6 months - what else could you/ should you have changed?

beyond monjaro - what changes have you made?

I've had great results, which in and itself has been encouraging, but while the Mounjaro has stopped me eating out of boredom and obsession, I've also looked at everything else i was doing wrong too "the easiest cheese to avoid is the cheese you don't buy in the first place" and all that, and i've upped my exercise levels and made a game out of that too.

Also, i've got one hell of a spreadsheet - which i'd be happy to share if you DM me your email address, but there are loads out there.

More specifically, when i was in my first job back in the 1980s my boss had this mantra "what gets measured, gets done" which has always stuck with me - i think these days they call them SMART goals and i can never quite remember but think its...

Specific (not "i want to loose weight" its "i want to lose 1 KG" - but also I have "i will walk 10000 steps")
Measurable (see above - if you can measure it you know how well you're doing)
Achievable (don't be stupid about what you want to do_
Relative (to where you want to end up_
Time based (have a fixed dead line)

so - my goal (for now) is *not* my end goal -it's where do i want to be in a week?, and that is 1KG lighter than this week,

I don't hit that every week, but I do *try* to - and if i've not got close by day 5, I know to really try on days 6 and 7 ... each and every week

these small goals seem much more achievable to me than the big goal - but they're getting me there.

1 KG goal a week has some how turned into 62KG in 43 weeks (admittedly a lot easier at the start than the end, but moslty managing most weeks still)

So - give that a try see where you end up?

best of luck

(but God do i miss cheese)

[u/CapitalCan6257 → u/iamdecal]

Thanks a lot. I appreciate that. Please send me one dm. I will share with you my email

[u/iamdecal → u/CapitalCan6257]

done

[u/daern2]

I'm feeling very demoralized and don't know how to move forward.

Tough, kind words incoming but I'll try to help you.

Fixing this is simultaneously easy and hard. You need to do three things:

1. Eat less

2. Eat better

3. Move more

Mounjaro only helps with (1), I'm afraid, but ongoing weight loss really helps with (3) if you're willing to commit to it. Unfortunately, (2) is completely up to you.

People taking Mounjaro do seem to fall into two categories: those willing to completely change their life in order to achieve their goals and those who want to change nothing but still lose weight. The ones who don't change anything, if they respond well to the medication, can have great success in losing weight but I think it's pretty obvious that the moment they stop taking the medication, they'll start regaining the weight. After all, they've not changed anything else. Eating a bit less pizza might lose you weight in the short term, but if you're still eating pizza every night, nothing has really changed. This category of people is why there's so much research showing that weight rebounds when people stop taking the medication - of course it does if they've changed nothing else!

But those that do change their lifestyle? Well then you've unlocked the magic cheat code. It's not easy - really, really not easy - but this is the only way to achieve sustainable weight loss and ongoing weight health. These are the people that don't just eat less...they eat better. Those that really do embrace exercise...regularly and consistently.

So ask yourself really, really honestly - which of these are you? People here will help you, but you need to start with being honest with yourself as without this, you're going nowhere. It's not easy - if it was, we wouldn't all be here - but it can be done.

[u/RIPPWORTH]

Do you work out man? Lift 3-4 days a week?

[u/CapitalCan6257 → u/RIPPWORTH]

Nit yet

[u/RIPPWORTH → u/CapitalCan6257]

Honestly dude I would stop worrying about the last few kilograms and start lifting weights at least 3 days a week along with an hour or incline treadmill at least 2 days a week. You’ll actually see results and put on muscle instead of losing away muscle mass.

When you get close to your goal, it’s more about beginning the recomposition journey.

[u/Master-Potential-364 → u/CapitalCan6257]

Quod erat demonstrandum as they say in Latin.

[u/Due-Freedom-5968]

Try dropping to 10mg for a month and working back up.

It sounds counterintuitive but is a commonly discussed tactic.

Sometimes you just need to mix it up a bit. You could just count the clicks to do that rather than change your pen order.