Ep.12 - Navigating weight plateaus, intermittent fasting, and building strength as you age, a Q&A with Greg and Charlie

[upbeat instrumental music] So first section, weight loss.

So this question was off the back of our Science of Weight Loss episode with Dr. David Allison, and the theme was around plateauing during weight loss.

Mel in St. Helens has asked, "I successfully lost two and a half stone last year using Mounjaro.

I didn't change anything as I already eat a healthy diet, and I'm very active.

However, although I am keeping the weight off using a two point five milliliter dose weekly, I don't seem to be able to lose any more.

Why?"

First things first, not medical doctor, PhD, fake doctor right here, so please bear that in mind.

Oh, you're like Ross on Friends.

[laughs]

[laughs] Any decisions that you make about this should be made in conjunction with a medical doctor.

But I will share some thoughts because I want to be helpful.

I also wanna be clear that it's great that you've kept the weight off.

That's not that common.

After most people lose weight, they soon regain some or even all of the weight that they have lost.

Regarding Mounjaro, so the drug name is tirzepatide.

Just keep that in mind if I refer to tirzepatide.

The dose you've been using, two and a half milligrams, is a common starting dose.

But from that point, the dose is normally escalated depending on side effects.

For weight loss, people might escalate that dose in two and a half milligram increments up to a dose as high as 15 milligrams, so six times as high as the one that you've been using.

And if someone just takes two and a half milligrams per week continuously, I'd expect there to be some initial weight loss but then a plateau, and that is what seems to have happened here.

So if you wanna continue weight loss using the medication, you could try a higher dose under supervision.

You might have already tried one, but if not, that would be the natural next step.

Probably initially increase to five milligrams, see how you get on, and then continue that dose until you reach another plateau, and then you could increase that further to seven and a half milligrams and so on up to a max of 15, bearing in mind those side effects.

And then once you've reached your target weight, I would look to taper down to a maintenance dose, which might well be the two and a half milligram dose that you're currently taking.

And the evidence does suggest that if people just discontinue the medication, they will regain the weight, much as occurs when people stop weight loss diets.