Steve Julien provides a pragmatic framework for long-term metabolic health by prioritizing the "minimum effective dose" to balance weight stability with psychological well-being. This shift from aggressive weight loss to nuanced maintenance is essential for navigating the complexities of modern pharmacological weight management.
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Deep Dive
I Reached My Goal Weight on Mounjaro… What now?Hinzugefügt:
I've been taking Monjaro since last year and I'd have goal weight of 155 to 160 lb in mind. That is around 72 and 1/2 kg or between 11 stone 1 and 11 stone 6 lb if you're in the UK and are a little bit older like I am. And if I look back on my weight chart for last 3 months, I can see that my weight has been really steady in that band at all be it at the top of that band, but I'm okay with that. So, I feel like I've actually reached my maintenance goal now and unlike every other time before where my weight has done a V, it's just come down and then immediately bounced back up again. Things seem to be very stable at 5 mg every 7 days with Monjaro. And if we haven't met, when I reached my 50s, I was just going backwards. As I always struggled with my weight as a teen and in my 20s, I was like this and then in my 30s and 40s, I kind of got on with it and really brute forced my way to maintaining a healthy weight. And then by the time I'd reached 50, it was just starting to go backwards quite slowly even with what I would say was 100% reasonable effort. So, I was counting calories every day and have done since 2012, walking in excess of 5 miles a day and having four hard weight sessions per week as well as other cardio activities as well. It wasn't budging the needle and in fact, I was going slowly backwards as I mentioned. And when I reached 50 and I realized things were going backwards, I actually hired a PT for the first time ever in my life and we got a really good result. But what I realized was as soon as I started to balance back into my life, I went backwards as fast as I was going forwards. This was certainly something that worked for 3 months, but it's not something I could have done for say 3 years or the next 30 years. And interestingly, I have a friend and he is really active, he's a paddle boarder, he's an ex-rugby player and he's in a similar situation to me. And about a year ago, he said he was thinking about taking what we were joking about then, fat jabs. And I just said to him, why wouldn't you? You eat well, you're an active person. If you're not getting the progress you want and you're putting in the level of effort that I know you're putting in, why wouldn't you get that additional help? However, when it came to applying that message to myself, it actually took me at least another 6 months before I thought to myself, perhaps I need to look at this as well.
And it was at that point I got a consultation and started taking Monjaro.
And I'm in the UK, so we use quick pens and these are kind of like the doses are automatically administered. You pull this thing back for 60 clicks and then you inject yourself and then as you push it back in, it injects a set amount of liquid into you. And the therapeutic doses go up from 5 mg in 2.5 mg. So, 5, 7.5, 10, 12.5 and then 15. You start in a titration dose of 2.5, which is half the lowest therapeutic dose and then after that, you move into the therapeutic doses and it's just to get you acclimatized to the medication.
However, what I found was that 90% of my journey was on that titration dose. That 2.5 mg dose had a significant effect on me and I was able to get to very close to my goal without needing to go up to 5 mg. The last few pounds I did and that's where I am now and things seem to be, as far as my weight's concerned, very stable. I've also had lots of other benefits I wasn't expecting. My LDL, my bad cholesterol, has gone down quite a lot. My joints feel a lot better and probably the biggest one for me as somebody who was diagnosed with severe asthma and later severe allergic asthma um back in 1976, I've been under one of the UK's leading heart and lung hospitals last 15 years without any progress and since starting Monjaro, the anti-inflammatory effects, as far as I can tell, have taken my VO2 max from below average to above average, which means I feel so much better and I've even been discharged from that clinic. However, with all that said, I need to think about changing my dose. And I know what you're thinking, you've reached your goal, why would you stop doing something that's worked? And the problem I'm having is anhedonia, which has taken me a long time to learn to say that word.
It basically means a reduced enjoyment of life or whatever you're doing. So, what I found at 2.5 mg is my happiness went from a 7 out of 10 up to a 9 out of 10. When I went up to 5 mg, my happiness dropped back down to maybe a 7 or a 7 and 1/2 out of 10. And when I take my jab, that's when the most medication is in me. It's almost like driving along at 70 mph, very happily minding your own business and then someone just pulls the handbrake up. For the next couple of days, I do experience that kind of halting feeling, a bit like a whoa, maybe a bit more nauseousness than I like and just a dip in my mood for the first 2 to 2 and 1/2 days after my jab.
Now, these are symptoms or side effects that I can live with, I can kind of mitigate them or get around them to a degree, but I would actually rather not have them, which is why I'm looking to play around with my dose slightly. So, I'm going to tell you about what I'm planning to do and then I'll be interested to know what you think I should do based on what I say next. Let me show you this.
So, these are two websites that I use to sort of plot and track my dosing really.
So, one is called GLP-1 Plotter. This is kind of simpler to use. The other one is just a little bit more information on there once you get the hang of it, it's very good. Don't know who made it, but if you do use this one, then feel free to buy this person a coffee. They've done a lot of work into here. So, if I show you where I am now. So, I take 5 mg every week. The golden dose has gone in the UK, which everyone's unhappy about.
My target dose is 5 mg. I'll leave the cost out there for now. And what this shows me here is that each dose will be 60 clicks of the pen. With these Monjaro pens, the dose is 60 clicks basically and then you've got 240 clicks in here.
So, if some people split their dose where they might do half and half, they might just take 30 clicks and then another 30 clicks, but it's meant to be used all in one dose. So, that gives me 60 clicks per dose, four doses per pen.
Everything here is very standard. And you can see here as time goes on, it builds up in your system. So, you're looking at a high here of around 6.92 micrograms in the system after several weeks, which is a little bit higher than I would like and then the low point is about 3.65, which feels good. That's where I am today, jab day is tomorrow, so this feels pretty good as well. Now, the problem with this, as you can see, is there's quite a big swing all the way up from 6.92 or 7, we can say 7, down to below 4, so it kind of halves the amount that's in you. But you can see it here as well, it shows you at the bottom here. So, this is what I'm struggling with is this kind of high high dose, but I do appreciate the low dose. One thing about Monjaro, and you'll hear lots of people talking about this, is it gets rid of the food noise and I would describe that as like trying to work in a noisy cafe and then all of a sudden, someone puts noise-canceling headphones on you and just peace and quiet is just something else. And even if I hadn't lost any weight on Monjaro, just get rid of that food noise, I think would have been worth it. So, if I change my dose, I can go to 2.5, which is a slightly smaller pen every 7 days, but the main issue with that is the lowest level. So, the lowest level in me will be 1.83, which I think might be a little bit low for me and then the peak level is around what my low is now, which I think would be fine, but I think this may be a little bit lower than what I would want or what I would need. And if I kept with my 5 mg pen and took 2.5 mg every 4 days, then what you can see here is kind of like a much shorter period between the or number between the highs and the lows.
So, the peak level would be 2 micrograms lower than my peak level now, which I think would solve my problem and my trough would be around the same level it is now and I think this would be a much better kind of option for me or even though it does mean injecting every 4 days instead of every 7. What it would mean though, which is something to consider, is I'll be taking 30 clicks per dose instead of 60. Um it would give me eight doses in a pen. The pen is designed to last for 30 days once it's opened, so just over 4 weeks and 2 days.
This would take it to 4.6 weeks, which I don't think would be really a problem for me anyway, but it's outside of the scope, its shelf life once it's been opened. So, even though I know that would work the best for me because I know that my low is in a good place and my high is lower than it was before, which would solve my problem. In fact, when I was making the thumbnail for this video and when I make a video, I make three thumbnails and three titles and then YouTube will show it to people and then it will decide which one performs the best and it will keep that one. So, if you're not seeing this in the thumbnail when you go and look at it, then that's why. And these smell absolutely delicious. Jaffa Cakes are one of my favorite things. Actually, my mouth is watering very slightly, but I've got no interest in eating these and this explains the food noise because with Jaffa Cake, I'd be like, only 46 calories, you can have eight. But now, yeah, it's fine. These are going to go in the bin after this. Um they've been on a meat scale.
Interestingly, I found these cinnamon rolls in my daughter's bedroom. She's been at uni for about 3 months.
>> [applause] >> So, although I know that would work best for me, the reasons why it's taking the ball off the pitch really and it's outside of the kind of Monjaro rules are for the following reasons. So, when you take an injection, this is designed to give you four injections. So, if you're taking eight from it, are you kind of outside of the tolerance or the way this pen is designed to be used? And if you're keeping it in the fridge, say four or five days longer than its fridge life. So, you get a long shelf life and then when you open them, it's 28-day fridge life. Is that an issue? And if you look at the end there, you hopefully it focuses on that little red bung. When you take an injection, you've got a needle in there, you put the two together, and then you take your injection. This is designed to be pierced, this red bung, probably four or five times. Each pen comes with five needles, and if one of your needles doesn't work for any reason, the advice is just get another one. So, you're taking the piercing of this red bung from five times to eight times. And I know that every time you pierce it, you've got a small chance of adding more and more bacteria into there each time you do that. Another option would be just to take 4 mg from this pen every 7 days, which would lower the high slightly and not really affect the low too much. And each dose is 60 clicks.
So, 12 clicks in a 5 mg pen is 1 mg, so you just do 48 clicks instead of 60 clicks, and then you would get five doses out of this pen. The other option is just to go back down to 2.5 mg and see how that goes. So, I just need to decide what my next step is. I'm definitely not stopping Mounjaro. I don't want to do anything dramatic. I just want to make small, sensible adjustments where I can maintain the benefits I've got now, but just reduce the side effects slightly that I don't like, or ideally mitigate them completely. It's very much about maintenance. It's very much about balance and finding the minimum effective dose for me to allow me to stay on this journey and be very happy because overall I am very happy for a very long time. I'll put my full GLP-1 playlist here. This has got my videos in as well as other videos which I think you will really enjoy. YouTube knows you better than I do, and they think that you will like this video here. I hope you've enjoyed this one, and it's a bit more of a quandary video rather than me just saying this is what I'm doing next, but let me know what your thoughts are.
Until next time, see you soon.
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