biobob
Explorer
I've dropped 20 lbs by exercising and following a proper diet. Occasionally, I'm getting really hungry. The initial week was intense, and I expected that sensation to continue each week. Should I consider increasing my dose?
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That's an excellent drop! If the weight is still coming off, there's no reason to change anything. Fewer side effects, and so onbiobob said:
I take 2mg. My diet is good and I train too. I stay quite active. Starting from 385 makes it somewhat less difficult. Before reaching that point, I had dropped 55 lbs on my own.
If it were me, I'd wait until 4 weeks had passed. At 4 I didn't get the same feeling as I did at 2, though I'm still dropping about 2lbs per week, and I just took 6mg on Friday. At this dose the hunger suppression is strong. My wife disagrees, but she keeps losing too. I suppose everyone's different.biobob said:
At what point should I consider increasing my dose?
I’ve been thinking about moving up to 4. Is there any reason I shouldn’t spend a week at 3 first, before making the jump to 4?BNLFL said:
If it were me, I'd wait until 4 weeks had passed. At 4 I didn't get the same feeling as I did at 2, though I'm still dropping about 2lbs per week, and I just took 6mg on Friday. At this dose the hunger suppression is strong. My wife disagrees, but she keeps losing too. I suppose everyone's different.biobob said:
At what point should I consider increasing my dose?
Not in the slightest. At 4 we actually went with 5, and one went to 5 then straight up to 6mg. Since a week at 5 did nothing for me, I thought, might as well try 6. Friday will tell me whether 6 is hitting hard — that's when I weigh in. It definitely seems to be.biobob said:
I’m considering going to 4. Any reason I wouldn’t do a week at 3 before going to 4?
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Wow, thanks so much for posting this.Dogmandu said:
@biobob here is the Phase 2 data for Reta. Faster titration results in more weight loss. Slower titration results in fewer side effects.
Those who began at a higher dose (4 mg rather than a 2 mg start) and then titrated up shed a larger percentage of body weight. Per the study, if losing weight is goal #1 AND you can tolerate the side effects, then going up by 2 mg each month is the correct approach. When side effects are problematic, use the slower path - increase by 1 mg monthly. How well you tolerate it determines how fast you escalate.
I had trouble with sides, so my escalation was 0.5 mg each month. It took 8 months for me to reach 4 mg. My slower escalation means I will lose less weight. Still, I made it there without going crazy and without giving up.
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Given how well things are going, my suggestion is to hold off until your weight loss starts to level out.biobob said:
At what point should I consider increasing my dose?
I'm with you. Keep going until it stops working.bbbilly said:
stay at your current dose for now. as long as the weight is still coming off, then IMHO upping the dose isn't necessary. the goal is to squeeze as much as possible out of each titration step before hitting the max dose, or running into side effects that are too harsh. if nothing changes for over 3 weeks, then id think about going up, provided you can handle the hunger. once you do increase, id suggest waiting 4 weeks before even thinking about another bump. that's roughly how long the body needs for levels to stabilize and show whether it's doing what it should
A good chunk of that was probably just water.lessthanhalf said:
Starting from 385 lbs, you've got a considerable distance ahead, and in all likelihood you'll end up needing the maximum doses at some point. In my view, 12mg is the right dose for optimal weight loss, upkeep, and — even more crucially — long-term health.
Dropping 20 lbs within 4 weeks is quick. Was your weight holding steady before you began reta? You mentioned a prior loss of 55 lbs, so if things had plateaued even briefly, then 10 lbs of those 20 could simply be fluid instead of fat. My guess is the scale over the coming weeks will probably reflect a slower, truer rate of fat loss; sustaining over 2kg per week is nearly unattainable for long, unless someone is extremely heavy, barely eating, and physically active.
Given how things are going, there's no rush to move doses up unless hunger is bothering you. Still, I'd recommend keeping your long-term target on the higher end of dosing rather than the lower. Plenty of folks here will tell you to stick with the smallest dose you can, but for those with severe obesity I don't believe that advice holds — provided side effects aren't an issue.
My initial grey order is in. Fingers crossed it actually shows up!lessthanhalf said:
When it comes to bumping up your dose, the easiest framework is this: are side effects causing you trouble, and are you experiencing hunger / is sticking to the eating plan you need for weight loss easy or difficult?
Hungry with no side effects → raise the dose
Side effects but no hunger → hold off
Side effects plus hunger → really frustrating, and there aren't any great simple solutions. I dealt with that for a year on ozempic before I found out grey peptides were a thing; perhaps try smaller doses more often.
You can always go up by less than the standard increments — it'll take longer, but side effects tend to be milder. For reta and tirz, the suggested dose increases make sense; for ozempic they're badly designed and happen too fast.
biobob said:
I've dropped 20 lbs by exercising and following a proper diet. Occasionally, I'm getting really hungry. The initial week was intense, and I expected that sensation to continue each week. Should I consider increasing my dose?