On Reddit if you ask about results on different doses nearly everyone reports whether a certain dose is suppressing their appetite or not. They seem to titrate up only if their food noise and appetites are back.
My goal is weight loss. By the appetite measure I could stay at 2.5 mg for probably a long time, except the last 3 weeks on 2.5 mg I lost no weight. So I can’t get a “read” on if higher doses will help me lose weight beyond appetite suppression. Or if the magic is simply appetite suppression. 900-1000 calories a day has only lost 2 lbs in the last month on 5 mg. Wanting food isn’t a problem—no food noise, no hunger, no craving. Don’t tell me I’m eating too little. I’m post menopausal and I’ve eaten 1200 cal a day for 3 years without scale budging—tracking every bite. I have definite hormonal challenges to weight loss—PCOS, insulin resistant, etc.
Does Tirzepitide help hormonally resistant weight loss at higher doses? Or should Tirzepitide be considered just a terrific appetite suppressant? I’m honestly trying to figure out how the medicine works.
If you are having no food noise, no hunger and no cravings on 2.5mg of tirz, then before you increase your dose, look at other things. Caveat: 3 weeks without weight loss is not a stall and increasing one's dose should not be the initial response. A stall is much longer than that, a month, two, AFTER you've done/improved/changed other things that are in your control. Caveat: I too (like most on GLP-1s) - are, if not diabetic, insulin resistant, and for me, that's only one of many metabolic issues I've had to contend with. And yes, your PCOS is a hormonal challenge to weight loss. Also, as a result of your PCOS, insulin resistance, and whatever else, the typical TTDE calculators are useless to you. Those with hormonal imbalances, metabolic imbalances, hypothyroidism, etc. can't use those TTDE calculators as a guide for daily calories, or anything else. The calories they tell you that you need to eat are way too high. For instance, I set my daily calories at 1000, and now that I'm in maintenance, I try for more calories each day, but even in maintenance, that calorie increase is relatively small, 50-200 or so. You say you ate 1200 calories for years with no loss, and now you're eating between 900-1000 cals a day. Are you sure about that? Are you tracking your food on a food app, measuring the amounts? Many people think they know what 1/2 cup etc looks like, or how big a burger is, or how many almonds they ate, but often they are wrong, thinking the portions are smaller than they actually are. I would keep your calories as they are - 900-1000 - but start tracking them to see if those really are the calories you are taking in. Next, and immediately, you must make hydration intentional, hydration can't be something you try and do, and you should be using a packet of electrolytes daily. I prefer LMNT but there are many choices out there. And you should be drinking water from the start of your day. There are various calcs for how much water a person at a certain weight needs, you can look those up. I started out aiming for 100 ounces a day, and now drink 147 ounces of water every single day - 67 of them with one LMNT packet. Next, you must make protein your focus.There are suggestions that you calculate protein grams based on what you weigh now, or based on your goal weight, tons of ways to figure it out by googling. From the start, and even now in maintenance, I don't worry much about macros. I set my macros on the food app - I like Lifesum, but there are many others. I went through the various ways to determine my protein needs and chose 100 grams of protein a day, 93 grams of carbs and 26 grams of fat. I haven't bothered to change the macro %s because I'm used to it. I only focus on protein - and aim for a daily intake of protein between 130-180 grams. Every day. But note, in the beginning, I just tried to reach 100 grams a day. The carbs and fats come naturally with the protein you eat. It is impossible for me to get that much protein with regular food - or, if like me, one eats very little meat - so I, and others, find workarounds - starting using collagen peptides, they have protein, so your coffee becomes useful to you. Start using plant-based protein powders and make shakes. Most days, I make a shake with a Fairlife or Premiere Protein shake that has 30 grams of protein in it, and I add a scoop of Orgain or Live Conscious protein powder, and sometimes Javy protein powder, and whatever else and end with a shake that has 50 or more grams of protein in it. Oikos Pro is a great yogurt that has 20 grams of protein in each cup. If you start to track what you're eating/drinking, and greatly increase your hydration (and the electrolytes allow your body to use all that water rather than simply peeing it out, and you focus on increasing your protein, probably by a lot I'm assuming, and you give it some more time, things will likely start to change. Better to do everything you can do first before immediately going up in dose. Tirz is an appetite suppressant yes, and slows gastric emptying, but it works on the weight reduction as well. You've got the dose right for now, without experiencing side effects, so start making adjustments to what you are doing. I hope this is helpful to you.
