Starting Mounjaro after the Holidays

I have been waiting for a drug like Mounjaro for decades.

All my life I have struggled with my weight. I remember in elementary school they made us weigh at each report card time. In 3rd grade I broke 100 lbs. By my wedding at age 18, I weighed 170 lbs. And yes, the dress I had purchased a year earlier no longer fit. By my 40th birthday, I had reached what would be my highest weight ever: 253 lbs. It was at that point I was diagnosed with Polycystic Ovarian Syndrome (PCOS) and the accompanying Insulin Resistance (IR). Metformin helped me get down to where my body insists I should be: 200 lbs. For 20 years, my body and I have done a yo-yo dance. I have gotten as low as 168–for about 2 weeks and have weighed as much as 215, where I am today. Somewhere along the way, I began reading about weight loss pharma. I recall when they isolated the hormone that made you feel satiated. I recall the predictions that one day there would be a pill. I remember studies that connected Diabetes 2 and obesity. Oh, and I remember the first time my doctor noted “obese” on my chart and apologized for it.

Although D2 drugs that lead to weight loss like Ozempic and Wegovy have been around for awhile, it was not until the Mounjaro (tirzepatide) studies were announced with astonished and promising fanfare that I seriously began to hope. Was my 5 decade fantasy finally becoming a reality, like tvs in watches and time travel (I can hope, can’t I?)?

Mounjaro still has some setbacks: prohibitive cost, side effects, unproven record, threat of thyroid cancer, etc. But when I saw weight loss of up to 22.5% in study participants, I began to follow the research intently. It was approved by the FDA in May 2022 and showed up as an approved D2 drug in my insurance drug by Fall 2022. I decided to ask my doctor to prescribe it for me. I had my arguments laid out, see above with D2 threats sprinkled in. To my surprise, she had no qualms about trying me on it. My insurance company requires Prior Authorization, which I thought would take several days, but by that evening, tirzepatide showed up in my medications in MyChart. I was jaw droppingly amazed.

So here are some steps I have taken to begin my journey:

I bought scales to start weighing myself daily again. For me, it has to be every day.
I am committed to begin eating more healthily to start balancing out before I begin my Mounjaro, which will be when it gets in stock and after the holiday.
I am making sure my doctor calls the insurance company for a Prior Approval. With PA, the cost is $25. Without, $1,000. It’s worth my time to get the dang thing approved.
I took a “Day Zero” photo of myself. I have never done this, partly because I just never took the time to and partly because of really not wanting to see fat me documented in a photo. Mounjaro requires a re-wiring of the way you think, so I see this as a first step.

Day Zero Picture. Do you know how hard it is for me to post this picture? Even as I write, I can’t help staring at it. All I see are the fat parts. Well, it’s on.

To be honest, after reading blogs and sub-Reddit posts, I am a bit terrified of the side effects of Mounjaro. I won’t list them here, but the Reddit folks don’t hold back describing them. I can’t imagine working if I have some of them (I’m looking at you, Sulphur Burp). Still, I am willing to risk it. There are those who will judge and criticize me for not being happy and comfortable in my body, for wanting to put myself through a drug regimen to re-shape myself, for being driven by a smaller number and clothing size. Good for them. They obviously are not driven by the burning desire to shop for regular sized clothes at Talbots. I’m serious. When I go shopping there for my work clothes, I head straight to the back of the store for the plus sizes, which is about 1/4 of the store. The other 3/4 has a wide variety of cute, colorful, stylish clothes that go up to a size 16. I currently wear a size 16W, but those never come in candy apple red velveteen. So yes, what will get me through the nausea and other unnamed bodily functions are sexy pants and matching sweater.

I have included two helpful resources I found on Reddit. First is Best Food Choices for Ozempic, Wegovy & Mounjaro Weight Loss: Dr Lipman Endocrinologist

Here is Mounjaro/Ozempic/Wegovy/Trulicity Tips

*Take injection after a protein fortified meal

*Start fiber, magnesium powder or digestive enzymes listed below, at the start of the prescription so you don’t end up with severe constipation

*Take a multivitamin

*Eat protein every 3 hours (goal 80g – 100g a day) to maintain muscle mass during weight loss

*Drink 1-2 servings of sugar free electrolytes a day if eating low carb

*Drink 60+ oz of water daily

*Determine your daily caloric intake based on BMR & TEE determined by a dietitian/nutritionist. DO NOT go below 1000 calories – too few calories will stall your metabolism and the scale.

*Once you know daily caloric goal, track calories in an app like MyFitnessPal- https://www.healthline.com/nutrition/how-many-calories-per-day#calculator

Low Carb Protein Drink Suggestions

READY TO DRINK

-Orgain – https://amzn.to/3PBUwdi

-Premier Protein – https://amzn.to/3BQbD5w

-Fairlife Core Power – https://amzn.to/3WwMcxw

-Fairlife – https://amzn.to/3HKKHry

POWDERED

-Clean Simple Eats – https://amzn.to/3hKTOxE

-Premier Protein – https://amzn.to/3HJ6Y9c

– Just Ingredients- https://justingredients.us

Nausea

– eat protein every 3 hours

– drink electrolytes – https://amzn.to/3FJv2pR

– Non Drowsy Dramamine – https://amzn.to/3PMeu5e

– Ginger Tablets – https://amzn.to/3YyegT8

– Isopropyl alcohol inhalation – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189884/

– Zofran prescription – can create additional constipation

Constipation

– Fiber https://amzn.to/3VbCmAh

– Calm Magnesium Powder – https://amzn.to/3WurkHf

– Digestive Enzymes – https://amzn.to/3jfsBUv

– Miralax – https://amzn.to/3je8yWj

– laxatives, senna or Smooth Move tea are not suggested because they are absorb into the bloodstream and can be addictive

Burping

– Digestive enzymes before you eat https://amzn.to/3WtY6Iz

– Gas X before you eat https://amzn.to/3Vjuahy

– Vitanica Digestion Tonic – https://amzn.to/3G2Lsek

Acid Reflux

Immediate Relief

* Apple Cider Vinegar 2 TBSP in 8 oz of water

* Apple Cider Vinegar Supplement https://amzn.to/3v41rT6

* Tums https://amzn.to/3Yzyyvx

* Mylanta https://amzn.to/3G7CFrD

Long Term Relief (take daily) –

* Bromelain – https://amzn.to/3v3AFdq

* Digestive Enzymes – https://amzn.to/3WtY6Iz

Multivitamin

* Mary Ruth’s Liquid – https://amzn.to/3jgl6wu

* Passion 4 Life Liquid https://amzn.to/3v3KIPN

* Vimerson Health https://amzn.to/3W9uYGY

* Ritual https://amzn.to/3BJm7TV

Loose Skin/Hair Loss

* Vital Protein Collagen – https://amzn.to/3PGxTEz

* Physician’s Choice – https://amzn.to/3G4B0CV

* Sanar Naturals Collagen – https://amzn.to/3PUdk7T

* Dr Emil Hair, Skin & Nails – https://amzn.to/3BPaj2N

Long Term Results

The goal while losing weight is to learn how to make different choices and create new habits that will create sustainable, long term results that start with mindset work. Here are a few books on Audible that will help you assess your brain and your habits!

* Chasing Cupcakes – https://amzn.to/3WiaEDq

* Beck Diet Solution – https://amzn.to/3Wu04sr

* Beck Diet Solution Workbook https://amzn.to/3BN84Nl

* Never Binge Again – https://amzn.to/3BNA5UR

If you are looking for virtual doctors who are prescribing to compounding pharmacies, here are a few to research

* PUSH

* SEQUENCE

* JOINMOUCHI

Food choices:

https://www.richardlipmanmd.com/best-food-choices-for-ozempic-wegovy-mounjaro/?fbclid=IwAR3wEmM2HJ7W5nbZPQYhvkCmJumnvm8XcsdyJTG1kXIansUaTRi_kAALQok

Medical Advice Disclaimer

DISCLAIMER: THIS DOCUMENT DOES NOT PROVIDE MEDICAL ADVICE

The information, including but not limited to, text, graphics, images and other material contained on this document are for informational purposes only. No information on this document is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this document.

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My Sugar Addiction, Day 1

I am gaining my weight back. Again. Like just about every person who has ever battled their weight, I have tried every diet plan imaginable. I’ve taken diet pills–over the counter and prescription–and for awhile I took Alli fat blocking pills, which was the grossest diet plan ever. Google that one. I’ve done Weight Watchers, now WW so you will feel like a winner, thank you, Oprah. It’s still Weight Watchers. I’ve exercised for a solid year; that, along with WW, which works if you work it, resulted in my losing the most weight I ever had in my adult life: 70 pounds. It felt so good! I got a complete new wardrobe and felt young again. I was so encouraged this time when I read that if I could keep it off for 3 years, I could keep it off for good. When it started creeping back after about year two–those crisp white shirts and modern-cut pants started feeling snug (a word of terror for fat people)–I looked that factoid up again. It had said five years, not three. I had weighted 168 for exactly 2 days, and as I creeped back up in the 170s, I told myself that my body wanted me to be in that range. Again, if you’ve ever been a weight warrior, you know the feeling in the pit of my stomach as I watched myself outgrow my clothes. Again.

My size 10 Levis were the first item to go, then my pants for going out. I donated my cute pinstripe suit after church one Sunday when a guy jokingly–it’s always jokingly, you know, but there’s truth behind it and it hurts like a sucker punch–said “Hey girl, you trying to show off those biceps?” I looked down at curved stripes on too-tight sleeves. Last year, I bought size 16 Levis, telling myself I still had not reached my highest weight–253, so 16 was okay. I was still under 200 pounds. Then came another holiday season.

I don’t even bother making New Year’s resolutions any more. What is the point? It’s always the same: lose some weight. Weight warriors, familiar? Knowing most people gain a few pounds over the holidays, and also knowing I didn’t have any to gain, I was determined to practice portion control. I didn’t gain during the month-long eat fest, but I began to feel my body change beyond the feel of my clothes. I put out of my mind that the size 16 roomy L.L.Bean pants’ waistband was getting snug. (oh no!). I was out of breath in the shower. I developed a candida fungus under my belly fat. Yes, that is so far the most embarrassing thing that I’ve ever felt about my body. Fat can be fluffy if you tell yourself enough. But a seepy, smelly rash made me feel nothing but shame.

This weekend an interview with Molly Carmel popped up on my newsfeed, and led me to her new book, Breaking Up With Sugar: Divorce the Diets, Drop the Pounds, and Live Your Best Life. I had do decide whether to add another weight loss book to my Kindle. I have books on insulin resistance, carbs, and the keto diet, for example. I know the science, and I know the “secrets” of weight loss. If knowledge were enough, wouldn’t we all be thinner and healthy? That, precisely, is Carmel’s point. I ‘m going to call her Molly, since the tone of her book is friendly and encouraging. I’m reading Breaking Up now, and I’m glad I bought it.

Here’s Molly’s About the Author on Amazon: Molly Carmel has made it her life’s mission to help people find a sustainable solution to the battle of obesity and related eating disorders. After battling her own eating disorder for over 20 years and finding no solution in available treatment, she created The Beacon, where she helps clients recover from similar addictions. Carmel received her Bachelor’s in Social Work from Cornell University and her Master’s from Columbia University’s School of Social Work. She has extensive training in Dialectical Behavioral Therapy, addiction, and nutrition.

The chapters support the breakup/divorce/find a healthy relationship theme of the book. I’m on Chapter 3, “The Truth About Your Sweetest Love,” where Molly gives a summary of how sugar is in reality “Suicide on the Installment Plan.” I wanted to include her list of sugar’s lethal capacity here: But Sugar also negatively affects every single part of your body. Some of these harmful effects are more well known than others. Eating sugar has been linked to: inflammation, migraine headaches, anxiety, brain fog, trouble sleeping, weakened eyesight, gum disease, heart disease, increased cholesterol, asthma, suppressed immunity, kidney damage, nonalcoholic fatty liver, overworked pancreas, arthritis, osteoporosis, metabolic syndrome, and leptin resistance. There’s even terrifying research showing that Sugar increases the risk of developing certain cancers. And of course, let us not forget Sugar’s piece de resistance, glucose intolerance and diabetis…

And yet, knowing all of this and having encountered many of the effects on Molly’s list, I keep right on eating sugar and its evil twin flour anyway. I’m going to keep reading, but I’m open to the idea that I think and behave like an addict when it comes to sugar–and I suspect toward food in general. I looked ahead to see whether Molly had made me a shopping list and a suggested meal plan? She had? Ah ha, I thought, but are they easy or complicated? Maybe they were like keto, a list of foods and meals of stuff I really don’t like (how much butter can I eat?). Nah, Molly included good, whole foods. I felt healthier just reading the foods and plans, which are easy and sustainable. I went through her lists of proteins, fats, carbs and made a grocery list.

I’ve already started the self-doubt talk in my mind. I’ve done this before–so many times. What is different about this time? How long will I be able to eat this food, which I’ll get tired of, won’t I? It’ll take too long to lose this much weight, so what’s the point? But Friday is pizza night! You work so hard, don’t you deserve a reward? Molly, though, has already thought of this–she describes how she herself heard those same voices. Of everything I’ve read so far, this passage has hit me most profoundly was about how rats respond to excessive Sugar–which Molly capitalizes to remind us that we really are in a relationship. After describing sugar DTs, she writes, What’s more, when the rats withdrawing from Sugar were placed in water, they were less likely to swim or climb out, and more likely to passively float. They had lost their will to survive. I’m going to keep reading, Chapter 4 is “Defining Your Relationship: How Bad Is It Really?” There’s even a quiz. I know already; it’s pretty bad. I have a food addiction. I’ll start from there.

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