- Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat.

- No more feelings of hunger. At all. This is somewhat depressing. Eating is no longer enjoyable and feels like a chore. I woke up hungry for the first time in a while a couple days ago and was excited - jumped out of bed and ran to eat something just for the pure joy of it. I've only felt that a few times in the past few weeks, compared to every day off the drug.

- I completely stopped drinking. Have you ever been to a bar after eating a big meal at a restaurant, and had trouble drinking because you were too full from your meal? That's how I feel all the time. 1 or 2 beers and it becomes uncomfortable to have anymore.

- Normally I go grocery shopping and within 3-4 days, all the "good stuff" (snacks) I bought are eaten. Now, since I stopped snacking and eating much less, groceries simply last way longer. <-- $$ saved in groceries significantly offsets the monthly price of the medication

- My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks).

- Haven't noticed anything regarding impulse control outside of food. No anecdata to share on that point...

After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice (choosing not to take the drug).

The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day).

I'm the kind of person that used to be able to order just about anything on a restaurant menu and clean my plate completely. Now I simply can't do that. It's actually kind of embarrassing being at a restaurant with friends and being completely uninterested in the food.

I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons.

My insurance only recently started to cover these weight loss drugs, and I have been looking into them over the last month because I think I’m an ideal candidate for it.

If it gives this kind of control over cravings and appetite I’m really looking forward to how this can genuinely make my life better

Control would mean I might still feel hungry. Ever. Or that I could decide to eat heavily at one meal, but I don't and as long as I take the drugs, I won't. That doesn't feel like control, it feels like I've had something removed. I guess it's a matter of perspective?

I don't know if its a common sentiment but this drug treatment is the hardest thing I've ever done for my health. I'm not sure I'll be able to continue though. It's like I've robbed myself of the one joy I had left and now I have none. Tread carefully.

It sounds to me like it brings you enjoyment you miss. I respect that.

Food for me isn’t that. The lack of cravings and appetite means I would be firmly in the drivers seat with it. It means I can eat exactly the amount I’m suppose to and not feel like I must have more

For me, hunger is misery, and so is feeling over-full. I’d do anything to take that away (well, short of sacrificing my financial security to pay the market rate for the drug.)

> [but] my dose is fine [because] I'm under the care of a physician

Get a second medical opinion from a doctor experienced with prescribing these drugs.

Here's my experience (n=1):

* Zepbound is better than Wegovy. Wegovy has more side effects than Zepbound. Also the Zepbound pen is better than Wegovy.

* If you're worried about needles, don't be. The injection feels more like a rubber band snapping at the skin. And you'll get used to it.

* I typically have moody days maybe 2 or 3 days after I inject. I attribute that to blood sugar changes.

* Food tastes differently to me now. Food I used to really like can sometimes now just be okay. I don't like french fries so much anymore like I used to (they're good, but not what I remember). The huge bowl of chips I got from the Mexican restaurants don't taste as good anymore. Potatoes aren't really as attractive anymore. I prefer protein.

* I had constipation, which is a side effect. There was a stool softener I took from costco that helped. Eventually that went away.

* I got a bike for exercise. It's nice in that I feel like I actually go places rather than sitting on a Peloton. I also get fresh air. I had to find something I wanted to do, and I hate walking frankly.

* As I lost weight my alcohol tolerance dropped, but it's to be expected but still surprising when one beer hits you harder than it used to.

Maybe some tips:

* Nausea might a be a side effect, more so with Wegovy than Zepbound according to my doctor. So I guess plan to take it easy if you can.

* Your relationship with food will change, so be prepared mentally for that. Food used to make you happy maybe, and now it won't. So figure out what activities and interests that make you happy which don't involve food.

* Sugar is the one thing that can still ruin your progress. So be careful with desserts/candies/sweets/sugared sodas/etc.

* There's some debate about whether diet sodas spike your insulin levels or not. I would recommend going to black coffee to get your caffeine if you haven't already, and black coffee will also help to stimulate your bowels as well. That said, diet sodas are still better than sugared sodas.

I’ve seen cases where these sites are 5x cheaper than insurance

So compounders can no longer legally sell tirzepatide and will soon (April-May) be unable to legally sell semaglutide.

That said, the lowest doses direct from Lilly without insurance are $350-500/mo. And if you can do math, you can pay for a higher dose and spread it out over time to achieve a lower average price.

Your body has 2 separate engines that work completely differently

I have not lost my appreciation for good food, I just eat less of it. I used to be unable to leave any food on my plate regardless of how good or bad it was, now I’m perfectly happy to leave something uneaten if it isn’t to my taste.

Losing the pleasure of food was one of my main concerns starting it, and it hasn't been an issue whatsoever.

Meanwhile, I'm back down to my healthy weight range, which I haven't seen since 2021, which was about the third time I'd been at that weight and then ballooned up. I was just about at the top of that range after two months, down about 30 pounds, and it took no effort whatsoever.

I feel amazing. Muscle mass is also doing fine, and I'm well into middle age so any protective properties of youth are largely gone, still having no problems there.

That being said side effects vary and lots of people mention it gives them nausea. I can easily imagine how that would interfere with taste.

A month ago I suffered through a norovirus infection, the first time for me. In three days I lost six pounds (my BMI is 21.2 now). At first I wasn't surprised or worried -- after all, I had emptied out my digestive tract and was dehydrated. But a month has gone by and my appetite has been AWOL. I've lost another pound (5'11" @ 152 lbs). I have an appointment next week with my doctor's PA to see if something else is going on.

The taste of food is the same, but the craving is lacking. When I eat, my guts are telling my brain it is time to stop eating, as if I had eaten a pound of mashed potatoes only an hour ago.

I've never had any psychological difficulty with losing weight. I don't care if I'm hungry.

But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget about it -- my blood sugar is going to my muscles and I'm unproductive for hours afterwards as I just can't think. Also, if I go to the gym, my muscles take a week to recover instead of a couple of days, because they're just not getting the glucose they need to repair themselves.

I don't hear any of these complaints from GLP users though, which baffles me. Not eating enough affects us in lots of ways besides just being hungry. How has it been for you?

This is crazy, I have the completely opposite effect. On keto + calorie restriction I feel much more alert and sharp.

And my genetics also showed this to be the case too!

- 45 mins before workout: small bowl of oatmeal with milk

- 30-0 mins before workout start: 1 liter of water pre-hydration

- During workout: 1/2 liter of water per half hour of intense cardio training, less so for resistance

- Straight after workout: double black espresso coffee (high caffeine)

- Hit sauna for extensive slow cool-down, drinking one sports drink (sugars and electrolytes)

- hour later: full meal of mainly lean protein

Never had issues with muscle pains or "fog".

If you go really deep beyond your usual sustain, feeling physically exhausted and needing rest afterwards is normal. Eating your way through it is not the way to go.

This is a common misconception.

Yes, muscles are made from protein, and so you need additional protein to provide new "building blocks".

But the process of muscle repair uses a far greater amount of glucose to actually do the work of assembly. Estimates are generally that you need something like 10x as many calories from carbs/fats to build muscle, compared to the actual protein required.

So no -- muscle repair actually comes primarily from glucose, if you're measuring calories. But the point is that you need both. If you eat plenty of protein but your blood sugar is low, the muscle growth/repair will be extremely slow, or just not happen at all.

Also, your protocol is entirely about the workout. I'm talking about the 48h afterwards, when the growth actually occurs in response to the stresses incurred during the workout.

I get so confused because the small amounts of food that people talk about eating on GLP, don't seem like enough to sustain themselves long-term.

Are they exaggerating? Or do they talk about not eating dinner, but that's because they had 1,700 calorie lunch at the burger place? Or is that just during weight loss, and then once a target weight is hit, they're eating like a normal (healthy-weight) person again?

I just genuinely don't understand how people are surviving with the diets they describe.

Because obese folks have stored energy reserves. The body is really good at adapting and using them.

I was attempting to be at a 1k/day calorie deficit during my peak weight loss phase. I typically met or beat this target, usually eating around 1200-1600 calories/day plus a lot of walking - 25k steps/day minimum as an absolute non-negotiable. I'd check my step counter before bed, and put pants back on and go for a "midnight" walk if I was under my count for the day.

The first few weeks were quite hard, but it was pretty smooth sailing after that. Lots of naps. After that I was tired some days, but not overly so. I peaked at about 30lbs/mo weight loss for ~3 months, then tapered off to 5-10lbs/mo for my final 30ish I had to lose.

I don't really suggest anyone else attempt to "crash" their program like I did - but it's how my brain operates. I need immediate and obvious results, and those turn into a feedback loop for me. Being a bit more tired each day was perfectly acceptable for the goals being achieved.

That said - I wish I had started resistance training when I started my dieting program. I took it up at the very end of my weight loss, and it took me about 9mo to get back to roughly the same lean muscle mass as I had before I lost weight. I'm still working on min/maxing body comp about 18mo later.

The best weight loss program is the one that works for you. Pretty much full stop. It's going to be highly individualized. Some folks will do much better with a small deficit for a few years, but I know from experience that would never work for me.

I think a lot of the stuff you see on-line about "forgetting to eat dinner" is exaggerated and folks starting off on the drugs being amazed at it. Very few people will post a "well, I'm a bit less hungry" type of result. Everyone I know on them eventually became somewhat habituated to this sort of effect, but everyone is highly different. For me, I considered Tirzepatide a performance enhancing drug for my diet. I still went to bed hungry most nights - it was just far easier to chain together days and weeks of doing so on the drug vs. off. It still took a lot of willpower and habit building for me to pull it off at that level.

My baseline was in the ballpark of 3000-4000 cal/day. I'm losing about 5 lb/month, or 1.25 lb/week; assuming it's all fat, that's a 4400 cal/week deficit or ~625/day. 600 cal a day less is kind of a lot! Some people starting fatter than I was take bigger doses and have bigger deficits.

> Are they exaggerating?

In my experience: I'm not hungry for breakfast at all. Lunch: I try to have it, definitely have it if I exercised. (But if I didn't exercise it's pretty easy to just ignore hunger signals and eat my first meal at dinner.) Dinner is like, smaller than it was when I wasn't on the drugs. And then some post-dinner snacking.

I'm on the low end of the Rx dose range (2.5-15mg/week); on a higher dose, eating even less is plausible.

> Or do they talk about not eating dinner, but that's because they had 1,700 calorie lunch at the burger place?

1700 cal meals are mostly out of the question for me on these drugs. Your gastric emptying is slowed down, so you just can't house big meals in the same way.

> Or is that just during weight loss, and then once a target weight is hit, they're eating like a normal (healthy-weight) person again?

Yes, I think this is a big piece of it. To actually lose weight, you need to eat less than the sustainable steady state.

They are probably losing muscle mass!

So you're still eating plenty, but the point is that you no longer have any desire to over-eat?

And so at a restaurant you still order and eat, but the food just doesn't mean "enjoyment" the way it used to?

That makes a lot more sense then. If food becomes more about removing a negative feeling of discomfort, than a positive feeling of deliciousness, right then overeating would never make any sense.

Thanks!

I went out to eat today, and enjoyed my food. I didn’t order a big burger, but a smaller sandwich. I had a bite of an appetizer, but not more than a bite. Still super enjoyable, but it might be even better now because I don’t feel like a fat pig afterwards due to reasonable portion size.

I am food motivated like a dog, for whatever that’s worth.

For an alternative approach for comparison: My wife and I eat low carb and fast every other day for a year now. Around the 2nd month mark we got the exactly same outcome: food became a chore. We sometimes dont eat for 2-3 days when travelling or busy. I dont remember feeling hungry in about a year. We do sports - I sure have less peak power, but can sustain moderate efforts for longer (I use a power meter and Hr strap - my vo2max dropped). I feel significantly sharper mentally and managed to learn a new language (Dutch, from zero to B2) in a year - while working a cto job. Not eating easily gives 3hr extra a day, incl. what I get from waking up early.

Saves us a ton on groceries and eating out. The only thing we do watch out is carbs - I can eat a kebab or two tacos but dont eat any sweets, eat bread or drink beer/soda. Weight stabilized at my high school level. Not sure if I can recommend it as it is a bit tricky to practice, especially while having a job that requires routine socializing, but - it does work. The only really difficult thing is to start and endure the first two weeks or so.

I followed the same routine 4 years ago, then I stopped and when I started eating carbs my vo2max recovered overnight. I think one cant have it all - either you run on stored energy which caps the power to weight ratio - or on readily available glucose and glycogen. Its fine, I am not an athlete, I do sports to feel good. I dont see an impact on raw strength - just on anaerobic performance.

Not everyone can take these drugs. Some people will have severe side effects. It's very common to have nausea, vomiting, etc., and some people will experience these frequently enough that the prescribing doctor will rescind the prescription.

The rate is over 1% which isn’t a lot nor is it nothing https://jamanetwork.com/journals/jama/fullarticle/2810542

My doctor said that she now titrates the dose up slower than the recommended monthly increments and the side effects are less frequent.

Another problem is that GLP-1 drugs seem to synergize with other drugs that can cause GI issues.

Would Zofran throughout the day help with the side effects until the body adjusted?

The drug keeps me from binge eating, which is huge, but if I take enough to actually lose weight then I have weekly bouts of food poisoning because the sugars in my gut start to ferment. An entire day sitting on the toilet while holding a bucket because it’s coming out both ends.

I'm curious if daily oral doses which are smaller will solve a bunch of these problems at once, while also mitigating the supply-chain problems.

https://time.com/7130456/ozempic-side-effects-wegovy-mounjar...

Starbucks food is especially calorie dense. I realized this when I lost a bunch of weight in 2018 and I noticed the calorie counts on the printed cards that some stores have. Even for junk food, Starbucks junk food is more calorific than average for the same items.

I started to consider that for a typical customer's consumption, McDonald's might actually be healthier than Starbucks. Which totally goes against the image people have of both places.

People think if they are "going for coffee", it's better for you than having a milkshake and following it with candy. But it's essentially what they're doing.

(I heard this somewhere on the internet, about the Frappucino.)

It seems like there is a lot of disagreement on this very basic point. Surely there must be data from the decade or so it was prescribed for diabetes.

I wonder how the body reacts after being on the drug for years at a time and then you cut it off, are the cravings stronger than before you started the drug?

I think the craving is primarily a function of how much your stomach expects food, ie the more food the more craving, but also you can get it used to a lower regime. And to external factors like stress, tiredness, cold, etc.

I've never felt hungry in the morning. I've never eaten a lot. When I was younger, I often forced myself to eat more, because I felt bad about how I wasn't "big enough" (which feels silly now as a proper adult).

Impulse buying food and snacking is something I only do if I haven't eaten for a long time, i.e. if I'm actually very hungry.

If I go out drinking, I also make a point not to eat very much before or during the drinking, because otherwise I just feel sick after like one beer.

It’s a very interesting feeling to feel like you’re in full control of what you eat, not influenced by random cravings or hunger.

In my case I’m planning to only stay on it another month or 2 to drop 10lbs. I can easily see people cycling on/off this drug throughout the year to keep weight in check while removing will power from the equation completely. It’s quite remarkable.

I recommend that you listen to the most recent Peter Attia podcast, which is a 2+ hour interview with Ralph DeFronzo (diabetes expert) where he goes deep into the effects of GLP-1 agonists on insulin response and other metabolic pathways. I came away with the impression that we're being too casual with how these drugs are being used -- if you're overweight these impacts are probably all for the good, but if you're not, it's more questionable.

https://peterattiamd.com/ralphdefronzo/

If there’s a specific part you remember talking about the negatives I’d be interested to hear.

I legitimately have a difficult time finding anything negative when researching the drug, other than tolerable side effects like GI upset.

I don't have a list of exact timestamps, but there are multiple places where he discusses the impacts of the GLP-1 agonists (of various generations) on insulin signaling, glucose transport etc., and the conversation is generally complex, nuanced, and wide-ranging. We don't understand everything these drugs are doing, but they're clearly banging around a complicated metabolic/hormonal system with a big, blunt hammer.

[0] https://www.sciencedirect.com/science/article/pii/S266736812...

https://www.gov.uk/drug-safety-update/glp-1-receptor-agonist...

Sidebar: Mounjaro changed my life. I'd been very diabetic (300 units of insulin a day) for years on end. Taking that much insulin, my normally large frame got very large indeed. A couple of months into the Mounjaro and I was off insulin; a year into it and I was down 75 lbs and healthier than I'd been in 20 years.

I consider it a likely lifelong medication now simply due to that night and day difference to my life. It’s extremely rare I have a day where I need to be within 5 minutes of a restroom now.

My primary care doctor mentioned this might be a side effect when I first started, and she ended up being more correct than even she expected to be.

The only way this can possibly be correct is if you think that the "correct" weight is whatever the population average happens to be which is just...wild to me.

If we assume commenter is male (a statistical likelihood), then 20% is the high end of normal, and could very safely be halved. In the less likely case that they are female, then it is right in the middle of the normal range, and could safely be reduced by 5-10% at least.

The medical definition of overweight is basically if you're some number of standard deviations above the average from whenever they ran the stats, so population average = correct weight seems like as reasonable a standard.

Are you just using average as weasel words here? I get my best pump and generally have the best workout sessions at ~10-12%, which is easily maintainable for me, but definitely not for most people, having a drug that makes it effortless for most people is a GOOD thing. People shouldn't have to suffer to get to <15% if they aren't born with good genetics?

And what about strength athletes who want to build up a large runway? Now literally all of them can get down to ~7% no problem, and have no problems on the way up either.

Why do you think this? I agree that people who have associated risk factors should be prioritized, but if there's enough for everyone why wouldn't we give it to anyone who wants it?

And crowing about saving $200/mo not buying food at Starbucks, well now Novo Nordisk is getting that.

Toast a bagel at home for $0.50/day instead.

I do not agree that people who don't "need" to be chronically medicated should not be. I think you can decide to take whatever you want for your own reasons. I am not going to tell you what you can and and can't take - unless you're like...taking something that makes you destructive or generate externalities or whatever. But this seems like the opposite?

Lots of questions here around profit and the awful medical system in the US, but on a basic level I think people should be able to do what they prefer and is safe.

If they're like typical westerners, they already self-medicate with coffee every day, with alcohol occasionally, and a big fraction of them (though much less than couple decades ago) also treat themselves with tobacco smoke - and ironically, weight loss is one of the few benefits some people actually use to defend their smoking.

Do they need all that medication? Well, it's socially unfavorable to say so wrt. alcohol, but ask any of the daily coffee drinkers whether they need their morning coffee...

So, sure, we don't know the long term risks of semaglutide ("just" 30 years or so) — but I say let people try it if they want, we let them use things we explicitly know to be dangerous, so why should we stand in the way of something that only might be eventually?

I buy Thomas Everything bagels at the supermarket, FWIW.

This is being injected directly into your flesh, there cannot be any mistake, or shortcut.

Those concerns have nothing to do with the fact that it's ok for people to choose to start or stop medications if they would prefer (supplies allowing).

I can't speak to their choice of taking the drug, but it's wild how warped people's perceptions are now of what constitutes "healthy" and "fat" thanks to the obesity epidemic. People remark on how George Costanza on Seinfeld was once considered fat (because he was), or how Homer's scale-tipping 300 lbs. in the King-Size Homer episode of The Simpsons was considered comically obese (because it was). Never mind the fact that people almost always underestimate how fat they actually are and are almost always disappointed by their DEXA scans. Even if the OP's estimate is correct that they're just a little north of 20% BF (as a man), they're still overweight, and specifically overfat, and probably look soft and doughy.

For decades I've struggled with diets but tirzepatide is the only thing that's made me stick with it. Will power alone wasn't enough, but with tirzepatide I'm very confident I'll get down to a under 100kg for the first time since I was a teenager, within a few months.

But the late night trip to McD's always makes you feel like shit the next day, it's just that we then forget and do it again. (Same with drinking).

This is the largest of several reasons I hesitate to try it for myself. I am a very big guy (I would be about 184lbs if I had 0% bodyfat at my current musculature level). From the experiences I hear, I would not only struggle to have enough energy to do any kind of rigorous exercise, but struggle to consume the amount of protein I require to even maintain my current muscle mass.

I do have issues with overeating and the prospect of a drug that prevents me from consuming too many calories is attractive, but the side effects sound counterintuitive to any kind of natural fitness.

You really need to prioritize protein intake and make sure your calorie deficit isn’t extreme.

Losing too much weight too quickly, with or without the help of a drug, can be very unhealthy.

I drink 4 protein shakes a day (160g total) in addition to regular food. If it weren’t for the protein shakes I definitely would be protein deficient.

You’re 100% spot on with decreased energy at the gym. I’ve had to pull back 4x weekly cardio to 1-2x weekly. Then again, anyone who’s in a calorie deficit has lower energy. It’s not a unique phenomenon of the drug, just a side effect of weight loss.

Presumably if you're trying to lose weight, you have energy to burn you carry around with you. A calorie deficit doesn't imply lack of calories to burn. Presumably you're trying to trigger ketogenesis.

Granted, this is a lot less easy to access than simply eating simple carbs right before a workout and likely a lot less comfortable.

Only if you're actually on a keto diet; most weight loss routines run a calorie deficit without triggering ketogenesis.

Also there's this whole thing about set points - you probably got to your weight somehow, and if it wasn't through consistently making stupid choices over many years, chances are this is what the body learned to consider an equilibrium state. Which means that, if you start running a calorie deficit, it's going to fight you every step of the way. It will happily scale down performance to conserve energy instead of burning the accumulated fat, so you'll just be slow and groggy but not lose weight. There's been reported cases where people got mental illness-level obsessive thoughts about food, which appeared when they were hungry, and stopped when they ate enough.

The degree of this problem varies between people, but it's generally not that easy to effectively lose weight, and some people simply lost the genetic/environmental lottery on this.

Yea, I think your eating and food habits you learn as a child and teenager tend to shape you for life. I was malnourished as a child (I was considered a picky eater) but as an adult I've found it quite easy to keep within the caloric bounds a doctor told me to keep to. One thing I've noticed is that hunger just doesn't bother me the way it does with people who struggle to lose weight or with binge eating—mostly a pain in the ass (I need to remind and force myself to eat), but occasionally something I'm grateful for as I watch the people around me struggle on an existential level with their cravings and bodies.

I also don't have a sweet tooth, and I put that on not being allowed sweets as a child except under very exceptional circumstances. I'm also a (thankfully recovering) alcoholic, so don't mistake this for being generally good at avoiding cravings.

The idea of set points is controversial and not necessarily the accepted scientific consensus.

Is there evidence to back this up? It sounds reasonable, especially without a limit on "too quickly" but (anecdata incoming) I'm curious because:

   - When I first tried a low-carb diet (for non-weight reasons) I lost about thirty pounds in under three months without really trying, and hit something like 12% bodyfat
   - When I started intermittent fasting (mostly unrelated to weight) I again lost about thirty pounds, this time in a little over three months, and probably ended up around 15% bodyfat
   - Since then I found that neither low-carb nor intermittent fasting had a significant effect on my weight, so:
   - When my doctor suggested I lose some weight I pretty forcibly calorie restricted, and lost about thirty pounds over four months (only down to about 20-something % that time)
   - And just recently, for cholesterol, I've done it again and lost 25 pounds so far in something under three months.

All of which to ask, what evidence do you have, and what's "too quickly"?

1. the loss of muscle mass

2. low energy

3. unnecessary suffering

4. high fatigue

4.1. inability to maintain the low calorie diet for long enough

4.2. relapse; jojo-dieting.

1, 4.1 and 4.2 are the biggest problems.

The interesting thing will be once I stop losing weight and start rowing again seriously, can I get back to a reasonable performance level. Fingers crossed...

It's generally recommended to:

- do heavy resistance training

- losing fat at the rate of 0.5-1% of a body weight a week

- do it for 8-12 weeks

- (critical) after which to have a maintenance phase with a duration of 2/3-1 length of the dieting phase

- after that can do another dieting phase again.

- repeat as many times as needed.

- if wishes to build muscle/bulk, should do it 4 times slower than dieting. So 250g-1kg weight gain a month.

Sure, I get that, and I responded in the context of my original "I'm going to throw out anecdata" note. In that spirit:

I've generally gone longer than 8-12 weeks, but not by much -- longest is probably 16 weeks?

I've definitely lost more than 1% per week. I don't graph it, but I think I'm hovering in the 1% - 1.5% range.

I'm curious about the maintenance phase and strength aspects -- I'm not interested in bulk, just strength.

Giving a GLP-1 to a heavy drinker/alcoholic results in a skinny alcoholic.

Given that the overwhelming majority of alcohol is consumed by heavy+ drinkers this isn't the gamechanger people think it is.

In just the two weeks at that low dose it's been quite effective.

In fact the only reason I'm replying to your comment is because instead of being a bottle deep in front of the TV at this point in the evening I got bored after one glass and decided to noddle around on the internets.

Ask any heavy drinker/alcoholic and they will tell you that one doesn't just have 'one' drink and then move on with something else. One is always too much, and never enough. Now it feels like enough.

Happy the share more if you like :)

1. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

It would be fascinating and almost too good to be true if we found a way to suppress only largely harmful (in our current environment) urges but leave the good ones intact.

Something like that becoming widely available could change the world, and mostly for the better. It would refocus our entire economy on much more constructive pursuits instead of gambling, addiction, and pandering to transient urges.

I did have some energy loss, especially at first, but I assume that was because my body was struggling to cope with a lack of carbs. However, after a couple of weeks that for the most part disappeared.

I am talking about being okay in 900-1000 while my normal need was ~2500 and nutritionist had suggested to target around 2000 for first few weeks then bring it down to 15-1600 and then slowly bring it up near normal as weight settled. But by the end of 2nd week or 3rd I was struggling to finish 900-1000. I used to kinda force eat.

There was no medication involved in any way (not for this purpose; not for anything else).

Keto + intermittent fasting are my magic pill right now and have been for some years.

Keto, fasting and also breaking the "foodie" culture that eating and going out to eat becomes a hobby.

I didn't order/dine in at all from a restaurant in 2024. It is much easier to not over eat the boring keto meals I make myself. My "cheating" is eating basmati or jasmine rice with a stir fry instead of cauliflower rice.

There is actually not enough known side effects for me to take GLP-1s. They are either complete miracle drugs or side effects we don't currently understand haven't come out in the wash yet.

We have a pretty good track record when a new powerful medication like this is introduces of doing things quite wrong. There are probably risk mitigation strategies we will learn in the coming decades that we simply can't know right now. Otherwise, these are basically free lunch miracle drugs. That seems an easy short.

So they are going to force you onto a higher dose?!

Some doctors will go by the Lilly recommendations but I think more are allowing people to stay on the lowest dose providing benefits. That leaves your health insurance as the only other obstacle.

There is a chart at https://zepbound.lilly.com/hcp/dosage

I was one of the rare people that saw results with 2.5mg but by the end of that first month I had plateaued. After 3 months at 5.0mg I've plateaued again and will probably move up to 7.5mg in the near future and stay on it as long as I can.

Some people like to go back to 2.5mg as their maintence dose after reaching their weight loss goals.

https://www.goodrx.com/zepbound/dosage

The brand name GLP’s you can’t control the dose. But when you get it in a vial from a compounding pharmacy you can inject however much or little you want.

Not looking forward to ever using the brand name version specifically for this reason

Basically it is a ratcheting mechanism where after ~10 clicks you get .25 mg dosage and 20 clicks gets you .50. Basically, no doctor is going to endorse it, but you can dial a dose to whatever amount you want.

No. California has not banned compounding pharmacies, nor is there a significant movement to do so in the legislature, among the people (who could do so by ballot measure), or a proposal by the governor to do so. California does require additional licensure for sterile compounding, but that is very much not a ban on sterile compounding or compounding more generally.

Relevant to GLP-1s, though, several state pharmacy boards (not California’s, as far as I know) have raised issues that compounded GLP-1 drugs that they have seen appear to be illegal, because they use a form other than the FDA-approved base form of semaglutide (which is only available from Novo Nordisk), and th3 form used is not itself approved for human use, and have taken steps to crack down on that. But that's also not banning compounding, but enforcing existing rules on compounding.

https://www.barrons.com/articles/eli-lilly-zepbound-higher-d...

I was approved for semaglutide but now compounding pharmacies like Hims are stating their cheaper (<$200/month) compounded versions are out of stock.

First, there's no legislation. What is happening is that the branded drug was in shortage so compounding pharmacies were legally allowed to step in under existing regulations.

The shortage status was first updated in the summer, and Novo went on a lawsuit spree. Suing everyone mentioning GLP on a website.

But, there have been more back and forths since, very recent.

TLDR what is restricted now is not the sale of the compound, but the manufacture of it. Therefore, you can keep selling inventory past the restriction, but of course that will either run out, expire, or be restricted as well. As of now, if everything stays the same, expect the last few compound pharmacies to run out of product at the end of Q3/25 .

However, I understand there's groundbreaking legislation being worked on that will dramatically change the status quo for the better, meaning more choice for end consumers and less profits for Novo.

I wonder if with time, you can learn from this drug, form the helpful habits/behaviors and then stop taking it.

For those who do, it makes them have a normal appetite.

Additionally, it seems to make junk food taste less appealing and real food more appealing.

Personally, I love food. I can't live without stuffing candy in my mouth. But I also have a tendency to get fat, so I weight myself every day, and based on that I either have a diet day or a cheat day. Moreover, I do a lot of physical exercise every day. The idea of having to depend on a drug to live is scary to me.

Having said the above, I'm sure that one day we'll create a drug that makes life of majority of population better, and we'll be able to administer it to everyone without major consequences.

I've never had this reaction to fast food before. I only eat mcdonalds every few months and yea it's not the highest quality food, but I don't think there's anything in it to make you sick any more than other burger places have. I imagine you'd have to have restricted fast-food nutrition for quite some time before you feel a difference.

I'd like to see a study comparing people who ate mcdonalds who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic, or how much of the craving for mcdonalds is rooted in feeling like crap in the first place.

(Granted, I've never had an issue with maintaining my appetite before, in fact I have issues keeping weight on, so I might have a fundamentally different relationship with food.)

> I've never had this reaction to fast food before.

I do. Because of it, I eat fastfood when I'm willing to pay that price, ~5x/decade.

> I'd like to see a study comparing people who ate mcs who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic.

The notion that our psychology could be holding us back from fastfood completeness is one that never occurred to me. I like how novel it is.

Food sensitivities are primarily a lot of medical questions, for which we have few answers. For example many fresh breads will give me stomach cramps and Rosacea. I can eat those same ingredients+amounts in other foods and be fine.

Many fastfoods ramp my brainfog up to 11. I don't know why. I'm in a poor position to consider the issue while the brainfog is in play. I could consider it later but the best I can hope for is unsubstantiated guesses.

I used to view eating as a chore and it was great. Then (no joke) I got into tech and everywhere I work they have fancy food or frequent team lunches or something of that nature.

I wish I could go back.

My shits, however, have been glorious since starting the drug. Truly pleasant steamers that rocket right out.

This may be an ignorant take and if it is I apologize, but isn't it a choice anyway? A calorie deficit and minimal exercise will have you cutting body fat. Or am I missing something here?

You will probably land on "not often hungry". The feeling of being full very quickly when you do eat will stay

Zepbound/Mounjaro on the other hand has been fantastic. I just noticed I was hurting my muscles a lot and realized it was because I was losing muscle mass. I started taking protein shakes and that seems to have fixed it. Wish I’d realize it sooner as I’ve hurt my hip joint and can’t ride my bike which was primarily how I was exercising, so I need to go to physical therapy. I’m on 10mg and frozen at 260, have an appointment to go to the next dosage on Monday. Hopeful I’ll keep losing weight and get down to around 200.

> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month

Uh, you're allowed to stay there as long as you want. I was on 2.5 for two months and asked my Dr to up the dose, as progression kind of stalled in the second month. I've been hanging out around 3.5-4.5mg/week since then losing ~5 lb/month steadily.

Sounds like you're pretty sensitive to it, which is nice. You can lower the dose even further if you think it's too strong at 2.5mg/week.

It is definitely a game changer.

... what? Get a better medical provider, you can stay on 2.5mg as long as it's effective. Your hunger will come back. Going up every month is poor practice if you have hunger-suppressing effects, whatever the manufacturer says: speak to an endocrinologist who's experienced with prescribing it instead. The first couple of weeks I had no appetite, but I stayed on 2.5mg for three months and had a healthy appetite by the end, and continued to take it slow. Lost about 1kg a week, and enjoyed my food just fine.

Respectfully, you're in week 3, I think it's worth giving it a few months before you start sharing your experiences of it on the internet.

The much more common experience of this drug -- when you've been on it a little while and you've found a good dosage -- is you enjoy food, you have an appetite, you're just not ALWAYS thinking about food. There is enough anecdata in the many subreddits to constitute actual data about what a typical experience taking any of these things feels like.