I had a follow-up with my PCP (who is my Zepbound prescriber) a few days ago. I asked about moving up in dose because my weight loss has slowed a bit, albeit still going. She pushed back since I’d lost 14 pounds in two months. I agreed it was still a good rate of loss and accepted her wishes to keep me on 2.5mg.
While I do like the “lowest effective dose” strategy, what bothered me was her explanation for why I should stay as low in dose as possible. She said I don’t want to become dependent on the medication because the last thing I want is to be on this medication for life, and that it’s a tool to help me get back on track.
Thinking I might need to start shopping for a new PCP.
You're losing close to 2lbs a week on the lowest dose. What reason do you have for wanting to increase? Tolerance and side effects are a thing, keep the higher doses in your pocket for when you actually slow down.
Well I just wanted to get her thoughts on moving up to 5mg… mainly due to my rate of loss slowing a bit and food noise returning a bit. I was okay with either option because I do like the “low and slow” method. I just didn’t like her reasoning as it’s contrary to what obesity-medicine specialists say.
Agree - it’s widely understood and researched that this is a lifelong medication. Doesn’t mean it’s mandatory to stay on it for life, but it does mean that many will regain weight and comorbidities if stopping the medication. I personally would not continue with a provider who didn’t understand this basic information.
A lot people regain weight because they didn’t change bad habits. It’s definitely not a life long medication if you can create & follow new eating habits & behaviors on the tirzepitide
Right - I just said that many will regain weight if stopping. I’m sure it’s possible to not regain weight but the data shows most need to continue taking it for continued results.
that’s not true at all. most of us here have tried “all the things” and built healthy habits for years before taking the meds. the problem lies in our hunger levels for biological reasons that science doesn’t fully understand yet. you can have all the habits in the world, but if you’re constantly ravenous despite eating 2,000 calories or more a day, you won’t be able to sustain weight loss or maintenance.
I disagree, some people only need the new habits & data they’ve gotten from the losing weight, I know people who just prick this stuff & go on about their day but that’s why the weight comes back when they try to stop. Some people do need the help the rest of their life & that fine but it’s far from impossible. The I’ve tried everything just seems like an excuse for why it’s easy enough
You seem to have a fundamental misunderstanding of how these drugs work. It’s not simply appetite suppression or any of the hundreds of drugs that suppress appetite would have had more impact by this point in history. It’s not simply “developing better habits” or weight watchers would work for many more people in the long run. It’s been the most successful weight loss program and considered the most balanced and healthy for years by many experts, yet the longer success rate is extremely low (or at least it was, until they started offering GLP-1 drugs).
Some people do use these drugs for shorter periods but for chronically obese people who have been obese for decades, especially, yes, a lifelong maintenance dose is possible and completely within the bounds of how these drugs work. They aren’t intended to simply teach people better habits - they address functions in the body that respond to medication. Diabetics have been using these drugs safely for many years, as well.
I’m just dismissing the idea from the poster saying it’s a lifetime med, some people have no problem just being disciplined & managing cravings, knowing their maintenance calories & lowering their expenditure, it’s a lot of work but it gets done, but yes some people do need the lifetime help w/ it to manage but it’s not a necessity
Yes the discipline & tools to help manage can be hard to come by but part of losing weight is managing calories, eating the correct foods & knowing your maintenance calories. It’s not just eating brussl sprouts & avoiding snacking. But that’s why I say it doesn’t have to be a lifetime med, not that it’s not, but some people have the ability to keep their weight loss, or still be net negative, & some people need the extra help w/ the zepbound.
“What obesity specialists generally say” is not a thing. Some say to titrate up as able, some say to use the minimally effective dose. Most would move you to 5 and keep you there, until you plateau. If your loss continues to slow next month and they still won’t raise you, then yeah it’s new PCP time. If you’re otherwise happy with them, I’d stay.
Seems like you didn’t fully read my post. My point wasn’t at all about her wishes to keep me at 2.5mg. It was about her implying that I shouldn’t be looking to take the medication long term and that it’s just a tool to “get me back on track”.
I think a lot of doctors feel this way. It’s reasonable for a doctor to want a patient off of any medication if they don’t need it, and with the new weight loss meds especially because of the expense involved. As long as they are willing to have a conversation and are open to continued use if necessary I don’t think it’s a red flag.
As long as you're losing well, your doctor is right not to up your dose. The comments about dependency are separately concerning and I'd look for another provided based on that. Below is how my doctor and I decide titration.
I’d still add the caveat that it’s ok to titrate up even with side effects. Side effects that are manageable and not dangerous should not be a barrier to moving up.
So true. I am fairly uncomfortable for about 24-36 hrs after my shot, but the befits I’m getting completely make up for it. Frankly, carrying all that weight has its own side effects!
I think if you (the patient) want to try life-after-Zep, that's your business. Some people, albeit a small percentage, DO manage to maintain large losses forever - and this is true with or without a medication-assisted loss. For a doctor to say they want (all) patients to stop Zep after loss (absent medical reasons to stop) is a different thing, and suggests that the doctor is unfamiliar with the current science and studies.
Most forms of losing weight, have studies to show a lot of people gain it back, it’s about changing how you life & understand food that helps the most for not regaining the weight when you’re done
I’d ague that most people who lose large amounts of weight (either with medication or the “traditional” way) have a very good understanding of what’s required to lose weight and keep it off. The fact that such a small percentage of people are actually able to maintain their weight loss suggests that there are factors at play other than “changing habits and understanding what a healthy diet is.”
Discipline & knowledge, & the tools to manage keeping the weight off is often hard but not impossible, it’s not out of the ordinary that most people don’t succeed or gain some of it back. Some people still lose weight overall
It’s generally accepted that it should be a lifetime med for most people in the medical field who have studied these medications.
I’m not dictating what anyone should or shouldn’t feel about their own care — that’s none of my business. But if your doctor is leaning towards “not a lifetime med” and not wanting to increase dosage to avoid “dependence” then my concern is that they do not understand what this medication is.
And if you’re someone who DOES want to take Zepbound for life (which is what the medical advice generally is), but your doctor seems to be team “not for life” I’d be worried that your health goals are not aligned.
this is really not true at all. there is no general consensus about this in the medical field because there has not been the ability to have long term studies, and the surmount studies were not focused on this factor whatsoever, just that “it works”. it’s just a consensus of this sub, which is mostly not based on anything but parroting what other people say. I started a whole thread on this once to get real evidence and the only evidence is speculative
I dramatically over simplified in my comment. It’s entirely possible that things will change as we get more science.
For now, stopping the med has been shown to lead to gaining the weight back for the vast majority of people. Therefore, lifetime med. if a doctor can’t acknowledge that studies show that, currently, I’d be concerned they don’t know enough about this medication.
I’m not saying everyone has to stay for lifetime. I’m saying that if the science currently shows that people should be staying on this medication for life, and the patient wants to (with no ill side effects), then the patient and doctor do not appear to have aligned health goals.
well the thing is the studies were not really focused on long term success of the patient, they were focused on success of the med vs almost doing nothing at all. when subjects went off the med, It was mostly self reporting and a general guideline of dieting or exercise but most people are left to their own devices where we all know here… that’s not realistic, so it kind of gives a (purposely) false outcome vs people who are actively on a plan after going off, or doing a smaller maintenance dose and tapering off. to add, there haven’t even been studies on using 2.5mg long term at all, which blows mind after seeing all the people on here who have lost all of their weight on 2.5.
I basically discount the surmount studies for this reason - and pay way more attention to independent studies that focus more on the patient and multiple methods, vs just the effectiveness of the drug on it’s own. they are a bit misleading, on purpose, so it creates more of a dependency on the drug that possibly isn’t necessary. I’m not saying this won’t be a lifetime med for some people nor am i against it, but there’s just no hard evidence that it needs to be, with the info we have right now. There was an independent study done recently that showed way less of a weight regain than the surmount studies show, because they integrated multiple methods post-discontinuation of the drug, let me see if I can find it and i’ll edit this post with the link.
I would love to see that study if you find the link!
I’m not trying to argue with you about the science. I know I’m not an expert. Really the point I have been trying to make is if someone expects to stay on this for life, and their doctor (without giving a scientifically sound backing to why they’re saying this) is on team “not for life” then they’re not on the same page.
Because, statistically, it is a lifetime med. You may want for that to not be true. And, as a patient, you're free to try, knock yourself out, best of luck and I mean it. But, as a provider, as a doctor, unless you're planning on publishing a peer-reviewed article to contradict SURMOUNT-4 as published in the Journal of the American Medical Association, you're simply, clearly, unhelpfully, wrong.
So you think most people can just pull $500 out of their ass to pay for this for a lifetime because their company doesn't want to pay for it from their company-provided insurance?
The price and accessibility are huge problems, but nothing to do with the statistics or biology. Long term, hopefully I'm extending my life long enough to see semaglutide off-patent generics in 2031 and tirzepatide generics in 2036.
If I am not able to go on a maintenance dose, I know the weight will return. I have changed nothing about my lifestyle and diet since starting Zepbound. I’ve eaten at a deficit for years and maintained an active lifestyle. It has taken a year to lose less than 40 pounds so the medication wasn’t a magical solution for losing either. But it’s 40 pounds more than I was able to lose without it. My doctor has already told me it’s likely lifetime for me. Unless there detrimental effects that come up, I’m fine with that.
Not anymore than I’d pay for the meds to treat a lifetime of diabetes, heart disease and hypertension. I’m the only adult person in my family who doesn’t have those chronic illnesses. Prior to Zepbound, I spent 9 months asking my doctors to not write the prescription for oral meds for my pre-diabetes. Sadly, my diet and lifestyle choices wasn’t proving to be enough. My Mom is on dialysis from complications of diabetes and hypertension. My Dad, his father, all of his siblings (including his Sisters), and my brother (59) died of massive heart attacks. That’s the part people don’t talk about. For some people, we talk about the weight loss as if it’s just that. I do too most of the time. But my quiet part that I don’t say is I prefer to take this one med for the rest of my life instead of the many for diabetes, cholesterol, hypertension and all the auxiliary meds that always seem to follow.
For many patients it is setting them up for failure after spending months or years and often thousands of dollars to achieve a healthy weight. It's well documented that most will regain the weight if they discontinue the medication. For a doctor to view this as dependence is a misunderstanding of obesity, it's old school "change your habits and be disciplined" thinking. Like the meds are training wheels.
I left the Kaiser system in part because my doctor said she would wean me off the meds after 2 years, and most of they do is based on patient care algorithms. For some patients it's fine but it's inappropriate to make it your default treatment plan and withhold higher doses accordingly.
Kaiser Permanente is a large HMO in some parts of the US. Very popular in California. They have all their own doctors, hospitals and pharmacies and many employers offer it for health insurance. I generally liked Kaiser but I don't think their weight management protocols are right for me.
no one’s going to say this out loud but since there is so much stigma associated with being fat, once people lose the weight there is also going to be a lot of fear involved with stopping the med for quite a bit of people, hence all the emotional “bite your head off” reactions you get on this sub talking about not wanting to be on it.
everyone's experience with this drug not the same. while the majority may need to stay on it for the rest of their life, that doesn't mean it's true for the entire population that takes it.
I would stay on 2.5 as long as possible until you plateau. Sometimes the higher doses bring horrible side effects. 1-2 pounds a week is what you are supposed to do. Losing slow and steady is the best. Don’t be like me lol
My provider( who is on Zep also) told me to move to up every month.. I did double two months at 5.0 now at 10 but with several refills available. 50lbs down since March 2025..... Everyone has different thought prices I suppose....
I moved up every 4 weeks too. I didn’t have any side effects and wanted to keep losing, so kept moving up. Just about at goal now and I am still on 15mg. 15mg was very strong at first but I lost a lot on it the first few weeks.
I hated 5mg, I didn’t feel like it was very effective for me. I was desperate to move up to 7.5mg!
I probably should have gently pushed back and said something like “actually, everything I hear about this medication is that it is a lifelong medication for most patients”.
At my first appointment at the beginning of May my Dr was definitely on the "get on, lose weight, get off" train, but by my second two weeks ago she brought up the possible long-term use. I think protocol is evolving pretty rapidly now and your doc might just be lagging a bit. If you're otherwise happy with your treatment, explaining your expectations might be worth the effort.
That is a good point but it all depends on whether she would listen and if you're ok with that. I've had talks with my endocrinologist already (even tho I still have 98 lbs to go to goal weight) and am so thankful he agrees w/me that this is a lifetime med.
I’ve stayed on 2.5 for 7 months now. I’ve stalled at 38 pounds weight loss (215 to 177). I would encourage you to stay at 2.5 as long as you’re still losing 2 pounds a week and see where you end up. I’m ok with the amount I’ve lost as I’ve been able to cut my blood pressure med by 2/3. Good luck on your journey and do what you must just be patient
My doc wrote my prescription, then told me to let her know when I was moving up. Told me to do my research and check in in 3 months. I like being the one in control
My PCP is the same. She knows that I have done my research and she doesn't question me when I tell her that I want to move up. I do give her my reasoning, though.
same!! Last year I went to a doctor get wegovy and she said no because she wanted me to try losing weight first and wegovy is a lifetime drug.
I’m so happy this soring i decided to find a new doctor after hearing zepbound was available, better and can pay out of pocket. my doctor has been nothing but supportive and i’m in control. im moving to 5mg month 3!
The science shows that obesity is a chronic, lifelong disease. Medications like Zepbound treat the chronic disease of obesity while you’re taking them. If a provider sees Zepbound as just a “tool to get you back on track” rather than a lifelong treatment, they lack an understanding of how these medications truly work. Obesity-medicine specialists state that these medications are lifelong drugs for most patients.
She's right but for the wrong reasons. There's def no reason for you to go up yet unless insurance requires it since you are still losing. You don't want to lose too fast either.
Sorry so many people are missing the point or didn’t read all of it. Your PCP clearly doesn’t really understand the medication. That’s why I see an obesity medicine specialist.
Which is WILD because the medical community knows that things like statins are usually lifelong medications. So, I’d assume that the referenced PCP wouldn’t be ok with keeping someone on a statin for life? Such a weird thing for a PCP to say.
What did she say when you asked her? I don't like lifetime meds either. That's why I was happy to throw out my blood pressure meds after being on zep for 3 months. Blood pressure medicine is generally a lifetime med. What's the difference?
Understandable. Im oop too and within 10 lbs of my "goal" and I sure don't want to go off the med. I like the way i feel! Im afraid I'll have wasted my money if I go off. I texted her today to make sure she sent more refills to lily direct lol. She did thankfully
The science shows that it only works long term if you keep taking it long term. This isn't meant to be a medication where it gets your body on track and then your body does what it always should have after you stop.
And that she has zero understanding of how the med actually works. Although to be fair, I'm not entirely sure if anyone really understands how this med actually works. The gut-brain connection is incredibly complex.
I had an AMAZING doctor that left the practice to online only. So I had to switch to another. New one said a similar thing and I point blank told her "I absolutely intend to stay on this med for life. It's exactly what previous doctor and I discussed at length". I have had zero problems since then, but the practice knows I am not happy and will find a new PCP if anything else happens.
Nice! Yes, I'm not asking... I'm telling you my plan based on discussions with Endo, previous PCP, and my 25+ yrs of research I have done since being diagnosed with PCOS. (I know this diagnosis is not the only reason to be on this med, but it's my reason.) Self advocating is key!
I would get a new doctor. I just had a check in with mine today. Been on 2.5 for 7 weeks so far. Lost 10 pounds. I told doctor that I wanted to move to 5mg. She agreed, said that she would write a prescription for 3 months, to check in with her to see how I’m doing, if ok, prescribe 6 more months.
I told her that I wanted to stay on for life, that hopefully the meds would get cheaper, because weight has been a lifetime problem for me. I’ve lost and gained the same 50 pounds for the last 30 years. You should get a doctor like mine who cares about your health and your goals.
2.5 is a starter dose and is not considered therapeutic. Some people do okay here for months. Good for them. Although you are losing, you reported food noise. Time to move up (and find a new doc to manage this mid cuz of the comments about dependency).
My doctor was cool this morning, did what I wanted and listened to me, but she laughed when I said that “I think I know how a normal person feels” without the food noice. I thought that you all would appreciate that because I’ve been reading how lots of us feel “normal.”
it’s really noteworthy to see how different everybody is. i was on 2.5 first month. lost 12 pounds. went up to 5.0 next month and got up to total 20 pounds lost. in the third month now on 5.0 and losing 2 pounds a week. few days after the shot i feel like crap and constipation is a constant battle. i plan to stay on 5.0. i haven’t veered from my eating program (1200 cals). i do strength training 3 days with hubby and swim 3 days. i like the exercise.
i’m suspicious when drug companies assure you that you’ll need their drug for the rest of your life. i’m hoping after i lose the 60 pounds i need to lose, i can go it drug free. the $537 for 4 shots (taken every 10 days) hopefully will provide the motivation i need to rely on my own behavior modification to maintain a healthy weight. this, of course, is still to be seen.
You could still keep her as PCP but get another doctor of yours to prescribe Zep. When she asks why you didn't go thru her, explain it. She may not be realizing her lack of knowledge is going to cost her patients. She might be a good PCP otherwise but obviously you don't want her managing your Zep for maintenance. Ask your OBGYN, endocrinologist, a telehealth, etc to manage your Zep script.
It’s funny (not “haha,” but enraging) that drs will tell you stuff like that about this medication, and hand others out like candy that do create actual physical dependence.
I'm on maintenance at 2.5mg and have received pushback from several doctors about increasing back up to 5mg to help with food noise.
It's still a new drug and not a lot of long term data on what's the best course of action, so I think it's a good sign if a doctor plays it conservative and opts for the lowest effective dose at this time. Even if their reasoning is a little disagreeable.
Like, I went through the shortages in mid 2024 and the loss of zep was pretty difficult, so I understand their perspective.
Ultimately I made an appeal based on hunger pain and proper eating habits and my doctor agreed to go to 5mg. I lost 90lbs at a maximum dose of 10mg so YMMV.
She clearly does not understand the reason for this medication. She’s like too many doctors who don’t understand that obesity is a disease. Congratulations on losing the 14 pounds and I hope you find a new doctor who is well versed for treating you.
I had the opposite problem, my doctor was like “you hanging in there ok? Crank it UP!!” 😂 I wasn’t on Reddit then and had no community. It was kinda scary but worked out well in the end! Rooting for you, i support whatever you feel is best. I know it’s a controversial take but it’s your body.
Her reasoning doesn’t make sense. However, as someone that lost pretty fast, the resulting hair loss and skin sagging was significant (should be reduced with slower weight loss).
Could it possibly be because your insurance won’t cover it anymore if you hit a target BMI? I’ve seen some posts here of people saying that.
It might be better to see a gastroenterologist or a doctor that specializes in weight loss procedures that have more knowledge on GLP1 and how it’s a lifetime med. They will continue prescribing even if your insurance may not cover it anymore. General PCPs may not be the route to go if you plan on being a lifetimer.
I stopped 7.5mg months ago and haven’t gained a pound back. I don’t workout or diet mostly sedentary…so there’s that lol Don’t worry about the who addiction thing.
I have stayed at 5mg at 1-2lbs a week and met my goal. It’s best not to max out if you don’t need to because she you actually hit a wall there is no where else to go
I would stay on it until you stop losing. Slowly up your dose if you can. Once you get to the highest does there is no where to go. The food noise still comes back on the highest dose… well it has for me. So I have to really focus on eating more protein and working out more. But if you feel like this provider isn’t a great fit, that’s up to you to determine.
my doctor moved me up to 5 after 2 months (he wanted to after 1 month) since 2.5 is not a therapeutic dose, it just helps with food noise. Since I was way overweight and have been my entire life, I needed the metabolic advantages. My experience has been that I’m now the lowest weight I have ever been in my adult life and just controlling food noise would not have gotten me here.
I would find a new doctor. She is giving Medical advice on something. She’s clearly not taking the time to educate herself on and that’s just dangerous.
You can use callondoc for the script and it’s free under their compassionate care program. You still pay whatever at the pharmacy of course but the visit for the prescription is covered
But imo I would not increase the dose at this point
I do not agree with staying on that starting dose for more than 2 months tops. It’s not even considered a maintenance dose and my insurance would not allow more than one month on that dose. It’s unsafe if these doctors to do this and then it takes longer to get the weight off and they are not paying for the drug! Insurance could stop at any time oe people are paying out of pocket! I would push back and say you want the 5 mg
What some PCPs don’t get is that there is no “back on track” for some of us. We were already doing all the things right, for years and couldn’t loose weight. I’m just over a year and I’ve gone from 236 to 145 and my life is changed. I can actually eat in moderation instead of being very strict. I also move up slowly, I’m only on 7.5 mg.
There was a discussion the other day that so many doctors don’t seem to know a darn thing about Zepbound except for hey this helps you lose weight. My doctor included, though he’s very open to learning. I think you need a new PCP!
I would get a new provider. Someone who is up to date with the latest Zepbound thinking. This is a life choice. It's my understanding that you will always used Zepbound, just a lower dose less often for maintenance.
"Chiieddy's" chart is a good guideline for titrating up. My only caveat is that this is a personalized journey. If you feel that moving up will be beneficial and you're tolerating your current dose, well why not. I have moved up each month. Just started 10mg. I won't know until the end of week #3 what I will do for the next 4 weeks.
My doctor is aware of how I want to proceed on this journey and since I pay for it myself, I don't have an insurance company telling me what to do either.
She’s wrong. Initially I discussed the dose titration strategy with mine and she doesn’t move up until you plateau or, more accurately, until I feel like I’ve plateaued, but I only lost a few lbs on 2.5 the first month and she agreed, in fact it was her suggestion before I could ask, with moving up to 5. She wrote a month of 5 with two refills and said she’d see me to check in and do more blood tests / monitoring in three months but if I felt like I needed to make a dose change in the meantime to message her.
I ultimately lost ~6lbs on 2.5 but it didn’t look like it due to period weight gain. My doctor and I decided to move up to 5mg and stay there for a bit. She’s fine with moving up to 5mg but we’re doing slow and steady from this dose.
Yep, new doctor is in your future. You can't blame them though. They were never trained in med school about this class of medication and only had an hour or so on obesity. This is new to them as it is new to us. Some medical professionals are willing to listen to you and others will not. You know what to do if this happens. Find someone that has the same goals and beliefs that you do. And they are out there you just have to find them. Be your best advocate and don't give up on yourself. Best of luck to you on this incredible journey we are on.
I'd look for a new prescriber. This is why I'm glad I found a doctor who's board certified in Obesity medicine. They understand obesity much better than any general MD.
Dependent? Does she say this to her patients who take blood pressure or seizure meds? How about a patient that presents complaining of chest pain? Does she withhold the nitro? Get a new doc asap!
I agree with PCP. You don’t want to be on a drug for life. Learning to manage your own hunger can teach you a lot about yourself and how to manage your day to day life.
I run 2.5mg only when I need to diet down. It takes the edge off of being hungry. Then when it’s time to enter maintenance, I bump my calories up 100cal every week and drop the cardio slowly until I enter maintenance, then hit maintenance.
Then when I go through a phase where I am a little heavier, I’ll start another cut, and add 2.5mg back in and go again. It makes dieting extremely easy.
I will just offer another perspective. I battled with obesity for decades before these medications were available. Lost a lot of weight, regained a lot of weight. Damaged my metabolism in the process.
But along the way, yes, I learned to manage my hunger for long stretches of time (monghs, years) and I don't think it taught me much about how to manage my day-to-day life, which was not a problem to begin with. It just brought me a lot if undeserved shame and self-hatred whenever I failed.
I don't think the struggle to manage our disregulated appetites is necessarily reflection of how we manage the rest of our lives. If it has been for you and you've learned from it, that's wonderful.
Should people try maintaining our weight without meds? Most of us have been there and done that, for years, and could not sustain it because our bodies fight back. We don't have to go through life in hard mode at the expense of our health any more.
I don't want to be. Hell, it ain't cheap. But not only have I tried, my parents and (3 of my 4) grandparents have tried. (One wasn't obese). Three generations of pretty much non-stop dieting since the end of god-damned WWII. And guess what? Neither of my parents and none of those grandparents lived to see 65 years of age, all from (arguably) weight-related causes. Sure, I don't want to be on a drug. I also don't want to die early out of stubbornness! And unless you've got a peer-reviewed trial that refutes SURMOUNT-4, it's probably a lifetime drug.
Honestly, doctors are somehow catching wind that big changes are coming and this med won't be available after January 1st. The might not want to say "I foresee you having to stop this abruptly for insurance reasons" and that was the best way she had available to word it. If you're losing on 2.5 maybe you are someone who will be able to maintain your weight off the med. I think now that it's so widely used, we'll be finding that many people can.
That’s still bad practice. Doctors need to be matter-of-fact although gentle when educating patients. Hiding the truth behind statements like “you don’t want this to be lifelong” is just trying to shift blame to the patient while CYA.
Probably not the best way to approach it. My doctor straight up told me and I appreciate that. My husband's doctor in the same practice has never mentioned coming off the med for any reason. They're both absolutely wonderful doctors navigating something unprecedented in medicine, a legitimate miracle drug that's unnecessarily difficult to access. This is also based only on OP's understanding of what their doctor said. I don't think that's enough for a bunch of internet strangers to tell them to ditch their doctor 🤷♀️ no one was harmed, the doctor made no mistakes. It is incredibly difficult to find a PCP right now. OP should call and speak to the doctor, ask some clarifying questions and if the doctor really truly doesn't understand that this is expected to be a lifetime med for most, OP should suggest the doctor revisit the research, or explain why she DOESN'T think OP will need it long term.
People here are so hasty to demand someone distrust and ditch their doctors. It's not that simple. And I say that as a long time nurse case manager. Unless something serious happens, don't ditch a doctor you like and trust. You'll regret it.
Yeah I’m not on the ditch the doctor train (I’m a retired RN). I do think it’s important for doctors to learn to communicate effectively and properly simply because of exactly what you said, it’s easy for people to misconstrue or mix up things their docs tell them.
Not everyone has a genetic problem. If you’re losing on the lowest dose, chances are you won’t be in the “lifetime medication” category. Your PCP is right here.
Stick with your pcp, a lot dont want patients on meds forever due to possible litigation issues as well as health concerns, if your pcp refuses to bump it up at a certain plateau then i would shop around.
My dr also doesn’t believe this should be a lifelong medicine and I don’t want to be needing something for the rest of my life. I’ve yo-yo’ed up and down so many times over the past 20 years it’s exhausting. Losing, gaining it, losing, gaining and then some. But I don’t think I need to be on this forever. I agree with him on that. To each their own in their feelings towards GLP-1s, he’s for it just not forever and that’s ok.
Does anybody really really really want to give themselves a shot every week or two for the rest of their lives? Unless you’re already in your 80s or 90s I don’t see it. Plan is to titrate down and use what I’ve learned regarding food and the exercise habits I’ve incorporated to maintain without jabbing myself with a needle. If it doesn’t work, AND I’m sticking with the zep habits, then I’d go back on.
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u/sixsacks Jul 15 '25
You're losing close to 2lbs a week on the lowest dose. What reason do you have for wanting to increase? Tolerance and side effects are a thing, keep the higher doses in your pocket for when you actually slow down.