Why am I still hungry on Mounjaro?

Jump to: Mounjaro isn’t a magic pill | 1) Be patient on Mounjaro to see results | 2) Eat a diet based on whole foods on Mounjaro | 3) Find other ways to soothe challenging emotions | When to seek medical help | Frequently asked questions | Take home message

You might still be hungry on Mounjaro because it takes time for the medication to reach its full effect, your current dose may be too low, or lifestyle factors like diet and stress are influencing your appetite.

While Mounjaro (tirzepatide) mimics two hormones, GLP-1 and GIP, to lower hunger, everyone responds differently to the drug.

Some people notice lower appetite within days, while others need several weeks or higher doses to experience the full effects.

Understanding why you’re still experiencing hunger can help you work with your healthcare provider to optimise your treatment and make lifestyle adjustments that support the medication’s effectiveness.

Let’s explore the 3 main ways you can lower your hunger while on Mounjaro.

1) Be patient on Mounjaro to see results

Our first recommendation to optimise your results on Mounjaro is to be patient.

Tirzepatide, the drug in Mounjaro, is a long-acting medication that’s started at a lower dose to reduce the number and severity of side effects as it’s built up to a higher maintenance dose.

Tirzepatide can take 4-8 weeks to reach a level in the body we call a steady state¹. A steady state is when the drug’s levels in the body remain consistent rather than spiking and falling.

Based on data from randomised controlled trials⁴, you can expect to lose approximately 2% of your weight in a month on Mounjaro. After two months, you could lose over 4%. However, individual responses vary significantly.

Interestingly, this initial weight loss is similar to other weight loss treatments or diet interventions. The real impact of tirzepatide is seen beyond 3 months.

So, it can take up to 3 months before Mounjaro supports greater weight loss than is typically seen with traditional interventions like diet and exercise alone.

During these earlier stages, your hunger levels may still be higher than you’d like, which may rise and fall between meals.

However, if you’re able to persevere with Mounjaro and make some positive changes to your diet and lifestyle, you’ll be able to achieve your weight loss goals in the long term.

After 6 months, you’ll be on the maximum dose of Mounjaro at 15 mg, which is likely when you’ll experience the greatest reductions in hunger and appetite.

Key points

• Mounjaro is a long-acting medication, and it can take up to 8 weeks before it reaches a steady state
• Individual responses vary significantly; some people notice effects sooner, others later
• Perseverance and positive lifestyle changes will help you reach your weight loss goals

2) Eat a diet based on whole foods while on Mounjaro

Ultra-processed foods are digested much quicker than whole foods, bypassing the signals our gut releases to the brain to lower hunger and appetite.

Research shows that when we consume ultra-processed foods, the hormones that signal to the brain to lower hunger and make us feel full are much lower than when we eat whole foods².

The effect (or lack thereof) of ultra-processed foods on our appetite is why we recommend consuming a diet rich in whole foods while on Mounjaro.

Here’s a list of food we recommend eating while on Mounjaro:

• High-quality protein sources: Fish, meat, eggs, tofu, tempeh, yoghurt, cheese, and seafood. We recommend a portion the size of an open hand in each meal.
• Fat from whole foods: meat, fish, eggs, dairy products, nuts, seeds, avocados, and extra-virgin olive oil.
• High-fibre complex carbohydrates: Whole grains like quinoa and brown rice, sweet potato, white potatoes, pumpkin, legumes like lentils, chickpeas, beans, and butternut squash.
• Fruits and vegetables: Take your pick, variety is key. Aim for at least 5 portions daily.
• Make water your drink of choice: Hunger signals can indicate insufficient water intake. Aim for 2-3 litres daily.

Here’s a list of foods we recommend limiting while you’re on Mounjaro:

• Ultra-processed foods: Most boxed cereals, supermarket bread and pastries, fast food, microwave meals, oven pizza, crisps, biscuits, fizzy drinks, and supermarket sandwiches.
• Added sugar: Particularly from soft drinks
• Refined carbohydrates: White pasta, white rice, and instant oats
• Refined vegetable oils: Sunflower and vegetable oil

We also recommend eating three meals a day and including protein-rich snacks if necessary.

Having a consistent meal pattern can help support the balance of our body’s hormone levels and keep you feeling fuller for longer.

Key points

• Choosing a diet based on whole foods is best while on Mounjaro
• Eating too many ultra-processed foods can adversely affect our hunger levels
• Eat three meals a day and enjoy protein-rich snacks if needed

3) Find other ways to soothe challenging emotions

Our psychological health can influence our eating choices, and we may experience hunger or cravings for food beyond our physical requirements when stressed, lonely, or sad³. This is commonly referred to as emotional eating.

Food provides us with great comfort, and research shows it lowers the intensity of challenging emotions and makes us feel better.

However, if we only use food to soothe ourselves during challenging times, it can adversely affect our health and hunger levels, as our brain will start associating these emotions with eating.

So, we must find alternative ways to soothe ourselves when feeling challenging emotions like stress, loneliness, or sadness.

Here are two things you can do to move away from emotional eating:

1. Find acceptance: We’re always going to experience challenging emotions, and if we can accept them as part of our lives and daily mood changes, we’re more likely to move beyond them.
2. Find alternative ways to soothe emotions: If we can find alternative behaviours or habits, known as ‘substitutions’, to soothe challenging emotions, we can move away from emotional eating. This might be taking a 5-minute walk, making herbal tea, or calling a friend.

Key points

• Our emotions can impact our hunger levels and make us crave food beyond our physical needs
• By finding acceptance and alternative ways to soothe emotions, we can move away from emotional eating

When to seek medical help

While some hunger is normal on Mounjaro, certain situations require medical attention:

• Persistent extreme hunger: No improvement in appetite after 12 weeks on medication
• Weight gain: Gaining weight despite following the medication schedule and dietary guidelines
• Hypoglycaemia symptoms: Especially important if you have diabetes or take insulin/sulfonylureas. Symptoms include dizziness, sweating, confusion, and extreme hunger
• Severe side effects: Nausea or vomiting that prevents eating, severe abdominal pain, or other side effects affecting nutrition
• Binge eating episodes: Uncontrollable eating despite the medication

Your healthcare provider may need to adjust your dose, check for other medical conditions, or provide additional support strategies.

Frequently asked questions

How long does it take for Mounjaro to reduce appetite?

Most people notice some appetite changes by weeks 4-8, but individual responses vary significantly. Some may feel effects sooner, while others may need to reach higher doses.

Is it normal to still feel some hunger on Mounjaro?

Yes, mild hunger before meals is normal and healthy. Mounjaro reduces excessive hunger and food noise but doesn’t eliminate hunger completely.

At what dose do most people experience appetite suppression?

This varies widely. Some people notice effects at 5mg, while others need 10-15 mg. Your healthcare provider will adjust your dose based on your response and side effects.

Can certain foods interfere with Mounjaro’s effectiveness?

There’s no direct food-drug interaction, but ultra-processed foods may increase hunger and cravings, potentially offsetting the medication’s benefits.

Why do I feel hungry at night on Mounjaro?

Consider your meal timing, protein intake at dinner, and sleep quality. Ensure you’re eating enough during the day and managing stress levels.

Should I increase my dose if still hungry?

Only increase your dose under medical supervision, following the standard titration schedule. Rapid dose increases can cause severe side effects.

What percentage of people don’t respond to Mounjaro?

Limited data exists, but clinical trials suggest approximately 10-15% of people may be “non-responders” who don’t achieve significant weight loss⁵.

How can I tell if Mounjaro is working beyond hunger?

Look for gradual weight loss (0.5-1kg per week), improved energy levels, better blood sugar control, and reduced food noise.

Take home message

Despite being a very effective medication to help lower hunger and support weight loss, we may still experience hunger on Mounjaro, particularly in the early stages of taking the medication.

However, if we can be patient, follow the treatment plan, eat a healthy diet based on whole foods, and address emotional eating patterns, we’ll give ourselves the best opportunity to maximise our results on Mounjaro.

Remember that individual responses vary significantly, and what works for one person may differ for another. Work closely with your healthcare provider to find the approach that works best for you.

References

1. Frias JP, et al. (2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine. 385:503-515.
2. Hall KD, et al. (2019). Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain. Cell Metabolism. 30(1):67-77.
3. van Strien T. (2018). Causes of Emotional Eating and Matched Treatment of Obesity. Current Diabetes Reports. 18(6):35.
4. Jastreboff AM, et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 387:205-216.
5. Garvey WT, et al. (2023). Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2). The Lancet. 613-626.
6. National Institute for Health and Care Excellence. (2023). Tirzepatide for treating type 2 diabetes. Technology appraisal guidance.
7. Medicines and Healthcare products Regulatory Agency. (2023). GLP-1 receptor agonists: reports of diabetic ketoacidosis when concomitant insulin was rapidly reduced or discontinued.