My doctor started me on Mounjaro (tirzepatide) in September 2023. I am writing this at the 6-month mark because I want to give people a realistic long-term picture, not just the honeymoon phase.
Month 1 (2.5mg): Mild appetite reduction. Nausea on days 1-2 after injection, manageable with ginger tea. Lost 4 lbs. Honestly was not impressed yet.
Month 2 (5mg): This is when it kicked in. The appetite suppression became dramatic. I went from eating 2500+ calories without trying to struggling to eat 1200. I had to consciously remind myself to eat protein. Lost 11 lbs this month. Side effects: constipation (managed with fiber supplements), sulfur burps (the worst part — they smell terrible and come without warning), and fatigue on injection day.
Month 3-4 (7.5mg, then 10mg): The weight was falling off. I was losing 2-3 lbs per week consistently. People started commenting on my appearance. Clothes I had not worn in years started fitting. The nausea was mostly gone. But I noticed two concerning things: my hair started thinning noticeably (my dermatologist said this is telogen effluvium from rapid weight loss, not the drug directly), and I was losing muscle along with fat despite eating protein.
Month 5-6 (12.5mg): I hired a personal trainer and got serious about resistance training 3x per week and eating 130+ grams of protein daily. The weight loss slowed to about 1-1.5 lbs per week, but my body composition improved significantly. I had some loose skin developing on my arms and abdomen.
6-month stats: Starting weight 267 lbs, current weight 212 lbs. Total loss: 55 lbs (20.6% of body weight). Waist circumference down 7 inches. A1C dropped from 5.9 (prediabetic) to 5.1. Blood pressure normalized without medication.
The things I wish I had known from the start: prioritize protein from day one, start lifting weights immediately (not after you have already lost muscle), the sulfur burps do eventually go away, and keep electrolytes on hand because you will not be eating enough to get them from food alone. This medication changed my life but it requires active management — it is not a passive experience.