Stalled

[brooke0620]

Hey guys,

So I started S in October. I have lost 45 lbs. I was on the max dose and have been stalled for a month. I switched to T at 2.5 mg. That did nothing and food noise is back. I did 2.5 more midweek and started Saturday on 5. Still talked, still hungry, still having craving and food noise. I have tried every trick. More water, more calories/less calories , changing injection sites. I’m losing hope. Please help!!

 

[jaestar]

From what I have read, Semaglutide has a lot more food noise reduction than tirzepatide. How long was your stall? I know some people add a small dose of sema if the food noise suppression wears off on tirz or reta.

 

[FrankTdog]

Going from the max dose of Sema to the minimum dose of tirz could be a factor as well. It may not hurt to go ahead and bump up to 5 and see how that treats you.

 

[Skidude]

Most of the posts I have seen when changing from one GLP-1 to another, they continue current dosing, slightly decreasing, while titrating up on new GLP-1
This might also benefit you.
Those that use Tirz also sometimes add a sprinkle of sema

 

[Calm Logic]

There is also possibly more variability with how one's body responds after losing a lot of weight already.

 

[Iamnew2this]

Hey guys,

So I started S in October. I have lost 45 lbs. I was on the max dose and have been stalled for a month. I switched to T at 2.5 mg. That did nothing and food noise is back. I did 2.5 more midweek and started Saturday on 5. Still talked, still hungry, still having craving and food noise. I have tried every trick. More water, more calories/less calories , changing injection sites. I’m losing hope. Please help!!

If you were on the max dose of sema, it might be probable to increase your dose of tirz again. 5mg isn't a therapeutic dose. You might have to go to 7.5mg or even 10mg. You should be feeling it by then. It wouldn't hurt to try as long as, you don't have many bad side effects at 5mg.

 

[Calm Logic]

I remember someone saying somewhere (in other words, don't quote me), that 7.5mg of tirz is like the max dose of sema. I don't know if that's true, but it may be true for someone.

Like everyone else, I agree with upping the tirz (or whatever else you want to up). I have only been on tirz, and I went up 2.5 mg each week until I reached 10 mg.

When you were stalling with the sema, how did the food noise/cravings compare to now? In other words, are you eating more now (or wishing you were) than when you were stalling on the sema? Or are the stalls similar, including with the scale (or blood sugar or whatever)?

Something I plan to do if/when I stall for weeks is to try continuous glucose monitoring, which has always seemed interesting to me anyway (despite costing $90 a month or so). Other options include adding a non-GLP medication like phentermine or metformin. Another way to manage a stall (mostly from the world of "bro science" but it applies to women too) is to focus on gaining muscle (focusing on body composition rather than weight).

 

[Skidude]

It is also my understanding, not verified, that Tirz has less blocking of food noise but has more feelings of satiety.
It has been my experience when I absolutely kill my goal of 1200 calories, and feel like I am cheating like an animal at a feast, my calories remain between 1800-2000, but I am full.
Also, anecdotally, when I have gained a few pounds, it has not been when I over ate, and I am baffled as to why-

 

[Calm Logic]

A study equating 5 mg of tirz to the efficacy of 2 mg sema:

"HbA1c and weight reductions were significantly greater for tirzepatide 10 and 15 mg versus semaglutide 2 mg and were similar for tirzepatide 5 mg versus semaglutide 2 mg."

 

[brooke0620]

I remember someone saying somewhere (in other words, don't quote me), that 7.5mg of tirz is like the max dose of sema. I don't know if that's true, but it may be true for someone.

Like everyone else, I agree with upping the tirz (or whatever else you want to up). I have only been on tirz, and I went up 2.5 mg each week until I reached 10 mg.

When you were stalling with the sema, how did the food noise/cravings compare to now? In other words, are you eating more now (or wishing you were) than when you were stalling on the sema? Or are the stalls similar, including with the scale (or blood sugar or whatever)?

Something I plan to do if/when I stall for weeks is to try continuous glucose monitoring, which has always seemed interesting to me anyway (despite costing $90 a month or so). Other options include adding a non-GLP medication like phentermine or metformin. Another way to manage a stall (mostly from the world of "bro science" but it applies to women too) is to focus on gaining muscle (focusing on body composition rather than weight).

I remember someone saying somewhere (in other words, don't quote me), that 7.5mg of tirz is like the max dose of sema. I don't know if that's true, but it may be true for someone.

Like everyone else, I agree with upping the tirz (or whatever else you want to up). I have only been on tirz, and I went up 2.5 mg each week until I reached 10 mg.

When you were stalling with the sema, how did the food noise/cravings compare to now? In other words, are you eating more now (or wishing you were) than when you were stalling on the sema? Or are the stalls similar, including with the scale (or blood sugar or whatever)?

Something I plan to do if/when I stall for weeks is to try continuous glucose monitoring, which has always seemed interesting to me anyway (despite costing $90 a month or so). Other options include adding a non-GLP medication like phentermine or metformin. Another way to manage a stall (mostly from the world of "bro science" but it applies to women too) is to focus on gaining muscle (focusing on body composition rather than weight).

It’s unfortunately the same stall. So I swapped right over and I am still stalled. I would say that the food noise and fullness is about the same as it was when I was taking Sema a few weeks ago. Thank you for replying!

 

[jaestar]

It’s unfortunately the same stall. So I swapped right over and I am still stalled. I would say that the food noise and fullness is about the same as it was when I was taking Sema a few weeks ago. Thank you for replying!

How long has your stall been?

 

[Garbo]

I have tried every trick. More water, more calories/less calories , changing injection sites. I’m losing hope. Please help!!

I hesitate to jump in here, because my views are not in keeping with the current vogue of virtuous low dosing, lol, but: To my way of thinking, you've tried every trick but the medication itself.
And the medication is why we're all here. Many of us, maybe most of us, have heroically dieted for years, with limited or short-lived success. Or great success, but damn, It was hard.

And then one day, along came sema, and then along came tirz. And omg. Everything was doable, and with so much less ... torture. The medication fixed our systems. We were happy to do the rest.

Diet tips and tricks have always been around, and they're always going to be. And they're great, and yes yes yes we should all be eating and drinking and exercising sensibly. But we are here, in the main, because we needed and were grateful to find a medication that enabled our bodies to operate correctly. Some people's bodies require very little of the meds, but for many if not most, the higher doses are where the greatest benefits are experienced.

You are on a very low dose.

I know, I know ... soooo many people say It's best to stay as low as you can. They say, After all, what will happen when you max out? Where will you go then?
And that's great advice, I guess — when the medication is working for you.

But if it's not working, what is the benefit of staying low? Indeed, what is the point of taking the medication at all?
I ask these questions sincerely, because I am often puzzled and sad that so many of our community are willing to endure a long stall, when they have at their fingertips the ability to increase their dosage until it works.

 

[Calm Logic]

But if it's not working, what is the benefit of staying low?

Re: "not working"
It is likely that the tirz is working to some degree, even without the scale changing, such as reducing inflammation, lowering A1c, and/or preventing weight gain. So even for a "non-responder," obesity specialists will continue with the GLP-1 medication while adding something else.

Re: "staying low"
The OP just increased the dose (to 5 mg). In my case starting with tirz, one of the side effects only appeared near the end of the week (diarrhea), so I would be wary to up the dose midweek. This is just to say the OP, in the here-and-now, is already more aggressive than most people regarding tirz dosing. For better or worse, the standard of care for tirz is to only increase the dose by 2.5 mg every four weeks, even when switching from sema:

Typical Switching Process:

1. Discontinue Semaglutide: Take your last dose of semaglutide as prescribed.
   
   
2. Wait for the Washout Period: Allow the semaglutide to clear from your system. A typical recommendation is 7 days after your last semaglutide injection.
   
   
3. Start Tirzepatide at a Low Dose: Your doctor will likely prescribe the starting dose of tirzepatide, which is typically 2.5 mg once weekly. This low dose helps to assess your tolerance and minimize potential side effects.
   
   
4. Follow the Tirzepatide Titration Schedule: Your doctor will guide you on how to gradually increase the tirzepatide dose, usually in 2.5 mg increments every 4 weeks, until you reach the target maintenance dose. The maximum maintenance dose of tirzepatide can be up to 15 mg weekly.
   
   
5. Monitor for Side Effects and Efficacy: Pay close attention to any side effects you experience and report them to your doctor. They will also monitor your blood sugar levels (if applicable) and weight loss progress to determine the optimal dose for you.

For his tirz patients, my internist suggests increasing the dose every week, as necessary. So one would get to 7.5 mg on the third week of tirz at the earliest. (I found this doc, who specializes in weight loss, by asking my pharmacist.)

 

[Garbo]

Re: "not working"
It is likely that the tirz is working to some degree, even without the scale changing, such as reducing inflammation, lowering A1c, and/or preventing weight gain. So even for a "non-responder," obesity specialists will continue with the GLP-1 medication while adding something else.

Re: "staying low"
The OP just increased the dose (to 5 mg). In my case starting with tirz, one of the side effects only appeared near the end of the week (diarrhea), so I would be wary to up the dose midweek. This is just to say the OP, in the here-and-now, is already more aggressive than most people regarding tirz dosing. For better or worse, the standard of care for tirz is to only increase the dose by 2.5 mg every four weeks, even when switching from sema:



For his tirz patients, my internist suggests increasing the dose every week, as necessary. So one would get to 7.5 mg on the third week of tirz at the earliest. (I found this doc, who specializes in weight loss, by asking my pharmacist.)

Excellent counterpoints. Thanks for balancing me out. You've earned your name once again