Mounjaro Update: Week 36

I’m back with another update about my experience with the Type 2 diabetes drug Mounjaro. This week, I continue last week’s discussion of the tools I use to track my progress, and I’ll add some comments about weight loss drugs for children. As usual, I close with the current status of all my old fart conditions.

How I Track My Exercise

Last week, I provided an incomplete list of equipment and software apps I use to monitor my progress. What I left out were the two tools with which I track exercise: a Fitbit smart watch and the Jefit exercise tracking app.

Fitbit Versa 4

I’ve used Fitbit Versas since 2020. I bought a second Versa 2 after an unfortunate accident with the first one, and more recenly, I bought a Versa 4 (available from Amazon.com for $149.99). It does everything you would expect from a fitness tracker: heart rate, sleep quality, respiration, pulse oxygen, steps taken, etc., at a much cheaper price than competing products from Apple, Garmin, and Samsung. And it can tell time, too.

Although I have a couple of nice, traditional (dumb) wristwatches, I find myself wearing the Fitbit all the time. I like that it will automatically log exercise if it detects fifteen minutes of activity. It even tries to guess the type of activity. If I am taking a hike, its internal GPS receiver creates a map showing the path I took, giving me heart rate and pace for each segment. If I am at the gym, I start it up before my warm-up and wear it throughout the workout. When I’m done, it gives me my stats.

The associated app is wonderful for analyzing workout exertion with its heart rate graph. The Versa 4 has loads of features. With the basic package, I have found that I get everything I need without spending additional money on the premium membership subscription fee.

Jefit App

How do I keep tack of which exercises I do, how much I lift, how many reps? The Jefit app does all that and much more. You can download it free from the Apple App Store or Google Play. If you want the full features, you’ll need to pay an annual subscription costing $69.99. Paying the big bucks ties you in to their huge exercise database, where you can search for exercises targeting specific muscle groups. You can filter results by equipment, like dumbbells, barbells, machines, body weight, etc. Each exercise has a video showing how to perform it, as well as detailed, written instructions.

You’ll find that a bit of a learning curve is necessary to master how to set up workouts and do the tracking. For me, the time invested in learning how to use Jefit was well worth the effort. Aside from the ability to track progress from workout to workout, at the end of each workout Jefit reports which muscle groups you have worked and which have been neglected. It uploads the data to the cloud so I can access it on multiple devices. I set up Jefit to track my workouts both at the gym and at home.

That wraps up what I wanted to share with you about how i track my health and fitness. Next, I move on to vent my opinion on some current research. As those who know me well can attest, I have an opinion or two, and when I get torqued up about something, I vent.

Big Pharma Takes Aim on Our Chilllldren

Being a career hypochondriac, I receive daily digests from the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM). A study published recently in the latter journal caught my eye: Liraglutide for Children 6 to <12 Years of Age with Obesity — A Randomized Trial. This annoyed me, so I dug into the abstract, wading through the medicalese and statisticalese describing the trial until I arrived at the final, parenthetical sentence: “(Funded by Novo Nordisk; SCALE Kids ClinicalTrials.gov number, NCT04775082.)”

Novo Nordisk is the Danish manufacturer of Victoza, their brand name for liraglutide, as well as Ozempic and Wegovy, similar GLP-1 RA drugs whose generic name is semaglutide. Of course, the practice of studies funded by Big Pharma is nothing new — we live in a money-driven world where self-interest is no longer a conflict. Their marketing effort is a full-scale assault on society from all directions. Direct-to-consumer advertising targets Joe Citizen, who they command to: “Ask your doctor if Victoza is right for you!” Funded studies published in prestigious medical journals like NEJM aim at not just the endpoint prescribers, but also at the broad medical community. It is an all-out blitz.

How Can I Bilk Thee? Let Me Count the Ways.

The aim is to establish prescribers as an extension of the marketing arm of Big Pharma, and from the reported sales numbers of GLP-1 RA drugs, they’re succeeding big time! Treating obese patients, many doctors now just skip the counseling about lifestyle interventions like diet and exercise and go straight to prescribing the vogue weight-loss drugs from Big Pharma, notably Novo Nordisk and Eli Lilly & Company.

To make that pill easier to swallow (pun intended), the medical community is removing the personal responsibility aspect of being fat. If we can be convinced that we are fat through no fault of our own, we can take lifestyle improvements off the table and go straight to the high-cost alternatives. I encountered some suggested practice guidelines from the UK, published in JAMA, which counseled physicians to avoid the subjects of diet and exercise and never, ever mention the word “obese” within earshot of a patient. Be gentle, Doc. Wouldn’t want to hurt anyone’s sensitive feelings.

It’s Not My Fault That I’m Fat

WTF! We know we’re fat and we know what we must do about it. Now, they want to facilitate creation of a class of victims. The article went on to say that the practitioner should introduce the subject kindly, referring to earlier conversations, like, “Didn’t you tell me last year that you would like to lose some weight?” Oy, gevalt! What will follow, once the subject is on the table, is easy to imagine. “Have I got a drug for you! Now that it is your idea to lose weight, we’ll get you started!” However, if the patient shows signs of wanting to avoid a conversation about avoirdupois, the doctor must immediately clam up or change the subject. So goes the learned author team’s advice.

The current mantra promoted by Big Pharma and their dutiful servants in the medical community is that obesity is “a complex, chronic, relapsing condition”. Some go as far as to call it a disease. Leveraging this characterization, Big Pharma has reoriented the doctor-patient relationship to find angles that strike paydirt by conning patients into making it their idea to ask the complicit physician, “Is Wegovy right for me?!” Now that patients have been absolved of responsibility for being fat, having been told it’s not their fault that they caught a treatable disease, we can jump right into the pharmacotherapy for same with no shame, no stigma, and best of all, no nasty diets or exercise. (Or so patients may be led to think).

No Easy Way

If physicians must avoid suggesting that we fatsos get up off our asses, go to the gym, shitcan the donuts and start eating broccoli, then the alternatives are drugs and bariatric surgery. These are both worth more money to the medical services and pharmaceutical industries than kickbacks from dietitian referrals and gyms. (Unfair accusation, I know. I don’t know whether such graft exists, but that’s beside the point. What I am saying here is that surgery and drugs are big money-makers whereas recommending traditional lifestyle adjustments does not significantly pump-up medical revenue).

Back to my original point. The prepubescent market is out there and it is ripe for exploitation, uncharted territory for the profiteers. Thus, now, we want to target six- to twelve-year-olds: “Tell your mommy to ask the pediatrician if Victoza is right for you!” Never mind that you’ll be subjecting your kids to a once-daily subcutaneous injection of a foreign substance. It’s all about parents seeking society’s approval. We don’ wan’ no freakin’ fat keeds! Parents take heed! Drug your kids and make them addicts for life, but they’ll look maaahvelous!

Let Kids Be Kids

How long will they need to stay on the drug, and at what cost to their family and to society? No one knows. In this one-sided so-called war on obesity, getting the foot in the door is 90% of the battle. The street-corner drug pusher knows that once their clients start, many will be customers for life (suitably shortened by malnutrition and overdoses). Same thing for Big Pharma. Get ’em started young! Damn the torpedoes! Full speed ahead!

We’re not fixing the problem. We’re allowing the food industry to proceed unchecked, making our kids unhealthy. Instead of doing something about the crap we feed our kids, we are coerced to subject them to expensive, injectable drugs to fix what the food industry fucked up while we sat back with our thumbs up our asses. Why do we allow this perpetual motion machine to wreak havoc on our youth? We make them sick, then we drug them. We’re not fixing their lives. We’re ruining them.

Parents, stop feeding your kids crap. Stop tolerating school lunch programs that serve crap. Get their asses off the video gaming chair and into the playground. And please don’t drug your children!

My Health Update: Mounjaro and Whatever the Hell Else

First, I’ll tell you that we finally have closure on the urinary tract infection. A urine culture ordered by The Irascible Dr. Scrooge came back with no indication that anything is growing in my pee. The first urinalysis he had ordered a couple of weeks ago showed som leukocytes, which indicated that the infection had persisted. That is why he ordered the culture. Now, it looks like the Serratia marcescens have departed. Good riddance!

The rest of the tests ordered by Scrooge came back negative, too. Negative for celiac disease, and negative for occult blood from the digestive tract. These are all good things. However, along with the good comes the need for further invasive exploration to determine the cause of my functional iron deficiency. What Scrooge had originally proposed was an upper GI endoscopy and a colonoscopy, followed by a capsule endoscopy of the small bowel. I imagine I’ll be getting a call from his people to schedule those diagnostics.

Mounjaro by the Numbers

I mentioned last week that I have noticed a rebound in my numbers, suggesting that my Mounjaro dose might need an increase. I have been at the minimum therapeutic dose of 5 mg/0.5 ml since September. (Earlier, I was at the starter dose of 2.5 mg). This puts me on the horns of a dilemma, as I do not want to be chasing increasing doses up to the maximum dose of 15 mg. If my aging carcass develops a resistance at that level, then what?

Recall that I had discontinued metformin back in November. The key to getting this situation back under control might be to resume the metformin along with a modest increase in the Mounjaro, to 7.5 mg. I will discuss this with the doctor at our February 24 encounter.

My average blood glucose for the week was 108 mg/dL (6 mmol/L), about the same as last week. However, fasting glucose, my first thing in the morning reading, has sucked, averaging 107 mg/dL (5.94 mmol/L), up from 100 mg/dL (5.56 mmol/L) last week and 93 mg/dL (5.17 mmol/L) the previous week. This puts me back in the pre-diabetic range. Apart from clinical thresholds and characterizations, the increased glucose levels will cause damage. That ain’t good.

My weight was up 1.6 lbs (0.8 kg) for the week. I wanted to hold at the current level, so the gain is yet another indication that something is awry.

What have I been doing differently that might be responsible for the reversal? If anything, I have increased my energy expenditures by adopting a rigorous exercise schedule. At the same time, I have diligently tracked daily protein intake, which I have increased commensurately with the workout program. Perhaps I am getting too much protein, which can’t help my marginally functional kidneys.

That’s it for this week. Thanks for reading! Writing this drivel is therapeutic for me, as well as imposing the need to keep track of my numbers on a weekly schedule. If anyone else can derive some benefit from my shared experiences, I’m doubly happy. Stay healthy!