Would you titrate up?

[BNLFL]

I only weighed in once a week, same time.
I only titrated when needed, even after gaining in a week.
here is my titration to goal:
View attachment 28267


1 lb a week is not bad, if you are losing you are winning!!

I would suggest adding steps or other resistance prior to more GLPs as you are doing fine and will get to your goal with what you are doing.

My only regret is not paying more attention to muscle loss, I have since added 4-6lbs with resistance and high protein.

Looks and sounds like me. I started at 215 and started first week of January at 2mg, those first 2 weeks were 5 and 4lbs, water weight I'm sure. Pretty much stuck to a week 4 weeks on all, but did 6 weeks on a couple that were working well, currently at 9mg. I had a 170-175 goal, and have reset that lower. I averaged 2.2lbs/week. I had a couple weeks with nothing, a few with slight gains. I need to start working on a maintenance dose/plan. I plan on staying on it as long as I can. I'm only weighing one day a week also. This is all Reta.

 

[midlifeoptimized]

1300 at that weight is way too low.
Your body thinks it's starving.

You're actively sabotaging your weightloss by downregulating your metabolism.
Measure your maintenance intake (I guess it'll be around 2600ish), subtract 500kcal max. and just keep that up for the next 3-4 months.

#TrustmeBro

First of all great job tracking everything that goes into your mouth, that takes dedication! I agree that you actually need to eat more. Upping to 1800 would really help. you will have more energy and once your body realizes it's not starving and you should start loosing more weight.

 

[lessthanhalf]

First of all great job tracking everything that goes into your mouth, that takes dedication! I agree that you actually need to eat more. Upping to 1800 would really help. you will have more energy and once your body realizes it's not starving and you should start loosing more weight.

I would really love to see a scientific reference supporting the idea that increasing calorie intake can increase weight loss, it sounds great, but in general is not consistent with how the body works either in normal mode or in the far less well understood weight loss or post weight loss reduced energy expenditure mode.

My experience of energy expenditure dropping with weight loss occurred very gradually over a year, with 70 kg of weight loss, where the exact same calorie intake caused 6kg of weight loss per month from 145kg to about 90kg , then slowed and finally stopped at 75 kg about a year later on exactly the same calorie input of 1600-1800 kcal/day. After that I maintained between 75 to 83 kg over the next year, then another year with low dose ozempic. And minor increases in calorie intake caused obvious increases in weight, even 1-200 kcal / day made a few kilos difference over a few months. This is how physiology is meant to work. I most certainly did not lose more weight by eating more despite being in a reduced energy expenditure state.

I have never seen any research that shows long term reduction in energy expenditure from weight loss can be modified, short of putting back on weight. ( or substantially increasing exercise ) It is not known for certain how long it persists, I have seen conflicting information about this saying it tends to renormalise over years or that it may be permanent at that lower weight. In me it has stayed the same for 3 years after losing the weight , to stay weight neutral calorie intake needs to be about 1600-1800 kcal/day, with or without GLP drugs.

My guess is the post weight loss reduced energy use mode is very slow to start and stop, occurring over several months, and my guess is it is based on weight more than calorie intake, so that rises in EE require gaining weight first, as the purpose of this metabolic adaptation is to maintain some fat reserves in seriously adverse conditions, such as famines, and is an adaptive state to improve survival in those conditions. But not so useful in the current environment.

 

[dizzy]

Would you titrate up? I did. I’m curious what others would have done in this case.

Weight 264
Average daily calories last week were just under 1300 and from last week I lost .4 pounds hahahhahahaaa fuk

I’m seeing about 1 pound a week loss, and in my opinion and for the calories and my weight, it’s not sufficient.

View attachment 28052View attachment 28051

Up your protein to at least 1.2g per kg of lean mass. Take more electrolytes. get more exercise. The standard schedule is 2.5 -> 5 -> 7.5 -> 10 -> 12.5 -> 15.0 so you have plenty of run way to go up. Don't titrate up more often than once every 4 weeks, and don't titrate up if the new dose causes your sides to be too bad, and don't titrate up if your food noise is under control. That's the basic formula, and worked stupendously for me.

 

[lessthanhalf]

45 yo Female
5’6
BMI 42.3
GLP start weight was 285 on 3/27/26 (first 20 pounds lost in weeks 1-2) with a HW of 400 pounds (115 lost naturally through diet and exercise)
No sides (even after titration to 10mg Tirz)
This reasoning is why I titrated up….
I did increase my calories to 1750 yesterday, and still lost, 10mg titration was the right move.

Thank you for your comment and insight 😊

I think one issue here and I am sorry to point this out, is that you probably have to count the start weight as the weight before you lost any , not the weight when you started the Tirz, in terms of likely total weight loss or when stalls might start to be a real issue, although maybe not the stall time, I think maybe time to stall is measured from the last dose increase, though I doubt you get a whole extra year of slow weight loss from bumping the dose from 10 to 15mg.

The main reason it is an issue is that from 400 down to 285 lbs is going to have taken quite a long period of low calorie intake, and both from the weight loss and the low calorie input daily energy expenditure will have fallen, so that maintaining a deficit will require less calories in. And the break even point where weight loss stops is going to be sooner or at a higher weight if you start at 400 versus starting at 285. The true stall time is when with weight loss energy expenditure is less and hunger is greater due to weight loss, and the drug then is strong enough to reduce appetite to prevent weight regain, but not to cause more weight loss, and usually takes a year.

That being said responses to these drugs are very variable, and there are lots of people on this forum who have lost way more than the average results would suggest, and it sounds like you are both responding to tirz ok, with weight loss, and do not seem to have any obvious dose limiting side effects. And you can always add in cagri or elora at that point if needed.

One important issue is maintenance, as keeping off the weight is almost certainly going to require staying on the tirz, and even if weight loss stops before your target weight , keeping the weight you lost off is the single largest factor in preventing long term health problems, as even getting stuck at 250 lbs is probably ten times lower risk for a lot of problems than being at 400lbs.

 

[Stace_wow]

This is great….

So I started my WL around 2016 at 400 pounds. Using various diet and exercise to get down to 285, where I was able to maintain my weight for a duration of a couple years loosely utilizing a low carb diet. I would lose and gain the same 10 pounds over and over again, month after month….in 2020, I listened to friend of mine who said they could put me on a diet that would drop the weight. I did a bodybuilding prep diet which is basically no carbs and no fat….i did this for 30 days and was able to get to 240 pounds.

The diet was hugely restrictive and it sent me into a binge eating cycle that I couldn’t stop. I had restricted carbs for so long, and truly didn’t want to have the same mentality with food, so over the next few years I attempted to heal my terrible relationship with food, and that ballooned me to 330 and into depression in 2023. In the middle of 2024, I started to focus on my nutrition again..,.I wasn’t ‘dieting’ I was just being mindful…..no food was off limits and everything was fine in moderation….without trying my body dropped back to 285, no active calorie restrictions. That’s where I sat until i decided I would look into peps late 2025.

With all that said….do you still think that I should consider my start weight at 400 for this period, or have I had enough of an ‘off diet’ reset?

I thought that my years of low carb actually changed my ‘body set weight’ and that 285 is a genuine starting point considering I’ve spent a good deal of time at this weight.

Thank you, I’ve found your comments so helpful and insightful….

 

[lessthanhalf]

I was assuming the 400 lbs was a bit more recent than 2016, so I really do not know what effect it will have , but a fair bit less than if it was last year. Maybe the 330 is a more reasonable recent reference point, but if you were not gaining weight at 285 without deliberate cognitive constraint of calorie intake then 285 might be right too.

I started losing weight in 2022 and got to 75 kg in 2023 and calorie intake to stay weight neutral has basically stayed the same ever since at about 1600-1800 kcal/day, so it has stayed lower than the standard calculators would suggest for age and activity for 3 years, but a lot of the drop in EE is from the lost weight itself. I actually asked chatgpt about this this morning, and the answer is no one really knows if EE stays lower long term or normalises and the research is contradictory.

I never really had the experience of using them to lose the weight only to try to make my life more comfortable keeping it off so I did not have to always finish eating while still hungry, and not eat when I was hungry if in danger of getting too many calories that day. I did stick pretty strictly to the diet in terms of types of foods allowed, with the idea that if the caloric density was low enough it was impossible to get in too many calories. Like eating 1-2 kg of strawberries a day has very few calories and pretty hard to eat more than that no matter how hungry you are.

I also had issues with food addiction/binge eating . And found that the worst problem was after weight loss, where if I ate small amounts of rich/high calorie/highly rewarding / high glycemic index foods I would get extreme rebound hunger an hour or two later, and it was near impossible to stop. And once going could put on a kilo a week. So my diet involved absolutely zero of those foods, and was generally low glycemic index, extra high protein, low fat and low calorific density, and this did effectively prevent any binge eating issues, but did not stop me from being hungry a lot or having cravings. But the GLP drugs help a lot with those issues. I have not seriously tested it to see if the extreme hunger response is still there as I really do not want it back, but I do seem to be able to eat 100 calories at a time of nuts or dark chocolate without issues , which is better than it used to be. Hopefully there is a calorie threshold effect where it does not kick in unless over a certain number of calories, so that then I can at least eat tiny amounts of extra nice foods rather than none. Or maybe the GLP drugs have fixed whatever the weird brain circuitry problem was. I think GLP drugs will eventually be a standard treatment in binge eating disorder, especially with obesity, but the papers on binge eating disorder are all from psychologists or nutrition people who do not see drugs as an answer, as it does not fit in their world view well. So it will likely take a while to get adopted into the field. The few papers that do exist are pretty positive.

 

[Stace_wow]

Yes, I was and do eat lots of fruit and veggies as a default and try and listen to my body…I want to be as healthy as possible and love watching my micros!

GLPs have been amazing for me for the hunger as well, and where I may have over eaten before, I have been able to set aside my chosen portion and be satisfied with that.

Thank you for your comments and insightful! And sharing part of you story as well!

I guess we will all see how it goes together 😊