Mounjaro for T2D but weight loss stalled?

check out r/mounjaromaintenance and r/glpgrad for some stories. this med really proves it's not all willpower—some people have actual metabolic issues it's correcting. might not be able to maintain without it long-term. kind of like asking someone with bad vision to see without glasses.

The community plateau playbook has a whole section on T2D stalls if it helps

I'm four months into taking Mounjaro, almost on my sixth. It's been prescribed for my diabetes, and my blood sugar levels have improved drastically, based on what I'm seeing daily. My next A1C test is later this month. I'm on 5mg right now and have been getting those sulfur burps since week two on 2.5mg. I've only managed to drop around 8 lbs in these months. I want to continue because of the positive impact on my blood sugar, but the lack of weight loss is a bummer. I've tried losing weight several times over the last two decades, and the best I've done was losing about 20 lbs after two years of working out with a trainer and dieting perfectly. Has anyone else had a hard time losing weight on this medication? What should I discuss with my doctor at the end of the month? Will upping the dosage make the sulfur burps worse? I've also noticed my appetite returning towards the end of each week, even though I'm eating way fewer calories than before. My doctors in the past haven't seemed to believe me that I'm doing everything right but not losing weight. Controlling my diabetes has been a huge win, and my sleep apnea is also under control (thanks to the CPAP), so that should be helping too. It's like my body wants to stay around 275 no matter what I do. I reached 268 recently, then jumped back up to 273 almost immediately. Any advice or encouragement would be appreciated. Thanks!

For those with T2D, it's common for your body to focus on stabilizing your A1c before significant weight loss occurs.

Try Dramamine for sickness and Gas-X for the sulfur burps. I also take digestive enzymes, plus stay hydrated with lots of fluids and fiber. Dehydration and constipation can cause problems. There's no harm in going up a dose. I had the worst gas on 5mg but barely any side effects when I went up to 7.5mg. If you're a woman, you might have PCOS or other metabolic issues that make Mounjaro take longer to work. You'll start losing weight eventually. You might be doing too much while not eating enough. Increase your calories. Eat enough to fuel your body. I know from experience that cutting too many calories can stop weight loss and mess with your metabolism. When your body is getting steady fuel, it'll let go of extra fat. I didn't lose much weight until I was on 7.5mg for a few months. Now it's about a pound a week, but it's done wonders for my diabetes.

Do you track your calories and know your total daily energy expenditure?

I was on 12.5 mg weekly about a year ago, constantly pushing my doctor to increase the dose because I wanted to lose weight faster. I ended up in the ER one morning with a heart rate of 130 bpm. I was severely dehydrated, and they had to give me five liters of fluid before I even felt the urge to pee. I spent three days in the hospital and then stopped Mounjaro, going back to Metformin. About four months ago, I decided to try Mounjaro again, but this time, I'm not rushing to lose weight and I'm careful about my fluid intake. Now, I'm more focused on my A1c, and I know that weight loss will follow in time. Staying hydrated is key.

Studies have shown that people with T2D usually lose weight more slowly than those without diabetes.

I understand your concerns and have accepted that even if I'm not losing weight, I'm still improving my A1c, and that's what matters. Good luck and stay healthy!

I've lost around 40 lbs over the last 8 months. It's slowed to about 2 lbs a month these last two months on 7.5mg. But my A1C has gone from 6.5 to 4.5, and I'm off Metformin. It's been a miracle for my T2D. It's frustrating seeing others lose 70+ lbs in the same time, so I get how you feel. But I'm still losing, and I have another 40 lbs to go, so it'll take as long as it takes. I'm not giving up. Hang in there!

I can relate to your experience a lot. I was on Ozempic for 5 years to manage pre-diabetes. My A1C stayed at 6.0, and I lost barely any weight. My doctor suggested Contrave while still on Ozempic. My A1C stayed the same, but I lost 30 lbs. However, I couldn't handle the full dose because I was losing so much hair – I'd rather be overweight than bald! Now I'm on Mounjaro. I started at 5.0 for a month and am now on 7.5mg. I've only lost 6lbs. It's annoying! I walk and am eating much less, but still nothing. I have hypothyroidism, which probably doesn't help. For those who suggest tracking calories and macros, if that worked for everyone, we wouldn't need meds like Mounjaro. And yes, I've used calorie trackers already. Good luck on your journey.

I'm in my 6th week and haven't dropped much weight yet. I'm also stuck at a specific weight, but I know I need to give it more time. The sulfur burps were awful at first and kept me awake. I started taking probiotic pills daily and added fermented foods to my diet, and that fixed the problem.

Upping the dose helped me. I'm at a healthy BMI now.

Good job! Yes, recommended loss is one to two pounds weekly.

What's your diet like? Try simple foods like eggs, meats, and even very low-sugar protein shakes. Stay away from sugar, carbs, and oils. This should help your sulfur burps. Drink plenty of water, especially 16+ ounces 30 minutes before your shot; it helps the peptides. Digestive enzymes and a TUDCA supplement can also help with digesting fats. 5mg is the lowest therapeutic dose, and 2.5mg is to see if you can tolerate it. You've just started, and your body is getting used to it. Even though this is your fifth month, I'd go up to 7.5mg. Your body needs more to get the job done. You might not see results right away, but things are happening inside. Stick with it. Listen to your doctor. Diet and exercise are key. And drink lots of water.

Spot on. I had the same issue – eating little while exercising a lot and not losing weight. My body went into protection mode and hoarded energy. Whenever I plateau, I have a big meal with carbs to boost my metabolism. It's called a "cheat meal" and works wonders. I don’t gain weight from the carbs but instead restart the weight loss.

I watched a video that touches on the topic. https://youtu.be/NBCJv0vwz6s?si=5OcCBLigvKAnkEK0

I've needed to increase doses to lose weight. I sometimes get side effects, but it's more related to the foods I eat.

I feel you

Ash1992 said:

I've been on Mounjaro for 4 months now, about to be on my fifth...my blood sugar levels are amazingly improved.

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I took tons of insulin daily before starting, and now I'm completely off Lantus! It's been amazing with minimal side effects so far.

I saw someone say they lost a ton of weight on these meds. Incredible progress!

L-J-K-91 said:

2.5 yr later - 273lb to 108

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Congrats on reversing your liver issues and getting your A1c down!

L-J-K-91 said:

I do have food noise.

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Same here. Does anyone else struggle with food noise even while on these meds? I'm finding that I'm still thinking about and craving food more than I expected.