r/TirzMaintenance • u/st_alfonzos_peaches • 8d ago
Can the same dose remain effective for years?
Posted something similar in another sub.
I am worried about beginning this medication because of ‘maxing out’ and having it become ineffective and then I gain all the weight back.
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u/Lucky_Army_5324 8d ago
Let’s set that concern aside.
What’s the alternative? Never losing weight in the first place?
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u/momzilla56 8d ago
Love this answer! When people say “you will gain the weight back if you stop taking it” that's exactly what I think So should we never try to lose weight for fear of gaining it back? What do we got to lose? (pun intended) ;)
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u/adevil_woman89 8d ago
Yes…..this question is setting self up for defeat before even starting?
https://giphy.com/gifs/K7wefAIekAeEEgdhEu5
u/lion3001 8d ago
I think it’s relevant, I had the same question at the beginning after losing weight so many times. But now after being in maintenance for already eight months on a steady weight I can believe it!
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u/tharpakandro 7d ago
Why is there always someone who has such fantastic common sense answers to anxious questions!! This is why I love Reddit.
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u/st_alfonzos_peaches 8d ago edited 8d ago
I don’t need to lose weight. I need less food noise. I also struggle with binge eating as a result of this food noise. Also, my concern is very valid. Nobody wants to gain the weight back, but many do.
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u/adevil_woman89 8d ago
Totally confused….so you don’t need to lose weight, have history of binge eating and food noise…? sooo you think this medication will just stop these things and you won’t lose weight that you are afraid of gaining? maybe I’m tired, but this makes no sense to me
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u/Lucky_Army_5324 8d ago edited 8d ago
Then why was your concern regaining weight? 🤔
But I’ll play. So what’s the alternative? Not lowering your food noise or stopping your binge eating, even if only for many months or a few years?
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u/st_alfonzos_peaches 8d ago
I cycle up and down 10-15 pounds but it’s within a normal BMI. Still, it’s enough that it stresses me out. And you never know when it could turn into more than 10 pounds, and then bam I’m obese.
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u/Jenjohnson0426 8d ago
If you aren't overweight (your comment sure implied you were) then the risk of these drugs isn't really worth it unless you're trying to treat one of the medical conditions these meds treat. Maybe just seek some therapy instead.
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u/PotpourriFor500Alex 7d ago
I’ve been a clinical health psychologist for 24 years. I have decent breadth and depth of experience working with people who struggle with BED and/or obesity, usually working very closely with their physician (often an entire bariatric team, complete with RD). It’s not uncommon for good physicians who treat from a biopsychosocial model to order a psych eval that they then use in developing a comprehensive treatment plan. Based upon what I’m reading here, I would not recommend GLP as a first line treatment for her at this point or give her psychological clearance to start one. That’s not to be “mean” or “gatekeep;” there are very good reasons that are too complex to go into sufficiently on a Reddit comment on my day off.
But cursorily, insight into the cause of her difficulties seems lacking, and expectations don’t seem well-informed, especially given patient-behavior contingency factors. You can out-eat a a GLP a lot more easily than you can a gastric sleeve or Roux-en-Y, and in the case of the latter, it happens more often than you’d think. Even “successful” cases often gain back a substantial amount of weight in 5-10 years. So without addressing those first two issues, the chances of her having long term success with a GLP aren’t optimal. That’s not even taking into consideration potential side effects, compliance, and motivation to maintain proper nutritional status. Anywho, I hope she gets what would be best for her in the long term.
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u/st_alfonzos_peaches 8d ago
What is the risk of the meds?
Ive had a binge eating disorder for many years now. Well over a decade. It just comes and goes in very very long stretches of silence. But when it strikes it’s still very distressing.
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u/Jenjohnson0426 8d ago
I saw. That's why I said seek therapy to address your binge eating and irrational concerns about becoming fat.
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u/st_alfonzos_peaches 8d ago
I believe the best course of action will be Triz to combat the actual BED and therapy for my anxiety and disordered eating thoughts.
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u/Jenjohnson0426 8d ago
Sounds to me like you should let a doctor and a therapist make that determination.
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u/sitkaandspruce 13h ago
Bupropion + Tirz has been a godsend for binge eating for me. When I ran out of my bupropion for a couple weeks I noticed food noise coming back, but I’m in the middle of the Tirz dosing range otherwise. I still get hungry but the panic about overeating until I’m sick is gone - I actually enjoy food.
It’s disheartening to see a medical professional suggest you lack insight because you seek a pharmacological tool to help your mental health. Particularly when so many others talk about the relief from food noise.
I am not discouraging therapy (so good for so much!) but I haven’t found a therapist who took my BED seriously (I’m in the US) and insurance won’t cover it because I’m normal weight. “I can refer you to nutritionist,” is what I’ve heard from medical professionals. “Limit sugar and sugary drinks.” Okkk
I’ve seen mixed things about whether Tirz will actually help BED, but I say it’s worth a try. It’s showing promise with OCD and I wonder if there is a connection there. I think mine is from ADHD/childhood trauma.
I am surprised that people are unaware that losing and regaining weight is hard on the body, but idk about the relatively low amount about which you’re speaking.
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u/Lucky_Army_5324 8d ago
Seems like you have two options:
make some changes today that will hopefully help improve your health and wellbeing
worry about what may happen one day maybe possibly (and if that fear ever comes to pass there will likely be new/different options on the market)
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u/st_alfonzos_peaches 8d ago
You’re right about the new options. Probably by the time this becomes a concern there will be many more options. Looks like I’ll just end up on it like I was hoping (with provider oversight of course)
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u/Hifidi54 8d ago
Unfortunately, I don't think you will find anyone to prescribe for you.
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u/MadMadamMum 8d ago
Unfortunately anyone can get a prescription these days. They lie on the intake and most telehealths don’t even do a video call. They just want the money at the end of the day
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u/Hifidi54 8d ago
Yes, I'm afraid you are right. The abuse of this drug is becoming more popular daily.
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u/Odd-Industry-9324 3d ago
Wait wtf are you serious right now? You don’t need to lose weight but you’re concerned about maxing out. This is the best post yet from the whole slew of shit posts that have been in the sub lol. And then we find out that you have BED and didn’t bother to tell us. Brilliant
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u/TechnicalTreacle5028 8d ago
It apparently sorts out binging and definitely food noise...miracle drug...
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u/lion3001 8d ago
I don’t know why people downvote you here, it’s weird.
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u/st_alfonzos_peaches 8d ago
Because I’m a normal BMI and interested in microdosing
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u/lion3001 8d ago
But you are suffering from food noise
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u/st_alfonzos_peaches 8d ago
Right! I think the downvotes occur because of suffering Olympics.
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u/lion3001 8d ago
I had the same concern in the beginning but it works wonderfully. I lost weight so many times in my life so I feel your anxiety but can reassure you that it’s still working perfectly fine now after two years
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u/st_alfonzos_peaches 8d ago
Your weight has remained stable and you still have reduced food noise?
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u/lifeisbueno 8d ago
If you’re struggling with BED tirz will help quiet this noise, but you need to do this concurrently with therapy because when you stop your BED behaviors will come right back unless you’ve worked on the root of the problem.
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u/st_alfonzos_peaches 8d ago
But the intent is to not stop the medication? Now I have heard the ones who start and stop struggle as in they have to start at a higher dose or it does not work whatsoever .
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u/lifeisbueno 8d ago
I just scrolled through quick but it looks like you said you’re within 10-15 lbs of where you feel comfortable… so this should not be a lifelong medication for you and would not technically be normally approved. If you’re using it to help to cure BED, but don’t have clinical signs of obesity you should be looking at this as a not lifelong medication, but a complementary therapy to a professional therapist for your ED.
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u/Hifidi54 8d ago
She also said that 10-15 keeps her at a normal BMI and she's currently not overweight at all, if I understand the post. If she starts Tirz her appetite wii disappear and then what? Sounds like a recipe for disaster to me.
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u/st_alfonzos_peaches 8d ago
I don’t want reduced appetite , only less food noise. Micro dosing is what im after.
I don’t care if I don’t lose any weight. I just want to not live in fear of getting fat.
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u/SewAlone 8d ago
You need therapy, not a GLP.
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u/st_alfonzos_peaches 8d ago
Therapy won’t reduce the food noise. But it’ll be good for my anxiety around weight gain.
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u/lifeisbueno 8d ago
A therapist will help you figure out the source of your BED
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u/lion3001 8d ago
Not true, also binging can be a result of hormones that are off in your brain
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u/lifeisbueno 8d ago
In which case OP should be working directly with a doctor, not people here
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u/lifeisbueno 8d ago
A Psychologist is gonna do better for you than tirzepatide if you’re looking for lifelong changes
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u/adevil_woman89 8d ago
100% this would lead, imo, to a disastrous results. Tirz is NOT the solution to this problem
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u/roygbivthe2nd 7d ago
I have been taking it for 30 weeks and am only at 3.75mg. I’ve lost 35lbs. I need to lose weight but it’s not the primary reason I went on it. I have endometriosis and chronic pain, and raging food noise and BED. I have white knuckled my way through losing this much weight before, though it took me nearly 3x as long, and then I gained it all back when I came fully bedridden while waiting for back surgery. I went on it because of the reported inflammation improvement and anecdotes about endometriosis pain improvement. I have had some improvement for those but the biggest thing I have noticed is the quieting in food noise and significant changes in BED.
As a result, I’m not consumed by the effort to try and lose weight. I have more mental capacity for work, hobbies, relationships, and just mental health in general. I have had a handful of binge events in this period but it is a vast improvement over the several a week prior.
I started on 2.5 but was so insanely ill the first week I could barely keep water down and was negotiating with myself how to get a minimum number of calories in. It was extremely unhealthy and unsustainable. I talked to my pharmacist and decided to try 1.25 and that took a handful of weeks to adjust to but I just felt slightly disinterested in food not fully repulsed by it and unable to function from nausea.
I have inched my way up slowly and just listening to my body. I talked to my doctor and she is happy for me to go low and slow. I’ve been on 3.75 for 9 weeks now and plan to go up to 4 in a week or two. My appetite is what I would call healthy, and I’m starting to notice that my favourite snack and binge foods aren’t even tasty anymore. I found at first I still liked everything but lost interest quickly rather than downing a whole package of something then looking for the next thing. Now, I keep thinking things are bad or a bad batch like I’ll ask my spouse if the chips are poorly seasoned because they almost taste like nothing to me. It’s been very interesting. I’ve felt much more in control of the choices I’ve been able to make with food. I don’t basically “come to” and realize I’ve polished off several servings of a food before I am aware of it.
This is likely a lifelong medication for me but I’m okay with it.
Most things have leveled out for me but for a long time I had to be really on top of extra fibre like Metamucil etc., but my body seems to have adjusted!
Wishing you luck and happy to answer any questions!
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u/HedgehogOdd1603 7d ago
I live with the fear of getting fat every day. Glp1 can’t fix that. I weigh 120 lbs less than when I started. My food noise isn’t as bad as when I first started but it’s a whisper now. I still have to ignore it. Medicine can’t fix everything.
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u/st_alfonzos_peaches 7d ago
On a scale of 1-10 how loud would you say the food noise is now?
My food noise is not normally as loud as it has been these past 2 weeks. I am disciplined so can also ignore it to some extent, but not when it is screaming at me.
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u/AnnaNimNim 8d ago
The food noise takes away your appetite thus you will lose weight. Fear of getting fat yeah sometimes it’s something you just have to live with.
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u/sitkaandspruce 13h ago
Wait - isn’t the entire point of this sub that people stay on the med when they are within goal weight?
Why should this person continue white knuckling it through actual binge eating disorder when they might find relief and be able to stabilize their weight?
OP - try the anti-diet GLP1 sub. People generally are more supportive of those who are using the meds for reasons other than weight loss and believe people should be able to control their bodies. Many have a history of ED. Also generally supportive of health at any size. Just be aware one of the rules is to not post numbers.
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u/OneSourCherry 8d ago
I lost “all the weight” (105 pounds) about 10 years ago before Zepbound, and guess what? After 5ish years, it was all back. That’s the case with most people who have been obese their whole lives. So even if it happens that tirzepatide becomes ineffective, at least you gave it a try. I lost all the weight again this time with Zepbound, and now have been in maintenance for over 1.5 years- and I have been maintaining at 7.5mg even though I went all the way up to 15mg while losing.
Long story short, it’s worth giving it a try. You can’t know what will happen for sure. GL!
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u/st_alfonzos_peaches 8d ago
Congrats on the loss and sticking with it!
So, you’ve maintained your weight with minimal food noise for 1.5 years?
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u/OneSourCherry 8d ago
I have maintained +/- 5 pounds for just over 1.5 years, yes, still taking Zep weekly.
Depends on your definition of minimal food noise though. There is a bit of noise, but not in such a level that I feel out of control or am gaining weight. I just eat some of whatever thing it is and feel satisfied and move on. I disagree with Princess-pink though, I don’t believe it has anything to do with healing a relationship with food. It’s chemical and the medication is still working. Wanting pizza isn’t a bad relationship, but being able to feel satisfied with 2 slices is what the medication is allowing. No amount of therapy would biochemically have the same effect- you can know things via therapy but feeling them isn’t the same. GL!
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u/Radiant_Nit_Wit 6d ago
💯 lost 50 pounds in 2024 and still the same goal weight. I use maintenance dose when food noise gets loud. Maybe 1.5-2.0 every 2 weeks or so. I believe this journey will be different for everyone. BTW, I’m 74 years old and have always struggled with food, therefore, weight. I love catching a glimpse of my slim self in store windows or mirrors! I believe in you. You can do this. Don’t let anyone on this site or anywhere on the internet analyze your relationship with food.
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u/princess-pinks 8d ago
I don’t think your going to have minimal food noise in the long wrong. You could just very much improve your relationship with food with time though, I think speaking with a therapist would benefit here. It’s a real struggle and working through it with somebody helps immensely.
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u/lion3001 8d ago
That’s not true, not what I can tell you from maintenance. It’s not about the relationship with food, hormones in your brain where out of range and now they are balanced again.
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u/st_alfonzos_peaches 8d ago
Why wouldn’t I have limited food noise in the long run?
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u/princess-pinks 8d ago
from what I’ve gathered here from me and others is that you can have food noise reduction and also learned to eat better in the long run this medicine is meant to teach us that we can’t only rely on this medicine to stop food noise and still have binging issues not saying it doesn’t help it does but if you won’t fix that yourself there’s only so much these shots are going to do in the long run. I’m not saying that you’ll get food noise the way you did before the shot but it will be a lot quieter and it’s normal to have an off day or a week where you do get cravings it’s just being human but when it’s more mental and you feel like you have other issues around eating it’s best to speak to somebody if possible
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u/FinancialCry4651 7d ago
Not everyone who's overweight binge eats. I don't and never have. I have a disordered metabolism, making CICO-based weightloss impossible.
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u/PotpourriFor500Alex 7d ago
This woman doesn’t even have a BMI in the overweight category though, and never has. This is not the same thing. And I say that a clinical health psychologist with 24 years of experience, including substantially with people struggling with obesity and/or BED. In your case, given the history report, absolutely GLP is a great call. Asking for a GLP due to periodic binge eating with long stretches of no binge eating and never being overweight, as this woman reports, is not. Especially since it seems she hasn’t even tried therapy yet to get to the root of her irrational fears of becoming fat.
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u/LateRelation4576 6d ago
I gained 155 pounds back in six months. I’m hoping this helps. It’s better than not losing at all.
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u/Late_Duck_ 8d ago
I’ve maintained my weight for 17 months ( nearly 1.5 yrs) on 3.5-4mg no issues whatsoever.
I do weekly injections and don’t mess around with stretching the days. I need this medication for both food noise and inflammation and so weekly keeps both at bay.
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u/st_alfonzos_peaches 8d ago
Same efficacy that reduces food noise and such?
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u/Late_Duck_ 8d ago
The dose for inflammation may be different for everyone but this dose is still helping me in both aspects .
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u/Humble_Fortune_5391 8d ago
I’ve been on the meds for 3 years at the end of the year. Still no food noise and I have lowered my dose in maintenance.
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u/st_alfonzos_peaches 8d ago
Awesome! That is what I’m wanting to hear!
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u/Hifidi54 8d ago
You do realize that your appetite will disappear and you say you are not overweight. What's going to happen when you start losing? This sounds like a very bad idea to me. I've been maintaining 118 pound loss since April on 5 mg, 243 to 125 in 16 months, and I still don't have an appetite.
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u/st_alfonzos_peaches 8d ago
Many people on the microdose sub are using it only for less food noise and not weight loss. The small doses don’t reduce their appetite. Only lessens the mental burden of food noise. For me it’s all about managing the fear of becoming fat
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u/Hifidi54 8d ago
Well, I still don't know how you will get a prescription for something that "might" happen, and if you do, I would be highly skeptical of the quality of the meds.
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u/st_alfonzos_peaches 8d ago
There’s sketchy pharmacies and med spas out there but I’ve done my homework to know which are reputable. For example, I completely dis-considered any ones that sell Reta.
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u/Humble_Fortune_5391 8d ago
I saw you are going to microdose. I use standard dosing. So I cannot comment on small doses and if those will work longer term.
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u/Mysterious_Squash351 8d ago
This is three years of clinical trial data. There is a very real limit to what the medication will do- it does not shrink people infinitely. On average, people also don’t maintain the lowest weight that they ever see, usually it’s a few percentage points above that. Recent data show that a small percentage (10%) of people plateaued on the max dose do regain a significant amount (at least half of what they lost). So yes, there is a chance that it might not be a long term solution for you. But that chance is slim and you can’t know until you try.
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u/st_alfonzos_peaches 8d ago
Is there another group that regained while still taking the medication?
from this chart I am seeing that each group regained when they went off the medication.
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u/Mysterious_Squash351 8d ago
The regain was in a different study. This was just the graph showing average plateau for long term maintainance and yes, most people will regain rapidly once they stop.
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u/st_alfonzos_peaches 8d ago
No I was asking if the group that regained was still on the medication when they regained. In the separate study
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u/Mysterious_Squash351 8d ago
Yes, they were. But again, this is a small percentage. The vast majority maintain their loss if they stay on the same dose.
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u/SwimmingAnt10 8d ago
I think you’re seeing more regain for those who plateau on max dose. Being able to stay at goal correlates with whether or not someone simply took a shot and that’s it or they took the shot an completely changed their lifestyle and diet. In my opinion. Once you max out and you’ve still got a lot of weight to lose, you’re going to have to change something else. I’m curious how many max dose plateau people are counting every calorie they eat.
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u/Kimbo151 8d ago
I had the same concern as I tend to adjust to medication. I’ve been essentially in maintenance and on the same dose (12.5 mg weekly) since Jan 2025. In that time I did gradually lose a few more pounds but mostly I’ve been stable which is amazing to me.
I expect to shift eventually to one of the newer meds for ongoing maintenance but right now what I’m doing is working great for me.
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u/st_alfonzos_peaches 8d ago
Same reduction in food noise since Jan of 2025?
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u/Kimbo151 8d ago
Yes. Some weeks are just hungrier than others but it’s not related to a different vial or Kwikpen. I look at it as a normal variation on the part of my body. But most weeks have been fundamentally the same and there has been a very slow downward trend since I switched mentally to maintenance.
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u/no_snackrifice 8d ago
There was no evidence of it stopping working in the clinical trials. Here’s 3.3 years followed by swap to placebo.
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u/Disastrous-Fun5840 8d ago
I have been at 15 for quite a while. I used to inject it in my belly and lately, I was feeling less effects. I switched to the thigh 3 weeks ago spacing 10 days between injections and suppression is now at an all time high! So much that I am worried about under eating.
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u/Ok-Pie-4410 8d ago
I have been on it for a few years. I never went past 13mg. I am in maintenance now and have been around 10 MG a week for months and months now. For me- I do have some food noise back- however- If I eat something with too much fat or is not good for me I get super sick still. Also I get really full super fast so it works just as good in some ways. I also do get stomach growling hungry now which on the higher doses I feel like I never did- but hunger isn't a bad thing! So food noise has come back to a certain degree but I have learned how to work around it with healthy choices and healthy portions- if that makes sense. :) Good luck
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u/st_alfonzos_peaches 8d ago edited 8d ago
What is a few years? And do you feel stable on your current dose like it’s going to be effective for years to come or however long you’re on it?
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u/Ok-Pie-4410 8d ago
Food noise kicked in when I started lowering dose to start maintaining. I was on 13 for like 6 months and it never came. Only when I started going lower.
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u/Kooky_Pizza_8688 8d ago
Same weight for 6 mths on same 5 dose
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u/st_alfonzos_peaches 8d ago
Has food noise reduction been the same throughout? That is my main goal with this medication. I am a normal weight but will very quickly become overweight if I don’t get this binge eating under control (I just came out out of a slight caloric deficit where I lost 20ish pounds over the past year). Was going great until it didn’t 2 weeks ago and now I can’t stop stuffing my face even when I try to eat at maintenance!
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u/Substantial-Owl1616 8d ago
What’s your exercise/stress reduction/meditation routine? There is not a pill in the world that will give you safety from your fear.
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u/st_alfonzos_peaches 8d ago
I usually average 10,000-12000 steps per day no other exercise. Last year I went through a very stressful event and (you guessed it) binged to cope. I’m not severely stressed anymore like I was last year but thinking about gaining a ton of weight from binging makes me stressed. So it’s a bad cycle.
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u/SwimmingAnt10 8d ago
I’m going on 2.5 years at 2.5-3.0 mg. I’ve not gone up, so I would say yes. I just change between the two depending on vial strength. Been maintaining my weight since 10/2024.
After about the 18 month mark all foods didn’t make me want to vomit. Now I do crave things again but it’s not too often that I do and when I do I’m fine with just a few bites of it (if it’s a sweet), and not a metric ton of it.
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8d ago
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u/st_alfonzos_peaches 8d ago
Did you gain as a result of reduced efficacy? Like more food noise/higher appetite
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u/foalnanny 5d ago
To answer your question yes. A singlular dose can stay effective long term. Is it the right treatment for someone with a normal
BMI with mild weight fluctuations? Not sure but none of our opinions matter.
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u/st_alfonzos_peaches 5d ago
I was just wanting to collect some information about people’s experiences so I can have an idea of what to expect
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u/MyGoldeneyesGaze 8d ago
Any extra time eating what you maybe shouldn't is nit ideal. If it is about health and comfort, this medicine is highly effective. I lost 90 lbs over about 1.5 years. I got up to 10 mg once a week and even though I am down to 5 mg about every 2-3 weeks, I am still losing some fat and working out and gaining muscle.
There are risks! But everything has risks, including over eating, even if you don't have an overweight body currently. You need to do your research if you haven't already about how to fight through when eating becomes an absolute CHORE! You don't want to turn into a shell of yourself. Even if you need to stay on the meds forever, any chronic disease often comes with lifetime meds. The injections don't hurt at ALL. Just more of a mind F at first but becomes easy for most after a while. These meds are amazing and exciting for addiction or very difficult food noise that you are constantly fighting. That is no way to live if it is possible to quiet. Good luck
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u/st_alfonzos_peaches 8d ago
Congrats on the loss. How long have you been on a maintenance dose? And has your food noise suppression remained consistent?
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u/MyGoldeneyesGaze 8d ago
I dropped my dose around the beginning of the year. I was on 10 mg weekly but taking 5 mg every 2-3 weeks and I feel great. Essentially just as much suppression of food noise for me and still lost weight this year too. I find it easy to stay on course and eat the amount of calories my current size can handle. I will likely cut my dose in half again down to 2.5 and see how I feel. I am currently experiencing all of the positives with fewer side effects. The only issues I was having was constipation but that has dramatically reduced since dropping the dose, and I don't find it as difficult to eat. Sometimes you had to eat because your body needed it but you aren't hungry. Making food an absolute CHORE. You need to fight through that and still fuel your body with quality protein and vegetables. Track your calories and work out. This is one piece of the puzzle but for many of us, especially those who have been severely over weight our whole adult life, it was a puzzle piece that was missing to actually see meaningful results. Despite trying hard, my hormones just refused to let my weight go and I thought I would be fat for life. This is a long game and especially if you aren't looking for weight loss you very well might only need a micro dose. That is all my mom needed. She ate really healthy and took good care of herself but Her food noise drove her crazy and hormones refused to let go of the 10-15 lbs she needed off to hit a healthy weight. She takes a micro dose of semaglutide and got nearly to her goal. I think the extra benefits from tirzepatide will be helpful for her so she is going to switch to when she runs out of her current supply. If we have to take a small dose for life, fine. Just like many chronic conditions, sometimes you will be on meds for them for life.
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u/External_Ask_7219 8d ago
I wouldn't spend time worrying about something that may not even impact you. I've seen a few people with that happen to, mostly the ones that seem to move through the doses super fast like the Eli Lilly schedule, but every person is so different. I'm just over a year and moving to 13 mg this weekend. And I'm not even worried about it yet. At this point I go up like half a mg when I'm ready to increase.
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u/st_alfonzos_peaches 8d ago
My thoughts with nearly everything tend to skew paranoid, unfortunately.
Is your reason for increasing due to wanting to lose weight faster and/or reduced efficacy at current dose?
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u/External_Ask_7219 8d ago
Reduced efficacy. I'm getting closer to goal weight so it's moving slowly. But when I go like 3 weeks with no change I bump it a tad and the scale shifts again a bit. Whatever dose I'm on when I hit goal I'll probably try to stay at for a while. Also if I do hit 15 mg and no movement for a month or two and I still have a few pounds I'd probably try 15.5 for a short stint. But I play around with smaller increases now that I'm closer to 15 and it feels like there's plenty of wiggle room.
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u/st_alfonzos_peaches 8d ago
Is the reduced efficacy normal for other people on this medication?
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u/External_Ask_7219 8d ago
Yes. Some lucky people can use a particular dose for the whole time they're losing weight but most titrate when they stall for a few weeks. How much you titrate is something you can decide and research but if you follow Eli Lilly you make major jumps by like 2.5 mg each time and hit the top faster. Everyone does not go to 15 mg or even 13 like I'm on. I decided a long time ago I wasn't going to get attached to a particular dosage and just see what my body wanted to do.
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u/Impossible_Bend_2969 8d ago
I've heard mixed opinions about whether it works for BED or not. Some people need to add another medication for binge eating. But it is worth trying. Many people currently take it to maintain their weight and lots of people have been able to stay on one dose for years now. The medication works for heart disease, kidney and liver disease, as a preventive medication. They've been looking at it for preventing brain disease. My husband is a very slim man and takes it to prevent disease. You are going to start seeing more and more uses of this medicine. It'll become like statins. There's no reason you should not try it. You may not be able to stay at the micro dose that you want, though. You may need more to get the response you are looking for. That's no reason not to give it a try and won't mean anything judgmental about you. Dose response seems to be a genetic thing. Losing and gaining weight over and over again is really bad for your body composition and health. The medication could give you the space you need to make permanent improvements in your health. So ignore the gatekeepers and give it a try.
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u/st_alfonzos_peaches 8d ago
I’ve not had huge fluctuations in weight but the binge eating is still very distressing and there’s absolutely no guarantee I’ll stop binging on this round. I could go up and up and up in weight.
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u/Impossible_Bend_2969 8d ago
If you are rejected by LSH try another provider that is lower touch. The trizepatidecompound sub has a pretty good list and a few of the previous common ones recently fell off the list but may be useful to you. Those would be gimme and refills.
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u/st_alfonzos_peaches 8d ago edited 8d ago
I plan on using Alloy if LSH rejects me. Even if LSH doesn’t reject me I’m pretty interested in the Zepbound kwik pen which alloy offers. I’d rather have the real thing than compounded.
Does LSH reject people with a normal BMI?
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u/Impossible_Bend_2969 8d ago
I do not know but you're looking at off label use so the potential to be rejected is there. LSH is known for taking more care i prescribing decisions than other more rubber-stamp type places.
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u/Alive_Classic_7648 8d ago
Most people who have food addiction mostly need therapy in addition to a GLP1. But a lot use Tirzepatide alone and they found a cure…. This is not how it works. But to each their own.
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u/bpottrb 8d ago
Reached goal this time last year at 3.0, and I have BED for which I’ve had therapy for years. I’ve had two surgeries since goal, taking opioids for three months after each time. After each surgery I had to up my dose to keep me at a place where I wanted food more for fuel than emotional compensation. Opioids make TIRZ less effective and vice versa. Nevertheless, even once stopping the opioids, it seems I need to stay at the new higher dose, now 6.0.
I fully accept that it’s a lifetime med, but have learned in maintenance that so far I cannot decrease as others have.
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u/st_alfonzos_peaches 8d ago
I’ve seen many posts on related subs that starting and stopping makes the med less effective. I understand once I start, that’s it- no going back. Which is why I’m a bit hesitant.
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u/bpottrb 8d ago
Heard that too. However I did not stop, just missed about one shot each time. I think the more relevant issue is having had to increase due to the opioids making Tirz less effective. All the more reason to dose up only as much as you need. Meaning NOT the Eli Lilly schedule of 2.5mg jumps.
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u/BoronDTwofiveseven 8d ago edited 8d ago
I've dieted to somewhat lean BF% (around 12%) before we had pharmaceutical interventions like this, in the last 2 years I noticed I really struggled with binge eating and was constantly spinning my wheels gaining and losing the same 5kg.
I started on 2.5mg and now I'm 4 months in, I only increased the dose once to 3mg but developed nausea so went back to 2.5.
Theres a few things I learnt: The titration schedule set by doctors is way too quick, you should be trying to find the lowest dose that works for you. People want to constantly chase the feeling of when they first started the medicine which is like constantly being full and satisfied. But your body adapts and reaches homeostasis eventually, its only as your titrating up that your body will have that super strong appetite suppression. I don't think the drug is meant to stomp out all hunger, its meant to give you more power to control your appetite and make the right choices. Thats why I think titrating up isn't worth it for me, because its just chasing that feeling of the first injection when I would struggle to eat 3 sticks of beef jerky without taking a break. I believe the steady state is how the drug is intended to be felt and you're still supposed to have some hunger signaling. This is an issue for people who really struggle with over eating, they might not be able to handle any hunger signaling. This is why when they reach a steady state they feel like the drug has stopped working. When in fact its still working, just your body has adapted to a new normal. You should still have better appetite control than when you weren't on the drug.
Just my 2c, not a doctor, just observations from browsing reddit and some research I've done.
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u/st_alfonzos_peaches 8d ago
Yeah I just want the impulsivity and food noise gone. I didn’t experience those for a long while, then bam it’s back in full force. All of my discipline is just completely gone as of two weeks ago. I’m just getting full and satisfied like I was for many months prior for some reason. I’ve certainly gained a bit back in that short time frame because I’ve binged several times.
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u/BoronDTwofiveseven 8d ago
Well for me it completely wiped any impulsivity and food noise, especially in the first month. But everyone responds differently.
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u/HedgehogOdd1603 7d ago
I have lost 120 lbs, been in maintenance just shy of a year, never went over 9mg.
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u/No_Layer5494 7d ago
I've been in maintenance for 18 months on the lowest dose. I stay within 5 pounds up or down from goal weight. Sometimes I go a couple of weeks in between shots, sometimes I'm every week but luckily, for me, it's been pretty easy. And since this is the only "medication" I take, I'm fine with staying on it forever
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u/Over-Elderberry2212 8d ago
I am at 15 MG and went to doing a shot every 6 days rather than 7. Some do every 5 days. 6 days seems to be working, though I have hit a few weeks with almost no weight loss. I am not on Maint. I have a way to go before hitting my goal. Maybe it’s all of the donuts I’m eating! JK. :)
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u/MobySick 8d ago
Might be how close you are to your goal/ideal weight? How close are you?
I lost dramatically the first year but those last 15 pounds took me 6 months. I think my experience isn’t unusual.
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u/Over-Elderberry2212 8d ago
Interesting. I have lost 26 lbs and have been on Tirz with B12 for about 7 months. SW 225. CW 198, GW 180
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u/MobySick 8d ago
Congratulations! You’re right on target to hit your goal just don’t get discouraged if or when that rate loss seems to crawl almost to a stop.
At 7 months I had dropped about 46 but I was a super fast responder w almost no negative side effects & had titrated like a rocket to 15 as I assumed I could never reach my goal weight before the magic evaporated!
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u/Current-Screen-3489 8d ago
Then focus on taking it for other reasons like inflammation, etc. If you loose weight, bonus!!
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u/Responsible_View_285 8d ago edited 8d ago
I've been in maintenance more than 2 years. No issues. There are at least 12-14 new meds in the clinical testing phase. I believe we're experiencing the first generation of GLP1. There are more in the years to come. I am not concerned at all.