Not seeing progress in 2 weeks.

amosmylove

amosmylove

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Hey all. I'm relatively new to GLP1s. I've been on grey Tirz for 9 weeks. I just took my 2nd dose of 7.5mg yesterday. Started 9 weeks ago at 2.5mg. I lost 19lbs in the first 7 weeks, and my side effects were tolerable. Mainly burps and diarrhea as the worst of it. However,
I haven't lost weight or even changed weight in about 2 weeks. I thought once I got up to 7.5mg I'd really start seeing change. I've also noticed more hunger amd less satiety when eating the last two weeks.
The most likely culprit seems that when I bumped to 7.5 I also started a new vial of 60mg Tirz. I got them both from the same website, but my first vial was a 30mg vial. I'm wondering if the 60mg vial is less potent, or perhaps the first vial had more endotoxins which was giving me more bowel trouble? I've not had any stomach/burping/loose stool issues on this new vial.

I guess I'm wondering what you would do in my shoes. Bump up my dose or take a midweek dose to try to start something?
I was consistently loosing about 2.5lbs a week and now nothing for over 2 weeks. I haven't been eating poorly or excessively by anymeans. Still at a calorie deficit and I fast for mosy of the day. I have been rather slothful. Definitely struggling with energy which could be attributed to the weightloss from previous months.
Starting weifht 207, current weight 189.

I did just finish a BPC/TB stack cycle past week. Also a DSIP cycle.

Is this normal to not have changes or is it a bum vial?
 
It takes 4 weeks, sometimes 5 or 6, to start feeling the full effects of tirz. You should wait at least that long before increasing to a higher dose or assessing whether it's working or not. You want to be on the lowest effective dose so that you have room to increase if you start building a tolerance. Waiting 4 weeks before increasing helps to prevent or decrease side effects as well.

It's also normal for your weight to plateau for a few weeks after losing a fair amount. Your body just has to recalibrate.

I'd continue at 7.5mg for at least 2 more weeks.
 
Chances of a “bad vial” are pretty low. It is recommended to stay on each dose a minimum of four weeks, and it’s also not considered a stall or plateau unless you have not lost for 4 weeks. 19lbs in 7 weeks is very quick loss, and your body is likely just adjusting. Stay at 7.5 for at least the next two weeks, if you see no movement on the scale at that point, then I would think about titrating up
 
cheaperseeker said:
It takes 4 weeks, sometimes 5 or 6, to start feeling the full effects of tirz. You should wait at least that long before increasing to a higher dose or assessing whether it's working or not. You want to be on the lowest effective dose so that you have room to increase if you start building a tolerance. Waiting 4 weeks before increasing helps to prevent or decrease side effects as well.

It's also normal for your weight to plateau for a few weeks after losing a fair amount. Your body just has to recalibrate.

I'd continue at 7.5mg for at least 2 more weeks.
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I felt confident that I was responding really well to it almost immediately. It's just that since starting a different vial everything is different. Almost like I'm at half the old dose.
When you say it takes 4 weeks, or 5 or 6, to feel the ' full effects of tirz' are you meaning 4-6 weeks at a specific dosage? Why do clinical guidelines suggest titrating up every 4 weeks if it should take longer? Maybe I am just misunderstanding you though.

I just don't understand why I was responding so well to the 2.5/5mg dosages and now going to 7.5 it plateaus . Seems counterintuitive. Unless the vial is less potent/junk. That's when things changed.
 
One more thing. Fasting for most of the day is likely contributing to your lack of energy.

Are you a woman? I recently heard that all the studies that say fasting is so good for you were done on men, and it likely is not so great for women because our bodies are more sensitive to energy availability. So, if your body is sensing food scarcity, it could be holding onto the weight to have "back-up energy".

Even if you're a man, too much of a calorie deficit could signal scarcity.

Eat at least 3 times throughout the day and make sure you're getting enough calories. I'd actually recommend not tracking calories at all and just eating when you're hungry. You might be surprised by what the scale tells you when you relax and let the tirz do it's job.
 
wileyhorse said:
Chances of a “bad vial” are pretty low. It is recommended to stay on each dose a minimum of four weeks, and it’s also not considered a stall or plateau unless you have not lost for 4 weeks.
Click to expand...

I can hang out at 7.5. I guess the lack of any side effects while also increasing the dose is making me think it's not working. I don't enjoy diarrhea, but I knew the glp1 was doing it's thing when I had it! LOL

I need to be more patient. I have been expecting to keep loosing consistently so I was disconcerted at no change for 2 weeks and counting.
 
amosmylove said:
I felt confident that I was responding really well to it almost immediately. It's just that since starting a different vial everything is different. Almost like I'm at half the old dose.
When you say it takes 4 weeks, or 5 or 6, to feel the ' full effects of tirz' are you meaning 4-6 weeks at a specific dosage? Why do clinical guidelines suggest titrating up every 4 weeks if it should take longer? Maybe I am just misunderstanding you though.

I just don't understand why I was responding so well to the 2.5/5mg dosages and now going to 7.5 it plateaus . Seems counterintuitive. Unless the vial is less potent/junk. That's when things changed.
Click to expand...
Because plateaus are a thing. It’s not the medicine or the dose. It’s your body taking a reset.

Also, are you meeting your protein goals? That can affect loss rates.

Additionally- are you getting your kits tested/joining a group test? Vendor test results can’t be trusted. I doubt the kit is junk, but without testing there is no way to know.
 
cheaperseeker said:
One more thing. Fasting for most of the day is likely contributing to your lack of energy.

Are you a woman? I recently heard that all the studies that say fasting is so good for you were done on men, and it likely is not so great for women because our bodies are more sensitive to energy availability. So, if your body is sensing food scarcity, it could be holding onto the weight to have "back-up energy".

Even if you're a man, too much of a calorie deficit could signal scarcity.

Eat at least 3 times throughout the day and make sure you're getting enough calories. I'd actually recommend not tracking calories at all and just eating when you're hungry. You might be surprised by what the scale tells you when you relax and let the tirz do it's job.
Click to expand...
I am a woman, yes. I don't track anything but I do know I am at a deficit simply from years past of monitoring my food intake and scale response. I maintain my weight at about 1800-2000k and lose if under 1500 cals. I am definitely under that 1500 mark these days.
I have not been earing 3x a day in general. Usually my first meal is at dinner and a snack before bed. Sometimes a snack in the late morning.
I've been eating mainly salmon or chicken everyday.

I'll have to been more deliberate about eating more often to not be overtired.
 
amosmylove said:
I am a woman, yes. I don't track anything but I do know I am at a deficit simply from years past of monitoring my food intake and scale response. I maintain my weight at about 1800-2000k and lose if under 1500 cals. I am definitely under that 1500 mark these days.
I have not been earing 3x a day in general. Usually my first meal is at dinner and a snack before bed. Sometimes a snack in the late morning.
I've been eating mainly salmon or chicken everyday.

I'll have to been more deliberate about eating more often to not be overtired.
Click to expand...
Ah. Are you eating enough? You really need to track your intake. There are free trackers like my fitness pal that can let you track your calories, protein, et cetera. Getting enough protein not only will help with fatigue , it will prevent the hair loss that many experience during weight loss
 
amosmylove said:
I felt confident that I was responding really well to it almost immediately. It's just that since starting a different vial everything is different. Almost like I'm at half the old dose.
When you say it takes 4 weeks, or 5 or 6, to feel the ' full effects of tirz' are you meaning 4-6 weeks at a specific dosage? Why do clinical guidelines suggest titrating up every 4 weeks if it should take longer? Maybe I am just misunderstanding you though.

I just don't understand why I was responding so well to the 2.5/5mg dosages and now going to 7.5 it plateaus . Seems counterintuitive. Unless the vial is less potent/junk. That's when things changed.
Click to expand...
Yes, 4-6 weeks at each dose.

It could just be coincidence that your stall happened when you started a new vial. Although, as wileyhorse said, it's not really considered a stall until you've been at the same weight for at least 4 weeks, because it's normal for weight loss to pause occasionally. You also lost that weight pretty fast. A "healthy" amount to lose is 0.5 - 2 pounds per week. Still, it wouldn't hurt to recheck your reconstitution and dosing math as well.

The guidelines probably say 4 weeks because most people's levels are close to the full amount by that time, and they wanted to have a standard protocol that they could give everyone so they don't have to do blood work on each patient every week. But everyone is a little different. I've noticed it takes me around 5 weeks to feel the effects fully and consistently.

It's good that you're getting in protein, but make sure you are getting some healthy carbs and fats, too.
 
Every time someone says they're not losing weight, a bunch of people show up to tell them they need to be eating more. More meals, more carbs, more everything. Makes absolutely no damn sense.

I don't mean to be abrasive but like, that's just not know anything works. Try eating more salad, more soup, more vegetables, more exercise, and fewer calories. It's ok to skip meals, it will not kill you. You don't have to if you don't want to, but for a healthy overweight adult it's not gonna cause any harm. Forcing yourself to eat three meals a day when you don't feel like it just defies all logic.
 
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deleted.user.16 said:
Every time someone says they're not losing weight, a bunch of people show up to tell them they need to be eating more. More meals, more carbs, more everything. Makes absolutely no damn sense.

I don't mean to be abrasive but like, that's just not know anything works. Try eating more salad, soup, vegetables and fewer calories. It's ok to skip meals, it will not kill you. You don't have to if you don't want to, but for a healthy overweight adult it's not gonna cause any harm. Forcing yourself to eat three meals a day when you don't feel like it just defies all logic.
Click to expand...
You absolutely do need to eat a certain amount of calories to lose weight and to stay healthy.

Some key points from the article below (there are also many other articles and studies from credible sources that say the same things):

Extremely low-calorie diets trigger metabolic adaptation, forcing the body to slow its metabolism and conserve energy, which causes a weight-loss plateau. Additionally, this can lead to muscle loss, severe fatigue, increased cravings, and hormonal imbalances, making it harder to sustain long-term weight loss.~

www.weightkidneycare.com

Why Eating Too Little Can Stall Weight Loss

Eating too little doesn’t speed up fat loss but it slows it down. Your metabolism needs energy to function well, and nourishment is the key to sustainable progress. Check out more information in this article.
www.weightkidneycare.com www.weightkidneycare.com
 
cheaperseeker said:
You absolutely do need to eat a certain amount of calories to lose weight and to stay healthy.

Extremely low-calorie diets trigger metabolic adaptation, forcing the body to slow its metabolism and conserve energy, which causes a weight-loss plateau. Additionally, this can lead to muscle loss, severe fatigue, increased cravings, and hormonal imbalances, making it harder to sustain long-term weight loss.
Click to expand...
I know all about unhealthy weight loss. A few years ago I got hit with some major depression. Lost 40lbs in 3 months. Not on purpose. It was just legit major depression. Then lost almost all of my hair! Which triggered worse depression. That sucked big time as a woman. It's all back now but I started wearing wigs because of it.
 
amosmylove said:
I know all about unhealthy weight loss. A few years ago I got hit with some major depression. Lost 40lbs in 3 months. Not on purpose. It was just legit major depression. Then lost almost all of my hair! Which triggered worse depression. That sucked big time as a woman. It's all back now but I started wearing wigs because of it.
Click to expand...
😟 All of that sucks big time. I hope you were able to work through it, and are feeling better lately.
 
deleted.user.16 said:
Every time someone says they're not losing weight, a bunch of people show up to tell them they need to be eating more. More meals, more carbs, more everything. Makes absolutely no damn sense.

I don't mean to be abrasive but like, that's just not know anything works. Try eating more salad, more soup, more vegetables, more exercise, and fewer calories. It's ok to skip meals, it will not kill you. You don't have to if you don't want to, but for a healthy overweight adult it's not gonna cause any harm. Forcing yourself to eat three meals a day when you don't feel like it just defies all logic.
Click to expand...
I wasn’t advising to eat more of anything but protein. And meeting protein when not hungry prevents muscle and hair loss, among other things. I lost most of my weight when I had absolutely no appetite and forced myself to drink 3 protein shakes daily to meet my protein needs. After that, I didn’t care. Malnutrition is real and it’s not fun, so starving yourself because you aren’t feeling hungry is very different from making sure you meet some basic nutritional goals.
 
cheaperseeker said:
You absolutely do need to eat a certain amount of calories to lose weight and to stay healthy.

Some key points from the article below (there are also many other articles and studies from credible sources that say the same things):

Extremely low-calorie diets trigger metabolic adaptation, forcing the body to slow its metabolism and conserve energy, which causes a weight-loss plateau. Additionally, this can lead to muscle loss, severe fatigue, increased cravings, and hormonal imbalances, making it harder to sustain long-term weight loss.~

www.weightkidneycare.com

Why Eating Too Little Can Stall Weight Loss

Eating too little doesn’t speed up fat loss but it slows it down. Your metabolism needs energy to function well, and nourishment is the key to sustainable progress. Check out more information in this article.
www.weightkidneycare.com www.weightkidneycare.com
Click to expand...
There is no consensus in the medical community that three meals a day is required for everyone, especially for already overweight individuals. Just as you can find doctors that says you must eat three meals a day, I can also find other doctors that says skipping meals can give you a long list of health benefits.

giving.massgeneral.org

Doctor Recommends Intermittent Fasting

Angela Fitch, MD, associate director of the Mass General Weight Center, discusses intermittent fasting and how it can help patients lose weight.
giving.massgeneral.org giving.massgeneral.org
health.clevelandclinic.org

6 Tips for Healthy Fasting

Fasting is common for certain religious observances and eating styles. Our expert explains how being prepared, drinking water, limiting exercise and planning for medications can help you stay healthy during your fast.
health.clevelandclinic.org health.clevelandclinic.org

I just don't think telling someone plateauing to eat more is good advice.

And Amos, I am sorry to hear about your depression and am glad you are doing better now. I have also lost half my hair at one point in my life because of a major stressful event. But in that same period I gained 20 pounds from overeating. There have been other times when I ate an extremely restricted diet for months and lost no hair whatsoever. Isn't it possible that stress is what causes the hair loss? That's not to say that it's impossible to get hair loss from undereating. Hair loss is one of the common side effects of anorexia. But that usually happens to people at a 12, 13 BMI. If someone is very overweight and they eat, say, 1200 calories in a day split into one or two meals, they will be fine. Eating more for no reason is counterproductive.
 
deleted.user.16 said:
There is no consensus in the medical community that three meals a day is required for everyone, especially for already overweight individuals. Just as you can find doctors that says you must eat three meals a day, I can also find other doctors that says skipping meals can give you a long list of health benefits.

giving.massgeneral.org

Doctor Recommends Intermittent Fasting

Angela Fitch, MD, associate director of the Mass General Weight Center, discusses intermittent fasting and how it can help patients lose weight.
giving.massgeneral.org giving.massgeneral.org
health.clevelandclinic.org

6 Tips for Healthy Fasting

Fasting is common for certain religious observances and eating styles. Our expert explains how being prepared, drinking water, limiting exercise and planning for medications can help you stay healthy during your fast.
health.clevelandclinic.org health.clevelandclinic.org

I just don't think telling someone plateauing to eat more is good advice.

And Amos, I am sorry to hear about your depression and am glad you are doing better now. I have also lost half my hair at one point in my life because of a major stressful event. But in that same period I gained 20 pounds from overeating. There have been other times when I ate an extremely restricted diet for months and lost no hair whatsoever. Isn't it possible that stress is what causes the hair loss? That's not to say that it's impossible to get hair loss from undereating. Hair loss is one of the common side effects of anorexia. But that usually happens to people at a 12, 13 BMI. If someone is very overweight and they eat, say, 1200 calories in a day split into one or two meals, they will be fine. Eating more for no reason is counterproductive.
Click to expand...
I see where you're coming from. I think stress played a huge role in my hair loss, but losing so much weight in such a short amount of time via the unintentional starvation definitely set me up for vitamin deficiencies that I'm sure also contributed. It was a bit of a storm where everything just compounded and my hair was one of the outward signs of how much damage my body was taking. I recall when/if I did eat at that time it was like a poptart or icecream. I stopped eating family meals etc so nothing good was going into me when I did eat. Bad news all around.
 
After 19 lbs of weight loss in 9 weeks, 2 weeks of no change is totally normal and should just be ignored. Weight normally fluctuates a kilo or 2 up and down with fluid balance, and initial weight loss often has up to 10 lbs of weight loss due to fluid loss as you use up stored liver glycogen and then you body gets rid of all the water that was stuck to the glycogen molecules. After a while there is some readjustment of fluid balance which is most likely what is happening now.
Assuming the number of calories you are eating per day has not changed over that 2 weeks, then you are almost certainly still losing fat, regardless of what the scales say. True plateaus from GLP drugs are usually about a year after starting not 9 weeks. And reduction in energy expenditure from weight loss is not a major issue at less than 10% change. You can try measuring waist circumference if you want to see evidence of weight loss but it is not super accurate as how tight the measuring tape is makes a few cm difference. But if calorie intake was causing weight loss and that has not changed, then the results will show on the scales eventually.
Whether you should increase doses at this point depends mainly on what side effects you are getting, and how much weight you want to lose. The more severe the obesity and the longer it has been an issue, the stronger the reasons for increasing doses towards 15mg, as well as if there are health problems from obesity, and overall cardiovascular risk. Do not have enough info to guess all I can see is start weight at 207lbs but no age or height or associated health issues.
 
deleted.user.16 said:
There is no consensus in the medical community that three meals a day is required for everyone, especially for already overweight individuals. Just as you can find doctors that says you must eat three meals a day, I can also find other doctors that says skipping meals can give you a long list of health benefits.
Click to expand...
The post you're responding to wasn't talking about three meals a day. It was simply saying that not eating enough stalls weight loss and causes other health problems. I never said that everyone must eat 3 meals a day. That was simply a suggestion for this individual.
deleted.user.16 said:
If someone is very overweight and they eat, say, 1200 calories in a day split into one or two meals, they will be fine. Eating more for no reason is counterproductive.
Click to expand...
So you agree that people should eat a minimum number of calories, your example being 1200?
 
cheaperseeker said:
So you agree that people should eat a minimum number of calories, your example being 1200?
Click to expand...
No, not necessarily. I'm currently eating between 50 and 700 a day (with rest periods where I'm eating 1000-1200) hopefully for the next 2-3 months. I've even done 200-400 calorie diets before for periods of around 2 months with no negative effects (in fact skin, hair, energy, and all health markers improved once you get past the first few weeks of energy slog). Not that I'd recommend this to someone online because you never know if they have some rare preexisting condition that might make this dangerous for them. This is just to say skipping a meal or two occasionally won't kill you.

I would like to see some evidence that not eating enough stalls weight loss. Not some organization or a particular doctor's personal suggestions, an actual study that compares one group eating, say, 1200 calories a day and another group eating 700 calories a day that shows the 700 calorie group loses less weight once this theoretical "scarcity mode" activates. I think an extraordinary claim like that would need extraordinary evidence to back it up and I don't think I've ever seen any.
 
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deleted.user.16 said:
This is just to say skipping a meal or two occasionally won't kill you.
Click to expand...
Nobody said it would. OP stated she fasts most of the day, struggles with energy, and "Usually my first meal is at dinner and a snack before bed. Sometimes a snack in the late morning. I've been eating mainly salmon or chicken everyday." That goes beyond skipping a meal or two occasionally.
deleted.user.16 said:
I would like to see some evidence that not eating enough stalls weight loss. Not some organization or a particular doctor's personal suggestions, an actual study that compares one group eating, say, 1200 calories a day and another group eating 700 calories a day that shows the 700 calorie group loses less weight once this theoretical "scarcity mode" activates. I think an extraordinary claim like that would need extraordinary evidence to back it up and I don't think I've ever seen any.
Click to expand...
I can't dictate how the studies were carried out, but the first one is pretty pretty close to what you specified. Please note that most of them refer to "adaptive thermogenesis", rather than the layman's term, "scarcity mode".




https://psychiatry.duke.edu/blog/starvation-experiment
(^^This one details another well-known, and often referred-to, study which I couldn't locate the original report of)

[Edited to remove links that I accidentally pasted twice]
 
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cheaperseeker said:
Nobody said it would. OP stated she fasts most of the day, struggles with energy, and "Usually my first meal is at dinner and a snack before bed. Sometimes a snack in the late morning. I've been eating mainly salmon or chicken everyday." That goes beyond skipping a meal or two occasionally.

I can't dictate how the studies were carried out, but the first one is pretty pretty close to what you specified. Please note that most of them refer to "adaptive thermogenesis", rather than the layman's term, "scarcity mode".




https://psychiatry.duke.edu/blog/starvation-experiment
(^^This one details another well-known, and often referred-to, study which I couldn't locate the original report of)

[Edited to remove links that I accidentally pasted twice]
Click to expand...
Okay. From your first link:

While it says that in the first few weeks the low calorie diet people were burning less energy, the fourth sentence in the abstract is "The REE [resting energy expenditure] of the VLCD [very low calorie diet] patients increased during 12 subsequent weeks of realimentation such that differences in REE between the two groups were not statistically significant at week 24. There were no significant differences between the groups in pre- to posttreatment changes in REE [resting energy expenditure] normalized to FFM [fat-free mass]."

Doesn't that run counter to your point? Can't read past the abstract because paywalled.

On your second link:

I am familiar with the Biggest Loser study mentioned in that study as having caused adaptive thermogenesis. Those people were eating 1200 calories a day, not fasting though. Maybe I am reading it wrong, but article seems to show that all weight loss causes adaptive thermogenesis, not that extreme diets cause it?

From your third link:

"Furthermore, a recent study showed that ADF [alternate day fasting] for 4 weeks did not affect RMR [resting metabolic rate], although the intervention led to reductions in energy intake (−37%) and body weight (−5%) (Stekovic et al., 2019). Similar findings have been made for the comparison between continuous CR and CR implemented every other week (Byrne et al., 2018). While the intermittent fasting approach achieved more pronounced weight loss, RMR declined less, after adjustment for changes in body mass and the mechanism for this difference is unexplored."

It basically says all calorie restriction diets caused metabolic adaptation, but the ones that involve fasting (intermittent and alternate day fasting) caused the least decline in resting metabolic rate. So that also runs counter to your point.

From your fourth link about the Minnesota Starvation experiment, yes those people sound like they were having a terrible time. But they were eating 1570 calories a day, so that is moderate calorie restriction and not fasting or extreme calorie restriction. Also the participants started at normal weight (non-obese) so I'm not sure the results of putting already normal weight people on a diet is super applicable to overweight people.

I didn't read through all your links in detail as that would probably take me days, but from a quick skim, they all seem to say that calorie restriction and fat loss in general causes adaptive thermogenesis? Not specifically that extremely low calorie diets cause it and moderately restricting calories doesn't cause it?
 
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Ok, you're right. You're never going to find a study that states the exact words you want, in the exact order you want them.

Nor have you produced what you requested of me: evidence that not eating enough for an extended period of time doesn't cause weight loss stalls, "Not some organization or a particular doctor's personal suggestions, an actual study".

I've already wasted too much of my time getting sucked into responding to circular arguments. I'm moving on.
 
Metabolic adaptation to weight loss is very real and an important effect in limiting weight loss after a lot of weight has been lost and increasing risks of putting weight back on. In my experience my energy expenditure dropped by about 50% from start at 145kg to end at 75kg, with about 1600 kcal/day causing 6kg of weight loss a month initially to 0 kg a month 12 to 14 months later with zero change in calorie input.
Not sure exactly how many calories you eat per day really changes it much, it seems to be more determined by total weight lost and maybe length of time of low calorie intake. Seemed to take till I got to about 90kg before it started slowing down or 55kg lost or about 9 months, might be different for different people but is not a significant factor in initial weight loss only towards the end.
 
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