Can you take Mounjaro with fibromyalgia?

Jump to: What is fibromyalgia? | How Mounjaro works | Fibromyalgia and weight | Fibromyalgia vs chronic fatigue syndrome | Foods to focus on | Movement and fibromyalgia | Looking after your mental health | Mounjaro clinical data | Frequently asked questions | Take home message

You can take Mounjaro if you have fibromyalgia. There’s no known interaction between tirzepatide (the drug in Mounjaro) and fibromyalgia, and research suggests that weight loss may help reduce pain, fatigue, and other fibromyalgia symptoms.¹

Fibromyalgia affects around 2-4% of the population and is characterised by widespread pain, fatigue, and cognitive difficulties often called ‘fibro fog’.²

Around 36% of people with fibromyalgia also live with obesity, and a further 30% are overweight.¹

Having a higher body fat percentage can increase inflammation, place more strain on joints and muscles, and worsen symptoms such as pain sensitivity and poor sleep.

There are no clinical trials looking at Mounjaro specifically in people with fibromyalgia.

But the evidence on weight loss and fibromyalgia symptoms is encouraging, and Mounjaro is one of the most effective weight-loss medications currently available.

This article covers what the research says about fibromyalgia and weight, how Mounjaro works, and practical guidance on food, movement, and mental health that’s relevant if you’re living with both conditions.

What is fibromyalgia?

Fibromyalgia is a long-term condition that causes widespread pain throughout the body, along with extreme tiredness, sleep problems, and difficulties with memory and concentration.²

The exact cause isn’t fully understood, particularly because women’s health conditions have been understudied for decades.

Current thinking is that fibromyalgia involves changes in how the central nervous system processes pain signals, making the brain and spinal cord more sensitive to pain than they should be.²

Common symptoms include:

• Widespread pain and tenderness across the body
• Severe fatigue that doesn’t improve with rest
• Cognitive difficulties (‘fibro fog’), including poor concentration and memory
• Sleep disturbances
• Headaches
• Sensitivity to temperature, light, or sound
• Morning stiffness

Symptoms tend to fluctuate. Many people with fibromyalgia describe good days and bad days, and flare-ups can be triggered by stress, overexertion, weather changes, or poor sleep.

There’s currently no cure for fibromyalgia. Treatment focuses on managing symptoms through a combination of medication, physical activity, and psychological support.²

How Mounjaro works

Mounjaro is a once-a-week injection that contains the drug tirzepatide. It works by mimicking two gut hormones, GLP-1 and GIP, that communicate with the brain’s appetite centre (the hypothalamus) to reduce hunger and food-seeking behaviour.

It also slows down digestion, so food stays in the stomach longer. This means you feel full sooner and stay satisfied for longer after eating.

In clinical trials, people taking Mounjaro lost up to 26% of their body weight after two years.³

For someone with fibromyalgia, this level of weight loss could meaningfully reduce the physical load on joints and muscles, lower systemic inflammation, and improve sleep quality, all of which influence fibromyalgia symptoms.

Fibromyalgia and weight

The relationship between fibromyalgia and weight is bidirectional. Carrying extra weight can worsen fibromyalgia symptoms, and fibromyalgia itself can make weight management harder.

A 2021 meta-analysis found that 36% of people with fibromyalgia are living with obesity, and those who are tend to experience more severe pain, greater fatigue, and poorer physical function than those at a healthy weight.¹

There are a few reasons why extra weight makes fibromyalgia worse:

• Fat tissue produces inflammatory chemicals (cytokines) that can amplify pain signalling. More of these chemicals are released when fat cells expand and get larger with weight gain.
• Additional weight puts more mechanical stress on joints, muscles, and soft tissues
• Obesity is linked to poorer sleep quality, which is already disrupted in fibromyalgia
• Reduced mobility makes it harder to stay active, which can worsen pain and stiffness

On the other side, fibromyalgia makes weight management difficult because chronic pain and fatigue limit physical activity, certain medications used for fibromyalgia can cause weight gain, and disrupted sleep affects hormones that regulate appetite.

Research shows that losing weight can improve fibromyalgia symptoms. Studies have found reductions in pain, improvements in sleep quality, and better scores on questionnaires that measure how fibromyalgia affects daily life.¹

By reducing appetite and supporting significant weight loss, Mounjaro may help to break the cycle where fibromyalgia symptoms and weight reinforce each other.

Fibromyalgia vs chronic fatigue syndrome

Fibromyalgia and chronic fatigue syndrome (CFS, also called ME/CFS) are separate conditions, though they share some overlapping symptoms and are sometimes confused.

The main difference is the primary symptom. In fibromyalgia, widespread musculoskeletal pain is the defining feature. In CFS, the core symptom is severe, persistent fatigue that doesn’t improve with rest.

Both conditions can involve fatigue, cognitive difficulties, and sleep problems. But in fibromyalgia, pain tends to dominate, while in CFS, the fatigue is typically more debilitating than any pain.

It’s possible to have both conditions at the same time. If you’re unsure which condition you have, or whether you might have both, your GP or rheumatologist can help with a diagnosis.

Foods to focus on with fibromyalgia

There’s no single ‘fibromyalgia diet’, but a growing body of evidence suggests that what you eat can influence pain, fatigue, and inflammation.

A 2024 clinical trial found that people with fibromyalgia who followed a personalised Mediterranean-style diet based on whole foods saw improvements in pain, fatigue, anxiety, and overall quality of life after eight weeks.⁴

This was compared to those who didn’t change their diet.

The common thread in the research is reducing inflammation and supporting overall health through whole, minimally processed foods. Here’s how that looks in practice.

Protein at every meal

Protein helps preserve muscle mass, which is important as fibromyalgia and reduced activity can lead to muscle loss over time.

Good sources include chicken, turkey, fish, eggs, Greek yoghurt, beans and lentils, and tofu.

Anti-inflammatory fats

Omega-3 fatty acids have anti-inflammatory properties that may help with pain and stiffness.

Extra virgin olive oil also contains compounds with anti-inflammatory properties, including oleocanthal, which works in a similar way to ibuprofen.

Research on the Mediterranean diet and fibromyalgia specifically highlights the role of healthy fats in symptom management.⁴

Include oily fish (salmon, mackerel, sardines) at least twice a week, along with extra virgin olive oil, nuts, seeds, and avocado.

Vegetables and fruit

Aim to fill half your plate with vegetables at main meals. They provide fibre, vitamins, and antioxidants that support overall health and may help to manage inflammation.

Berries, leafy greens, broccoli, peppers, and tomatoes are all good choices. Variety in our diet is more important than focusing too much on any single ‘superfood’.

Complex carbohydrates

High-fibre carbohydrates are digested more slowly and provide a more gradual energy release which helps to maintain steady energy levels. They also support gut health, which emerging research links to pain processing.

Choose from wholegrain or sourdough bread, rolled oats, brown rice, potato, sweet potato, quinoa, beans and lentils, wholemeal pasta or noodles, and wholemeal couscous.

Make sure you eat enough

Mounjaro significantly reduces appetite, which is necessary for weight loss but can sometimes lead to eating too little.

This increases the risk of micronutrient deficiencies, particularly if meals aren’t nutrient-dense.

We recommend eating three balanced meals a day based on nutrient-dense whole foods, the majority of the time, even if you’re not hungry.

On days you’re struggling to eat, aim for foods that are easier to manage and nutrient-dense: Greek yoghurt with berries, a handful of nuts, scrambled eggs on sourdough, or a smoothie with yoghurt, milk, spinach, banana, and protein powder.

Batch cooking on better days can also help. Having meals ready to reheat means you’re less likely to skip meals or rely on ultra-processed convenience foods when you’re feeling tired or lethargic.

Foods that may worsen symptoms

Some people with fibromyalgia report that certain foods seem to trigger flare-ups. Common culprits include alcohol, ultra-processed foods, and foods high in added sugar.

The evidence here is less robust than for anti-inflammatory eating patterns, so rather than following strict elimination diets, it’s worth paying attention to whether particular foods seem to affect your symptoms and discussing any patterns with your healthcare team.

Movement and fibromyalgia

Physical activity is one of the most consistently recommended treatments for fibromyalgia, with research showing it can reduce pain, improve sleep, and lift mood.⁵

But getting started, and staying consistent, can feel overwhelming when you’re dealing with pain and fatigue every day.

The most important thing to know is that any movement is better than none. You don’t need to hit any particular target.

A short walk, some gentle stretching, or a few minutes of movement can all help to build a baseline level of fitness to work from.

Starting small and building habits

Research on habit formation shows that it takes an average of 66 days for a new behaviour to become automatic.⁶ It helps to choose something that feels easy and attach it to something you already do.

For example, a five-minute walk after your morning coffee, or some gentle stretching before bed. Once that feels natural, you can gradually do a little more as it feels manageable.

Pacing is essential

People with fibromyalgia often experience ‘boom and bust’ cycles: doing too much on a good day, then crashing for days afterwards. Pacing means deliberately doing less than you think you can on good days to avoid triggering a flare-up.

This might feel frustrating, but it’s one of the most effective strategies for building consistent activity levels over time. Your physiotherapist or occupational therapist can help you develop a pacing plan.

Types of movement that tend to work well

Systematic reviews of exercise for fibromyalgia consistently show benefits from both aerobic activity and resistance training.⁵ But the type that works best is the one you’ll actually do regularly.

Options that many people with fibromyalgia find manageable include:

• Walking, starting with whatever distance is comfortable
• Swimming or water-based exercise, where the water supports your body weight and reduces joint strain
• Gentle yoga or tai chi, which combine movement with breathing and relaxation
• Light resistance exercises using bodyweight or resistance bands
• Cycling on a stationary bike at a gentle pace

Aquatic exercise has particularly good evidence for fibromyalgia, with research showing improvements in pain, sleep quality, and physical function.⁵

Looking after your mental health

Living with fibromyalgia takes a significant psychological toll. A 2025 meta-analysis found that around 51% of people with fibromyalgia experience depression and 47% experience anxiety.⁷

These aren’t surprising figures when you consider what fibromyalgia involves: chronic pain that others can’t see, unpredictable flare-ups that disrupt plans, fatigue that makes everyday tasks exhausting, and often a long road to diagnosis.

‘Fibro fog’ and cognitive difficulties

Cognitive dysfunction is one of the most frustrating aspects of fibromyalgia for many people.

The majority of people with the condition report significant problems with concentration, memory, and mental processing speed.

‘Fibro fog’ tends to worsen during pain flare-ups, periods of poor sleep, and times of high stress.

It isn’t a sign of cognitive decline in the way that dementia is. It’s linked to the way chronic pain and poor sleep affect brain function.

Managing sleep, reducing stress where possible, and pacing your cognitive demands (not just physical ones) can all help.

The weight stigma dimension

For people living with both fibromyalgia and a higher body weight, there’s an additional layer: weight stigma.

Some people describe feeling dismissed by healthcare professionals who attribute their pain to their weight, or feeling judged for not being more active when exercise is genuinely difficult.

If you’ve had experiences like this, it’s worth knowing that fibromyalgia is a real neurological condition that exists regardless of body weight.

Seeking care from healthcare professionals who understand this can make a significant difference.

When to speak to your GP

If you notice persistent low mood, loss of interest in things you used to enjoy, increased anxiety, or thoughts of self-harm, speak to your GP. These are treatable conditions, and getting support early makes a difference.

Cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT) both have evidence for helping people manage chronic pain conditions like fibromyalgia.² Your GP can refer you.

Mounjaro clinical data

Frequently asked questions

Can Mounjaro make fibromyalgia symptoms worse?

There’s no evidence that Mounjaro directly worsens fibromyalgia. The most common side effects of Mounjaro are gastrointestinal, including nausea and reduced appetite, which typically ease as your body adjusts to each dose.

If you notice any changes in your fibromyalgia symptoms after starting Mounjaro, discuss them with your prescriber.

Will losing weight on Mounjaro reduce my fibromyalgia pain?

Research suggests it may help. Studies show that weight loss in people with fibromyalgia is associated with reduced pain, better sleep, and improved physical function.¹

However, fibromyalgia is a complex condition, and weight is only one factor. Not everyone experiences the same level of symptom improvement.

Can I take Mounjaro alongside my fibromyalgia medications?

Mounjaro doesn’t have known interactions with common fibromyalgia medications such as pregabalin, duloxetine, or amitriptyline.

However, because Mounjaro slows digestion, it can affect how quickly other oral medications are absorbed. Always tell your prescriber about all the medications you’re taking so they can advise on timing.

I have very low energy from fibromyalgia. Will Mounjaro make my fatigue worse?

Mounjaro doesn’t typically cause fatigue, though eating significantly less than usual can leave some people feeling low in energy.

Focusing on nutrient-dense foods, staying hydrated, and eating regular meals can help. If your fatigue worsens noticeably, speak to your healthcare team.

How do I exercise with fibromyalgia if I’m also dealing with Mounjaro side effects?

Start very small and listen to your body. On days when you’re dealing with nausea from Mounjaro or a fibromyalgia flare-up, even a short walk or some gentle stretching counts.

It’s more important to maintain consistency than to push too hard on days you feel good.

Is there a specific diet I should follow if I have fibromyalgia and I’m taking Mounjaro?

There’s no single prescribed diet, but a diet based on nutrient-dense whole foods, rich in vegetables, oily fish, olive oil, nuts, and fibre-rich carbohydrates, has the best evidence for helping fibromyalgia symptoms.⁴ This aligns well with eating for overall health while taking Mounjaro.

Can fibro fog get worse on Mounjaro?

There’s no evidence that Mounjaro affects cognitive function. Fibro fog tends to fluctuate with pain levels, sleep quality, and stress.

If you’re eating well, staying hydrated, and managing your energy, Mounjaro shouldn’t worsen cognitive symptoms.

How long before I might notice improvements in my fibromyalgia symptoms from weight loss?

This varies from person to person. Some people notice improvements in mobility and joint comfort relatively early in their weight-loss progress, while other symptoms like widespread pain may take longer to respond.

Research suggests that even modest weight loss, around 5-10% of body weight, can lead to noticeable symptom improvements.¹

Should I tell my rheumatologist if I’m starting Mounjaro?

Yes. It’s good practice to keep all members of your healthcare team informed about any new medications. Your rheumatologist may want to monitor whether weight loss affects your fibromyalgia symptoms and adjust your management plan accordingly.

Take home message

You can take Mounjaro if you have fibromyalgia. There are no known interactions, and research suggests that the weight loss Mounjaro supports could help reduce pain, improve sleep, and make daily activities more manageable.

No clinical trials have studied Mounjaro specifically in people with fibromyalgia, so the potential benefits are based on broader evidence linking weight loss to symptom improvement in this condition.

Alongside medication, focusing on anti-inflammatory foods, building gentle movement habits, and looking after your mental health can all support symptom management.

Second Nature’s Mounjaro programme combines medication with support from registered dietitians and a structured habit-change programme.

It’s built around the balanced plate model (half vegetables, a quarter protein, a quarter complex carbohydrates, plus a serving of fat) and focuses on sustainable changes rather than restrictive dieting.

In a published study, active subscribers on Second Nature’s semaglutide-supported programme lost an average of 19.1% of their body weight at 12 months, with 77.7% achieving at least 10% weight loss.⁸

References

1. D’Onghia, M. et al. (2021). Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis. Seminars in Arthritis and Rheumatism, 51(2), 409-424.
2. NHS. (2024). Fibromyalgia.
3. Aronne, L.J. et al. (2024). Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomised clinical trial. JAMA, 331(1), 38-48.
4. Casini, I. et al. (2024). A personalised Mediterranean diet improves pain and quality of life in patients with fibromyalgia. Pain and Therapy, 13(4), 1017-1030.
5. Sosa-Reina, M.D. et al. (2017). Effectiveness of therapeutic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised clinical trials. BioMed Research International, 2017, 2356346.
6. Lally, P. et al. (2010). How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology, 40(6), 998-1009.
7. Zhang, L. et al. (2025). The global prevalence of depression and anxiety among fibromyalgia patients: a systematic review and meta-analysis. Journal of Affective Disorders, 380, 479-489.
8. Richards, R. et al. (2025). Weight loss outcomes in a digitally delivered, medicated weight management programme in the United Kingdom. JMIR Formative Research, 9(1), e72577.