u/Boring-Current-1512

So I had to stop 5mg cold turkey (grateful it was not higher) six weeks ago at 12 st 4lbs - a BMI of 26.1 for me and my maintenance weight. I was set to use MJ for life. However, the medical issue is still ongoing and I am possibly months away from being able to restart. At this point, if I can maintain my overall loss I question whether I will restart - but early days for now.

I experienced all the rebound hunger over these weeks and just gave into it when it felt like actual hunger and tried to haul in the sugary treats with mixed success. I was alarmed at my increased appetite and at how good everything was tasting suddenly and each week saw the pounds creep on but I held steady and refused to go back to a deficit, turning back to that lifelong dieting seesaw and I just kept tracking, aiming only to get back to maintenance calories and finally this week the hunger has abated and I stayed closer to my allotted 2,150 cals a day and I have dropped 2lbs this morning. Big phew!

**Notes**: More than a glass of wine / beer in a session increases my hunger and cravings sharply I so I am keeping tipple to an absolute minimum.

I have also found that my “NO” muscle is getting stronger each time I flex it.
I have lately managed to stop eating when I hit my calories and just sit with a cuppa and the urge to snack for the rest of the evening. What I am finding is that the urge to continue snacking is weaker and weaker the longer I don’t relapse.

So tentatively, I am hopeful I will maintain my overall loss, I can live with a few pounds up (5lbs rather than 7lbs up currently - which feels better :0)).

I had my sleeve surgery 14 years ago. No noticeable reflux issues in that time, only a couple of brief gastritis flare ups very quickly resolved with a week or so of PPIs. Started Mounjaro consistently Sept 2025 - August 2026, started with globus lump sensation in July (presumably due to ongoing silent reflux) and ceased MJ late August pending an ultrasound … am hoping to restart MJ but am thinking will I need continuous Omeprazole 20mg first thing and then Gaviscon Advance last thing at night? Am concerned about side effects of long term PPI use … has anyone else experienced reflux that resolved even though sleeved & on Mounjaro?

For about six weeks I have had a lump sensation in my throat which waxed and waned and which at first I thought was muscular, then it seemed to be helped with anti-reflux meds but this week I realised I was not imagining things, something significant was off and saw my GP who confirmed a swelling on the left side of my thyroid and is sending me for blood tests and an ultrasound scan asap. Part of the reason I did not seek medical attention sooner is that I quite recently had a blood test panel done including thyroid levels that came back all clear. So up until this week my logic was “but my thyroid just tested fine”. But the GP tells me that was not the specific levels they need to test for. I guess my priorities are skewed but am not particularly alarmed about the thyroid issue at this stage - and maybe I should be - but mostly I am gutted that I need to immediately pause my Mounjaro. Not that the GP told me to do that mind you, I stated loud and clear to them that I am on it, they have it in my notes, but all the GP’s at my surgery go weirdly glassy eyed whenever I mention it and ignore the topic - in this case I would say that is really odd but hey ho … but luckily I have educated myself on this sub reddit. But I fear that MJ may not be a part of my life again depending on the outcome of this swelling. Cold turkey (from 5mg) here I come… 🫤.

Is this a serious issue I should get looked into?

I read that the known resting heart rate increase with Mounjaro is between 5 - 9 bpm (and normal RHR ranges between 60 - 100bpm) and for me my normal RHR is 61bpm or lower. On MJ I am around 90bpm. 😯. It drops back to normal ten days after I jab. I only recently realised all this as I have a very cheap fitness watch but assume it has been this way over the past year or so I have taken MJ. I have no dizziness, palpitations or any other symptoms relating to this. I don’t want to go to my NHS GP about it as I can only imagine they will tell me to stop but neither will they want to spend NHS ££ on looking into it. But should I be taking this more seriously? I have felt fine this past year but now am thinking will this 50% higher heart rate be bad for me even though still within healthy range overall. (is my maths right 30bpm increase is 50% of my normal 60bpm)?

So after a year(ish) I keep attempting to call halt on my Mounjaro treatment (due to annoyance at the cost and a low level paranoia about possibly eventually suffering gallbladder or pancreatic side effects) and come off the pen. I make my mind up that being retired with loads of time to focus on calorie and macro tracking and meal planning and getting out walking whenever I feel like it plus the significant factor that I have a gastric sleeve, that I should successfully maintain off the pen. I should at least give it a decent try off the pen. But when that six week re-order deadline comes up there I am re-ordering again. I am still receiving 15mg pens with the GD (I inject 7.5mg and each pen lasts 10 weeks) and my rationale when re-ordering is to have enough until my last 15mg pen expires in May 2027. So I will have a little stash and a six or seven month cost free period coming up soon which will be nice, but my partner would ideally like me to stop and I would ideally like me to try … but when push comes to shove I dread going back to the old days of constant craving. So here I am stuck in a loop, lucky to have this dilemma no doubt.

Just to say I had a gain of 6.5lbs on the scale when weighing in the day after my return from 10 day holiday (no flights but a 900 mile rail journey on three separate trains plus traversing 2 cities by taxi in crawling traffic in a heatwave). I had been on 7.5mg pre-holiday then missed 3 x weeks jabs over all (which enabled me to enjoy a drink with the family whilst away) so started back at 3.75mg last Tuesday then topped that up with 5mg 4 days later. I got back to my routine of slight deficit of 1800 cals a day and 7000 to 10,000 steps a day. 4.5lbs slipped off in 5 days then another 2lbs bounced off (literally peed out) when 31 degrees heat dropped to 21 degrees. I do feel like shaking off holiday weight was not this smooth before the pen, I love the ability it gives me to decide on the best course of action nutritionally and movement wise for me and to live it with ease. 🙏❤️

We are off to South of France on Eurostar on Friday, travelling via London overnight at hotel on Thursday. Should I risk temporarily storing a fairly new 15mg Kwikpen (that I short dose 7.5mg from) in a BreezyPacks Insulin Cooler travel case in a warmer climate? Pen will be a total of 48 hours away from a fridge, of that will be in 30 plus degree heat for maybe 6 hours max, kept inside my leather back pack style hand bag. We will have a full kitchen and fridge on arrival at our holiday accommodation.

Has anybody used these room temperature “guaranteed” insulin cases before? No ice packs needed.
https://amzn.eu/d/03nYCvpq

Am wondering if I should instead delay this week’s dose, due today, by 2 days until Thurs when we travel, keep the pen safely at home, skip the next dose then resume 11 days after last dose when I get back. It is just that I have only recently found a good balance in maintenance again after titrating down too low and don’t really want to mess with that either.

Is there a recent article / summary of the clinical trials that I can share with my brother in law who needs all the info and confidence to do this?

He is late 50’s, hilarious, dearly loved and a super bright, he would be your phone a friend on Who Wants To Be A Millionaire. He has a BMI of very likely over 40, diabetes, thyroid related hashimotos, diverticulitis and an evening drinking habit that is becoming worrisome amongst other health conditions. After years dragging his feet on tackling his obesity, he is on the brink of approaching his GP to see if he will qualify for Mounjaro. However, he sees his GP regularly and they have never broached the subject of a GLP1 treatment with him. He can easily afford to go privately if NHS GP at least says there is no health or medical impediment for him - he is on a cocktail of drugs for his various conditions already.

Only six weeks on the maintenance gig, but already list of discoveries and surprises:

1. My jeans (and belt) continued getting looser even though I have not lost any more weight. I have had to clear out 4 more pairs that just began to look ridiculous this past couple of weeks and may even need to move a size further down. I have relaxed my gym habit due to a shoulder injury and am just relying on walking for exercise, so very much doubt this is muscle recomp.

2. As I experiment with my maintenance dose,
   I have had to sit in my complex feelings around wanting to graze on crap food for seemingly no reason, I have had to step outside myself and watch as I reach for the sweets and chocolates out of pure habit in front of the TV. Like, yes, I do have this drug, but these age old habits still dogging me? really? Enough already. Now no longer being diverted by chasing losses is making me take a long and hard look at myself. Like maybe now I will finally start to lean into the mental work.

3. I feel a burgeoning void I need to fill now that the project of my life - weight loss - is for all practical purposes tied up. For sure maintenance is a head wobbler - see 2 above - but my hope is for food fixation to fade away. The search begins for more enriching pastimes - especially as I am retired. I feel a bit exposed and also slightly in shock (a bit mad even) that food has had such a viper like hold on me all these years.

4. Now that I have more calories I have had to readdress my meal plans, portions and ingredients. I am relearning how to truly eat enough at each meal, and to eat the way I ate before all the crazy diet sickness took over my psyche. Stepping far away from current influencer trends and embracing 40 plus year old approach to three meals a day, keeping it very simple, unexciting on the whole, but nutritious. I don’t need to be seduced by tantalising flavours and culinary adventures, I need food to become fairly uninteresting to me, more a pragmatic fuelling and far less a passion.

5. My mood is sublime the days I hit the lowest number on my maintenance range and yet I am a moody old bitch when I am at the higher end of that range (only have a 3lb range). I weigh daily … if I don’t weigh each morning I get real twitchy. I probably need to suss another approach to this as it makes me feel bad more than half the week - maybe lowering the whole zone another 3lbs so I feel good anywhere in it?? We shall see.

6. I still cannot eat intuitively - tried this early on in maintenance and my eating got out of whack pretty darn quick - so I count those cals 5 days out of every 7 and that works for me.

**I have not named the pharmacy here as I am not sure if they have interpreted the guidelines in my favour in this instance or if it is completely above board and I am just lacking understanding how this works**

Reading many posts from UK peeps on approach to MJ supported maintenance I realised that rather than waiting a few more months whilst I ran my mini stockpile down, contacting my pharmacy ahead of maintenance to see how the land lay with them and what they could do for me was advisable.

Plus as I have come to the conclusion I am in need of MJ for life I was kicking myself a bit as had I realised sooner that I am a “lifer” i.e. within six weeks of ordering my last pen I would have reordered a couple more 15mg, especially as the GD is soon disappearing. 5mg from a 15mg pen that still has the GD comes in at c. £20 a week.

So I contacted them via their chat / message function expecting as it was 10 weeks since my last order, to be told I had to reorder at 2.5mg but basically they said so long as I confirmed date of my last jab (which was 3 days ago) and stated clearly my current pen had lasted so long due to me micro dosing (they also made clear to me that they would never agree to a micro dosing schedule) they are fine to issue me with another 15mg pen this time and indeed this has just been approved.

I am guessing if I do this again, wait another 10 weeks or so, therefore leaving no doubt what I am up to, it will be a firm start back at 2.5mg … but the way they worded it made it sound like I might be able to keep ordering in this way now that I am already on 15mg??? …. it would be very beneficial for my finances if that were the case and has left me feeling that these wonderful GP led pharmacies do really want to assist and will be as flexible as they possibly can be. If this is something they can do in future - within official guidelines - then I am really counting my blessings.

I have, with much dithering on this matter, come to realise that after 4 + long decades of struggle around food and weight Mounjaro is to be a permanent feature in my life.

My partner (and I) were not delighted at the prospect of needing to find £150 ++ per month forever more (or certainly for the next ? 6 / 7 years ? until hopefully cheaper generic versions become available in the UK. Also my partner is sad that they now get to drink alone as I am pretty much teetotal as alcohol gives me the ick.

But, with coming off completely in mind, I recently titrated down to 3mg and OMG the resulting food obsession and grazing!, it put me mentally right back where I began and the reason why I started this med in 2025 in the first place, 60lbs ago.

We are now both in agreement fortunately - me going back to those dark days is just not worth it. The peace I feel on 5mg makes me so happy, satiated, content and living binge free. A no brainer at the end of the day.

Help / worried! We will have just 1 hour 9 mins between arrival of Eurostar from London at Gare du Nord to departing on TGV to Avignon from Gare de Lyon and it looks like best bet is to take RER D southbound one stop to Gare de Lyon. The one station stop is only 7 minutes but / however, google AI instructions I can find are saying allow 90 mins to 2 hours for this transfer if it is your first time navigating these Paris stations which it is for us. Do not want to rely on getting a taxi as am assuming taxis will have very long queues just after a Eurostar train has arrived, plus the RER transfer will be included in our Eurostar ticket price ….

An advice, reassurance / tips?

Many thanks… 😬.