PCP Wants To Put Me On Mounjaro

[Jimmie]

After being pre-diabetic, overweight (not obese), high triglycerides, high blood pressure, and worsening peripheral neuropathy for past 5 years, my PCP brought up the topic of going on Mounjaro, as my A1C levels now put me in the diabetic range. I've really tried to lose weight for some time by walking 4 miles a day and play golf twice a week, along with eating very sensibly. I've been somewhat successful in that I've dropped 20 lbs this year, but really need to lose another 35-40 lbs. I'm not going to hit that goal without medical help. We've talked about Metformin but doesn't help with weight loss, which I need to impact my triglycerides & blood pressure levels. I do not have thyroid or pancreas issues to complicate matters when using Mounjaro and understand special care must be taken when needing to go under anesthesia.

My first reaction was the high cost and supply shortages of Mounjaro, as well as needing to take it for the rest of my life. However, I have pleasantly found that my Medicare Part D plan does cover Mounjaro (with a minimal deductible) and my pharmacy says they usually always have it stock. Given that, I'm still somewhat nervous about starting the regimen and was curious if others have experiences to share to help me decide?

 

[Surewhitey]

I'm not far off from the exact same scenario. I'm doing a hail Mary low carb, high protein for the past 2 months. Hoping to really dent the triglycerides & A1C. Supposed to go back early October to get results of ~4 months disciplined diet. Having DW on my plan (sorta) really helps on not buying the processed, sugary junk.

I'm trying to not go on Metformin & def not any of the weight loss stuff as it seems you either stay on them to keep the weight off or the weight will return if you get off it. I'm still curious of the long-term problems.

For ref, my
Tri's is 173
A1C is 7
Glucose 147
Weight 195 (now 185)
Age 53

 

[pacergal]

I have not used mounjaro, but my personal experience with starting metformin for pre-diabetes was that it helped me lose 17 pounds within 4 months of starting it. Still working on losing more.
My brother started ozempic and has lost over 20 pounds and his A1C is much better. He has been an out of control diabetic on insulin for several years, so it's a good thing. He had a bit of nausea and headache at first, but now says he has no side effects.

 

[Koolau]

Supplies of these drugs should increase soon, so I wouldn't be too concerned about that. Have you consulted a "good" dietician who is familiar with treating diabetes with diet - plus weight loss? What you eat may be more important than how much you eat. Triglicerides being high suggests too many or wrong kind of carbs. I've lost a fair amount of weight AND all my markers for blood sugar/triglicerides have all gone way down. I'm on a relatively low carb diet and I think that's key. Sounds like you're doing the right things, exercise wise.

I'm leery of the new weight loss drugs, but they do w*rk. I'd say first, get the blood sugar/A1C down with Metformin or similar, keep up the exercise and get some help with diet.

I'm no expert, so your doctor is the expert! Keep that in mind, but no reason you shouldn't ask her/him for help (like dietician, etc.)

 

[Jimmie]

I have not used mounjaro, but my personal experience with starting metformin for pre-diabetes was that it helped me lose 17 pounds within 4 months of starting it. Still working on losing more.
My brother started ozempic and has lost over 20 pounds and his A1C is much better. He has been an out of control diabetic on insulin for several years, so it's a good thing. He had a bit of nausea and headache at first, but now says he has no side effects.

That's interesting. My PCP said to not count on metformin for weight loss and google search says the same. Was it just diet or did you increase exercises too?

 

[Jimmie]

I'm not far off from the exact same scenario. I'm doing a hail Mary low carb, high protein for the past 2 months. Hoping to really dent the triglycerides & A1C. Supposed to go back early October to get results of ~4 months disciplined diet. Having DW on my plan (sorta) really helps on not buying the processed, sugary junk.

I'm trying to not go on Metformin & def not any of the weight loss stuff as it seems you either stay on them to keep the weight off or the weight will return if you get off it. I'm still curious of the long-term problems.

For ref, my
Tri's is 173
A1C is 7
Glucose 147
Weight 195 (now 185)
Age 53

I hope it works for you. Historically, I've always had high triglycerides. Pretty sure it genetics as grandfather & father both had same issues. I've been on a no fried foods & red meat diet for a year now. Also minimized consumption of processed foods and sugar too. Tons of healthy veggies, chicken, and fish. As I said, I've lost some pounds, but really think there's no way I'm going to lose another 30 or so olbs.

 

[RetiredHappy]

I hope it works for you. Historically, I've always had high triglycerides. Pretty sure it genetics as grandfather & father both had same issues. I've been on a no fried foods & red meat diet for a year now. Also minimized consumption of processed foods and sugar too. Tons of healthy veggies, chicken, and fish. As I said, I've lost some pounds, but really think there's no way I'm going to lose another 30 or so olbs.

High Triglycerides is a result of high carbs diet. There is a direct relationship between Triglycerides, fasting glucose and A1C levels. Lower carbs to about 50 g per day, all 3 numbers will drop. I am not diabetic and I try to limit my carbs to under 80 g on non-golf/exercise days. Otherwise, all 3 numbers would go up.

 

[Jimmie]

High Triglycerides is a result of high carbs diet. There is a direct relationship between Triglycerides, fasting glucose and A1C levels. Lower carbs to about 50 g per day, all 3 numbers will drop. I am not diabetic and I try to limit my carbs to under 80 g on non-golf/exercise days. Otherwise, all 3 numbers would go up.

Familial hypertriglyceridemia: A common disorder that's passed down through families and causes higher-than-normal levels of triglycerides in the blood. It's likely caused by a combination of genetic defects and environmental factors.

 

[SecondCor521]

I hope it works for you. Historically, I've always had high triglycerides. Pretty sure it genetics as grandfather & father both had same issues. I've been on a no fried foods & red meat diet for a year now. Also minimized consumption of processed foods and sugar too. Tons of healthy veggies, chicken, and fish. As I said, I've lost some pounds, but really think there's no way I'm going to lose another 30 or so olbs.

I think you can do it.

My Dad was obese for many years and is now merely overweight. About 8 years ago, he ate reasonable portions, chicken and vegetables, low carb, no dessert for about a year and lost about 100 pounds.

I have been overweight and have yo yo'ed for about 15 years. Last fall I changed my diet and exercise regimen and lost 25 pounds over the course of a few months.

I am usually amused by the advertisements: "FatBurner 2000 plus diet and exercise makes people lose weight!" "People lose weight with Super Organic Beet juice plus diet and exercise!" "Vitamin C cleanses plus diet and exercise, and you'll lose weight!" I'm fairly certain it's because diet and exercise make you lose weight; whatever else you add doesn't really matter, unless what you're adding is chocolate ice cream.

I'm old enough to remember other weight loss miracles like fen phen and how that turned out later. I understand that the current crop of GLP-1s (which I think includes Mounjaro) probably help people lose weight. I just worry that we haven't figured out all the long term downsides of these things. Maybe, hopefully, there won't be any, but I personally am skeptical.

Diet and exercise - done properly - will work. Mounjaro probably will work, but may harm you in the long term. I wish you luck and everyone can make their own choices - for me that choice will be diet and exercise for now.

 

[RetiredHappy]

Familial hypertriglyceridemia: A common disorder that's passed down through families and causes higher-than-normal levels of triglycerides in the blood. It's likely caused by a combination of genetic defects and environmental factors.

I am aware that there is an injection that can lower triglycerides. I don't remember if it is every month or every few months. A couple whom I know take the jabs but in their case, they cannot stay off carbs. They love their Pad Thai, and everything sweet and carby.

 

[Goldendoodlebug]

I think you should try Mounjaro. The GLP drugs have proven effective with very few side effects.
As for having to take it the rest of your life, I take a daily allergy pill. I will take it the rest of my life, happily, I was miserable and often sick before. Why wouldn’t I use something that works?
My husband has high blood pressure and takes medication daily. He found out he had hypertension when he was hospitalized for it. The medication saves his life. He will need to be on it the rest of his lifeIt saved his life.

I know people on this board believe diet and exercise will cure all ailments, but I’m a little skeptical and believe medications work

 

[Golden Mean]

This video has certainly changed my life and, I suspect, many others.

 

[RetiredHappy]

I think you should try Mounjaro. The GLP drugs have proven effective with very few side effects.
As for having to take it the rest of your life, I take a daily allergy pill. I will take it the rest of my life, happily, I was miserable and often sick before. Why wouldn’t I use something that works?
My husband has high blood pressure and takes medication daily. He found out he had hypertension when he was hospitalized for it. The medication saves his life. He will need to be on it the rest of his lifeIt saved his life.

I know people on this board believe diet and exercise will cure all ailments, but I’m a little skeptical and believe medications work

+1 Well said!

 

[SecondCor521]

I know people on this board believe diet and exercise will cure all ailments, but I’m a little skeptical and believe medications work

I didn't say diet and exercise cured all ailments.

What I did say is that diet and exercise, done properly, are very effective at weight loss. Done properly, diet and exercise also have few if any negative side effects. Also, besides weight loss, diet and exercise also help improve mood, sleep, daily physical functioning, and aches and pains. They're also known to reduce the risk of (not cure) most of the top killers of Americans, including heart disease, cancer, stroke, Alzheimer's, and diabetes. Although they don't prevent or cure all diseases and death, they do extend life span and health span.

Diet and exercise do have some drawbacks. They take time and effort and discipline. You might sweat and need to take more showers.

I agree with you that GLP-1s and most mainstream medications work. But every medication I've been on, with the possible exception of Tylenol, have had negative side effects of one form or another. Usually minor, but sometimes major. I also think that GLP-1s are new, and therefore the long-term effects and possible risks are unknown. Fen-phen was also described as a great weight loss drug and completely safe initially. Didn't turn out that way in the long run.

 

[Surewhitey]

I think you should try Mounjaro. The GLP drugs have proven effective with very few side effects.
As for having to take it the rest of your life, I take a daily allergy pill. I will take it the rest of my life, happily, I was miserable and often sick before. Why wouldn’t I use something that works?
My husband has high blood pressure and takes medication daily. He found out he had hypertension when he was hospitalized for it. The medication saves his life. He will need to be on it the rest of his lifeIt saved his life.

I know people on this board believe diet and exercise will cure all ailments, but I’m a little skeptical and believe medications work

I think healthy skepticism is warranted for any drug. Even with the rigorous testing and in the market, Vioxx & Fen Phen were killing folks (I personally know one). Short time in market is a red flag to me. I too take meds for gout, BP & cholesterol, so not against them, just would rather not get another one if I can personally do something about it.

 

[Koolau]

I think you should try Mounjaro. The GLP drugs have proven effective with very few side effects.
As for having to take it the rest of your life, I take a daily allergy pill. I will take it the rest of my life, happily, I was miserable and often sick before. Why wouldn’t I use something that works?
My husband has high blood pressure and takes medication daily. He found out he had hypertension when he was hospitalized for it. The medication saves his life. He will need to be on it the rest of his lifeIt saved his life.

I know people on this board believe diet and exercise will cure all ailments, but I’m a little skeptical and believe medications work

Yeah, I hate to think of all the meds I have to take every day to keep those extra days coming. It's not a death sentence to be on meds for life.

My guess (strictly a guess) is that going off the GLPs does NOT put the weight back on a person. The person does so by going back to old eating habits they had before the GLPs helped them change their habits for a while. Strictly YMMV as I'm no doctor and certainly no expert on GLP drugs.

 

[Koolau]

I didn't say diet and exercise cured all ailments.

What I did say is that diet and exercise, done properly, are very effective at weight loss. Done properly, diet and exercise also have few if any negative side effects. Also, besides weight loss, diet and exercise also help improve mood, sleep, daily physical functioning, and aches and pains. They're also known to reduce the risk of (not cure) most of the top killers of Americans, including heart disease, cancer, stroke, Alzheimer's, and diabetes. Although they don't prevent or cure all diseases and death, they do extend life span and health span.

Diet and exercise do have some drawbacks. They take time and effort and discipline. You might sweat and need to take more showers.

I agree with you that GLP-1s and most mainstream medications work. But every medication I've been on, with the possible exception of Tylenol, have had negative side effects of one form or another. Usually minor, but sometimes major. I also think that GLP-1s are new, and therefore the long-term effects and possible risks are unknown. Fen-phen was also described as a great weight loss drug and completely safe initially. Didn't turn out that way in the long run.

My major side effect of exercise is pain. Pain while doing and pain while recovering. Yes, I've had the pain checked out and it's basically arthritis that I've received some help with but not enough to make exercise enjoyable (or even bearable often times.) YMMV

 

[Teacher Terry]

I have known two people that lost a significant amount of weight on metformin. One lost 50 and one 80 pounds. I’m surprised to read that it doesn’t help most people with weight loss.

 

[Koolau]

^^^^^^^^^^^

Here's a site that suggests taking Metformin gives rise to an "anti hunger" body chemical. No idea if true. DW never lost weight on Metformin. It did lower her A1C and blood glucose.
She did lose weight through dieting after she stopped taking Metformin.

Weight loss caused by common diabetes drug tied to “anti-hunger” molecule in study

A Stanford Medicine study found that metformin, a commonly prescribed diabetes drug associated with moderate weight loss, stimulates production of lac-phe, a molecule abundant after exercise.

med.stanford.edu

 

[RetiredHappy]

Metformin is supposed to cause weight gain. However, uncontrolled diabetes will cause weight loss.

 

[PaunchyPirate]

I had been taking Trulicity (in addition to Metformin) for a couple years to keep my A1C under control. But even with the combination of the two, I my A1C was at 6.5. At the beginning of the year, I told my doctor that I was going to work hard on losing weight. I was tired of my weight impacting my lifestyle. He suggested that we switch from Trulicity to Mounjaro because it was likely to better impact A1C as well as help me loose some weight.

8 months later, I have lost 50 pounds. And my recent A1C was 5.6. Now, in addition to the Mounjaro, I significantly have watched what I eat. I eat a prepped, portioned meal for most lunches. I eat a large salad and some protein for most dinners. But I also eat in restaurants now and then. Mostly when I travel. I don't obsess about what I eat, but I do try to reduce my intake. I have rarely felt hungry.

I take the 7.5 mg dose of Mounjaro. There are stronger versions and there are weaker versions. I switched directly to the 7.5 mg dose from the Trulicity. I never had any noticeable side effects when starting Mounjaro. I never had any with Trulicity either.

My doctor reduced my blood pressure medicine dosage at my last appointment because of the weight loss. I am still taking Metformin. I've take it for years.

Your mileage may vary, but my response to Mounjaro has been a positive one. There have been some challenges getting the prescription filled, but in the last couple months it has not been an issue. My insurance covers all but $150 per month of the price, but there is a manufacturers coupon that reduces my cost to $25 per month. However, I seem to recall you can't use the coupon with Medicare. But you should double check that. You can find the coupon details on the Mounjaro website.

 

[Sarah S]

I take metformin for an off label indication that has nothing to do with glucose or insulin resistance. I unintentionally lost over 20 pounds in under a year. I have pretty much stabilized but I have to work to maintain. I am unable to exercise so it was all change in appetite and taste

 

[Jimmie]

I had been taking Trulicity (in addition to Metformin) for a couple years to keep my A1C under control. But even with the combination of the two, I my A1C was at 6.5. At the beginning of the year, I told my doctor that I was going to work hard on losing weight. I was tired of my weight impacting my lifestyle. He suggested that we switch from Trulicity to Mounjaro because it was likely to better impact A1C as well as help me loose some weight.

8 months later, I have lost 50 pounds. And my recent A1C was 5.6. Now, in addition to the Mounjaro, I significantly have watched what I eat. I eat a prepped, portioned meal for most lunches. I eat a large salad and some protein for most dinners. But I also eat in restaurants now and then. Mostly when I travel. I don't obsess about what I eat, but I do try to reduce my intake. I have rarely felt hungry.

I take the 7.5 mg dose of Mounjaro. There are stronger versions and there are weaker versions. I switched directly to the 7.5 mg dose from the Trulicity. I never had any noticeable side effects when starting Mounjaro. I never had any with Trulicity either.

My doctor reduced my blood pressure medicine dosage at my last appointment because of the weight loss. I am still taking Metformin. I've take it for years.

Your mileage may vary, but my response to Mounjaro has been a positive one. There have been some challenges getting the prescription filled, but in the last couple months it has not been an issue. My insurance covers all but $150 per month of the price, but there is a manufacturers coupon that reduces my cost to $25 per month. However, I seem to recall you can't use the coupon with Medicare. But you should double check that. You can find the coupon details on the Mounjaro website.

Thanks much for the input. Exactly what I was looking for. Glad to hear you didn't have any side effects. If I decide to use Mounjaro, I'm hoping for the same, along with a 50% reduction in blood pressure medicine dosage (maybe eliminating it altogether). I will continue with my exercise & sensible diet regimen.

You're correct about using coupons with Medicare. Under my Part D plan, Mounjaro will cost $556 for the 1st month, and then it's $11/month ($677/yr).

 

[Koolau]

Metformin is supposed to cause weight gain. However, uncontrolled diabetes will cause weight loss.

My understanding is that Metformin is an insulin sensitizer. As such, I suppose it might tend to turn one's excess glucose into fat. But I've never heard of it causing significant weight gain. Yes, a full blown diabetic might lose weight because glucose is expelled in the urine. IIRC Metformin (and the other insulin sensitizers are only for people who are moving toward diabetes (or are "prediabetic.) I don't think full blown diabetics would normally take Metformin, but I could easily be wrong as I'm no expert. YMMV

 

[RetiredHappy]

My understanding is that Metformin is an insulin sensitizer. As such, I suppose it might tend to turn one's excess glucose into fat. But I've never heard of it causing significant weight gain. Yes, a full blown diabetic might lose weight because glucose is expelled in the urine. IIRC Metformin (and the other insulin sensitizers are only for people who are moving toward diabetes (or are "prediabetic.) I don't think full blown diabetics would normally take Metformin, but I could easily be wrong as I'm no expert. YMMV

Yes, "full blown" diabetic type 2 take Metformin. Diabetic type 1 take insulin. I live with a diabetic and he has been a type 2 diabetic for more than 2 decades but have kept it under control through drugs and diet. Taking Metformin absolutely puts on weight.

Uncontrolled diabetics lose weight, as long as not due to diet. Unless one is on one of those weight loss meds.