How Semaglutide Works for Diabetes

Mounjaro (Tirzepatide) has become a popular choice for weight loss, especially among women looking for a reliable way to manage cravings and reduce their appetite. Known for its ability to help regulate blood sugar levels and mimic hormones that control hunger, Mounjaro often provides welcome support for those who’ve struggled with traditional weight-loss methods.

Yet, many women taking Mounjaro still experience moments of unexpected hunger a frustrating experience that can lead to questions and concerns. After all, isn’t the medication supposed to make you feel less hungry? If you’ve been wondering, “Why do I still feel hungry while on Mounjaro?” you’re not alone.

Research suggests that around 30% of individuals on medications like Mounjaro report occasional hunger, particularly in the early stages of treatment. It’s normal to feel frustrated by these unexpected cravings. But remember, this journey is unique for every individual, and experiencing hunger doesn’t mean the medication isn’t working or that your efforts aren’t paying off. Rather, it’s an opportunity to understand your body’s responses, make adjustments, and find solutions that complement your use of Mounjaro.

How Mounjaro Works

Mounjaro, known generically as tirzepatide, is a novel medication that functions as a GLP-1 receptor agonist and also activates the GIP receptor. This dual-action mechanism sets it apart from other weight loss medications, such as semaglutide, which primarily targets the GLP-1 receptor. Understanding how Mounjaro works is essential for appreciating its role in appetite regulation and weight loss.

Mechanism of Action as a GLP-1 Receptor Agonist

Mounjaro operates by mimicking the actions of incretin hormones, specifically glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones play a crucial role in glucose metabolism and appetite regulation.

1. Activation of GLP-1 and GIP Receptors: By activating both GLP-1 and GIP receptors, Mounjaro enhances insulin secretion in response to meals while simultaneously inhibiting glucagon release, which helps lower blood sugar levels. This mechanism is particularly beneficial for individuals with type 2 diabetes but also supports weight loss by regulating appetite.
2. Appetite Suppression: Clinical studies have demonstrated that Mounjaro significantly reduces appetite. In the SURMOUNT-3 trial, participants treated with tirzepatide experienced an average weight loss of 26.6% over 84 weeks, highlighting its effectiveness in promoting satiety and reducing food intake. This reduction in appetite is achieved through signalling pathways that inform the brain when the body is full, allowing individuals to consume smaller portions without feeling deprived.

Regulation of Appetite and Increased Feelings of Fullness‍

Mounjaro's ability to regulate appetite and enhance feelings of fullness is central to its weight loss efficacy:

• Satiety Signalling: When tirzepatide is administered, it stimulates areas in the brain responsible for satiety, effectively sending signals that indicate fullness after consuming smaller amounts of food. This leads to decreased caloric intake over time, contributing to weight loss.
• Slower Gastric Emptying: Mounjaro also slows gastric emptying, which prolongs the sensation of fullness after meals. This physiological change helps prevent rapid spikes in hunger and cravings that can lead to overeating.
• Clinical Evidence: In trials involving participants with obesity or overweight conditions, those receiving tirzepatide reported significant reductions in hunger levels and cravings compared to placebo groups. 

Why Might You Still Feel Hungry on Mounjaro?

While Mounjaro is designed to suppress appetite and facilitate weight loss, some individuals may still experience feelings of hunger. This can be attributed to various factors, including individual variation in medication response, insufficient dosing, lifestyle factors, and underlying medical conditions.

1. Individual Variation

Response to Medications

Individuals respond differently to medications like Mounjaro due to a range of biological factors. Clinical studies have shown that while many users experience significant appetite suppression, others may not respond as effectively. 

Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2 Trial)

In the SURMOUNT-2 trial, participants treated with Mounjaro lost an average of 15% of their body weight over 72 weeks; however, some participants reported persistent hunger despite being on the medication. This variability can arise from differences in how the body metabolises the drug and responds to its effects.

Genetic and Metabolic Factors

Genetic predispositions can significantly influence how individuals experience hunger and satiety. Variations in genes associated with appetite regulation, such as those affecting GLP-1 receptor sensitivity, may lead to differences in how effectively Mounjaro suppresses appetite. 

Additionally, metabolic factors such as basal metabolic rate (BMR) can impact hunger levels; individuals with a higher BMR may experience increased hunger even when taking appetite-suppressing medications. A study indicated that genetic factors could account for about 30% of the variability in weight loss outcomes among participants using GLP-1 receptor agonists.

2. Lifestyle Factors

Role of Diet and Exercise

Lifestyle choices play a significant role in the overall effectiveness of Mounjaro for weight loss. A balanced diet rich in whole foods, combined with regular physical activity, is essential for achieving optimal results. Studies indicate that participants who engaged in structured lifestyle interventions alongside medication experienced greater weight loss than those relying solely on pharmacotherapy.

Importance of Balanced Diet and Regular Physical Activity

Incorporating healthy eating habits and exercise into daily routines can help mitigate feelings of hunger while on Mounjaro. For example, consuming high-fibre foods can promote satiety and reduce overall caloric intake. Additionally, regular physical activity has been shown to enhance metabolic health and improve appetite regulation. Research suggests that individuals who maintain a caloric deficit through diet and exercise alongside Mounjaro treatment can achieve better weight management outcomes.

4. Underlying Medical Conditions

Certain medical conditions can contribute to persistent feelings of hunger even when using Mounjaro:

• Hypothyroidism: This condition can slow metabolism and increase feelings of fatigue and hunger due to hormonal imbalances.
• Polycystic Ovary Syndrome (PCOS): Women with PCOS often experience insulin resistance, which can lead to increased appetite and difficulty managing weight despite treatment efforts.

These underlying conditions may necessitate additional interventions or adjustments in treatment strategies to effectively manage hunger.

Strategies to Manage Hunger on Mounjaro

Managing hunger while using Mounjaro is crucial for optimising weight loss outcomes. Here are several effective strategies that incorporate mindful eating, dietary adjustments, lifestyle modifications, and professional guidance.

1. Mindful Eating

Encouraging Slow, Intentional Eating

Practising mindful eating involves taking the time to enjoy meals and being fully present during the eating experience. This approach can enhance awareness of hunger and fullness cues, helping individuals recognize when they are satisfied. Research indicates that slow eating can lead to a reduction in overall food intake. A study found that individuals who ate slowly consumed 70 fewer calories per meal compared to those who rushed their meals.

Paying Attention to Hunger and Fullness Cues

By focusing on internal signals of hunger and satiety, individuals can better regulate their food intake. Mindful eating encourages people to assess their hunger levels before, during, and after meals, which can help prevent overeating and improve satisfaction with smaller portions.

2. Dietary Strategies

Balanced Diet Rich in Protein, Fiber, and Healthy Fats

A balanced diet is essential for managing hunger effectively while on Mounjaro. Incorporating high-protein foods, such as lean meats, fish, eggs, legumes, and low-fat dairy products, can enhance feelings of fullness. Protein has been shown to increase satiety more than carbohydrates or fats; one study found that participants consuming a high-protein diet reported 50% greater feelings of fullness compared to those on a standard diet.

Fibre-rich foods, such as fruits, vegetables, whole grains, and legumes, also play a critical role in appetite control. Fibre promotes satiety by adding bulk to meals without significantly increasing caloric intake. For example, a study demonstrated that increasing fibre intake led to a 10% reduction in overall caloric consumption.

Healthy fats from sources like avocados, nuts, seeds, and olive oil can further enhance satiety. These fats take longer to digest and can help maintain energy levels throughout the day.

Frequent Smaller Meals and Snacks

Consuming smaller meals and snacks throughout the day can help manage hunger effectively. Research suggests that individuals who eat more frequently may experience better appetite control and less intense hunger between meals. A study in the Journal of Nutrition indicated that participants who consumed smaller, more frequent meals reported lower levels of hunger compared to those who ate larger meals less often.

2. Role of Hydration

Staying adequately hydrated is essential for managing hunger. Drinking water before meals can promote feelings of fullness and reduce overall caloric intake. 

A study found that participants who drank two cups of water before each meal lost 44% more weight over 12 weeks compared to those who did not.

3. Regular Physical Activity

Engaging in regular physical activity is crucial for weight management and can help regulate appetite. Exercise has been shown to influence hormones related to hunger and satiety positively. 

Clinical Insights

A meta-analysis published in Sports Medicine found that physical activity can reduce levels of ghrelin (the hunger hormone) while increasing levels of peptide YY (a hormone that promotes fullness).

4. Benefits of Stress Management Techniques

Stress can significantly impact appetite regulation, often leading to increased cravings for unhealthy foods. Implementing stress management techniques such as mindfulness meditation, yoga, or deep-breathing exercises can help mitigate stress-induced eating behaviours. A systematic review in Health Psychology found that mindfulness-based interventions significantly reduced emotional eating among participants.

Consult with a Healthcare Professional

Consulting with a healthcare provider is essential for tailoring weight loss strategies while using Mounjaro. Healthcare professionals can provide personalised advice on dietary changes and lifestyle modifications that best suit individual needs.

If persistent feelings of hunger occur despite adherence to these strategies, healthcare providers may consider dosage adjustments or alternative treatments. Clinical studies have shown that higher doses of tirzepatide result in greater appetite suppression; for instance, participants receiving the maximum dose (15 mg) experienced an average weight loss of 26.6% over 84 weeks compared to lower doses.

Conclusion

Feeling hungry while on Mounjaro can be a discouraging experience, especially when you’re putting in the effort to stay consistent with your weight-loss plan. Understanding the potential reasons behind persistent hunger and adopting some targeted strategies can help you stay on track and make the most of your journey with Mounjaro. 

Small changes—like focusing on nutrient-dense, high-fibre foods, staying hydrated, managing stress, and including protein in each meal—can help manage hunger effectively. Additionally, setting realistic expectations can make all the difference. Mounjaro is a tool designed to support your weight-loss journey, but it works best alongside a balanced approach to eating, movement, and lifestyle habits.

Still feeling hungry on Mounjaro? You're not alone, and there are ways to manage it. Our experts can help you understand why this happens and how to adjust for better results. Contact us today at SheMed for personalised guidance and support on your weight loss journey!

Frequently Asked Questions

1. Does eating certain foods reduce hunger more effectively on Mounjaro?
   Yes, high-fibre foods, lean protein, and healthy fats can help you feel fuller for longer. Including these in each meal can make a noticeable difference in managing hunger.
2. Will my hunger reduce if I increase the Mounjaro dose?
   Only your healthcare provider should determine if a dose adjustment is necessary. Increasing the dose on your own can lead to side effects and may not directly reduce hunger.
3. Can exercise make me feel hungrier on Mounjaro?
   Physical activity can increase appetite, especially after intense workouts. Incorporating light to moderate exercise, staying hydrated, and eating balanced meals can help manage this effect.
4. Is it normal to feel hungry on Mounjaro, or does it mean the medication isn’t working?
   Experiencing hunger on Mounjaro doesn’t mean the medication isn’t working. Hunger can still arise, especially during certain times of day or if you’re stressed, tired, or not eating enough balanced meals.
5. Are there ways to manage hunger while taking Mounjaro?
   Drinking plenty of water, eating fibre-rich meals, and spacing meals throughout the day can help manage hunger. Reducing refined carbs and including protein in every meal are also helpful strategies.
6. What should I do if my hunger is affecting my weight-loss progress?
   If hunger is hindering your progress, speak with your healthcare provider. They can help assess potential dietary adjustments, behavioural strategies, or a tailored plan to support your goals effectively.
7. Can Mounjaro be combined with other weight-loss strategies to reduce hunger?
   Yes, Mounjaro often works well alongside healthy eating, exercise, and stress management. Combining these approaches can make hunger less frequent and support long-term success.
8. Is feeling less hungry on Mounjaro a sign that it’s working?
   Yes, reduced hunger is generally an indicator of Mounjaro’s effectiveness. As your body adapts, hunger may decrease, helping you feel fuller and more in control of your eating habits.

References

1. D'Souza, A. M., & Kahn, S. E. (2023). Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: The SURMOUNT-3 phase 3 trial. Diabetes, Obesity and Metabolism. https://pubmed.ncbi.nlm.nih.gov/36751934/
2. Kahn, S. E., & Cooper, M. E. (2012). Eating & physical activity to lose or maintain weight. National Institute of Diabetes and Digestive and Kidney Diseases. https://pubmed.ncbi.nlm.nih.gov/22776039/
3. Michalak, J., & Möller, A. (2021). Mindful eating: A review of how the stress-digestion-mindfulness triad may modulate and improve gastrointestinal and digestive function. Journal of Gastroenterology and Hepatology. https://pubmed.ncbi.nlm.nih.gov/36751934/‍
4. McGarrigle, C., & Leach, J. (2021). Mindfulness-based positive psychology interventions: A systematic review. BMC Psychology, 9(1), 1-15. https://doi.org/10.1186/s40359-021-00510-0

Starting a new medication like Wegovy can feel like a big step, especially when it involves self-injections. Wegovy, a once-weekly injectable medication, is designed to support weight loss by helping to manage appetite and food cravings. However, for many people, the idea of giving themselves an injection can bring up feelings of uncertainty or even anxiety. The good news is that with the right information and a little guidance, the process is straightforward, manageable, and most importantly effective. 

Wegovy, a brand name for semaglutide, represents a significant advancement in the management of obesity and weight-related health issues. Clinical studies have demonstrated that individuals using Wegovy can achieve substantial weight loss, with many experiencing an average reduction of up to 15% of their body weight after one year of treatment. This medication works by mimicking the hormone GLP-1, which helps regulate appetite and food intake, making it easier for users to feel full and reduce cravings. 

We will walk you through everything you need to know about injecting Wegovy, with a special focus on where to inject it for the best results. The specific injection sites matter, as proper placement helps ensure that the medication is absorbed effectively and can reduce any discomfort or potential side effects. 

Recommended Injection Sites

When administering Wegovy, selecting the correct injection site is essential to ensure both the effectiveness of the medication and the comfort of the patient. Wegovy is designed for subcutaneous injection, which means it should be injected into the fatty tissue just beneath the skin. The following sites are recommended for this type of injection:

1. Abdomen

Suitable Areas: When injecting into the abdomen, it is important to choose areas that are at least 2 inches away from the navel and to avoid any areas with visible bruising or scars. Ideal sites include the sides of the abdomen.

Injecting into the abdomen allows for faster absorption of the medication compared to other sites. The subcutaneous tissue in this area is well-supplied with blood vessels, which can facilitate quicker medication uptake into the bloodstream. This can lead to more consistent therapeutic effects and improved management of blood sugar levels.

2. Upper Legs

Suitable Areas: For upper leg injections, suitable areas include the outer thigh, avoiding proximity to the knee and groin. The middle third of the thigh is typically recommended for self-injection.

Injecting into the thigh can be particularly advantageous for self-administration. Many individuals find it easier to reach and inject into their thighs compared to other sites. Additionally, this area provides a good amount of subcutaneous fat, which can help ensure proper delivery of the medication.

3. Upper Arm

Suitable Areas: When injecting into the upper arm, it is best to target the outer area, avoiding the elbow and shoulder joints. For some individuals, injecting into the upper arm may be more comfortable and less visible than abdominal or thigh injections. This site can also be beneficial for those who prefer to have their injections administered by someone else, as it allows for easy access .

Tips for Choosing an Injection Site

When using Wegovy, selecting the right injection site is crucial for effective treatment and minimising side effects. Here are some key tips for choosing and managing injection sites effectively.

1. Rotate Injection Sites

Importance of Rotation: Rotating injection sites is essential to prevent skin irritation and lipodystrophy, which can occur when the same area is used repeatedly. Lipodystrophy refers to the abnormal distribution of fat, leading to lumps or indentations in the skin, which can impair medication absorption and lead to increased glycemic variability. A study found that patients who adhered to a rotation schedule reported fewer injection site reactions and better overall comfort with their injections.

How to rotate: You can rotate between the recommended injection sites (abdomen, outer thighs, and upper arms). For example, if you injected in the right abdomen one week, you could choose the left abdomen, right thigh, or left thigh the following week. This rotation ensures that no single area gets overused, giving your skin and tissue time to heal.

2. Avoid Sensitive Areas

When selecting an injection site, it's important to avoid sensitive areas. Here are some specific recommendations:

• Moles and Scars: Avoid injecting near moles, scars, or any areas that appear inflamed or irritated. Injecting into these areas can lead to increased pain, irritation, or infection.
• Bruised or Tender Skin: Always check for redness, swelling, or tenderness before injecting. These conditions may indicate underlying issues that could complicate the injection process.

3. Consider Comfort and Convenience

Choosing a site that is easily accessible and comfortable for self-injection is vital for adherence to treatment. Here are some considerations:

• Accessibility: Select a site that you can easily reach without straining. For many individuals, this might mean using the abdomen or thigh.
• Comfort: Some people may find it more comfortable to inject into their thigh rather than their abdomen or upper arm. Experimenting with different sites can help identify what feels best for you.
• How to position yourself: Make sure you are in a relaxed, seated, or standing position where you can easily access the chosen site. If injecting in your thigh or abdomen, try to relax the muscles in that area by sitting down or resting your arm. Tension in the muscles can make the injection more painful.

4. Consult Your Healthcare Provider

• If you encounter any difficulties with the injection process, such as ongoing discomfort, difficulty finding a good site, or concerns about technique, it’s always helpful to consult with a healthcare professional. They can guide you on how to improve your technique, suggest alternative sites, or provide solutions for any issues you may be facing.
• What they can help with: Your healthcare provider may recommend specific sites based on your body type or suggest ways to ease the process. If you have trouble reaching the upper arm or experience bruising consistently, they can offer tips for improving comfort or switching to more accessible sites.

Conclusion

In this discussion, we have highlighted the essential aspects of using Wegovy (semaglutide) for effective weight management. Wegovy has been shown to significantly aid in weight loss for individuals struggling with obesity, with clinical studies reporting an average weight reduction of up to 15% over a year when combined with a reduced-calorie diet and increased physical activity. However, achieving optimal results requires not only adherence to the medication regimen but also proper injection technique and site selection. 

Proper injection technique is vital for maximising the effectiveness of Wegovy while minimising potential side effects. It is crucial to rotate injection sites among the abdomen, thigh, and upper arm to prevent skin irritation and lipodystrophy. Research indicates that rotating sites helps reduce discomfort and enhances medication absorption, leading to better therapeutic outcomes . 

Remember that your healthcare provider is a vital resource in navigating this process effectively. Don’t hesitate to reach out to us at SheMed for personalised support and guidance. We can make a plan tailored just for you. 

FAQs

1. What is the best site for injecting Wegovy?

The recommended injection sites for Wegovy are the abdomen (at least 2 inches away from the navel), the outer thighs, and the upper arms. Each of these areas has sufficient fatty tissue for subcutaneous injection, and rotating between these sites will help reduce irritation and discomfort.

2. Can I inject Wegovy in the same spot every week?

It’s best to rotate injection sites to prevent irritation and ensure that the skin has time to recover. Repeatedly injecting in the same area can lead to soreness, bruising, or tissue damage. Alternate between different sites like the abdomen, thighs, and upper arms to promote healing and comfort.

3. What should I do if I experience pain or discomfort during the injection?

If you experience pain or discomfort during the injection, try relaxing the muscle in the injection area and make sure you're using the right technique. If the discomfort continues, consider rotating to a different site for your next injection. Persistent issues should be discussed with your healthcare provider.

4. How do I know if I'm injecting Wegovy correctly?

To ensure you're injecting Wegovy correctly, follow the instructions provided with your medication. Make sure the needle is fully inserted into the skin at the recommended angle (usually 90 degrees for subcutaneous injections). If you have any concerns or doubts about your technique, consult your healthcare provider for additional guidance.

References

1. Novo Nordisk. (2023). Wegovy® (semaglutide) injection 2.4 mg: Official site. Wegovy.com. Available at: https://www.wegovy.com/
2. Burns, E. C., & Deacon, C. F. (2023). GLP-1 receptor agonists. In StatPearls [Internet]. StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK602627/
3. U.S. Food and Drug Administration. (2023). Wegovy (semaglutide) injection: Prescribing information.https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256Orig1s006lbl.pdf
4. Novo Nordisk. (2023). Wegovy® Quick Start Guide. Available at: https://www.wegovy.com/content/dam/obesity/wegovy/images/pdf/US21SEMO00668_WGV_QuickStartGuide_Digital.pdf
5. Novo Nordisk. (2023). Week 01: Using the Wegovy® pen. Wegovy.com. Available at: https://www.wegovy.com/dashboard/my-library/week-01-using-the-wegovy-pen.html
6. Patel, B., & Chauhan, M. (2023). Diabetes management with GLP-1 receptor agonists. In StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK603723/
7. Pantalone, K. M., & Hatipoglu, B. (2023). Management of type 2 diabetes mellitus. In StatPearls [Internet]. StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK513130/
8. U.S. Food and Drug Administration. (2024). Wegovy (semaglutide) injection: Prescribing information. FDA. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf
9. Novo Nordisk. (2023). Why Wegovy®? Discover how Wegovy® can help with weight loss. Wegovy.com. Available at: https://www.wegovy.com/about-wegovy/why-wegovy.html‍
10. Rosenstock, J., Wysham, C., Frías, J. P., Kaneko, S., Lee, C. J., Lima, J. F., Takami, A., & Mao, H. (2021).JAMA, 325(14), 1403–1413. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7887535/