What are the five most dreaded words heard at every doctor’s visit?
“Please step on the scale!”
For me at least, those words were never welcomed, and one of the benefits of COVID was that, with remote visits, I didn’t have to be accountable to the scale.
But alas, measuring weight is one of the core health assessments we have, and it’s tied to our mental health, our cardiometabolic risk, our risk of developing diabetes, our level of insulin resistance, and the list goes on. And weight is highly correlated to genetics and family history.
Dieting Isn’t Easy, Even for a Dietitian
I am a Registered Dietitian in my late 40s, and I have worked in the medical device industry focusing on diabetes and cardiovascular disease for the past 20 years. I KNOW every aspect of what a healthy diet looks like – I have been teaching it to patients for years. But knowledge does not always equate action, and it definitely does not overcome what you are genetically predisposed to (though it can help).
I have struggled with my weight for the last 20 years, ever since my 30s. Every five years it seemed, it became harder to maintain and control my weight. I’m Italian, so I ate when I was happy, when I was sad, when I was bored, when I was stressed… food was social and the center of so many parts of my life. I struggled throughout the years, constantly beat myself up, and avoided all mirrors! I tried every fad diet – the Keto Diet, the Blood Type Diet, the Mediterranean Diet, the Zone Diet, intermittent fasting, liquid diets, cleansing diets, and recently Golo. All had some benefits and I would lose 10 or so pounds, but I never really got to the root cause of my weight issues. Weight issues are so individualized, and everyone’s physiology and metabolism directly play into their ability to lose weight. I wish it was as simple as ‘just eat less and exercise’.
Add In Hypothyroidism
Towards the middle of last year I started to feel dizzy a lot, especially when getting out of bed. I couldn’t focus, I was shaky, and if I just looked at food, it seemed like I gained weight. I went to my primary care physician and got my blood work done. I was diagnosed with hypothyroidism and was put on Levothyroxine. Long story short, I was not treated as aggressively as I would have liked, so I went to my friend and colleague, Dr. Steve Edelman, for help.
Dr. Edelman to the Rescue
I’ll never forget that day – I was excited to know I would be in good hands and get this thyroid thing under control. After we talked about my thyroid issues, Dr. Edelman asked if there was anything else I wanted to address. Before I knew it, we were discussing my family history of cardiac disease and my risk factors. Dr. Edelman looked at me and said, “I can help you with that.” It was such a lovely way of saying without saying, “Keri, you have a weight issue, and we need to do something about it.”
My Mounjaro Journey Begins
Next thing I know, Dr. Edelman had his staff check my benefits, and GLP-1s were covered by my insurance. I do have prediabetes, and because of my current cardiac risk profile and family history, the GLP-1 drugs were covered for me. Dr. Edelman and I discussed if we (and I say “we” because I see weight loss as a partnership between the patient and trusted MD) should go on Ozempic or Mounjaro. Because of the more aggressive weight loss portfolio, we went the Mounjaro route. Mounjaro is not officially approved for the primary indication of weight loss at this time, but it most likely will be approved in the near future.
Another wonderful question Dr. Edelman asked me was, “What weight would you like to be?” It was so non-judgmental and so supportive of my goals. This was November 2022, and after we set my weight loss goal, my one ask was to wait to start the medication until after Thanksgiving, which is my favorite holiday.
November 26: Kick-Off!
Week 1 wasn’t bad. In fact, I had very few side effects from Mounjaro throughout my whole course of treatment, which involved titrating up from a weekly dose of 2.5mg to a dose of 15mg, from November 2022 to May 2023. The first week (and every first week I went up in dosage) I felt nauseated, especially in the morning. I often kept Ritz crackers with me to help coat my stomach in the morning as I was prone to having a sour stomach, and I wanted to stay ahead of it.
What Worked Well for Me While Taking Mounjaro:
- Drinking lots of water.
- Drinking diet ginger ale to help soothe my stomach after a meal, or when it ‘gurgled’.
- Listening to my body. When I felt full, I stopped eating. If I overate on the medication, it felt like food sat in my stomach forever.
- Eating small, frequent meals and snacks.
- Picking my foods wisely. I didn’t go for convenience foods, processed foods, etc. I made an effort to focus on how many fruit and vegetable servings I ate each day, avoiding refined foods, and ensuring a protein source every time I ate. I didn’t feel like eating much on Mounjaro, so when I did eat, I ate a variety of fresh, unprocessed foods.
- Watching my muscle mass. As you lose weight (especially a considerable amount) you risk losing muscle mass, so it helped me to exercise while on Mounjaro.
So the Big Question…What Were My Outcomes?
- I lost approximately 50 pounds over six months (an average of 8 pounds per month).
- I had a 5.3-point reduction in my BMI. This was a huge win because BMI is directly correlated with overall health, and to lose 5 points is quite an achievement. As Dr. Edelman told me, you don’t grow in height at my age, so it was all about losing a ton of weight.
- My cholesterol panel is now all within normal limits.
- My blood pressure is normal.
And I feel GREAT! Mounjaro was my miracle drug. I feel like it was exactly what my body needed. It worked on my brain and neurotransmitters to increase my satiety and make me feel less hungry and feel full quicker. Most importantly for me, it addressed my insulin resistance and increased the insulin sensitivity in my body, which directly correlated to my weight gain and inability to lose weight.
Mounjaro unlocked all the challenges I had with my weight. It is not a drug you can just take and then do whatever you want to though. My advice is to listen to your body, exercise, drink plenty of water, don’t overeat, and try to make healthy food choices to nourish your body. Find a doctor (if you can) who will be your coach, your cheerleader, and your supporter on this vulnerable journey, and hold yourself accountable to the commitment of getting to a healthy weight for YOU. Have the conversation with your doctor about being on Mounjaro short-term to help reach your goal weight, or longer-term to maintain your weight and overcome some of the physiologic challenges your body has, while protecting your heart and other cardiometabolic risk factors (a lovely side effect of taking Mounjaro). Whichever way you go is up to you and your doctor. For me, it looks like it will be long-term.😊
Lilly Diabetes was active partner of Taking Control of Your Diabetes® at the time of publication, but editorial control rests solely on TCOYD.