Call: Mounjaro™ for Weight Loss
Posted: Jun 22 in Weight Loss Medication by Dr. Lazarus
The FDA has approved a very exciting medication called Mounjaro™. Although approved for treatment of type 2 diabetes, a side effect of Mounjaro™ is weight loss. The same molecule, tirzapeptide, is being researched for weight loss as well.
Mounjaro™ is the newest in the class of GLP-1 analogues. GLP-1 (glucagon-like peptide 1) is a hormone that the body naturally makes in response to food intake. It signals the body that we are in a fed state (satiated), and lowers blood sugar. Human GLP-1 only lasts a few minutes, but Mounjaro lasts a whole week. In addition, it contains GIP (Gastric inhibitory peptide), another hormone with similar properties.
Similar to Wegovy™, Mounjaro is available as a once weekly injectable medication (self-administered). In the studies for type II diabetes, people lost an average of 25 pounds on the 15 mg weekly dose. Note that this was a side effect when used for diabetes treatment – in the first study for weight loss, people lost an average of 52 pounds (22.5%) on the 15 mg dose, with 63% of people losing more than 20% of their body weight (click here to read more).
The graph below shows the weight loss from the diabetes trail:
Side effects are mostly gastrointestinal – nausea, etc., and for most patients, gradually improve over time. For more information on side effects, contraindications, etc., click here.
I am a breast cancer survivor and have been on Letrozole for two years. My BMI is 31 and I’m desperate to lose weight. Would this be an option for me?
Heidi – generally speaking, yes – we use all of the different weight loss medications with breast cancer survivors. I don’t believe any interact with letrozole. Whomever the prescriber is, just be sure to have them run an interaction check between letrozole and whichever weight loss medication is desired. We use phentermine, tenuate (diethylpropion), contrave, Wegovy, Saxenda and now considering Mounjaro for medical weight loss for our breast cancer survivors. Weight loss is thought to be helpful to prevent recurrence.
I was on Wegovy for 7 months and lost 34 lbs. My insurance changed and would no longer cover it making it cost prohibitive for me to continue taking. My Dr. has now prescribed Mounjaro which is covered and also offers a savings card. I will see how the weight loss works with this new medication.
That’s great! Thanks for sharing. Yes – for those with commercial insurance, there is a coupon for Mounjaro so it can be filled for $25 / month I believe x 1 year. Note that this will not work for Medicare / Medicaid / etc.
My BMI is 31. I have protein C deficiency. I see a Hematology/Oncology doctor for my blood disorder. I have tried everything to lose weight. Would this drug be available to me? My Dr. has advised me not to have bariatric surgery so I need something to help loae the weight to help with my blood clots.
Generally we don’t do surgery unless the BMI is above 35 with compelling comorbidity. Protein C deficiency I would think would make you higher risk for surgery, but no higher risk for medical treatment. I’d recommend finding a doctor in your area certified by the American Board of Obesity Medicine. There is a good “Find a Clinician” tab at obesitymedicine.org. Where do you live? Perhaps there is somebody I could recommend.
I am inquiring
I live in NOrth Carolina
Please visit obesitymedicine.org – click on the find a clinician menu to find a provider in your area certified by the American Board of Obesity Medicine (if looking for weight loss). If wanting on-label treatment with Mounjaro for type II diabetes, talk to your primary care provider, or your endocrinologist 🙂
How long, approximately, is Mounjaro taking to ship to pharmacies once ordered?
I believe many already have it in stock – try your local pharmacy. Ours all have it.
Is this medication being covered by some insurances for chronic obesity without T2D?
No; however, they have a coupon at this time for $25 / month for people on commercial insurance (not Medicare, Medicaid, or Kaiser, I believe). But, when the coupon runs out, good luck – it will be around $1000 / month. I am not aware of any way to get it for less yet at this time.
Do you have to have diabetes my bmi is 25
Thank you
Mounjaro is only approved for use in type 2 diabetes. It can be used for weight loss, but that is not its approved indication. Therefore, it is “off-label” for use for weight loss irregardless of BMI. This would be a decision between you and your doctor. Frankly, in my opinion, for most patients, this would be using a bazooka to kill an ant – there are several effective and safe medications that could help with weight loss, but again, at a BMI of 25, none are FDA-approved for use, so the use would be considered “off-label.”
What is the daily average of weight loss?
In their initial weight loss study, the weight loss was reported as 52 pounds after 1 year of treatment. It is not reported daily. Further, it is an exponential scale, so weight loss is greatest in first month, less in second month, etc, with a flattening of the curve by 12 months.
I’ve been on Wegovy for the past 7 months with very good results (even with the lower dosage of .5). Now there is an issue with finding W in stock.
I contacted my DR and received a message back from her cover DR (she’s on leave right now). The message indicated that he has prescribed Mounjaro with the expectation that I start taking it this next week.
I do not have Diabetes and am concerned about using a medication that’s designed for Diabetes and has not been approved for weight loss only.
Could you please share your thoughts on this situation?
Thank you!
That is correct – it is approved for diabetes, the use for weight loss, while fine in my opinion, is “off-label” and unlikely to be covered by any health insurer. Again, consider the use of a medication that will be more cost-effective for you over the long haul, until Mounjaro is approved for weight loss (likely 1-2 years) AND your health insurance company covers it.
when it is no longer covered by the coupon card, is there an alternative? It is working well for me but wonder how I will manage when i can no longer get at discount. $1,000 plus a month is not an option. I’m not diabetic.
Consider using the older medications like phentermine and diethylpropion, if they would be safe and appropriate for you. Urge you insurance company to add coverage for anti-obesity medications (determined by employer, usually).
What options are there for someone that is on Medicare? Are there any forms of assistance out there? Seems like all savings programs only accommodate those with commercial insurance. Ty!
This is an issue with Medicare – Medicare continues to deny coverage far all FDA-approved anti-obesity medications, stating that they are cosmetic, like products for hair replacement. There is a bill in congress to change this – the Treat and Reduce Obesity Act (TROA), but it has been stuck in the muck for 7 years. I encourage you to contact your state legislators and urge support for TROA. In the mean time, the older medications like phentermine and diethylpropion are very inexpensive, if they would be appropriate for you.
Hello,
I have a BMI of 32 and I’m a non-diabetic. Up to this point my insurance co co won’t approve it and I’ve only been using samples of ozempic and currently Saxenda which was just declined. So now the doc prescribed Mounjaro. Is this something I should be taking I’m 5’9 250lbs. I am a little weary as this is a brand new medication. Any info would be appreciated.
Thank you!
I can’t provide medical advice in a blog, but in my experience, Mounjaro is well-tolerated, similar to Ozempic and Saxenda. It is in the same general category of medication, and I have been using it in similar situations for weight management (off-label), even though the current indication is for type 2 diabetes (as is ozempic). I am hopeful that Mounjaro will get FDA-approval for weight loss.
If the weight loss effects level off after a year, do you have to continue to take it? What happens when you stop taking it?
Thanks so much
Medications for weight management only work if they are taken chronically. The weight loss leveling off indicates the effectiveness of the medication used, similar to using a blood pressure medication – the pressure comes down over a few weeks and levels off. If the blood pressure medication is stopped, the blood pressure goes back up to the same levels they were at before treatment. Multiple studies have demonstrated this for weight management medications as well – only instead of taking a few weeks, these curves go over 6 to 12 months. So if the medication is stopped, it is likely the weight will return to the pre-treatment level.
My BMI is 29.2, I am 56 and I weigh 164 at 5’3”. I have a family history of diabetes. My maternal grandmother died at 82, complications Reno failure, my mother had diabetes as well, and I lost her just recently, she was 76. I am quite concerned, since menopause I’ve gained weight and I also have a back injury that interrupted my routine and I have had a difficulty time in losing the weight effectively. I have not given up I have been seen by a specialist for my back injury and have done physical therapy as well slowly have increased in my strength and feel some weight shedding off; however, the scale says differently. I have concluded to not look at scale but how my clothes fit. Still, frustrated with the weight around mid area; my son feels that I should consider this medication he is an ER doctor in Indianapolis and felt that I should look into it what are your thoughts?
It sounds like you would definitely benefit from working with a doctor specializing in obesity treatment. This is one of many treatments available – keep in mind it is “off-label” to use it as a weight loss treatment. It is approved for diabetes treatment – this is causing issues regarding getting the medication paid for. So certainly discuss with an obesity medicine doctor, but you can also consider multiple other options which may make more sense from a cost perspective.
I have colitis that is currently in remission with taking Entivioy infusions. Would this drug be okay to take?
I am not aware of any contraindications with regards to colitis drugs. Running a quick interaction check in Epocrates between Entyvio and Mounjaro shows no interactions.
Can I get this in Australia??
According to Dr. Google, it is not approved yet in Australia.
Do you have Medicaid? I am prescribed ozempic and first shot I got flu like symptoms and been very weak, fatigue in general, and cold sweats band my sugar is fine. Also I slept for 24 hours I could not hold my eyes open. Considering mounjaro now
In my experience, side effects get less as people get used to the GLP-1 medications like Ozempic and like mounjuaro. You can discuss with your doctor, but if patients have side effects, I have them do a lower dose than the .25 – you can count the clicks to the .25, then go back to beginning (turn counter-clockwise), then do 1/2 that number of clicks, so around .125 mg dose. You’d need some extra needles (ask doctor to prescribe novofine 32g pen needles), then increase the dosage much more slowly. Doing this is “off-label” but I have had good success with this approach. Again, I am not your doctor – so please discuss with your prescriber. Mounjaro is a fixed dose – so no opportunity to adjust the dose if you have side effects, other than if it happens at a higher dose pen, can go back to lower dose. Discuss options with your doctor. No, we do not work with Medicaid, sorry.
Any interactions with this while taking Tamoxifin?
I do not believe so; however, always a good idea to double check and make sure the Oncologist does not have any concerns.
I am on Medicare, have Humana advantage plan. Will it cover the medicine?
I don’t get why Medicare itself won’t cover , we need the help.
Thanks
Medicare does not allow coverage for any medication for weight loss; however, it does allow coverage for type 2 diabetes. Right now, I don’t think any insurance will cover Mounjaro for purposes of weight loss because that is considered “Off-label.” Hopefully it will get approved for weight loss in 2023. In the mean time, though, if you you have type 2 diabetes, you can ask your dotor if Mounjaro might be an option available with Medicare, as it would not be excluded for that indication.
I’m 5′ 4″ and 182 lbs…clinically obese. Also have hypertension and borderline diabetic (insulin resistant). My endocrinologist will prescribe wegovy but it’s not covered under my insurance nor is there a significant savings program. Can’t afford wegovy. She refuses to prescribe mounjaro which does have a great savings program even without insurance approval. How can I get a mounjaro prescription? I desperately want to lose weight for multiple health reasons and especially now with the $25 per month cost savings program available. Any suggestions for getting this mounjaro Rx? Thank you!
Many are of the opinion that Mounjaro should only be used for Diabetes, and won’t prescribe “off-label” for weight loss. The option to use Mounjaro “off-label” for weight loss is likely to end very soon – rumor has it that the coupon will only work for people with diabetes starting October 1, 2022. You could ask your primary care, or find a weight loss doctor specializing in obesity medicine – check the find a clinician tab at obesitymedicine.org as a starting point. Alternatively, see if somebody would prescribe one of the more cost-effective oral medications. Wegovy remains unavailable for new starts at this time – the shortage is expected to run through the end of the year. So, good time to consider other options.
Makes no sense to me why Ins or Medicare wont cover for weight loss. Lower weight and many other expensive maladies can be improved or eliminated…saving them money in the long run.
I qualified for monjaro prescription for obesity. I’m not diabetic. I was denied using the $25 savings card because im a Medicare/Medicaid recipient. I have high blood pressure also osteoarthritis. I need a knee replacement. The extra weight doesn’t help my knee pain. I can’t take the older less expensive drugs because they are stimulants. I can through a bunch of aggravation to get approved for gastric bypass surgery. This is something I don’t want to do but feel like it’s my only choice financially. Please consider a way to help others like myself in this situation to be able to get a affordable chance with this medication to help with obesity.
This definitely calls for an obesity medicine specialist – go to obesitymedicine.org, find a clinician, and try to find a good doctor certified by the American Board of Obesity Medicine (ABOM) in your area. It is absurd that Medicare refuses coverage for all anti-obesity medications. We have been working on a congressional act, TROA (Treat and Reduce Obesity Act) which currently has 175 co-sponsors. Encourage your state representatives to sponsor TROA!
I recall reading that mounjaro can be prescribed for people with 30+ BMI. Is that not true?
It is only approved for the treatment of type 2 diabetes, but that does not preclude a doctor from prescribing it “off-label” for weight loss. There is a coupon going now for $25 / month (does not always work – for example, can’t use if on Kaiser, Medicare, Medicaid, and others), and my understanding is that starting on October 1st, the coupon will only work if you have type 2 diabetes. Insurance companies typically will not cover its use for weight loss. Hopefully they get it approved as an anti-obesity medication for weight loss in 2023!
I would like someone near chapel hill or Burlington NC. For the next weight loss medication.
Dr. Westman is certified by the American Board of Obesity Medicine – does a lot with ketogenic diets…
I had been taking Trulicity for a while and just last week switched to Mounjaro, 5. At what point should I see weight changes. My numbers are very good.
Great question, and not sure. Obviously in clinical studies, mounjaro has dramatically better weight loss than trulicity; however, there is neither a head-to-head study for weight loss, nor a titration study. My suspicion is that when you get to the higher dosages (10, 12.5, 15 mg weekly) you’ll see the weight loss pick up. Obviously, the Mounjaro is indicated currently for the treatment of type II diabetes, and at this point the weight loss is a “side effect.” Hopefully the Mounjaro gets approval for weight loss soon, at which point we should also have more published clinical trial data. Further, the company has not provided guidance to the best of my knowledge on how to titrate from other GLP-1 like Trulicity to Mounjaro. I’d suggest patience, stick with healthy lifestyle, and monitor the weight and the a1c! All the best, and great question.
When do you think that mounjaro will be available for weight loss only. I’ve been the same (over) weight for years due to a total thyroidectomy. I’ve run numerous triathlons and have eaten clean and no weight changes. Would this possibly help?
On October 6th, the FDA approved Lilly’s fast-track request for approving Mounjaro for weight loss. This means they can submit in April / May, and with any hope we will see it next year some time. Yes it could help, although so could all of the other anti-obesity medications currently available (phentermine, qsymia, contrave, saxenda, wegovy, etc.) Why weight? https://investor.lilly.com/news-releases/news-release-details/lilly-receives-us-fda-fast-track-designation-tirzepatide
Can you take this medication after having gastric sleeve?
We have successfully used all the GLP-1 medications including Saxenda, Wegovy, and Mounjaro in patients who have had bariatric surgery – our experience has been very good! A sleeve is not listed as a limitation of use of these medications. Of course, this is assuming you do not have any contraindications to be on a GLP-1 (personal or family history of medullary thyroid cancer, multiple endocrine neoplasia type 1, or a history of pancreatitis or gastroparesis). This of course would be a decision between you and the treating physician.
I have been on Mounjaro since Sept. 3 (it is 10/24). I have never tried a weight loss med before. I was 204 and am now 189. I have not been able to lose weight for many years. I am now 64. Currently on the 5 mg dose to go up to 7.5 in another week. I just had blood work done 3 days ago and my A1C has gone from 6.4 to 5.8 in that short time. I have been in the pre-diabetes range for years so that is a happy change. Kidney levels are great as are liver levels. Side effects have been minimal for me. Very pleased with this medication and hoping it is approved for maintenance for weight loss only in 2023. I think the combination of GLP-1 and GIP is a total game changer.
Can someone with heart problems take Mounjaro for weight loss?
I do not know of any limitations of use for patients with heart disease; however, there are a lot of types of heart problems – heart disease, different forms of heart failure, valve problems, rhythm problems like a. fib. You would need to discuss with a physician skilled in the use of this medication, or perhaps review with your cardiologist first. The full prescribing information can be reviewed here: https://uspl.lilly.com/mounjaro/mounjaro.html#pi
Can someone get this prescription online or your personal Doctor?
Any physician / PA / NP should be able to prescribe Mounjaro.
I have a fatty liver ,high cholesterol and triglycerides. I am 5’4 and 228 .I have medicaid. Do you that might be good for me to try ?
Tricky question. Weight loss, however it is achieved should be helpful for the problems you listed. Whether or not Mounjaro is the best choice would need to be discussed with your doctor. Furthermore, it would only make sense if insurance covered the cost of the Mounjaro. There are many other approaches that could also be successful for you if Mounjaro turned out to be too expensive.
I am a type 2 diabetic. I had a bmi=24.8 when I started taking Mumjaro. I’ve taken Munjaro for 3 weeks and I am down 12 lbs. BMI = 22.7. I can’t afford to loose any more weoght.
Does the weight loss slow ot stop at some point?
I don’t want to stop taking the med, because I meed it to control my s8gars. Any thoughts?
Hi Doug – not sure how the weight loss will look as you proceed with the Mounjaro. If losing too much, could consider a GLP-1 medication with less with loss as a side effect – like Trulicity. Or, could consider more weight neutral options like SGLT-2 (farxiga / jiardance, etc) or Metformin. Also, there are 6 strengths of Mounjaro – if choosing to stay on mounjaro, might want to stay at 2.5 mg weekly to minimize weight loss. We recently wrote an article on this topic in Obesity Pillars, which you / your doctor can access free here: https://www.sciencedirect.com/science/article/pii/S2667368122000304 (written from the perspective of Anti-obesity medication).
Hi, I am a 66 years old and weigh 211 at 5’2”. I am on treated a-fib meds now and my family physician prescribed saxenda because of shortage of wegovey. Now I have United Health care and it doesn’t cover it. I have tried all the other meds with not much success over the years plus with a-fib the doctor doesn’t want me on stimulants. I am really scared of weight loss surgery at my age and with A-fib. I am starting to feel hopeless about my situation. I eat pretty healthy and exercise. I just sent in an appeal to UHC for Mojourno which was turned down. I do not have high blood pressure or cholesterol but I do have sleep apnea. Any thoughts?
I’d suggest seeing a Doctor certified by ABOM (the American Board of Obesity Medicine). I treat a lot of patients with these types of concerns and can usually figure something out. There are many options – Wegovy is now widely available, Ozempic (off-label), maybe Contrave. Again, seeing a board-certified doctor would be the best first step. Visit obesitymedicine.org and click the find a clinician tab.
I am currently on Mounjaro I am on 7.5 mg went to a weight loss clinic in Slidell Louisiana but they only except cash or credit card will not accept my insurance so this is my last round can’t afford anymore. I’m trying to find a doctor to prescribe it to me. Hopefully I will soon I have been using peptides having to mix it myself.
I would advise against using copycat versions of injectable weight loss medications. In fact, the FDA issued an advisory warning that they may be counterfeit – https://www.cbsnews.com/news/ozempic-wegovy-fake-weight-loss-drugs-fda-investigating-trade-group-warns/, as did the Obesity Medicine Association https://obesitymedicine.org/obesity-medicine-association-issues-a-position-statement-on-compounded-peptides/. You can go to obesitymedicine.org, click find a clinician, and search for a board-certified physician near you to continue your weight loss journey. First and foremost, it is important that the treatment options you use are appropriate for you and safe!