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Mounjaro Weekly Rant: Our New Theme Song

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Well, hello laddies, lassies, and tweeners! I am back with another weekly dose of Mounjaro related musings and observations. Here, you won’t get the usual, repetitive, second-hand, derivative crap you find on YouTube, where treatment with Mounjaro and its sister drugs constitute a “weight loss journey” and obesity is defended as a “disease.” I blow off most of those with “thumbs-down” to avoid proliferative pollution on my “home” screen, where I would rather view engineering marvels. You get none of the typical cosmetic weight loss oriented smarmy bullshit here, just straight talk, so let’s start this week’s insouciant stream of consciousness with our new theme song.

Our New Theme Song for our Non-Adventure
First, South Park did it, then Ari. Or she was first. Who knows! But this is great. The gratuitous weight loss crowd sure takes a lot of heat for their “journeys”, as well they should. Enjoy this hip-hop rendition for its ironic parody of what has become a ridiculous obsession!

Old Guy on Mounjaro for Type 2 Diabetes

Being an old guy, I provide a distinct perspective from that of the typical, healthy, middle-aged Mounjaro fanboy/fangirl crowd you see on YouTube. Many of them are playing around with Mounjaro and its sister drugs like they have found a new toy, clinging to another desperation hope that they can miraculously lose weight with little concern over long-term side-effects. They have few comorbidities, so their cheerleading is based on a ridiculously small and flawed sample. I bring a worn-out old type 2 diabetic body to the mix to distort their rosy statistics. From them, you never hear about the negatives, which are certainly important to evaluate whether “Mounjaro is right for you”. From me, you’ll get the unfiltered truth, even if it offends some of you.

Not a Mounjaro Fanboy

We pull no punches here. A spade a spade, and a fanboy is a fanboy. We offer a break from the continual cheerleading and obsessively woke brainwashing mantra that “obesity is a disease and GLP-1s are the cure.” GLP-1 drugs such as Mounjaro, Ozempic, and other, forthcoming brands, are serious type 2 diabetes drugs. Their relabeled use for weight loss constitutes a profiteering abuse of desperate fat people, opportunistic exploitation of the giant weight-loss market. For now, it is the “next big thing”. That is, until it isn’t. How many “next big things” have we seen in the past?

And now, of course, we have the burgeoning secondary market vultures running fat farms, telehealth clinics, and compounding pharmacies all trying to slurp up the crumbs. The weight-loss industry is gigantic and ever-expanding due to the food industry pandering poison to us. The pharma companies, being no slouches at mining profitable diseases, have declared obesity to be a disease, just so they can offer a cure — for a price! And now, they want to shut down the parasitic operations so they can keep all the profits for themselves. That will surely expand the black market and illicit foreign procurement of the needed fixes for those addicted to the drugs. Capitalism in action is causing the fanboys to cry in their low-cal beer. They whine about the cost and demonize big pharma, but they must have their drugs. And the beat goes on.

I’ll shift gears to report my latest weekly results. More rants later.

This Week on the Tirzepatide Train

Mounjaro

Tirzepatide Train — get it? Take the T-Train, with apologies to Duke Ellington. Such a journey, already! All facetiousness aside, I’m glad we have a theme song here now. Hell, I might show up in a video twerking to Ari Dayan’s urban beat. I’ll save that for later, so you have something to look forward to in subsequent weeks. For now, here’s how I did this week.

Blood Pressure Improvement

My average blood pressure was down from 124/67 to 119/70, which prompted me to titrate the Losartan dose down from 100 mg to 50 mg. I had previously discussed this with my doctor (a real one, not a telehealth robotic voice with an ever-ready prescription pad), who was OK with it if I continued to monitor it closely. However, he cautioned that due to my CKD, he would not want me to eliminate it completely. I had previously discontinued hydrochlorothiazide, so 50 mg (or even 25 mg) of Losartan might be where I wind up. I suspect my increased exercise activity, along with modest weight loss, are the reason for the improved blood pressure.

Also, I’m told that old farts with type 2 diabetes and concomitant atherosclerosis might benefit from slightly elevated BP, like 130/80, to increase perfusion through those calcified pipes. Similarly, an optic neurologist once advised me that too much control of BP is not a good thing. Postural hypotension is also a problem for old farts with blood pressure that is too low. I am not a doctor, and I sure as hell won’t succumb to heeding oversimplified advice sophomorically pontificated by opportunistic chiropractors and fat ladies on YouTube. In collaboration with my doctor, I’ll arrive at a reasonable plan.

Glucose Progress A-ight

Moving right along to the big reason I’m taking Mounjaro, my average glucose readings were flat versus last week at 100 mg/dL. However, first thing in the morning, cobweb-eyed readings were down from 93 to 91. Slow, steady improvement is what I am looking for here, and it appears as if I am getting it, ten weeks into Mounjaro therapy. My goal is for morning glucose to be less than 82 and my A1c to be less than 5.2. I don’t want to get there too fast, to avoid treatment induced neuropathy, which I described in a previous opus.

Looseing (sic) Weight

Sorry, I couldn’t resist. How often do you see people writing about “loosing” or “looseing” weight on social media? Lord almighty, we’re a nation of illiterates, dumbed down by imitating our so-called peers on social media! I don’t doubt that the moronic utterances are yet another deleterious side-effect of the ultra-processed crap food that dominates our national diet. But I digress.

I lost three pounds during the past week. However, integrating that over two weeks, it comes to about one-and-one-half pounds per week, which is on target. Again, dropping too much weight too fast can cause profound consequences, especially in an old fart like me. Slow but steady wins the race. Mounjaro helps curb my appetite, but I have also made a conscious effort to avoid eating crappy, ultra-processed food — and believe me, given that we are bombarded with it now from cradle to (early) grave, it is difficult to avoid! (I detect a theme here).

Minimal Side Effects

My side-effects have been minimal through ten weeks. I have been on the 5 mg dose of Mounjaro for the past two weeks after being on 2.5 mg for the previous eight. Constipation goes with the territory, so I keep my fiber up and hope for the best. Fortunately, I have not yet experienced anything more serious than that, but time will tell.

Although serious effects like pancreatitis, gastroparesis, gall bladder disease, intestinal blockages are documented in the literature, you seldom (if ever) see anyone describing such things on YouTube. And did I mention the black-box warning about medullary thyroid cancer and multiple endocrine neoplasia type two (MEN2)? People who are suffering such serious adverse effects understandably lack the energy or inclination to post videos about their catastrophic ailments. They are just too damn sick! So, if you base your understanding of the risks on the flawed sample of YouTube fanboys, fangirls, and fantrans, you might think that constipation is the worst side-effect you would ever encounter.

Happy With Mounjaro Results Thus Far

As for me, ten weeks in, I am mostly happy with the modest results I have experienced on my non-journey. I am not expecting diabetic control miracles, and I am making serious lifestyle adjustments as an adjunct to the treatment. I am mindful of side-effects, but thus far I have not had any bad experiences. Finally, I want to establish a clear exit plan from this drug, one that does not result in giving back all or a portion of its positive effects. All that having been said, I’m going to talk about some beneficial effects I have weakly correlated with my Mounjaro therapy.

Mounjaro vs. Chronic Pain

If you have been following my cynical drivel for a while, you have gleaned that I would question why you think two plus two equals four. So, as you read this, understand that any association between my initiation of Mounjaro therapy and the abatement of a significant amount of chronic pain is anecdotal and weak. My unscientific approach should be enough for you to conclude that, but I want to throw out the disclaimer in advance.

The point I will make is that although I doubt that Mounjaro is solely responsible for the lessening of pain, it certainly is part of it, at least indirectly. From the outset of Mounjaro therapy, my knee pain and back pain, which had been debilitating, rapidly eased. Certainly, I had taken other steps along with the Mounjaro, most notably eliminating lots of the dreaded inflammatory, ultra-processed, crappy food from my diet and amping up the exercise, but this was a dramatic shift that presented itself quite graphically to me.

I had been dealing with significant knee and lower back pain for years. Because of my chronic kidney disease (CKD) precluding NSAIDs like aspirin and ibuprofen, I had been taking only Tylenol for arthritic pain, sometimes three or four times per day. However, since starting on Mounjaro ten weeks ago, I have not taken a single dose of Tylenol — even though I had been doing some strenuous hikes in the Central Florida heat until a dehydration episode convinced me of the folly of pushing my old body to extremes. I’ll lay off hiking until the average daytime temperature drops below ninety degrees Fahrenheit. For that, I’ll need to wait until October.

My Knees

One area in which I have dealt with chronic, debilitating pain, is the knees. This might sound facetious, but I fixed that by firing one knee specialist and engaging a new one. Alas, this is a tale that highlights the money-driven aspects of our medical system in the U.S., which I hope will my readers to be cautious in approaching their own, similar medical situations.

My right knee is a classic study in osteoarthritic degeneration, abetted by arthroscopic surgery around 2002. I had torn some cartilage in that knee when I twisted it ascending wet wooden stairs on a rainy day. The pain drove me to my all-purpose sports medicine orthopedic surgeon of the time, who cleaned out the torn, folded over meniscus, gave me rehab instructions, and sent me on my way. Later, I read that it was common to develop worsening arthritis twenty years after this type of surgery. Mine appeared a little ahead of schedule, probably because of the extra weight burden bearing down on the joint.

I didn’t go back to the original surgeon when I started having trouble. I figured “tabula rasa, man!” So, after getting an MRI, I asked my primary care doc for a recommendation for a new surgeon. As you’ll see, he turned out to be a complete dud.

“End-Stage Arthritis of Both Knees”

The first indication of the cursory approach by the recommended surgeon, who I will call Dr. Ferrari (not his real name), occurred at the initial visit, where he eschewed reviewing the detailed MRI. He had his people do a simple X-ray, which in his opinion, called for total knee replacement.

From that time on, for a couple of years, Dr. Ferrari, who is affiliated with one of the large hospital groups locally, relentlessly pushed me toward a knee replacement. A typical appointment would last five minutes, during which the doc, sometimes dragging an intern or a resident along, would cajole me to deal with the reality that total knee replacement was the only possible cure for my “end-stage arthritis of both knees.” (I had never heard the term “end-stage” applied to anything but life-ending terminal conditions). The doc would offer an injection to relieve the pain while he waited for me to make up my mind. Then he’d leave and say, “See you in three months.”

Keep on Pushin’

I was not ready for a knee replacement. While I knew that I could still hike five miles, doing so involved pain both during and after the hike. Nevertheless, I did not want to toss any parts onto the scrap heap if they still worked, even if they weren’t in the greatest shape. I became annoyed with the doc and his relentless technique, no doubt borne of pressure by his employer to perform, and to pay the mortgage on his multi-million-dollar house on the lake (although he told me his Ferrari was paid for).

The final straw was a rushed appointment last August at which Dr. Ferrari ordered x-rays but did not bother to review them with me. He merely popped in with a resident for his usual three-minute drive-by harangue about when we can schedule surgery, and he pooh-poohed my cautiousness over proceeding. I mentioned my age, which he dismissed saying, “You’re a YOUNG 76!” He continued to recommend surgery in connection with BOTH knees, sooner rather than later, even though I did not have significant arthritis in my left knee, just a soft tissue injury that was temporarily painful, but healing.

The Power of Google Reviews

The right knee might have been a candidate due to significant arthritis and soft tissue degeneration, but the left sure as hell was not. Furthermore, the cursory approach exhibited by Dr. Ferrari pissed me off. Knowing what would get his attention, I went home and wrote a bad Google review, stating that this doc was pushing me to get a knee replacement without even bothering to review x-rays with me, rushed through appointments with monomaniacal efficiency, not willing to listen unless it involved scheduling surgery. And, by the way, I could still hike five miles.

The review yielded results, as had previous reviews of medical slouches in other settings. A few years back, I had an oral surgeon (call him Dr. Adonis) who was more interested in his personal fortune and fame than he was interested in my mouth. He responded astonishingly fast to my scathing Google review. In that phone call, I got my chance to tell him what I thought of his egotistical ass.

Commendatore Enzo, the knee surgeon, was just as quick to respond to my poor Google review. That phone call was comical, as Dr. Ferrari tried to convince me that my characterization of his approach was unfair. He was adamant that he had spent more than five minutes with me, and that he is a partner with his patients in determining their care, so he certainly wasn’t ignoring my comments and questions. When I asked him why he didn’t even bring the x-rays up on the screen, let alone review them in detail, he went silent for a moment and then weakly added, “Most patients don’t want that.”

Goodbye, Doc! Go wax the Portofino!

Enter Dr. Kahuna

A few months later, I found a new knee doc, who is affiliated with a large orthopedic group out of Philadelphia. When the appointment date finally arrived, he reviewed x-rays and described my options. He manipulated the bad right knee, telling me that I had surprisingly good range of motion. I scheduled an MRI and follow-up appointment to have a look at the left knee to figure out the source of the pain on that side.

The left knee turned out to be just what I thought, a soft tissue injury that would heal, although being an old fart, things heal more slowly. At this point, after about a year and a half, the pain in the left knee is gone. The new knee doc, who I’ll call Dr. Kahuna, because his hobby is surfing, told me that it would not require surgery and was in good shape overall, with minimal arthritis.

I told the new doc that I would like to keep hiking if that wouldn’t be too hard on the knees. He encouraged me to do that, plus he told me that I should lose weight to make it easier on the joints, and if anything, INCREASE my activity level. I am deeply grateful to this doctor, who, by the way, trained under the legendary orthopedic surgeon who did my left total hip replacement twenty-three years ago. Dr. Kahuna provided the impetus to motivate me to play through the pain and get active again.

And then…

I got back out on the trails even before I started Mounjaro therapy on June 3. My knees and my back initially paid the price, along with the price of the large bottles of Tylenol. I imagined that I was trading modest pain relief for hepatotoxicity, because as I’ve said so many times here, there ain’t no such thing as a free lunch. However, as time went on, a few weeks into Mounjaro, the pain lessened. I gave up the Tylenol, which I no longer needed. Along with hiking, I increased my resistance training and cardio schedule to five days per week. Paradoxically, aside from some sore muscles, the joint pain eased even more.

Surely, the advice by rheumatologists to osteoarthritis patients to stay active is validated by my experience. Furthermore, the change in my diet away from inflammation-causing foods (about all our ultra-processed crap food these days), was a key factor in reducing my chronic pain. Several other variables, such as strengthening weak muscles, are also complicit in assuaging the creakiness.

You want to talk about “non-scale victories” (NSVs), as the weight-loss weenies refer to collateral progress that distracts them from their central obsession with the almighty scale? I’ll tell you. Before my Mounjaro awakening, I negotiated the stairway in my house painfully, one step at a time both ascending and descending, due to my chronic, debilitating knee pain. I am now bounding up and down the stairs normally and free of pain. I got yer NSV right here, fanboy!

Ultra-processed crap foods are big causes of inflammation and the pseudo-disease of obesity. This leads us into my next topic — a gigantic, world-class crap food business combination. Read on and take a “journey” into the future Pringle-ization of America!

Big Fooda’s Latest Consolidating Move

Oh, yes, what we need is more high-carb, high-sugar, high-crap snacks! Oy vey! To the unmuted joy of all U.S. crapophiles, Mars, Incorporated, of Snickers fame, is making a move to increase its share of the humongous U.S. foodcrap market by acquiring Kellanova, the Kellogg spinoff which makes junk food like Cheez-It!, Pringles, Pop-Tarts, and Eggo. The unabated American appetite for ultra-processed crap inspired Mars to shoot for the moon, valuing Kellanova at $35.9 billion. That’s a lot of crappy Pop-Tarts!

The combined entity wil now serve up even more doses of ultra-processed, addictive, sugary treats to us and our pets. Oh, yes, our pooch is fattening up, too, and soon, doggy Mounjaro (call it Bonejaro) will be available at your local telehealth vet and their affiliated compounding pharmacy. Mars’ “pet care” brands, with over $1 billion in annual sales include the familiar IAMS, Banfield, and Whiskas products, among others. For developing human addiction, in addition to Snickers, Mars offers M&Ms, Twix, Dove, and Nature’s Bakery (which is about as close to natural butylated hydroxytoluene and guar gum as one cares to get). Mars’ 2023 top line was greater than $50 billion.

Snacking is Such a Business, Already!

In its positive evaluation of the business combination, the press release stated: “Snacking is a large, attractive and durable category that continues to grow in importance with consumers. Upon completion of the transaction, Kellanova will become part of Mars Snacking, led by Global President Andrew Clarke, and headquartered in Chicago, allowing Mars to bring even more beloved brands to more consumers globally. Mars intends to apply its proven brand-building approach to further nurture and grow Kellanova’s brands, including accelerating innovation to meet evolving consumer tastes and preferences, investing locally to expand reach and introducing more better-for-you nutrition options to meet evolving consumer needs.”

Better for you? Yep, I’ll have a tube of Pringles with my Pop Tarts and wash it down with a Snickers Blizzard! I hear that Eli Lilly is planning to produce 20 and 25 mg doses of Zepbound. We’re going to need it!

Ready-to-Wear R&D Department

What Mars REALLY gets in the deal is Kellanova’s R&D department, a well-established, professionally run operation with its roots in creating sugar addiction dating back to the Kellogg’s cereal days. I am told that some of the “food scientists” hopped over from the tobacco industry when the going got hot there. The release went on to say, “The addition of Kellanova’s R&D capabilities will enable the combined business to share best practices in brand building, deliver enhanced digital capabilities, unlock complementary channel strengths and advance brand ecosystems and immersions.” Oh, yeahhhh! What we need is some advance brand ecosystems and immersions! These inherited scientists will hone the promotion of and addiction to high fructose corn syrup to a razor’s edge (which figuratively cuts all our throats)!

More Information about the Merger

If you can stomach any more of this (pun intended), I have a website for you, dedicated to the dissemination of information about the merger. You’ll need to sign a disclaimer to get into it swearing sixteen ways to Sunday that you understand that the deal might not go through and that anything you read might well be bullshit. After you sign off on that, you are greeted with a splash screen that declares “Snacking is Better Together.” The menu provides four options: Overview, Portfolio, Resources, and FAQs.

On the “Portfolio” page, logos for the various brands are depicted and those that generate billion-dollar sales are starred. (An asterisk means greater risk that your ass will be addicted). The billion club includes Pringles and CheezIt on the Kellanova side, and the very healthful M&Ms, Snickers, Twix, Dove, and Extra (choong gum) on the Mars side.

On the FAQ page, a big question is whether the combined enterprise would continue to operate in Battle Creek, Michigan, given the rich heritage of the storied Kellogg brothers associated with that headquarters location. Mars gave some weak assurance that Battle Creek would “remain a core location”. “Mars understands and appreciates the special role Battle Creek plays in the Kellanova culture, as well as the highly complementary category expertise that Kellanova talent brings.” We’ll see how this shakes out.

I imagine those Kellogg scientists are already working on how to make Pringles and M&Ms a mandatory component in every school lunch program! As the late Senator Everett Dirksen once said, “A billion here, a billion there. Pretty soon, you’re talking about REAL money!” This deal is about real money and our continued descent into the crap food pit of despair.

Mounjaro to the Rescue

With all that new, scientifically marketed crap food coming to market, just think of the increased potential for big pharma profits! Hook more people on Cheez-Its, Pop Tarts, and M&Ms and you’ll have a self-sustaining vicious circle of obesity created and treated by corporate America. What could be better, from a standpoint of childishly externalized responsibility?!!? It is all out of our hands. Cure the dread disease we all enjoyed contracting!

So, yes, I have a few opinions all right, but in its place, Mounjaro has been a net positive for me. If I can keep my diabetes under control, weight loss is a secondary issue. I am certainly happy about the secondary benefits of reduced pain and debilitation I described above, but I remain wary about both short- and long-term adverse effects.

Next week, I will tell you about my yo-yo dieting career, and how I had my diabetes under control, but spun out of control. In the meanwhile, stay healthy, mind your carbs, and get that A1c below 5.0!

Mounjaro Weekly Rant: Week 10

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“Release the Vials!”

Mounjaro

Entering Week Ten on the weirdly named type two diabetes drug Mounjaro, I present my personal experiences, and I comment on the popular culture associated with the vogue use of the drug and its GLP-1 counterparts. As an “older man,” I am a curmudgeonly cynic, the antithesis of the Mounjaro/Ozempic/Zepbound/Wegovy fanboy and fangirl you will find promoting these products for cosmetic weight loss.

“Older Man”, My Ass!

What the hell is an “older” man? Older’n dirt? Why have we become so obsessed with non-offensive language that we can’t say “old man”. I call myself an old fart because that is what I am. I am not even an “elder statesman” or a “senior citizen”, and I am not seventy-seven “years young.” Here, we call a spade a spade, but I digress,

I will report my progress on Mounjaro first before launching into the weekly rant so those of you who don’t care for my opinions can have something for your trouble before you bail out. For those who can stomach it, I’ll add my commentary on the great triumph of the gratuitous weight-loss crowd, who have been calling on Eli Lilly & Company, manufacturers of Zepbound, a weight-loss product identical to Mounjaro, to “release the vials”.

Weekly Progress on Mounjaro, and Week 10 Recap

After my first week on the 5 mg dose of Mounjaro, my average glucose was 100 mg/dL, down from 101 mg/dL last week. I employ consistent methodology for measurement times and conditions, taking three readings per day: first thing in the morning, pre-prandial at dinner time, and two hours post-prandial. My morning average was 93 for the week, down from 101 the prior week. Nice!

My weight was down 0.8 lbs for the week. This is fine in conjunction with my desire to not lose too much weight too fast. Along with too rapid control of glucose, it can lead to a painful exacerbation of peripheral neuropathy known as TIND (treatment induced neuropathy of diabetes — which I documented in a prior weekly column). I had my difficulties during the week, which included a Thursday noontime visit to a German Bäckerei, Delikatessen und Biergarten, throwing me a midweek curve. I resisted the bakery counter, which the cosmetic weight-loss crowd would call a NSV (non-scale victory). However, in enjoying a fine German lunch of bratwurst, sauerkraut, and German potato salad, the carbs and sodium conspired to cause a moderate glucose spike and two-pound weight blip. Consequently, I doubled up on my Friday workout routine to compensate.

Blood pressure NSV (LOL) is progressing nicely, at a stable average of 124/67, about the same as last week’s 125/71. I am happy if it stays right there.

Side-Effects of Mounjaro Therapy

I have not had any disastrous or extremely debilitating side-effects from Mounjaro since the start of my therapy, unless you count constipation, which is universally reported. However, medical science cannot guarantee the absence of long-term adverse effects, as these drugs are too new. I want to steer people away from thinking they can buy into a miracle weight-loss drug without any risks, so please take my absence of side-effects with a grain of salt (unless you’re sodium sensitive like I am).

One note about appetite suppression. This is an excellent feature for those who cannot otherwise motivate themselves to avoid excessive eating. I certainly noticed the effect more at the outset of my Mounjaro therapy than I do now. I do not want to chase doses upward to maintain what the vogue weight-lossers refer to as an absence of food noise, for a couple reasons. First, once I chase the dose up to 15 mg, described by one YouTube weenie as “The King”, I can chase no more. Second, I want to self-motivate (an elusive butterfly in the past), and I do not want to rely on this crutch forever.

Week Ten Progress

As I enter Week 10, the most significant effect has been the drop in average glucose from 166 to 100. How much of this results from Mounjaro itself is impossible to say, as I have significantly adjusted two lifestyle factors since the inception of my therapy — namely, diet and exercise. While I have no doubts that the appetite suppression “feature” of Mounjaro facilitated my dietary adjustments, I cannot conclude that I could not have accomplished the same thing without the drug, which I have done several times in the past. So, in the worst case, Mounjaro is an expensive placebo with potentially unknown adverse effects that impels me to toe the line on diet and exercise to control my type 2 diabetes. (I TOLD you I am a cynic).

Could I have controlled the glucose and lost twenty-three pounds over nine weeks without the Mounjaro? Yes, I could have. I can state that conclusively because back in 2020, I lost seventy pounds on a low-carb diet, reducing my A1c from 7.5 to 5.5. Most of us gained weight in that pandemic year. However a lab report in October 2019 shocked me over my A1c and a concomitant diagnosis of Stage 3 chronic kidney disease, which impelled me to take action with a low carb diet.

Unfortunately, I gave up my gym membership in the Covid-19 quasi-shutdown, so I did not get back into a healthy exercise routine. Then, in 2021, complacency and boredom set in, so I gained back forty pounds over three years, putting me once again behind the diabetes and CKD eight ball. I found myself once again lamenting over yet another cycle of weight loss followed by rebound weight gain. This time, I am using Mounjaro as a crutch.

And you wonder why I am a cynic?

Will It Stick?

“Keeping it off” — the scourge of yo-yo dieters — is the holy grail few can find. The GLP-1s are too novel to conclude that they are not just another crash-dieting technique that will produce temporarily dramatic results followed by equally dramatic failure. As with all vogue weight loss plans, social media fanboys will bully away reports of failures while blowing much more noise than signal about successes which are necessarily temporary. The point here is that big pharma has hooked them on what those proponents feel is a miracle cure, which they will go to any length to defend — until they cannot.

So, in my case, I remain a cynic, although I am too old for yet another yo-yo cycle. The main thing is keeping my glucose in check while maintaining a healthy diet, forestalling the progression of chronic kidney disease, avoiding eating crap, and getting a decent amount of exercise. However, all those can be had without drugs, so the jury is out on where this is going in the long term, which at my age is not all that long! I do not want to be injecting drugs into me forever, and my history suggests that I will be non-compliant at some point.

We’re in uncharted territory here, so the best thing I can do is be honest with you in my observations. I am not one of those obnoxious YouTube cheerleading fanboys who backs into justifications and ignores the downside. That ain’t me. I’m just generally obnoxious!

Time to segue to the opinion section of my weekly column, and you know what “they” say about opinions!

Release the vials!

The outcry by the Mounjaro/Zepbound fanboys (aka “influencers”) on YouTube and TikTok has long been, “Release the vials!” What this means to the lay person is that they want Eli Lilly & Co, manufacturers of the vogue weight-loss sensational crash diet drug, Zepbound, to supply their favorite elixir in single-dose vials instead of dosing injector pens. They figure that it will be cheaper than the dosing pen and that it will give them flexibility to play with doses, as they would be drawing up their shots into insulin syringes. “Release the vials!” they shout.

Their fervent wishes have come true, but I doubt whether the fanboys who get their fixes from compounding pharmacies will ever be satisfied until Lilly gives them one hundred per cent subsidies. Nevertheless, Eli Lilly has released the vials. Hip, hip, hooray! I think. Lilly will sell initial doses of 2.5 mg and 5 mg in vials, which they can produce in greater quantities than the injector pen with less manufacturing complexity. This is, of course, an excellent move by big pharma to convince more people that they need this magical potion, broaden its distribution, and bring more potential addicts into the fold.

Just like the schoolyard pushers.

This parallels the neighborhood schoolyard drug pusher, doesn’t it? Addictive drugsare offered by big pharma as “helping” those in need. They’re striving to meet the burgeoning demand — which they created with their direct-to-consumer advertising, their sponsorship of “unbiased” YouTubers, and concerted efforts through funded research studies that conclude that obesity is a disease. They sure have convinced lots of people of that! You go to YouTube and all you hear is “obesity is a disease.” Lots of victims out there. Lilly to the rescue! Release the vials!

The World Health Organization, a politically motivated funding sponge that promotes redistribution of wealth and medical resources, agrees that obesity is a disease. Of COURSE they do. Not only do they suck up to big pharma because it enhances their funding position, but they can suck money out of the U.S. government, their favorite target. And the fanboys can use their logically fallacious appeal to authority by name-dropping the WHO liberally (pun intended) throughout their specious defense of the “obesity is a disease” dogma.

Go ahead and watch a few of those YouTubers with newfound cynicism. You’ll hear that obesity is a disease that this wonderful drug treats, so we need more of it, sooner rather than later. If obesity is not a disease, how come we can cure it with a drug? You think that groundswell drummed itself up without big pharma churning the seas? All these people on their Mounjaro or Zepbound “journeys” — they need increasingly higher doses. Release the vials, already, so Lilly can make more of the higher doses we crave.

Release the vials!

Speaking of Journeys

Why the hell do we need cutesy characterizations of serious things? Watching YouTube, you’ll see it all over the place. We do not have fat guts; instead, we have “tummies”. Hell, I haven’t had a “tummy” since I was six. “Does wittle Benny have a wittle tummy ache?” Similarly, now we must put up with smarmy, obnoxious “weight loss journeys”. Why the hell do they characterize it as a journey? Should I buy trip insurance just to be safe?

The 1980s rock band, Journey, sang, “Don’t Stop Believin'”, so maybe that should be the fanboys’ theme song: Don’t stop believin’ that Mounjaro will save humankind from the scourge of involuntary obesity.

Contrarily, one of the most down-to-earth Mounjaro vloggers I follow, another Ben, whose channel is called “Bored to Death”, is seriously diabetic. He is not using Mounjaro to treat the diabetes, not just to lose a few pounds. Ben, who does not accept sponsorship offers, shares his firsthand experiences without pontificating about the mystical wonders of Mounjaro. His words resonated with me the other day. He said he had unwittingly called his Mounjaro therapy a “journey” once and felt so dirty that he wanted to wash his mouth out with soap. That immediatly cracked me up with recognition laughter, as I obviously feel the same way. People calling this serious therapy a “journey” or an “adventure” are making it sound like they’re having fun, not making a strong and arduous commitment to treating their diabetes.

Journey to hell in a handbasket.

And those who are just in it for cosmetic weight loss already know what I think of their latest, expensive crash dieting technique. These are weight-loss junkies who might not even exceed the obesity threshold of a 30 BMI. They might need to characterize it as a “journey” as they take a cruise on the turbulently turbid seas of yo-yo dieting yet again, a roller-coaster ride to financial ruin along with yet another unproven long-term weight loss fad.

In the words of a gone but not forgotten comedienne, Pearl Williams, a trip around the world is not a cruise.

Yea, verily, it is not a pleasure cruise and it is not a damn journey. Fat people must change the habits that made them diabetic in the first place. That ain’t easy. In the aggregate sense, our country and the western world are taking a “journey” to bankruptcy caused by the vicious cycle a self-created societal problem where we ingest ultraprocessed crap which we need drugs to counteract. Don’t blame the drug companies for wanting to make profits on what the food industry created, with whom they conspired along with government to effectively channel our choices to a lifetime of eating crap and paying the price. It is a vicious cycle.

So, don’t give me “journey”. Well, if you insist, it is a one-way journey to hell in a handbasket.

And that’s a Mounjaro rantwrap!

So, here I am, another week into the Mounjaro therapeutic process. I believe I have made considerable progress, but the jury is still out regarding whether the progress is directly related to the Mounjaro. Is terzepatide merely a useful adjunct to the classic three keys to management of metabolic syndrome: diet, exercise, and behavioral changes? Too soon to tell.

What will happen now that Lilly has released the vials? No one knows. It is a “journey” into the unknown.

I’ll be back next week with another recap and rant. Who knows what will set me off!?!?

Mounjaro Weekly Rant

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Mounjaro

Nittany Turkey back atcha with another week of reporting Mounjaro progress, served alongside a 15 mg dose of opinionated diatribe. You know what they say about opinions? Well, I’ve gotta have one, and this is my platform for sharing it.

This is NOT a commercialized platform in any way, shape, or form. I don’t display ads or get click-through revenue. If I recommend products I use, it is because I use them and like them. Similarly, I do not offer medical advice, just a recap of my own experiences with Mounjaro for the treatment of Type 2 Diabetes.

I also write about Zepbound and compounded tirzepatide, which are all the same drug as Mounjaro. They are merely packaged differently. Mounjaro and Zepbound, both products of Eli Lilly & Co., are branded versions of tirzepatide. Mounjaro is approved for Type 2 Diabetes, while Zepbound is approved for weight loss. I have written lots about the social media influenced pop culture surrounding these drugs, fueled by direct-to-consumer advertising by big pharma and our societal penchant for hopping blindly onto the latest fad in can’t-fail weight loss treatments.

Today, I’ll recap my progress on Mounjaro therapy, which is neither a “journey” nor an “adventure”, I’ll introduce the concept of an exit strategy, and then I’ll serve up another editorial.

My Progress on Mounjaro

Having taken Mounjaro at the 2.5 mg loading dose for nine weeks, my progress stalled in both glucose and weight. Typically, you start on 2.5 and move up to 5 mg after the first four weeks. I, being an old fart who is wary about dangerous side-effects because of my long laundry list of comorbidities, stuck with the 2.5 dose for twice the typical time. While my numbers tell a subtle story of stalled progress, one thing stuck out like a sore thumb. The appetite suppression associated with Mounjaro evaporated.

Last Sunday night, Jenny and I went out to dinner for our anniversary. My unsuppressed appetite wanted everything on the menu, but I settled on a Caesar Salad, 14-ounce ribeye, asparagus drizzled with a balsamic reduction, and whatever the hell “smashed potatoes” are. I cleaned my plate like my mother always told me I should, which is why I got so fat in the first place. Thinking back to my first week on Mounjaro, I could not finish restaurant meals. So, I felt that this, coupled with the numbers, signaled time to up the dose.

My doctor agreed and I am proceeding cautiously, on the lookout for side-effects or anything unusual. I will certainly report anything out of the ordinary.

The numbers, already, Turkey!

OK, OK… who’s counting, already! Here you are with my progress for the week. Average blood glucose increased from 100 to 101, which still ain’t bad. Morning “dawn effect” readings averaged 101 as well. Weight dropped by one pound, which was due to a midweek lack of appetite caused by some bad heartburn. (On the whole, I blame my gigantic anniversary dinner transgression while Jenny focuses on the “smashed potatoes”). My blood pressure is trending nicely downward due to weight loss, averaging 125/71.

An encouraging sign is that this morning’s glucose reading was 89, the first sub-90 wake-up reading I can recall. Could be a coincidence, or it might be related to my having injected the first 5 mg dose of Mounjaro last night. So, let’s see where this 5 mg dose takes me. Thus far, I have experienced no noticeable side-effects. I’ll continue to report on my progress.

My Mounjaro Treatment Philosophy

I don’t want to be on Mounjaro for the rest of my life. It still amounts to injecting a foreign substance with many known and unknown side-effects into a well-aged body — a substantial risk for an old fart. No doubt, the big fooda/big pharma/big doctra/big governmenta conspiracy would love to view me as a guaranteed revenue stream, but I hope to avoid going down that rabbit hole. Thus, as I approach my goals, I intend to develop an exit plan.

That’s a tricky situation, because of the potential for reversing any positive accomplishments. I need some intelligent guidance (hint: it won’t come from social media) while I develop the plan. My doctor will be of limited value, because he is a member of the “prescribe, prescribe, prescribe” culture of this country’s current medical milieu. Like most modern docs, he is not comfortable with patient-driven care, and while I will accept input from him, I will make the decisions.

In the end, one way or another, I die. Between now and then, I will endeavor to do what is necessary to make life for me and those around me more enjoyable. One immense benefit of the Mounjaro, which seems to baffle my doctor but has been reported in studies, is a reduction in generalized inflammation. This could be a secondary effect, but it has been an obvious feature from the start of my therapy. It has enabled me to increase exercise, have more energy, and be less pissed off all the time. My pain levels are much lower now.

So, I will be gathering information from credible sources and working on the exit plan. I would like to be subjecting myself to the foreign intruder for no more than a total of fifteen to sixteen months, an arbitrary period based on what I think I can accomplish. Of course, at my age, shit happens, which will surely necessitate adjustments.

Mounjaro/Zepbound Shortages Lifted

Eli Lilly & Co. CEO David Ricks fired a shot across the bow of compounding pharmacies that dispense generic tirzepatide. Last Thursday in an interview with Bloomberg. Ricks declared that the shortages that enabled the compounders to legally sell the drug would soon be over. Once Mounjaro and Zepbound come off the FDA’s shortage list, US 503b compounding pharmacies can no longer legally sell the drug under the shortage exemption. They will have a sixty-day grace period to fill existing orders.

So sure enough, on Friday, the FDA shortage list reflected that both Mounjaro and Zepbound 10 mg and 15 mg doses, which previously had shown up as being in short supply, no longer had that designation.

This is the latest salvo from Lilly against those opportunists who are horning in on their territory. These operations exploit the massive, multi-billion-dollar weight-loss market for profit, benefiting from Lilly’s gigantic expenditure. Lilly invents a drug, ramps up manufacturing, develops a huge market through advertising, incurs huge development costs, and spends megabucks securing FDA approval, lobbying congressmen, and operating like big, bad, evil Big Pharma. Then, the vultures of telehealth operations and their compounding pharmacy partners swoop in to exploit the FDA loophole and as many desperate fat people as they can sign up.

Big Bad Pharma Wants to Protect Its Mounjaro Turf

I fully understand Eli Lilly wanting to protect its turf, and I have no problem with it. Meanwhile, vloggers are crying in their beer, which, by the way, some think they can drink while losing those twenty unwanted pounds. Their channels for cheap, compounded tirzepatide might be shut down soon. Then, my oh my, what will they do?

No legitimate doctor is going to prescribe a drug with potentially life-threatening adverse effects for cosmetic weight loss. (Along those lines, I recently saw one mid-twenties clown on TikTok saying how he was using compounded tirzepatide to get down to 155 lbs from 176; another on YouTube who I’ve mentioned in previous columns, was using it to reduce his body fat from 10% to 5%!). Well, boo-hoo! I hope Lilly succeeds in driving the cosmetic weight-loss industry back to herbal remedies, crash diets and other faddish pseudo-solutions.

The market fears that they and similar outfits might need to go back to concentrating on boner pills.

—TNT

Stock prices for Hims & Hers Health, Inc., one of the bigger suppliers of compounded tirzepatide along with generic Viagra with market cap of $3.78 billion, fell 16% in the wake of the Ricks interview. The market fears that they and similar outfits might need to go back to concentrating on boner pills. As of the publication time of this article, HIMS (NYSE) is trading about as low as $15.87, down from the August 1 high of $22.02, a 28% dive out the window.

Social Media Up in Arms

Social media wonks are outraged, displaying all the spoiled attributes of the entitlement society. Some of the more activist YouTubers exhibit signs of a messianic complex. Their self-appointed role as our savior impels them to think they can influence this multi-billion-dollar market by calling for a grass-roots effort to lobby the FDA and “prove” that shortages exist. But this is big-boy stuff, not influencer bullshit. They’re up against big pharma and big bucks. Will David take down Goliath? You answer that question.

And for meeker colleagues, their “journeys” and “adventures” are about to blow up, with predictable consequences. The wealthier ones will always be able to get their drug candy, so no effect there. The ones who are merely solvent and who have feathered their nest with YouTube revenues and referral fees from opportunistic telehealth providers will find either foreign or black-market channels for the fixes they seek. Then, they will tell their peers how to do it, further stoking their video revenue machine. They might get even more kickbacks that way, too. However, a few who are truly in need — and I don’t mean for cosmetic weight loss — will suffer, and I feel bad for them. I’m talking about those who are morbidly obese, with BMI northward of 40 and A1c to match.

Think of it this way. If we can shake the frivolous, cosmetic users out of the system, will there still be shortages? The unprecedented demand for the latest fad in weight loss magic bullets, GLP-1 agonists, is caused by a veritable plethora of relatively healthy yo-yo dieters hopping on the bandwagon of the latest fad. “But, but, dieting never worked for me!” Yeah, that’s the bullshit line. Think of it this way: For the $500 to $1,200 per month they are paying for a magical cure, they could have a gym membership, a personal trainer, and a regular appointment with a cognitive behavioral counselor. Moreover, they would have enough scratch left over for a healthy food budget. They could eat healthily while incurring no adverse drug effects.

But, noooooooooooo, they want magic.

Influencer, influence thyself!

What I hope will now dry up is the proliferation of YouTube vlogs proselytizing tirzepatide, especially the sponsored ones. I imagine that they’ll flail around for a while before the eventual shake-out. The worst are the ones offering dangerous advice on how to split doses, increase dosing frequency, and eat whatever you want. They’ll help you find a compounding pharmacy with a teledoc who will rubber-stamp your Mounjaro requisition, with referral fees flowing back to them. They’ll evaporate along with the compounded drugs they push. Finally, I sure as hell do not need any more middle-aged women man-splaining how these drugs work, middle-aged men with backward baseball caps calling me “you guys” while reporting the recycled incretin news of the day, or other so-called “influencers” attempting to advise me with anecdotal crap they heard from other influencers. Influence THIS!

Coming Soon: Over-the-Counter Mounjaro!

Over-the-counter Mounjaro is not so far-fetched! These drugs might well be offered over-the-counter in the future, because they are just about that freely distributed now. After all, you go to an integrated telehealth facility with a staff doc who doesn’t know you from Adam, you talk with a nurse or some other extender, and they give you your drugs — for a fee. Given our instant gratification society and our irresponsible lawmakers, coupled with the greed of big pharma and the conspiratorial complicity of a food industry that is poisoning us, why bother with perfunctory consultations and rubber-stamped prescriptions? Just drop the pretenses, cut out the middle-man and go OTC! Get your private-label CVS-branded Mounjaro today!

After all, how many states legalized recreational marijuana? How far are we from legalizing recreational Mounjaro? Follow the money.

That will do it for another fun weekly rant. Thanks for making this non-influencer feel that his words are being read. Whether you agree or disagree, about the novel weight-loss drug market, I hope I gave you some food for thought. I further hope that reports of my progress have offered encouragement to other Type 2 diabetics who seek solutions.

I’ll be back next week with more progress reports and more drivel.