Mounjaro, Wegovy: Persephone shares her unvarnished – and occasionally sulphurous -experience plus the tips she wishes she’d known from the start.

I have always had a healthy appetite. For many years, I could happily burn off what I ate simply by going about my everyday life.

Then menopause arrived and apparently took my internal “off switch” away with it — along with several other useful settings I had not realised were optional.

I could eat and eat and eat, yet still not feel satiated. My appetite stopped behaving like a normal biological function and started behaving like an unsupervised Labrador.

If I looked at something tempting, my taste buds would say, “That looks delicious. I want to try it.”
Then, like Oliver Twist, they would add: “Please, can I have some more?” and then more.. and more! If there was more than one delicious thing on the table, I felt compelled to have large quantities of everything that took my fancy – apparently choosing just one was no longer an option.

I had also been diagnosed as ‘pre-diabetic’ and was becoming increasingly thirsty. Unfortunately, instead of reaching for water, I often quenched that thirst with wine — which was hardly likely to improve matters.

I could quite happily demolish an entire large Pizza Hut, Domino’s or Papa Johns pizza by myself in one sitting — with the possible exception of the little plastic table in the middle.

Eventually, I gained around six stone, perhaps even more. By that point, I was too afraid of how depressing it might be to step on the scales and find out. This wasn’t helped by the all-too-frequent glasses of wine I was tempted to drink.

Trying to get help

Eventually, I bit the bullet and asked my GP about Mounjaro.

Demand was extremely high and, despite meeting some of the eligibility criteria, I did not qualify for it through the NHS. In slightly flippant terms, I apparently wasn’t “diabetic enough” — an achievement I was presumably meant to feel pleased about.

Instead, I was offered Orlistat.

Orlistat works by reducing the amount of fat your body absorbs from food. Unfortunately, evidence that it was working tended to reveal itself rather dramatically in the bathroom.

It can alter the colour, consistency and smell of your bowel movements. It did not agree with me. More accurately, my digestive system filed a formal complaint almost immediately.

Although my salary is fairly basic, I eventually decided to pay privately for GLP-1 treatment through an online provider.

Starting with Juniper

I began my treatment through Juniper.

My first 2.5 mg Mounjaro injection worked amazingly well. My appetite reduced almost immediately and, for a while, I even stopped craving wine.

I could look at a glass and genuinely think, “I’m really not bothered about having that.”

Frankly, this was so unlike me that I briefly wondered whether the injection had replaced me with a more sensible woman.

It was an extraordinary feeling. Food was still enjoyable, but it was no longer shouting at me from across the room.

What I wish I had known

Alcohol & caffeine made things considerably worse for me

Alcohol was one of my biggest personal triggers for side effects. Caffeine also seemed to aggravate things for me regularly.

Had I understood this at the beginning, I would have been much more cautious, particularly when increasing my dose.

This will not necessarily be everyone’s experience, but I now substantially reduce or avoid alcohol whenever I move to a higher dose.

Constipation is usually a given

So many people moan about this on Facebook communities, but I’ve found the most natural and comfortable product to use is something like Fybogel. One sachet not giving you relief? Then just take another to get things moving along the line again!

The first increase felt like a big jump

Mounjaro treatment usually starts at 2.5 mg before increasing to 5 mg. Numerically, this is the only stage in the normal schedule when the dose doubles. Later increases are generally made in smaller 2.5 mg steps.

For me, moving from 2.5 mg to 5 mg was when the side effects really began.
Apparently, my digestive system had not yet been sufficiently challenged.

Eating very little is not the same as eating well

Having a reduced appetite may sound like the entire point of taking a weight-management medicine, but barely eating is not the same as building healthy habits.

After reacting badly to the 5 mg dose, I also had a prolonged bout of flu. I was eating very little and, because I was coughing so badly, I stopped taking my usual vitamins.

I subsequently experienced noticeable hair loss exacerbated by a decrease in iron.

There may have been several contributing factors, so I cannot say that Mounjaro alone caused it. However, the experience reminded me that rapid weight loss, illness and inadequate nutrition can all take their toll.

Anyone experiencing unusual tiredness, weakness or hair loss should speak to a healthcare professional. It may also be worth asking whether iron, ferritin or other nutritional levels need checking. Women can be particularly vulnerable to low iron levels after years of menstrual blood loss, especially if their periods have been heavy or prolonged.

Knowing what I know now, if I had my time round again, I’d probably ask for a full set of bloods before starting on any weight loss treatment.

The Pros of Juniper

The educational support from Juniper was excellent.

There was a comprehensive video explaining how to use the injection pen correctly. The app also encouraged you to understand healthier habits, improve your diet and gradually increase your activity.

It included:

• meal ideas and menus;
• educational activities;
• progress tracking;
• access to health coaches;
• a private Facebook community;
• reminders and automatic prescription renewals.

The welcome package cost extra but included digital scales and a tape measure. Its digital tracking chart on the app was excellent, and I found watching my progress genuinely motivating.

As part of the assessment process, I had to supply front-facing and side-on photographs of my upper body. My face did not need to be visible.

Although not a pretty sight, personally, I had no problem with this: No face, no shame.
And the sight of the photos spurred me on and motivated me to lose weight even more.

The Facebook group could also be useful. However, like most Facebook groups, it contained helpful advice, genuine encouragement and several people determined not to read anything before asking a question that had already been answered seventeen times.

There was also a fair amount of moaning and groaning, although that is possibly written into Facebook’s terms and conditions.

The Cons of Juniper

My second pen automatically increased from 2.5 mg to 5 mg.

The 2.5 mg dose had still been working perfectly well for me. Looking back, I would have preferred to remain on it for longer rather than increasing simply because I had completed four weeks.

I had not realised that my second pen would automatically arrive at a higher dose, so I was completely unprepared when the 5 mg pen turned up.

The side effects were deeply unpleasant:

• sulphurous, eggy burps — easily the worst;
• nausea – just as bad.
• extremely painful and persistent wind.

The wind reminded me of having Norovirus several years earlier. It seemed endless, even when I was barely eating. At one point, I began to suspect that my body was operating as a small renewable-energy project and that I was personally contributing to greenhouse gases and climate change.

The nausea and abdominal discomfort became so bad that I had to take a day off work — under the guise of an upset stomach. Entirely true, of course.

A higher dose is not a medal.
There is no podium ceremony for reaching 15 mg first.

I stopped the medication for a couple of weeks and asked to return to 2.5 mg. By then, however, that dose no longer seemed quite as effective, so, after seeking advice, I went back up to 5 mg.

From that point onwards, I made sure that I discussed the dose I wanted before ordering. I stayed on 5 mg for quite some time and only increased when I felt its effects were genuinely diminishing.

A higher dose is not a medal. There is no podium ceremony for reaching 15 mg first.

Some members of the Juniper community complained about slow responses from the health coaches or felt that the information they received was too generic.

The app itself was good, but finding information you had previously viewed could be surprisingly difficult.

The recipes were not organised into especially useful categories such as breakfast, lunch, dinner, vegetarian or chicken. Finding anything felt rather like rummaging through somebody else’s kitchen drawer while they repeatedly assured you that the tin opener was “definitely in there somewhere”.

Better organisation would have made the content much easier — and therefore much more likely — to be used.

Moving to MedExpress

As the price of Mounjaro increased, continuing with Juniper became difficult to justify.
I then bumped into a friend who worked in the pharmaceutical industry. She was obtaining her Mounjaro through MedExpress, which was significantly cheaper at the time.

We were both able to use one of the introductory discount schemes commonly offered by private providers, so I moved to MedExpress for a while.

By this stage, obtaining weight-loss medication was beginning to feel less like healthcare and more like changing broadband suppliers.

The other downside of leaving Juniper was that its app no longer connected properly to my phone, and I could not link the Juniper scales to another application.
As a result, I lost the rather lovely progress chart, which I had found surprisingly motivating.

The Pros of MedExpress

MedExpress gave me more control over when I ordered and allowed me to discuss whether I wanted to remain on the same dose or request a change.

The service also offered consultations about switching to other medicines where clinically appropriate.

As with Juniper, I had to supply photographic evidence during the application process, wearing reasonably close-fitting clothing so that my body shape could be assessed.
It was not exactly a Vogue cover shoot, but at least my face could remain out of it.

The Cons of MedExpress

It was a no-frills service.

The information and ongoing support were considerably more basic than Juniper’s. You were largely expected to manage your own progress and seek advice when necessary.

For anyone who likes plenty of coaching, menus and encouragement, that may feel rather sparse.
For anyone who prefers to be left alone and not receive a motivational notification every time they eat a carrot, it may be perfectly adequate.

Moving again: ZAVA

Later, while having a blood test, I mentioned Mounjaro to the nurse. She told me that she obtained hers through ZAVA, which was cheaper than MedExpress at that point.

ZAVA worked in a broadly similar way. I could choose when to request another order and discuss which dose was appropriate, subject to the prescriber’s approval.

It felt less like a medical assessment and more like the least glamorous hostage photograph ever taken.

Initially, delivery was rather slow — possibly because of the import and supply issues affecting the medication at the time — although it has since improved significantly and is now very speedy.

When I first applied, I had to provide a photograph of myself standing on the scales in close-fitting clothing. I also had to hold up a handwritten piece of paper displaying the date to prove that the photograph was current.

It felt less like a medical assessment and more like the least glamorous hostage photograph ever taken.

I eventually increased to 7.5 mg without experiencing any significant new side effects.

However, with the continuing rise in the cost of living, I could no longer justify spending so much on Mounjaro each month. I therefore decided, following a consultation, to move to Wegovy.

Changing from Mounjaro to Wegovy

My personal perception is that Mounjaro worked better for me than Wegovy. However, the difference in cost made switching necessary.

That does not mean Mounjaro will be better for everybody. The medicines contain different active ingredients, work in somewhat different ways and can affect people differently.

One small advantage of the Wegovy injection pen was that I found it easier to use. Once I had selected the prescribed dose, the mechanism returned smoothly as the medicine was delivered.

Unlike with the Mounjaro pen, I did not find myself staring suspiciously at liquid left behind and wondering whether I had somehow been cheated out of half a teaspoon.

A few minutes later, my cousin commented that she could smell drains.

As I increased through the Wegovy doses prescribed to me, I experienced one particularly terrible episode of sulphurous burps.
Fortunately, it was a one-off.

It happened after a fairly heavy evening drinking some particularly “substantial” wine while on holiday.

The next day, we stopped for an ice cream in a small courtyard café. I silently produced a distinctly sulphurous burp.
A few minutes later, my cousin commented that she could smell drains.

Fortunately for me, there was an ancient stone trough filled with still water nearby, so the trough received the blame.
I said nothing.
The trough and I have an understanding.

Trying Wegovy tablets

More recently, ZAVA asked whether I was interested in changing to Wegovy tablets.

I said yes and, when the time came to reorder, the tablet option appeared during the prescribing process.
My prescriber selected the tablet strength as the appropriate equivalent to my existing treatment.

At the time of writing, I have been taking them for about a week and they appear to be having the desired effect.

It is important to understand that the milligram strengths of Wegovy tablets cannot simply be compared directly with the weekly injection doses or with Mounjaro doses. Anyone changing formulation should follow the specific schedule given by their prescriber rather than attempting to calculate their own equivalent.

At my current dose, my appetite is reduced, but I can still enjoy food.

The crucial difference is that I can now say no, stop when I have had enough and feel genuinely satiated without overindulging.

That may not sound revolutionary to someone whose appetite has always behaved itself.

To me, it feels like discovering a previously mythical bodily function.

I can now say ‘no’ – To me, it feels like discovering a previously mythical bodily function.

How to take the tablets

I follow the manufacturer instructions and take one Wegovy tablet when I wake up, on an empty stomach, with a small amount (a mouthful) of water.

Then I wait at least 30 minutes before eating, drinking anything else or taking other oral medication, in accordance with the instructions I was given.

It is easy enough to fit into my routine, although delaying my first cuppa may be the greatest test of commitment in the entire process.

For me, the most significant advantage is that the tablets cost considerably less than the injection pens.

Was it worth it?

So far, I have lost three & a half stone [22.5 Kg].
I haven’t calculated how much I have spent.

I feel much more comfortable and confident in my body, and I do not regret investing in my weight loss.

GLP-1 treatment has not done all the work for me, nor has the experience been entirely straightforward.

There have been side effects, expense, trial and error, awkward photographs and an unreasonable amount of time spent discussing burps, bowel movements and injection pens with complete strangers.

But the treatment gave me back something that menopause seemed to have taken away: the ability to recognise when I had eaten enough.

It has not been a magic wand. It has been more like a slightly temperamental tool — extremely useful, occasionally expensive and liable, under the wrong circumstances, to make you smell like a Victorian drain or erupt like Mount Vesuvius.

Persephone’s Top Tips

Treat the medicine as a tool, not the entire solution

A reduced appetite creates an opportunity to build healthier habits. It does not automatically provide a balanced or nutritious diet.

Try to ensure you drink adequate fluids (an absolute mainstay of weight loss) and prioritise protein, fruit, vegetables and especially fibre (fibre is your friend), even when you do not feel particularly hungry.

There is little point in losing weight if you emerge at the other end surviving entirely on half a yoghurt and a multivitamin as your body will go in to starvation mode and you will put it all back on again.

Do not rush through the doses

A higher dose is not automatically a better dose.

If your current dose is effective and well tolerated, ask your prescriber whether there is a genuine need to increase it.

Do not change, delay or alter a prescribed dose without discussing it with the clinician or pharmacy responsible for your treatment.

Your body is not a competitive titration event.

Be very cautious with alcohol and caffeine

Alcohol made my side effects considerably worse, particularly around dose increases.

It may worsen nausea and vomiting, so it is worth approaching it cautiously.

Caffeine also appeared to aggravate my symptoms, although that was my personal experience rather than a universal rule. I’ve certainly lost interest in caffeine and hot coffee completely – as too has a close friend of mine.

If you do drink alcohol, pay attention to how your body responds. A second glass may look appealing, but there is nothing appealing about spending the following day burping like an abandoned sulphur mine.

Keep moving & stock up with Fybogel

Regular exercise supports physical health, mood and long-term weight management.

Walking remains one of the simplest and most accessible forms of exercise. I particularly enjoy walking outdoors — nature’s gym is completely free and rarely asks you to renew your membership.

I sometimes use an inexpensive weighted vest. However, weighted walking is not appropriate for everyone. Anyone with joint, balance, pelvic-floor, cardiovascular or bone-health concerns should seek professional advice before adding extra weight.

Cycling is also great if you have joint problems and you can be doing your exercise just while getting from A to B! No need to put time aside for going to the gym.

Exercise and movement also helps with peristalsis, part of the digestive process to stop you getting blocked up. Peristalsis is a series of automatic, wave-like muscle contractions that move food, waste, and liquids through the body’s digestive and urinary tracts. It happens without you having to think about it, using circular and longitudinal muscles to push things forward. Eat as much natural fibre as you can – to prevent bloating and help relive constipation.

Tell your doctor what you are taking

Always tell your GP, pharmacist and other healthcare professionals about every prescribed medicine, over-the-counter treatment, vitamin and supplement you use and encourage your provider to notify them directly too.

This is particularly important before surgery or sedation and when changing between GLP-1 medicines.

Your doctor cannot consider an interaction with a medicine they do not know exists.

Safety matters: Use a legitimate provider

These are prescription-only medicines and should come from a regulated pharmacy following a proper clinical consultation.

Price matters, especially when you are paying privately, but safety matters more.

A discount code is lovely. A qualified prescriber is lovelier.

A Final Word

This article describes my personal experience. It is not medical advice, and GLP-1 medicines are not suitable for everyone.

Their potential benefits, risks and side effects should always be discussed with a qualified healthcare professional.

For me, the journey has involved several providers, two different medicines, injections, tablets, financial calculations and more digestive drama than I would ideally have chosen.

Nevertheless, I have lost three plus stone, regained much of my confidence and, most importantly, rediscovered the ability to feel full.

Menopause may have stolen my off switch. Now, with a considerable amount of help — and the occasional betrayal by a glass of wine — I seem to have found it again.

Persephone, Age 58, Midlands UK

Aphrodite’s Note

GLP-1 & GLP-2 medications may help quieten the appetite, but it cannot do all the nutritional heavy lifting for you.

If you are eating less, what you do eat matters even more. Take a look at our practical guide to boosting energy and focus through menopause, with simple advice on hydration, eating more real food and getting enough protein — because surviving on half a yoghurt and good intentions is not a sustainable wellness plan.

Read this easy and informative post: Boost Energy and Focus Through Menopause & Beyond