Pouch Reset and Mounjaro?

[UnderTheCaliSun 28]

Hi everyone!

I have a friend who had WLS a decade ago and regained a bit of weight. She recently went on the new medication called Mounjaro to try and re-lose that weight. She has done very well but said the most amazing thing that she found was that it reset her pouch. She said the restriction is back like it was right after surgery. She is encouraging me to use this mediation to reset my pouch.

I have maintained my weightloss for the most part but with menopause, I've regained about 20 pounds, mostly in my lower tummy which is never where I used to carry weight. I do admit that with the years passing, my restriction isn't what it used to be but it's not gone. I was thinking of trying this but wondered if anyone else has tried it and what their experience has been?

Thanks!

[Sleeve_Me_Alone 657]

Mounjaro is a GLP-1 and GIP agonist medication specifically for diabetes treatment. It is not yet FDA approved for weight loss, though some doctors are prescribing it off label. It absolutely does NOT "reset" your pouch, there is no such thing. Your post-op stomach is what it is and over time the restriction will naturally decrease. However, the medication does work in part by making you feel fuller sooner and stay fuller longer by slowing gastric emptying. This is temporary though, and will revert as soon as a person stops taking the medication. Most doctors agree that for these types of meds to work their best (Wegovy Ozempic are similar), they need to be taken long term, if not indefinitely. They are NOT a quick fix for weight loss. That being said, they can be helpful in long term weight maintenance, blood sugar management, etc. If you're interested, I would strongly suggest speaking with your PCP and/or bariatric surgeon and make sure you understand how the medication works, what it does, what the side effects are (there are many and some are quite unpleasant), as well as what treatment looks like long term. Lots of doctors are seeing success in their patients with these new meds, but its really important that the patient understands them, they aren't a magic pill.

[UnderTheCaliSun 28]

Thank you Sleeve_Me_Alone, yes, I have studied the medication and talked with my doctor. I understand how and why it works but I would love to hear more personal experiences with it especially from people who had previous WLS.

My friend has had mild side effects. She gets nauseous the day of and after her shot but she has learned to wear a sea sick patch which seems to fix that. She hasn't had any other side effects except for the one time she over ate. She said the result was the same as when she overate after surgery. It was awful. She hasn't done that again and she considers that a good side effect for her. I am hoping to find others who have experience too. It's a new medication so there may not be many. I'm currently on Metformin and will stay on that indefinitely so this was of interest to me but the costs are high. I Just thought I would ask. Thanks!

[kcuster83 1,505]

My Dietician consistently says there is no such thing as a pouch reset. The calorie deficit is what makes you lose weight during said "ouch reset phase" by going back to liquids for so many days it is simply less calories.

In addition, the restriction the same reasoning. Being on a liquid diet for a week, so when you eat solids your stomach reacts quicker because it is used to only have liquids again.

You had to have surgery to shrink your stomach, so just drinking liquids for a week is not going to magically shrink your stomach.

Everyone has different opinions on this, but if you really think about it it makes complete sense.

Regardless, if your friend thinks it is and it is working for her then that is great! And, no reason not to reset if you want to.

[vsgchick 118]

Hi! I was sleeved in 2014...original loss was 185 lbs. Regained 40 lbs during the pandemic. I started Saxenda in January of this year and lost 35 lbs. I moved to Mounjaro last week (off label, as I am not diabetic) because I was tired of Saxenda's daily injection. I don't view GLP-1s as a pouch reset, but they definitely help turn off the "food voice" in my head. I am on the beginning dose of Mounjaro, so haven't experienced the full power yet. I still have decent restriction, so capacity wasn't my problem. Slider foods/snacking caused my weight gain.

I know medication isn't for everyone, but I honestly believe GLP-1s should at least be mentioned to WLS patients dealing with regain. I see it as a 1-2 punch for me.

[UnderTheCaliSun 28]

7 minutes ago, vsgchick said:

Hi! I was sleeved in 2014...original loss was 185 lbs. Regained 40 lbs during the pandemic. I started Saxenda in January of this year and lost 35 lbs. I moved to Mounjaro last week (off label, as I am not diabetic) because I was tired of Saxenda's daily injection. I don't view GLP-1s as a pouch reset, but they definitely help turn off the "food voice" in my head. I am on the beginning dose of Mounjaro, so haven't experienced the full power yet. I still have decent restriction, so capacity wasn't my problem. Slider foods/snacking caused my weight gain.

I know medication isn't for everyone, but I honestly believe GLP-1s should at least be mentioned to WLS patients dealing with regain. I see it as a 1-2 punch for me.

Thank you! I appreciate your response. I would love to hear more about your transition to Mounjaro as you take this journey. I really like how you phrase it as turning off the food voice in your head. My friends says the same thing. She calls it a reset, not because it actually shrinks her stomach but she seems more physically aware of her restriction again. Maybe it is because the emotional food voices are more quiet? I don't know but GLP-1's do seem like a great tool for previous WLS patients. Have you had any new side effects that you didn't have on Saxenda?

[vsgchick 118]

Thank you! I appreciate your response. I would love to hear more about your transition to Mounjaro as you take this journey. I really like how you phrase it as turning off the food voice in your head. My friends says the same thing. She calls it a reset, not because it actually shrinks her stomach but she seems more physically aware of her restriction again. Maybe it is because the emotional food voices are more quiet? I don't know but GLP-1's do seem like a great tool for previous WLS patients. Have you had any new side effects that you didn't have on Saxenda?

You're welcome! Both medications delay gastric emptying, so that can definitely bring back the restricted feeling. I haven't had any side effects with Mounjaro yet. I ended my Saxenda run at the highest dose, so the beginning dose of Mounjaro (2.5mg) probably won't be an issue. I move up to 5mg next month, so we'll see what happens then. My side effects with Saxenda happened early on and were very mild...fatigue and a little nausea during the first week. I was fine after that. I am grateful to have a bariatric doctor that is educated on GLP-1s and open to prescribing them when needed. I didn't want to go the revision route (and probably wasn't a candidate because even with the regain, I've maintained over 70% of my original weight loss). I just needed an additional tool. [emoji4]

[Arabesque 7,612]

Hormones are the worst. My weight issues began with puberty. I bounced between 60 & 75kgs most of my adult life. When I began peri menopause, I gained weight & hit 75 more quickly then ever before When I began menopause I put on another 16kg even more quickly - felt like overnight - & suddenly I weighed 91kg. Couldn’t shift a gram of it. It’s why I turned to surgery.

Interestingly, the 49kg I settled at for a good year after surgery was about what I weighed when I was 12 & puberty hit.

Then, in late November last year, my GP upped my HRT dose & yep, weight gain: 2kgs in that first month. I modified my diet as soon as I realised & while I I haven’t gained any more, I haven’t been able to lose those kgs either.

I wonder if starting with your hormones & maybe trying to sort those out maybe a better place to start.

[Tupelo 23]

I just started Mounjaro 3 days ago and the amount of appetite suppression from day was was surprising. I totally lost interest in eating. Interested to see how it performs over time.

[UnderTheCaliSun 28]

To follow up, I did start HRT this summer and instead of gaining, I actually lost 7 lbs and my worse symptoms of menopause subsided but I quickly realized that any further weight loss was going to be really hard. My doctor prescribed Moujaro and is a big fan of it (who knew?). I started it right after I posted this thread and I'm already down 20 lbs. Holy smokes! The appetite suppression and restriction (yes, I do feel it much more now) is crazy. I relate it to the feeling I had about 90 days out from surgery. I can eat what I want but just not very much of it and I'm rarely hungry. I didn't expect to lose so much weight so fast and I really only want to lose another 10 lbs so I doubt I will hit the max Mounjaro dose. I'm currently on 5 mg with no side effects beyond nausea the day after my shot.

If this medication had been around when I had surgery, I don't know if I would have needed to have WLS but I am thankful it's here for me now. My doctor loves it to prevent recision surgery and regain in patients who are 36 months or longer out from their past surgery.

[L. Knight 36]

@Tupelo and @vsgchick I’m curious how is your weight loss going with Mounjaro now that it’s been months

[vsgchick 118]

[mention=408485]Tupelo[/mention] and [mention=216905]vsgchick[/mention] I’m curious how is your weight loss going with Mounjaro now that it’s been months

Hello! Mounjaro has been great for me. I lost the remainder of my regain and 10 additional pounds. I am currently under my lowest sleeve weight and see my bariatric office in 2 weeks to discuss a maintenance plan. I didn't go higher than the 10mg dose (the highest doses are 12.5mg and 15mg). I didn't have any crazy side effects. GLP-1s seem to be a game changer for a lot of people...especially veteran WLS that need a boost but don't want revisions.

[L. Knight 36]

@vsgchick I’m glad to hear you reached your goal. I just had gastric bypass revision endoscopic so they reduced my opening from 25mm to 8 and I got two sutures yesterday. I will wait until a month and get on Wegovy as well to increase my weight loss.

[Tupelo 23]

5 hours ago, L. Knight said:

@Tupelo and @vsgchick I’m curious how is your weight loss going with Mounjaro now that it’s been months

It’s been more effective than anything I’ve tried. I truly think it has the potential to replace surgery in the next decade or so for many.

I’ve consistently lost 1-2 lbs a week since starting. Below my personal goal (but not underweight 😄).

Like vsgchick, the 10 dose has been the sweet spot for me. Appetite control without appetite suppression. Easy to forget or skip a meal without minding but able to enjoy a meal as well.

Total loss here in week 21 is 30lbs, which I consider great since I was already pretty far in my journey to a goal weight and relatively inactive.

[vsgchick 118]

[mention=216905]vsgchick[/mention] I’m glad to hear you reached your goal. I just had gastric bypass revision endoscopic so they reduced my opening from 25mm to 8 and I got two sutures yesterday. I will wait until a month and get on Wegovy as well to increase my weight loss.

Hope your recovery goes well! A friend is doing fantastic on Wegovy. I am so glad we have another tool available.