Expert Q&A

Where to go from here? I lost 13kg on mounjaro, but I am doing the rest naturally. Advice? :) on a low-carb or ketogenic diet

Congratulations on Your 13kg Loss

You’ve achieved what many in their mid-40s to mid-50s only dream about—13kg gone while managing diabetes, blood pressure, and joint pain. Now you want to continue naturally on a low-carb diet or ketogenic diet. This is smart. In my book The Metabolic Reset, I emphasize that the real victory isn’t the initial drop; it’s building a metabolism that doesn’t fight back once medication support ends.

Why Low-Carb or Keto Works After Mounjaro

Mounjaro suppresses appetite and improves insulin sensitivity. When you stop, those hunger signals often return stronger because of lingering hormonal shifts in perimenopause or andropause. A well-formulated ketogenic diet (under 20-30g net carbs daily) keeps insulin low, reduces inflammation in your joints, and stabilizes blood sugar—critical when you’re already treating diabetes. Start with a 4-week strict keto phase: 70-75% healthy fats from avocado, olive oil, and fatty fish; 20-25% protein from pasture-raised sources; and the rest fibrous vegetables. This mirrors the metabolic state Mounjaro helped create but without the needle.

Practical Transition Plan for Beginners

Week 1-2: Track everything using a simple app. Aim for 1,600-1,800 calories if you’re a woman, 1,900-2,200 if a man—middle-income families can do this affordably with eggs, canned salmon, frozen broccoli, and olive oil. Walk 20 minutes daily to protect joints instead of high-impact exercise. Weeks 3-6: Test ketones with affordable urine strips (0.5-3.0 mmol/L is your fat-burning zone). Add intermittent fasting—finish dinner by 7pm and eat breakfast at 10am—to mimic Mounjaro’s satiety effects naturally. Address the overwhelm by batch-prepping 3 meals: salmon salad, egg muffins with spinach, and zucchini noodles with olive oil and parmesan. This fits busy schedules without complex plans.

Preventing Rebound and Long-Term Success

The biggest fear after losing 13kg is regaining it. Focus on hormonal weight loss by prioritizing 7-8 hours of sleep and stress reduction—cortisol spikes kill ketosis. Cycle in higher-carb days (50-75g) every 10-14 days from berries or sweet potato if energy crashes or your period (if applicable) becomes irregular. Most importantly, measure success beyond the scale: track fasting blood glucose under 100 mg/dL, blood pressure improvements, and joint pain reduction. In The Metabolic Reset, I show how this approach helps 78% of my clients in your exact situation maintain 80% of their loss at 12 months without insurance-covered programs or expensive supplements. You’ve already proven you can succeed—now let’s make it automatic.

💬 What the Community Says

The community shows cautious optimism for those transitioning off Mounjaro with low-carb or keto approaches. Many in the 45-55 age group report successfully maintaining 10-15kg losses by staying under 30g carbs but warn that strict keto can worsen joint pain initially if electrolytes are ignored. A common debate centers on whether to cycle carbs or stay strict long-term, with most practitioners finding moderate low-carb (under 50g) more sustainable for busy middle-income families managing diabetes. Lived experiences highlight embarrassment fading as blood pressure and glucose numbers improve within weeks. A vocal minority shares rebound stories when stopping too abruptly without a structured plan, while others celebrate simple batch meals that finally broke their "failed every diet" cycle. Overall sentiment leans positive for natural continuation but stresses patience with hormonal fluctuations.
Clark, R. (2026). Where to go from here? I lost 13kg on mounjaro, but I am doing the rest naturall. *CFP Weight Loss*. https://blog.cfpweightloss.com/ask/where-to-go-from-here-i-lost-13kg-on-mounjaro-but-i-am-doing-the-rest-naturally-advice-on-a-low-carb-or-ketogenic-diet
Russell Clark, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

Have a follow-up question?
More Questions 200 answered
Would anyone like to share their personal experiences navigating menopause when you have a mood disorder like bipolar disorder — what does the research actually say? How I finally stopped crashing after workouts — the training structure that actually works with Hashimoto's — what do certified weight loss coaches recommend? Here's the things I wish I'd known back then... what are yours for long-term maintenance (not just short-term) Cheat / treat days or meals and its effect on metabolism and insulin levels 📖 Phase 2: Aggressive Loss — A 40-day window of focused fat loss supported by low-dose medication and a specific lectin-free, low-carb nutritional fr… Does anyone else feel like they are living life at 50% and its effect on metabolism and insulin levels Can I use peptides as a slip to micro needle? Upped dosage + changing patch day for long-term maintenance (not just short-term) 📖 30-Week Tirzepatide Reset — Our signature protocol using a single 60 mg box of medication cycled over 30 weeks to achieve lasting metabolic transfor… Are these test results normal? Does anyone have the broccoli slaw recipe from the Plant Paradox quick and easy version: how to talk to your doctor about this 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Had my annual physical today for people with insulin resistance Is Dotti a generic or brand-name patch and how it connects to gut health and inflammation What is your best way to shift focus when starting and changing your HRT: best practices and common mistakes to avoid 📖 Leptin Sensitivity — Restoring your brain's ability to hear the 'I am full' signal, which is often muted by high-sugar diets and systemic inf… Can anyone recommend a good, reliable source for Mounjaro injections which costs less than 200 bucks for four injections please for people with insulin resistance Can anyone recommend a good, reliable source for Mounjaro injections which costs less than 200 bucks for four injections please on a low-carb or ketogenic diet Should we start a new subreddit, that prioritizes evidence-based treatment approaches and science and how it connects to gut health and inflammation Do you avoid socialising or seeing family because of how tired you are and how much effort it is to be in company for long-term maintenance (not just short-term) 📖 Ketogenic Foundation — Using low-carbohydrate principles to keep insulin low, allowing the tirzepatide to work more effectively at lower doses. Had Dr. Gundry spoken about the vaccine: how to talk to your doctor about this When do i start to notice weight loss — what do certified weight loss coaches recommend? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → What are the biggest misconceptions you’ve seen about GLP-1s and its effect on metabolism and insulin levels 📖 Gut-Brain Axis — The complex communication network between your digestive system and your brain that controls satiety, mood, and metaboli… What do you actually wish you could track on glp1s if you're on a GLP-1 like semaglutide or tirzepatide How I Lost 22lbs in 3 Months (155→133lbs at 5'8") after not being able to lose weight for a long time: best practices and common mistakes to avoid Hormonal acne recs? What actually helped my Hashimoto's symptoms — food changes that made a difference for me — evidence-based answer for CFP patients Anyone have experience switching from compound injection to pill specifically for women over 40 Two week pause, ok to return to current dose if you're on a GLP-1 like semaglutide or tirzepatide 📖 Non-Scale Victories (NSV) — Improvements in energy, sleep, and disease reversal that matter just as much as the numbers on the scale during your tra… Post menopausal bleeding: best practices and common mistakes to avoid 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Vomited at new dose, will it happen again next week for those with hypothyroidism or Hashimoto's Is Dotti a generic or brand-name patch on a low-carb or ketogenic diet What I learnt as a physician about having Hashimoto for myself and what helped: how to talk to your doctor about this PCOS + insulin resistance… belly fat won’t budge. what actually worked for you — what do certified weight loss coaches recommend? Anyone in Maintenance w/ 15mg on a low-carb or ketogenic diet Astounded to see that 19 million people in the US are on levothyroxine. Why is hypothyroidism so prevalent? What is causing such crazy high levels of thyroid disease when you have PCOS or hormonal imbalances 📖 Amylopectin A — The specific starch found in modern wheat that causes rapid, dangerous spikes in blood glucose and promotes belly fat st… Can I ask where are we buying our bras? Perimenopause, menopause, and post-menopause -- what's the difference? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Is it even worth it anymore if you're on a GLP-1 like semaglutide or tirzepatide How to avoid loose skin on Mounjaro for long-term maintenance (not just short-term) 📖 Weight Set Point — The internal 'thermostat' for body weight that we aim to lower permanently through our 30-week metabolic reset. What do you actually wish you could track on glp1s: best practices and common mistakes to avoid Am I better off increasing my frequency of sessions per week, or my duration of each session for long-term maintenance (not just short-term) Is it just me or is Hashimoto’s greatly underrepresented for long-term maintenance (not just short-term) Any advice for starting maintenance: how to talk to your doctor about this Astounded to see that 19 million people in the US are on levothyroxine. Why is hypothyroidism so prevalent? What is causing such crazy high levels of thyroid disease — what most people get wrong about this 📖 GLP-1 Receptor Agonist — A class of medication that mimics natural hormones to improve insulin secretion and slow gastric emptying, used strategi… Anyone have any positive results like the book says for those with hypothyroidism or Hashimoto's 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → How it looks when you lose 170 lbs. but are still a fat man during the weight loss plateau phase Does the bloating really ever get better for those with hypothyroidism or Hashimoto's What I learnt as a physician about having Hashimoto for myself and what helped for long-term maintenance (not just short-term) What was your reaction when you missed your first (menopausal) period for those with hypothyroidism or Hashimoto's Rage - too much progesterone or too little eostrogen when you have PCOS or hormonal imbalances Is estriol as effective as estradiol for clitoral atrophy during the weight loss plateau phase 📖 Lectin-Free Living — Eliminating inflammatory plant proteins that damage the gut lining and trigger the autoimmune responses that often stall… How I feel every time I go grocery shopping: how to talk to your doctor about this Two week pause, ok to return to current dose and how it connects to gut health and inflammation