A new weight loss treatment, called Tirzepatide (Mounjaro) is now “allowed” to be prescribed for people by GPs. We have previously only been able to use this medication for people with poorly controlled type 2 diabetes.
Tirzepatide (Mounjaro) weekly injections make you feel fuller and lowers your appetite, helping people lose weight. It especially seems to help people reduce hunger cravings, which are sometimes now called “food noise”, helping people choose healthier foods and smaller portions, avoiding snacking.
Gradual rollout
The rollout of this medication in Devon and nationally is limited to protect NHS budgets and drug supply, therefore year 1 will be limited to people with Body Mass Index (BMI) over 40 plus 4 of the following 5 weight related conditions:
- Type 2 diabetes – A condition which causes too much sugar in the blood.
- High blood pressure and on medication to treat this – When the force of your blood pushing against the walls of your blood vessels is too high.
- Dyslipidemia – When your blood lipids (like cholesterol) are not in the right balance.
- Obstructive sleep apnoea and on treatment for this – When your breathing stops and starts while you are sleeping.
- Atherosclerotic cardiovascular disease – Where your arteries become narrowed, making it difficult for blood to flow through them. This may lead to a heart attack or angina, a stroke, heart failure or poor circulation to the legs also known as (peripheral vascular disease).
There is an online NHS BMI calculator here.
Private supply
Currently around 10 people in the UK are buying mounjaro through private pharmacys for every 1 person prescribed this drug through the NHS. We have spoken to many of our patients who have found this medication very helpful to lose weight. It has also allowed people to feel in control of their eating and wellbeing.
There is a website called monj.co.uk which list the pharmacies selling mounjaro, and costs, with a discount price list to show best prices. Your private supplier will also be responsible for checking you are eligible and supporting you in using mounjaro safely, not just selling you the medication.
Risks of Mounjaro
As a new drug, we have several concerns regarding long term safety:
- Will people be able to sustain weight loss beyond treatment? Current data is a lot of people regain most of their excess weight after stopping treatment. You will need to sustain lifestyle changes to avoid medication forever.
- Will mounjaro for women in pregnancy harm the baby? This is especially important as weight loss can often trigger a boost to fertility, so contraception while on treatment is especially important.
- What other harms might be linked to mounjaro? It may take many years to known if there are other risks to people.
But despite the risks both known and unknown, we also consider the very important harms of being very overweight. Obesity is linked to heart disease, stroke, many cancers, blood clots, dementia, diabetes, joint damage.
Beyond Mounjaro
Long term Mounjaro and other weight loss drugs, like wegovy (semaglutide) have given us a new way to understand obesity:
What makes us obese is our hormones, especially high levels of Insulin (sugar hormone), cortisol (stress hormone), ghrelin (hunger hormone).
Controlling these hormones will control our weight. This can be managed in other ways, not just weight loss medications:
- Eating a healthy diet, with unprocessed foods, low in sugar and starch, these keep insulin levels low. Everything about processed foods – even the bright packaging, may contribute to eating too much.
- Improving our stress and sleep, including exercise, time with friends, good sleep patterns, these keeps cortisol low. Aim for at least 7 hours of good sleep.
- Avoiding snacking, alcohol, sweet drinks, which keeps our hunger hormones active all day, keeps ghrelin low. The problems with snacks is they make us hungry!
For more information about these lifestyle changes, see Healthyhart.co.uk. For meal planners see the excellent Freshwell Low Carb project.