One of the side effects of Mounjaro is that it slows gastric emptying, essentially making you feel fuller for longer. I don’t know how it does this, or what the point is in terms of what the medicine was originally designed to do (stabilize blood sugar, lower a1c). For me, the important part is that when your stomach takes a lot longer to empty, you have to be mindful of a few things.

1) Any medicine that is a timed release will work differently. The timing is based on normal gastric emptying, so if the release is meant to happen after the medicine is in your intestines, it might start in the stomach instead, and that will change the way your body absorbs it. For instance, when I had covid in November, the antivirals caused me to have much stronger side effects than normal because of when the medicine entered my system. I’ve also had to monitor my extended release anti-anxiety medicine to make sure it continues to function properly.

2) The slowing of your digestive system can cause cramping and abdominal pain if you eat too much fat or fiber. Thankfully, I haven’t experienced too much with regards to this because I’m pretty moderate (for better or for worse) on both fat and fiber.

3) If you eat too much in one sitting, you open yourself up to potential stomach pain, heartburn, and acid reflux.

Now, I’ve suffered from varying amounts of heartburn and acid reflux ever since my abdominal surgery nine years ago. I’m 99% sure that the doctor who did the surgery basically compressed my organs/muscles in a way that they press on my stomach, causing the above symptoms, as well as an inability to properly detect hunger cues. I never had any problems with those things prior to that surgery (minus pregnancy-related heartburn with my oldest child). I control much of the chronic acid-based symptoms through a combination of careful nutrition balancing and a doctor-monitored medicine regimen. About 50% of my days, I’m able to go without any medication at all, and the other half, I take a preventative. Only very rarely since I began the preventative last summer have I had any heartburn or acid reflux symptoms.

However, since I began the Mounjaro, I’ve had to be super careful, especially about the fat content of my food. Heavy fats, particularly those from animal products, tend to cause more acid problems. Now, I already preferred the taste of leaner cuts of meat, but even 90% lean beef will periodically cause problems if I eat too much in one sitting. Forget cheese or eggs in more than small quantities.

I fucked up last weekend. We made one of my favorite meals, Cincinnati chili, and I kinda didn’t pay attention to the quantity I was eating. Those four weeks on the lower level of Mounjaro during the shortage was enough time for me to forget the Rules. So I ate way too much, including far more meat/fat than I should have. Afterwards, my stomach began to hurt, a lot. That’s when I realized that I’d fucked up. I didn’t realize just how badly until I woke up at 4am with severe reflux and had to spend the rest of the night propped up in a sitting position, with emergency meds to try to control it. Whoops!

Note to self: I don’t care how much you like a meal, over-eating is not going to make you feel good!