Mounjaro and Me

I am guessing that not a lot of RJ readers have heard of something named Mounjaro.  But thanks to heavy advertising on TV probably most have heard of drugs named Ozempic and Trulicity.  Maybe also Weygovy.  All of them are a semi-new class of diabetes and weight management drugs classed as semaglutides.   They all have what is known as a GLP-1 agonist, which is a glucose-related peptide.  And yes, turns out “agonist” is the opposite of an “antagonist” in that an agonist is a positive thing. 

All people’s bodies send a signal to the brain when the person has had enough to eat.  The signal tells the brain “Stop eating—you’re full.”  That does not operate optimally in many people.  The GLP-1 agonist makes sure the signal gets sent early.  Most of these drugs also physically slow down digestion so that not just mentally but quite literally physically the body hits “full” very quickly when eating.

Mounjaro is Lilly Pharmaceuticals relatively recent entrant to this class of medication, having been FDA approved for diabetes treatment in May 2022.  In addition to the GLP-1 agonist, Mounjaro also has a GIP ingredient, which is an insulinotropic polypeptide that produces more insulin and that when used in conjunction with a medication like Metformin can work wonders on blood glucose and substantially lower a person’s A1C, the longer term blood marker that tracks sugar levels in the body.

By now it is clear I know so much about this because I have been taking Mounjaro for the last twelve months and two weeks.  Anyone who knows me knows that for a lot of my adult life, I have struggled with my weight and have been heavy—maybe not morbidly obese but “obese” has been on my medical profile for a long time.  As happens for lots of people, that excess weight can lead to Type-2 diabetes and indeed, despite my doctor’s good warnings for some years, I did arrive at that unhappy diagnosis some years ago.

Initially I did OK managing things and getting my A1C into acceptable ranges—not normal but low enough to avoid most of the significant negative health situations to which diabetes leads.  But by a little over a year ago, I had not been doing well and my A1C had gone into dismal and dangerous territory and my daily blood sugar readings were also very simply bad.  I write all of this with no small sense of shame.

So when my doctor suggested I get in touch with a pharmacologist to check out some new treatment options, I agreed.  The pharmacist pushed me to try this new Lilly drug Mounjaro, a once weekly injection.  Again, I was ashamed it had come to this.  But now a year later I have lost over 60 pounds and have completely normal A1C and blood glucose readings all the time.  As I have told people, it feels like my brain has been re-wired when it comes to food.  I don’t crave food or think about it a lot.  I hardly touch sweets or desserts and don’t generally miss them at all.  And I do hit “full” quickly when eating but in ways that never leave me feeling deprived.  The change has been profound.

And thus the drug I was ashamed to have had to start 55 or so weeks ago is now a gift.  When a time or two my pharmacy had a hard time refilling the prescription due to heavy demand, I almost panicked.  In any event, I write all this as a grateful person (and also one whose health insurance makes this pricey medication a possibility).

Turns out, however, this also has introduced me to an area of controversy in society and in some medical circles.  Many physicians and dieticians have written articles claiming that the success of semaglutides shows that obesity is a disease not always fully within a person’s conscious control.  For too long we have fat-shamed people in our society, chalking up people who are overweight as lazy and as clearly lacking in motivation and self-control.  While not for a moment denying those things play a role (and did to a degree also for me), I also know that when the hormones and appetite-related signal senders in my body began to work right (as they do for many people), I was changed—changed in ways I don’t think I could have disciplined myself into making happen without some outside assistance.

Why am I writing this in a RJ blog?  Because although I have not read any articles on all of this written from a Christian or theological point of view—and I have read a lot of articles on this in the past year—clearly the issues flagged in wider society on how we view and treat people creep into church contexts too.  There are many things we do not understand.  Obesity is one.  But for a very long time all things related to mental illness—and today I would say also dementia—are in this league of dimly understood realities too.  Many of us know only too well—and many of us pastors have sadly observed—that there is a stigma attached to needing medication and therapy for depression, for treating bipolar disorder or schizophrenia.

Indeed, as a pastor I ran into people with some frequency who were sure that people living with bipolar disorder or schizophrenia did not exist in their congregation.  As pastor, I knew otherwise.  But others were ignorant of this precisely because those dealing with these realities do not dare speak up about it out of shame and maybe even a sense that the strength of their Christian faith would be called into question if they could not overcome mental issues through faith and prayer.

Jane Kenyon has a series of poems titled “Having It Out with Melancholy” in which she talks openly about her lifelong struggle with depression.  The shortest poem in that collection was titled “Suggestion from a Friend” and it goes like this:

You wouldn’t be so depressed

if you really believed in God.

There are many things we don’t understand but that perhaps we need to learn more about so as to avoid marginalizing and shaming people or making rash assumptions about why they are the way they are. 

On Sunday The Washington Post ran an article that featured a series of short vignettes written by readers about how the COVID pandemic has continued to shape their lives.   One woman from Illinois wrote that even now, three-and-a-half years after the initial COVID outbreak, she still wears a mask in public for the sake of her husband who has been immunocompromised by a non-Hodgkins lymphoma for years.  But she feels people’s puzzlement if not dismissive attitudes when they see her in her mask.  The last line of her brief testimony is a good way to end this blog for now.  “So the next time you see someone like me masked in an N95, please resist rolling your eyes. You have no idea what people are going through. And compassion costs you nothing.”