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Consistent with this description of reduced DA release as a consequence (and not a cause) of an excessive calorie intake and given the experimental design applied by Johnson & Kenny [14], one might assume that the progressive decrease in D2R-availability observed in their study reflects the end-point of rather than the transition to compulsive overconsumption

Updated: December 2016

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2020;10:e191

Managing gallstone risk on Mounjaro Optimal weight loss rate The key to minimising gallstone risk is controlling your weight loss rate: Recommended targets: Week 1-4: 0.5-1 kg per week Week 5-12: 0.5-1 kg per week After 12 weeks: 0.5-1 kg per week Maximum safe rate: 1 kg per week Strategies to control weight loss rate: Start with the lowest dose (2.5 mg) Delay dose escalation if losing too quickly Ensure adequate calorie intake (maximum 10% deficit) Add protein-rich snacks if weight loss exceeds 1 kg/week Dietary strategies Specific dietary approaches can reduce gallstone risk during weight loss: Eat a diet based mainly on whole foods: Healthy fats: Include a portion the size of your thumb in each meal from nuts, meat, fish, olive oil, and dairy Fibre: Aim for half of your plate to come from vegetables Protein: Aim for a portion the size of an open hand in each meal Foods to moderate: Refined sugars and ultra-processed foods Take-aways Very low-fat diets ( 5 hours Fever with abdominal pain Yellowing of skin or eyes (jaundice) Dark urine and pale stools Medical monitoring requirements Baseline assessments Before starting Mounjaro with known gallstones: Essential tests: Complete medical history, including gallstone symptoms Physical examination Baseline weight and BMI Liver function tests (ALT, AST, ALP, bilirubin) Consider if indicated: Abdominal ultrasound if symptoms present Lipid profile Inflammatory markers if previous cholecystitis Follow-up schedule The following monitoring schedule represents expert practice suggestions rather than a fixed protocol: When to pause treatment Consider temporarily stopping Mounjaro if: Biliary colic episodes occur Liver function tests become abnormal Weight loss exceeds 2 kg per week consistently Severe gastrointestinal symptoms develop Pending gallbladder surgery Alternative weight loss options Other GLP-1 medications Different GLP-1 medications may have varying gallbladder risk profiles