Mounjaro Update: Week 40

First Week on 7.5 mg Dose

Greetings, fellow diabetics, pre-diabetics, and any other interested parties! If you are interested in the effects of GLP-1 receptor agonist drugs like Mounjaro and Ozempic, welcome! Here, we follow my progress on Mounjaro, which as this post’s title declares, I have been taking for forty weeks. This week is my first on a higher dose, 7.5 mg/0.5 ml, after dosing at 5.0 mg for the past few months.

If you’re new here, I’m a seventy-eight-year-old self-described curmudgeonly old fart. I was assigned male at birth and I identify as male. As I reported last week, I have the testosterone level to prove it! I remember when there were two genders. Back then, one “identified” as what one was, whether one liked it or not. But I digress, nostalgically pining for a bygone era.

My foremost goal is to control blood glucose, which is paramount for any diabetic. Next, I want to preserve muscle mass. The rapid weight loss linked with these GLP-1 drugs is up to about 40% muscle. At my age, sarcopenia has already caused significant muscle loss. Thus, I do not need to further jeopardize my golden years with frailty due to irresponsible promotion of weight loss. My ultimate goal is to get off Mounjaro when I am stable and my lifestyle adjustments have been set in concrete.

Patient, Treat Thyself!

Before I talk about lifestyle changes, I’ll interject that I am not a doctor. My admonishments here represent my experiences, which I hope will benefit others. Even though I tell you to “do it my way” below, I am not recommending that anyone adopt my approach without consulting their own healthcare team. Much of what I offer here is my personal, cynical opinion. Yet, if what I say makes sense, talk to your doctor and ask whether The Turkey’s advice is right for you!

My lifestyle improvements are the old, familiar diet and exercise. Boring stuff, I know. First, I adopted a low-carbohydrate diet. This dietary approach is essential for diabetics, no matter what bullshit the American Diabetes Association is spewing. They, after all, get funds from Big Pharma, who prefer to keep us diabetic so they can sell us drugs. Next, I exercise six days per week, both resistance and cardio, to keep the muscles and cardiovascular system going. I have increased the protein in my diet to make certain I can build muscle mass. In short, I do not regard Mounjaro as a magic pill. I can’t hope for long-term success in controlling diabetes without making proper lifestyle adjustments while I’m on it, and continuing with them when I’m done with the drug.

So, Who’s Getting Off?

I firmly believe that if I can stick with a proper diet and a rigorous exercise schedule, I can eventually ditch the Mounjaro. But my cynical side tells me that Big Pharma will not appreciate that! At retail prices, they’re getting about $1,200 per month for the drug. The global GLP-1 analogues market was valued at approximately $37.4 billion and is projected to grow at a compound annual growth rate (CAGR) of 33.2%. The biggest impediment to continued explosive growth the pharmaceutical industry faces is “early” discontinuation, which translates to unwanted disruptions to the ever-increasing revenue stream. They want us to make a lifelong commitment to their GLP-1 RA drugs.

For whatever reasons—and cost is certainly one of them—many patients discontinue GLP-1 RA drugs in their first year of therapy. In many cases, such patients experience rebound effects, namely worsening glucose control and weight regain. Both are undesirable for me. I want to make sure that my lifestyle adjustments can sustain me when I ditch the Mounjaro. I will not be lazily compliant, staying on this crap for life even if I can afford the cost. I am not one to use crutches when their need has passed.

Keep ‘Em Hooked

Estimates that 50% to 75% of patients stop the drugs within a year confound Big Pharma and the doctors they influence. But to their delight, a recent Journal of the American Medical Association (JAMA) Viewpoint implores that physicians must redouble their efforts toward educating patients about compliance. They declare those non-compliant patients as susceptible to weight regain and loss of other benefits of the drugs. These notions, of course, are partially true, but they are also thinly veiled threats to keep us dependent on the drugs for life—or else!

Do It My Way!

I state unabashedly, sophomorically, and naively that doctors should be encouraging my approach instead of prescribing magic pills and considering that a done deal. Put your patients on these drugs if they have useful short-term effects but eschew the open-ended approach. Reorient people to living well and taking control of their chronic conditions. Encourage them to be active participants in their treatment, so they can get off the drugs. After all, in most Type 2 diabetes cases, it is a crappy lifestyle and crappy habits that got them there in the first place.

If you want to read more about patient non-compliance with GLP-1 drugs, this article in TCTMD provides highlights and comments on the JAMA Viewpoint. Read it with a keen awareness of the “one hand washes the other” nature of the industry.

I’ll finish this discussion with my observation that the medical community is paying much more attention to keeping people on the drugs than assessing potential issues that would suggest discontinuation. I rarely see any passionate healthcare articles imploring doctors to regularly monitor side effects of GLP-1 RA drugs with the intent of stopping them if things go awry.

Now, I’ll move on to my numbers for the week and my overall progress.

Numbers for the Week on Mounjaro

This was my first week on the amped-up Mounjaro dose of 7.5 mg. My average fasting glucose was 94 mg/dL (5.2 mmol/L), about the same as last week. My weight has been nominally stable, with a 0.6 lb loss for the week. Nothing exciting here, so that will do it for another week.

I hope to return next week with more useful information. In the meanwhile, stay healthy!

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.