Could Your BMI Stop You Getting Mounjaro or Tirzepatide?

[00:00:00]Over the past few weeks, one question has come up more than almost any other, and it isn't how much weight have you lost? It's not what dose you are but something I honestly hadn't given much thought to when I started this journey.

[00:00:14]What happens if my BMI gets too low?

[00:00:18]It's a strange question when you think about it. You spend months, sometimes years, trying to lose weight. You celebrate every milestone. Every pound lost feels like a step towards better health. But then, almost without realizing it, a new worry appears.

[00:00:33]Could reaching a healthy BMI actually affect whether I can continue taking the weight loss medication?

[00:00:40]The medication that's helped me get here, where I am today.

[00:00:44]I've seen this question asked in Facebook groups, Reddit forums, in comments on my own videos, and the closer I get to my own goal weight, the more I've realized I don't actually know the full answer.

[00:00:56]So today, that's what we're going to look at. So if you knew me, I'm here. My name is Mantis Midlife, and this channel has documented a medicated weight loss journey for just over 12 months. In that time, I have lost over 80 lb. Now, a year ago, most of the conversations around Mounjaro were about getting started. Would it work? What are the side effects? How much weight can I realistically lose?

[00:01:20]But that conversation is slowly changing now. Thousands and thousands of people are now getting close to or reaching maintenance, and for the first time, people aren't just asking how to lose weight. They're asking how they're going to keep it off. And that's where this question about BMI suddenly becomes really, really important. Because if BMI is one of the things used to decide who can start this treatment, what happens when the medication does exactly what it's supposed to do? What happens when someone who once qualified no longer fits the criteria? Do they have to stop? Can they stay on a maintenance dose? Or does reaching a healthy BMI mean the journey is over?

[00:02:01]These aren't just theoretical questions anymore. They're questions that more and more of us are soon going to have to answer.

[00:02:07]And to understand the answer, we first need to understand the number at the center of it all.

[00:02:13]BMI.

[00:02:15]BMI stands for body mass index, and it's one of the most widely used ways of estimating whether someone is a healthy weight.

[00:02:23]And now, BMI was developed over 200 years ago in the 1830s by a Belgian mathematician. And what's interesting is that he never designed it to judge the health of individuals. It was actually designed to be used as a statistical tool to study populations. The formula itself is surprisingly simple. You take your weight in kilograms, you divide it by your height in meters squared. Simple as that. That number then places you into one of several categories. And here we are, nearly 200 years later, despite everything we've learned about obesity, metabolism, body composition, all the science, all the technology we've got, and BMI is still one of the main tools used by health care providers. It helps shape public health policy, guides treatment decisions, and in many cases determines whether you or I qualify for weight loss medication like Mounjaro.

[00:03:19]And that's where things really start to get interesting. So, what are the rules around Mounjaro?

[00:03:25]If you're starting Mounjaro for weight management, BMI plays a huge role.

[00:03:29]Because in the UK, the medication is licensed for adults with a BMI of 30 or above. It can also be prescribed from a BMI of 27 if someone has at least one weight-related medical condition, such as high blood pressure, sleep apnea, or type 2 diabetes. On the NHS, the criteria is even stricter and in many cases treatment is limited to people with a BMI of 35 or above alongside other health conditions. So on the surface it seems really straightforward, doesn't it? BMI helps decide who can start treatment, but here's the question that kept coming back to me.

[00:04:11]What happens after >> [clears throat] >> the medication works? So this is the part where things become less clear. Now let's imagine someone starts Mounjaro with a BMI of 39.

[00:04:24]Over the next year they lose 80 lb.

[00:04:29]Their blood pressure improves and mobility improves. Their quality of life improves.

[00:04:34]And then all of a sudden their BMI falls into a healthy range.

[00:04:38]And surely that's what the whole weight loss medication, the whole treatment is supposed to achieve. So does reaching that point mean they no longer qualify for the medication?

[00:04:48]And this is where a lot of confusion comes from because the BMI thresholds you've probably heard about, the ones we just mentioned, are primarily used to decide who can start the treatment.

[00:05:00]They aren't simply a rule that says once your BMI reaches this number, you must stop because in reality maintenance is recognized as part of the licensed use of Mounjaro. Decisions about continuing treatment involve a much broader clinical picture than that one little number on a chart. Healthcare professionals consider how well the treatment is working, whether it's helping someone maintain their weight, and what might happen if you stop taking the medication. But it is worth knowing that maintenance policies can vary from provider to provider. Different providers have different approaches, which is always important to discuss your own situation with your prescriber rather than assuming every single one is the same. And I am primarily talking about in the UK because I know the rules can be a little bit different in the US, Europe, Australia. Right, ever so quickly now, if you follow my journey for a while, you will know that I have been using the Hume body pod for quite some time now. Now, when I started this journey, I was obsessed with one number and one number only, my weight. Every single week, I'd step on the scales hoping to see that number go down because I thought that was the best way to measure progress. I am now over 80 lb down, but the closer I've got to my goal, the more I've realized that weight on its own can actually be really misleading. And if you think about it, we've all had those weeks where we've done everything right. [clears throat] We've eaten well, we've been to the gym, we've hit our step target, and the scales hardly move. In the past, I would have assumed it's been a bad week. Now, I know that's not true. And that's why I love my Hume body analyzer. It performs a full body composition scan, measuring your arms, your legs, your torso individually rather than simply estimating everything from your feet like smart scales do. It's around about 98% as accurate as the medical-grade in-body scanners you'll often find in gyms, except I can do it at home whenever I want. And there are certain numbers now I pay more attention to, muscle mass because I want to protect as much muscle as I can, my body fat percentage because that's really what I'm trying to reduce now, my visceral fat because that's closely linked with long-term health, even things like hydration and metabolic age are going to help me understand what's actually going on instead of simply reacting to one weight in every week. Because if you only ever look at your weight, you're only seeing part of the picture. And as I'm moving into maintenance, that's become more important than ever. I'm not trying to become lighter at any cost.

[00:07:39]I'm trying to become healthier. yeah.

[00:07:41]you'd like to find out more about the Hume Body Pod, I'm going to leave a link in the description below.

[00:07:45]If you use code Mando's Midlife, you're going to get a discount, and you can also, believe it or not, stack the discounts. Go and have a look now. Check it out.

[00:07:56]So, why does all this matter to me?

[00:07:58]Because this isn't just an interesting question I found online. It's becoming my reality.

[00:08:04]Maybe not today, maybe not next week, maybe in a few weeks' time.

[00:08:08]And for the first time since I started this journey, I'm getting close enough to my goal weight that these questions are going to actually start mattering to me. I'm no longer wondering whether Mounjaro works. I know it works. I'm thinking about what's going to happen next, and the more I've looked into it, the more I've realized one thing.

[00:08:25]Because if someone has transformed their health, improved their blood pressure, reduced the risk of disease, and built habits, they can hopefully maintain, should a calculation that was developed over 200 years ago be the only thing that defines the next stage of their journey?

[00:08:41]Because I don't think it's that simple.

[00:08:44]So, what am I going to do?

[00:08:46]So, after looking into all this, it naturally leads me to the next question.

[00:08:51]What am I actually going to do? And the honest answer is I'm not rushing anything.

[00:08:56]If you watched my video last Wednesday, I revealed, after a lot of cogitating, my complete maintenance plan. And it's long, it's drawn out, it's potentially going to take me five, maybe six months, possibly even longer, before I even consider whether I can stop taking the medication or whether I need to continue it.

[00:09:16]Which then arrives me at that destination where my BMI potentially may be too healthy for me to be able to get this medication prescribed.

[00:09:26]When I started Mounjaro, my goal was never simply to hit a number on the scales and stop overnight. My goal was to become healthier, and more importantly, to stay healthier.

[00:09:38]And that's why that plan has always been to approach maintenance gradually.

[00:09:42]Rather than making one big change, I'd much rather make these small adjustments, which is going to give my body time to respond and my habits time to respond. Cuz I'm going to continue monitoring my weight, but I'll be paying attention to other things like body composition, appetite, energy levels, and of course whether those old really boy habits and the food noise start creeping back in.

[00:10:05]What have I learned?

[00:10:07]I think the biggest thing I've taken away from researching all this is that we've reached a completely different stage in the conversation around Mounjaro.

[00:10:15]And when I say we, I don't just mean me and the people watching this video.

[00:10:19]I mean we're we're at a certain part of the journey, a lot of us, probably tens and hundreds of thousands of us, where we're no longer concerned about whether it's working, because we know it's working. More and more people are now asking, "What happens when it does work? How do you maintain your weight? How do you avoid regaining that weight? And how do you protect all the progress you've made over that length of time?"

[00:10:43]And these are the questions that are going to shape the next few years for thousands and thousands of people. And I think that's where the real value is all right now today. Not just celebrating the weight we've lost, absolutely we need to celebrate that, but we also need to learn how to live successfully afterwards.

[00:11:03]So, can your BMI become too low to stay on Mounjaro?

[00:11:07]And the answer isn't as straightforward as many people think. BMI is an important part of deciding who starts a treatment, but when it comes to maintenance, there are other factors that come into play. And those decisions should always be made with your healthcare provider. For me, this journey has changed. I'm still chasing that next milestone on the scales, and how do I make sure this isn't just weight I've lost, but a life I've changed?

[00:11:29]I genuinely love to hear your thoughts.

[00:11:32]If you're [clears throat] already on Manjaro, have you started thinking about maintenance yet? And if you've reached your goal, what has your experience been?

[00:11:40]If you've enjoyed this video, I'd really appreciate it if you would give it a like. Subscribe to the channel if you're new, and join me again on Sunday for another Sunday coffee morning where we will catch up on the week, answer the questions, pet peeve of the week, and see how this journey is progressing.

[00:11:56]I will leave my maintenance plan on the screen right now.

[00:12:00]And there will be another that YouTube algorithm central HQ has decided that you're going to love. So, if you want to watch those next, that would be amazing.

[00:12:10]Until I see you on Sunday, take care.