First time I am stalling. Should i increase?

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Purpletree

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Hi,

F26, 15th week of tirz, and 11th week at 5mg. For the second week running, I moved my pin days up to Thursday rather than Friday.

On Saturday this week (my official weigh-in day), the number on the scale matched last week's. I don't think I ate a lot more, but the ick for food doesn't arrive as quickly when I'm eating now. The ick is still there, just it fades fast and I can eat again pretty soon after.

So I've been wondering if the dose should go up. Increasing isn't something I'm a fan of, since I'd rather remain on the smallest dose I can for as long as possible, but I'm not going to watch my progress go straight to trash just because I can't stop eating. Yesterday, for the first time in the last 3 months, I had the noise I used to get daily before tirz, and it said "eat everything today and starting tomorrow we slow down with eating". Feeling that left me MORTIFIED. That was enough to make me stop eating lol.

Stalling isn't something I'm used to either. To be completely honest, I'm pretty disappointed in myself this week. I was used to losing at least 0.5-0.7 kg per week. There's still a whole lot to go: started at 88.6, now at 77.9 for the second week in a row, goal is anywhere between 53-55kgs. I am 1.61 meters short haha

Any opinions are highly appreciated. Thankssss
 
Whenever someone posts something similar, the typical response is to tell them to go up. Or you get the GLP crowd acting like long-term dieting finally works if you just "dial in" your macros and similar stuff. So my answer is: increase.
 
I'm not familiar with the trial data, but staying on a single dose for 11 weeks strikes me as plenty long. What I've come across says you should give a new dose at least 4 weeks (so it can saturate, and so on). You're way beyond that point. It also sounds like you're in tune with your body and your routines. Go off them
 
Going from 88 kg down to 53-55kg means dropping 33kg, which works out to roughly 37.5% of your body weight, and the odds of reaching that on 5mg of tirz are extremely slim. There is essentially no proof that the speed at which you raise your dose changes how much weight you ultimately lose, so holding back on increases to save room for later bumps does not really hold up. Raising doses gradually is sensible for keeping side effects in check, and when a low dose still controls hunger and delivers decent weight loss, there is no need to go up.

Daily energy expenditure drops as you shed weight, and hunger climbs, so it makes sense that after a while the medication feels less effective: your calorie deficit shrinks because you are eating more and burning fewer calories. It could also be that 12% weight loss is the ceiling for what 5mg of tirz can achieve in your case, though it is still a bit early to say, meaning this stall may simply be fluid shifts rather than a real plateau.

Still, to get anywhere close to 37.5% you will need at least 15mg of tirz/week, and that figure sits far above the average maximum weight loss for tirz, which is around 25%. So dose increases will be necessary, and I do not see much value in dragging out the climb to 15mg unless side effects are what is holding your doses down. Chances are you will hit a stall before reaching 55kg even at 15mg, and you might end up adding cagri or elora, but that is a problem for later.
 
Seems like the 5mg dose isn't doing much for you anymore, since your body has gotten used to it. In your position, I'd bump it up to the next dose.
 
lessthanhalf said:

Going from 88 kg down to 53-55kg means dropping 33kg, which works out to roughly 37.5% of your body weight, and the odds of reaching that on 5mg of tirz are extremely slim. There is essentially no proof that the speed at which you raise your dose changes how much weight you ultimately lose, so holding back on increases to save room for later bumps does not really hold up. Raising doses gradually is sensible for keeping side effects in check, and when a low dose still controls hunger and delivers decent weight loss, there is no need to go up.

Daily energy expenditure drops as you shed weight, and hunger climbs, so it makes sense that after a while the medication feels less effective: your calorie deficit shrinks because you are eating more and burning fewer calories. It could also be that 12% weight loss is the ceiling for what 5mg of tirz can achieve in your case, though it is still a bit early to say, meaning this stall may simply be fluid shifts rather than a real plateau.

Still, to get anywhere close to 37.5% you will need at least 15mg of tirz/week, and that figure sits far above the average maximum weight loss for tirz, which is around 25%. So dose increases will be necessary, and I do not see much value in dragging out the climb to 15mg unless side effects are what is holding your doses down. Chances are you will hit a stall before reaching 55kg even at 15mg, and you might end up adding cagri or elora, but that is a problem for later.
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Appreciate it — your reply is just as solid as it always is. Could you tell me what cagri and elora are, and what makes you think they'd be useful for me? The only one I'm familiar with is ghk-cu, which I know might help with loose skin, but that's about it lol 🙂))
 
Calm Logic said:

Whenever someone posts something similar, the typical response is to tell them to go up. Or you get the GLP crowd acting like long-term dieting finally works if you just "dial in" your macros and similar stuff. So my answer is: increase.
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Thanks! No, counting calories and macros is something I hate. I did that for 4 years before tirz, and the only result was weight gain. The awful part was knowing precisely how many calories everything contains, and feeling horrified when I'd take in 2000-2500 kcals in a day yet still not feel satisfied. The food noise was sucking the life right out of me haha

My thought was to bump up to 6mg so I can see how I'm adjusting to that
 
Prior to moving over to reta, my tirz schedule was every 5 days, which kept the late-week hunger rebound away. As an illustration, 5 mg dosed every 5 days works out to 7 mg weekly.
 
Purpletree said:

Hi,

F26, 15th week of tirz, and 11th week at 5mg. For the second week running, I moved my pin days up to Thursday rather than Friday.

On Saturday this week (my official weigh-in day), the number on the scale matched last week's. I don't think I ate a lot more, but the ick for food doesn't arrive as quickly when I'm eating now. The ick is still there, just it fades fast and I can eat again pretty soon after.

So I've been wondering if the dose should go up. Increasing isn't something I'm a fan of, since I'd rather remain on the smallest dose I can for as long as possible, but I'm not going to watch my progress go straight to trash just because I can't stop eating. Yesterday, for the first time in the last 3 months, I had the noise I used to get daily before tirz, and it said "eat everything today and starting tomorrow we slow down with eating". Feeling that left me MORTIFIED. That was enough to make me stop eating lol.

Stalling isn't something I'm used to either. To be completely honest, I'm pretty disappointed in myself this week. I was used to losing at least 0.5-0.7 kg per week. There's still a whole lot to go: started at 88.6, now at 77.9 for the second week in a row, goal is anywhere between 53-55kgs. I am 1.61 meters short haha

Any opinions are highly appreciated. Thankssss
Click to expand...
I belong to the camp that says begin at a low dose and move up gradually — I know that puts me in the minority. To me, 2 weeks doesn't qualify as a stall. That said, if the food noise is making you miserable, then more medication might be what you need.

Before that, though, it could help to think a few things over. How long has your deficit been going on? Might your body benefit from a pause from it? Occasionally I'll space my dose out further to find out when the food noise shows up. Ahead of that, I'll eat a bit extra, doing something my body isn't anticipating. Sometimes that alone is enough to get the loss moving again. In my view, anything under a month isn't truly a stall; it's your body adapting to weight loss and keeping some weight on in the meantime. I switch up what I eat, drink more (or less) water, try different exercises. It's about letting my body know not to get too set in its ways. I also toy a little with food noise, just enough to get some practice at self-mastery. More than a little of that is beyond me ; )

I've been on tirz since Dec. Right now I'm at 1.5mg tirz and 1.5mg reta. At my next dose I'll drop to 1mg of each, and that dose will come more than 7 days after the last one. I'm a long way from running out of runway, and I'd really like to keep it that way. For me that has mattered more than getting used to higher and higher doses. FWIW I've lost around 55lbs. Plenty of people here have lost that much in half the time. Almost all of us have landed on maintenance doses, some higher than others. I don't believe there's a "right" way to do this.
 
Two weeks of no movement after shifting your injection day could simply be water, so on its own I wouldn't take it as evidence that a higher dose is needed. That said, the return of strong food noise after it had been silent for months is, in my view, the more telling sign. I'm still on tirz and prefer to remain at the smallest dose that keeps the noise at bay, so if it's still there in another week or so, I'd go up slightly instead of staying put and battling cravings.
 
i'd suggest waiting a bit longer before changing anything. sometimes your body clings to weight by retaining extra water, and that can come from stress — whether it's mental or the physical strain of losing weight. get some additional rest, or skip a day of exercise and have yourself a nice treat or a special meal; you might be shocked at how effective that can be.

as an example, ive been working on gradually adding muscle and ive gained 10lbs over the last 14 weeks. during that entire stretch i never took a real deload week from the gym since i felt fine and kept making progress. i did an easy week at around 60% in the gym and logged alot of time on the massage beds and redlight booths...this week i lost 3 of those pounds i'd been trying to gain! even while eating a slight caloric surplus my body was dealing with alot of stress and holding onto extra water because of it. so think about what a steep deficit would be putting your body through.
 
Purpletree said:

Appreciate it — your reply is just as solid as it always is. Could you tell me what cagri and elora are, and what makes you think they'd be useful for me? The only one I'm familiar with is ghk-cu, which I know might help with loose skin, but that's about it lol 🙂))
Click to expand...
When you're still on a relatively low tirz dose, bumping it up makes far more sense than looking at other routes first. Both cagri and elora act as amylin agonists, meaning their target receptors differ from those of the GLP drugs. Eloralintide is the newer one, costs more, delivers greater weight loss and comes with fewer side effects than cagrilintide. If you reach 15mg of tirz or 12 of reta and then plateau before hitting your goal, these are likely the best weight loss drugs to add in. I brought them up only because you're aiming to lose 37.5%, which is a large amount, and typically tirz by itself won't produce that much loss. Some people have introduced them at low doses alongside non-maximum doses of tirz or reta, and I think that's reasonable when side effects stop you from reaching an adequate dose of reta or tirz, but apart from that it's usually less complicated to simply raise the tirz dose.

There is one reason to favor higher over lower doses of any GLP drug: if your risk of heart, liver or kidney disease, or diabetes, is high, the evidence is fairly solid that at higher doses these drugs prevent those problems better than at lower doses, and those effects aren't solely due to weight loss. Many people with significant obesity carry fairly high cardiovascular risk, particularly if they are older or have high blood pressure, high lipids or high sugars, and over the long term these drugs have a substantial effect in preventing a lot of illness, doing so more effectively at higher doses than lower ones. This matters even more as age goes up, so at 40 not so much, but by the 50's or 60's cardiovascular disease starts becoming increasingly common.
 
lessthanhalf said:

Going from 88 kg down to 53-55kg means dropping 33kg, which works out to roughly 37.5% of your body weight, and the odds of reaching that on 5mg of tirz are extremely slim. There is essentially no proof that the speed at which you raise your dose changes how much weight you ultimately lose, so holding back on increases to save room for later bumps does not really hold up. Raising doses gradually is sensible for keeping side effects in check, and when a low dose still controls hunger and delivers decent weight loss, there is no need to go up.

Daily energy expenditure drops as you shed weight, and hunger climbs, so it makes sense that after a while the medication feels less effective: your calorie deficit shrinks because you are eating more and burning fewer calories. It could also be that 12% weight loss is the ceiling for what 5mg of tirz can achieve in your case, though it is still a bit early to say, meaning this stall may simply be fluid shifts rather than a real plateau.

Still, to get anywhere close to 37.5% you will need at least 15mg of tirz/week, and that figure sits far above the average maximum weight loss for tirz, which is around 25%. So dose increases will be necessary, and I do not see much value in dragging out the climb to 15mg unless side effects are what is holding your doses down. Chances are you will hit a stall before reaching 55kg even at 15mg, and you might end up adding cagri or elora, but that is a problem for later.
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Also, @Purpletree, the tirz clinical trial data is worth checking out — it gives you a rough idea of what the typical person can expect. If the anticipated loss across a scheduled titration comes to 15-25% over 72 weeks, then you've barely begun to see what it's capable of; it simply requires time and a correct titration schedule 🙂

5mg: 15% over 72 weeks

10mg: 19.5% over 72 weeks

15mg: 25% over 72 weeks

Picture it as a rolling 72 weeks, because that 15% figure comes from 72 weeks spent at 5gm. If you then titrate up to 10mg, that doesn't guarantee 25% across the remaining 57 weeks (assuming you're already 15 weeks in), though you might come fairly close to it.

Like @lessthanhalf pointed out, a 37.5% weight reduction exceeds what any pep is expected to deliver within a 72 week program, even at the maximum dose. That number is definitely reachable, but it could take somewhat longer, and longer still if you don't titrate up.
 
This isn't guidance, just a rundown of my own experience — plenty of solid suggestions already in the thread.

I'd been dropping roughly .8kg each week for 15 weeks, then hit my first plateau. Like you, I was not happy about it at all.

I made a few hasty choices at first, then settled down and chose to stay at 5mg. I started watching my diet much more closely, and it became obvious I simply wasn't eating enough. I upped my lean protein intake for roughly a week and out of nowhere dropped another 2 kg.

My plan was to remain at 5mg for 8 more weeks before considering any titration upward...
 
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