Zepbound and a Few of Its Less Pleasant Effects

[Bellemorte1979]

Hi everyone! I'm hoping to hear some useful perspectives. Apologies in advance for the lengthy post.

To make a very long story short: I switched from Wegovy over to Zep in December 2025. The dose was raised gradually. Up until late March I was pretty much just holding onto the small amount of weight I'd already dropped, and then a big chunk came off once I moved to 7.5. After that, at the end of April, I began 10 MG. Wow. It has not gone well. Awful stomach and gas problems, a strong aversion to food, diarrhea (sorry for the TMI lol). I spent most of May traveling for work. Unfortunately, even these past two weeks at home, while trying to stick to my usual boring diet of nutritious foods (lots of fiber and protein), I'm still dealing with every kind of problem. I've gone through all the genuine, real tricks. I don't eat anything if I'll be in bed within 4 hours. The gas problems are still terrible every morning. I'm down to 1 or no fizzy drinks per day. I mean, I never had more than 2 anyway, and that was extremely rare, but I've made that change. Every so often I feel nauseous, though mostly it's been awful gas (pain, bloating) plus a really strong food aversion. I gave Gas-x a try and it helps sometimes. Last year on Wegovy I did get strong, STRONG food aversion as my doses went up, so we switched to Zep hoping it would be less severe. This may be worse. On the occasions I can eat, I know normal digestion is rare for me, so wanting to eat has been really difficult. If I were anywhere near a goal, I might quit. I'm still 90-100 lbs away from being under 200. I can't stop now. Does anybody have ideas? I was still losing at 7.5. Would going lower create problems? Back when I quit a high Wegovy dose and moved to a low Zep dose, I had serious food noise problems and felt non-stop hungry the whole time. Would you just push through and hope?

Thanks for any advice.

 

[Skidude]

At the 5-10 range, I dealt with a bunch of stomach-related issues, but they cleared up in time.

Should you be keeping track of how often you have a BM and making sure you drink enough fluids, the fix could just be dropping your dose down to 7.5 or 8.. if you were still dropping weight, there may be no reason to go higher.

just my 2cents

 

[deluge]

If 7.5 was still working and the side effects were few or absent, I’d stay at that dose.

My own Tirz run matches your time and dosage almost exactly. No side effects, though.

 

[cheaperseeker]

If 7.5 mg was still bringing weight down for you, that's the dose to return to. Give your body time to settle there. After that, should your progress stop for over 4 weeks, another bump is possible. Because 10 mg hit you so hard, move up gradually. Steps of 0.5 mg, holding each new dose for no less than 4 weeks, are the way to go.

As long as the scale keeps moving down, don't raise the dose, even at just 1/2 pound weekly. When 4-6 weeks pass at a new dose with no loss, that's when another increase makes sense. The goal is staying on the lowest dose that does the job, leaving room to go higher if tolerance develops.

 

[Bellemorte1979]

cheaperseeker said:

If 7.5 mg was still bringing weight down for you, that's the dose to return to. Give your body time to settle there. After that, should your progress stop for over 4 weeks, another bump is possible. Because 10 mg hit you so hard, move up gradually. Steps of 0.5 mg, holding each new dose for no less than 4 weeks, are the way to go.

As long as the scale keeps moving down, don't raise the dose, even at just 1/2 pound weekly. When 4-6 weeks pass at a new dose with no loss, that's when another increase makes sense. The goal is staying on the lowest dose that does the job, leaving room to go higher if tolerance develops.

I really appreciate the reply. Fortunately, I have access to the single-dose pens. The one upside of my job is that insurance pays for them, and I want to keep using the pens, so it's 7.5 (or possibly 7) followed by 10. I'm giving serious thought to reaching out to my physician to ask whether we could step back down. Since I stayed at the 7.5 dose for 3 months, returning to it may be the smartest move. Thanks once more!

 

[Bellemorte1979]

deluge said:

If 7.5 was still working and the side effects were few or absent, I’d stay at that dose.

My own Tirz run matches your time and dosage almost exactly. No side effects, though.

I'm giving it some serious thought. Appetite suppression doesn't bother me at all, but the GI problems have reached the point where they're messing with my daily life! Let's just say being on a plane was rough. Thanks a lot!

 

[Bellemorte1979]

Skidude said:

At the 5-10 range, I dealt with a bunch of stomach-related issues, but they cleared up in time.

Should you be keeping track of how often you have a BM and making sure you drink enough fluids, the fix could just be dropping your dose down to 7.5 or 8.. if you were still dropping weight, there may be no reason to go higher.

just my 2cents

I've been at 10 for roughly 1.5 months, so I figured things would have settled down by this point. The main problem is my job involves travel — occasionally flying, occasionally driving through the middle of nowhere. Stomach troubles make that a little complicated lol. I was definitely dropping weight, so I'll keep that in mind for sure. Appreciate the feedback.

 

[cheaperseeker]

Bellemorte1979 said:

cheaperseeker said:

If 7.5 mg was still bringing weight down for you, that's the dose to return to. Give your body time to settle there. After that, should your progress stop for over 4 weeks, another bump is possible. Because 10 mg hit you so hard, move up gradually. Steps of 0.5 mg, holding each new dose for no less than 4 weeks, are the way to go.

As long as the scale keeps moving down, don't raise the dose, even at just 1/2 pound weekly. When 4-6 weeks pass at a new dose with no loss, that's when another increase makes sense. The goal is staying on the lowest dose that does the job, leaving room to go higher if tolerance develops.

I really appreciate the reply. Fortunately, I have access to the single-dose pens. The one upside of my job is that insurance pays for them, and I want to keep using the pens, so it's 7.5 (or possibly 7) followed by 10. I'm giving serious thought to reaching out to my physician to ask whether we could step back down. Since I stayed at the 7.5 dose for 3 months, returning to it may be the smartest move. Thanks once more!

I suppose there are pros and cons to that. It would be nice if they were designed more along the lines of insulin pens, where you can adjust the dose. As you're aware, for certain individuals 2.5 mg represents a substantial increase.

If your next appointment isn't within the coming week or two, I'd suggest reaching out to your doctor's office by phone or message to inquire about lowering the dose.

 

[lessthanhalf]

Using the official pens doesn't lock you out of adjusting your dose. I've done it myself, after a year on ozempic and one painfully costly tirz script.

Those side effects you're dealing with usually do get better with time, though it can take months. Lowering your dose tends to work faster than just waiting it out. With ozempic, I had nausea and felt unwell the whole year, even after trying every-other-day microdosing, without relief. Tirz, on the other hand, treated me much better.

When side effects are hard to put up with or genuinely rough, you've got 2 options. Option one: split the dose in half and take it twice as frequently, if the problems only hit hard for a few days following each shot. Option two: reduce the dose back to a level where things felt manageable, then once the side effects settle and improve, raise it again very gradually after a gap. Tirz's dose steps are actually fairly reasonable, but reactions vary a lot between individuals. Going up by just 0.5mg or 1mg at a time might suit you better. The pens don't allow fine-tuning, which is a drawback, but the goal was foolproof use, not perfect dosing.

Official pens deliver a set number of clicks per dose. Search online for the click charts matching each pen strength. Say you want 6mg, and (just as an example, I don't recall the exact figure) 72 clicks equals a 7.5mg dose. Then 6/7.5=0.8, and 0.8 x 72 gives 58 clicks. So when you turn the dial, go slowly and count each click until you reach that number. Using the charts beats doing the math yourself. Double and triple check that the chart matches your specific pen. Getting the wrong dose isn't super easy, but it's not impossible either, so you need to be careful. (That's exactly why the maker advises against it.)

I only just noticed the mention of single dose pens at the end. Whether they support click counting, I'm not sure, but a quick google should tell you if there's a way to adjust with them. Alternatively, switch to the multidose pens, or head to the dark side, save a pile of cash, and control your own dosing. If they work like the multidose pens, you can pull the drug out with an insulin syringe and inject that way, but you must work out the right volume for your dose accurately. The older multidose pens held 5 doses, and getting that 5th one out required extraction like that.

 

[Bellemorte1979]

lessthanhalf said:

Using the official pens doesn't lock you out of adjusting your dose. I've done it myself, after a year on ozempic and one painfully costly tirz script.

Those side effects you're dealing with usually do get better with time, though it can take months. Lowering your dose tends to work faster than just waiting it out. With ozempic, I had nausea and felt unwell the whole year, even after trying every-other-day microdosing, without relief. Tirz, on the other hand, treated me much better.

When side effects are hard to put up with or genuinely rough, you've got 2 options. Option one: split the dose in half and take it twice as frequently, if the problems only hit hard for a few days following each shot. Option two: reduce the dose back to a level where things felt manageable, then once the side effects settle and improve, raise it again very gradually after a gap. Tirz's dose steps are actually fairly reasonable, but reactions vary a lot between individuals. Going up by just 0.5mg or 1mg at a time might suit you better. The pens don't allow fine-tuning, which is a drawback, but the goal was foolproof use, not perfect dosing.

Official pens deliver a set number of clicks per dose. Search online for the click charts matching each pen strength. Say you want 6mg, and (just as an example, I don't recall the exact figure) 72 clicks equals a 7.5mg dose. Then 6/7.5=0.8, and 0.8 x 72 gives 58 clicks. So when you turn the dial, go slowly and count each click until you reach that number. Using the charts beats doing the math yourself. Double and triple check that the chart matches your specific pen. Getting the wrong dose isn't super easy, but it's not impossible either, so you need to be careful. (That's exactly why the maker advises against it.)

I only just noticed the mention of single dose pens at the end. Whether they support click counting, I'm not sure, but a quick google should tell you if there's a way to adjust with them. Alternatively, switch to the multidose pens, or head to the dark side, save a pile of cash, and control your own dosing. If they work like the multidose pens, you can pull the drug out with an insulin syringe and inject that way, but you must work out the right volume for your dose accurately. The older multidose pens held 5 doses, and getting that 5th one out required extraction like that.

If only I could use the click pens, since splitting my dose into 2 shots each week instead of 1 would probably sort me out completely. Tirz is covered by my insurance for next to nothing (25 for 3 pens), so right now nothing else is within my budget. On Wegovy, malaise hit me hard. A few months in, I felt awful. My stomach and gastro problems have been truly, truly irritating and at times disruptive to daily life, but this doesn’t compare to how I felt back then. I’ve still got energy and genuinely feel like doing stuff. The main drawback of the lower doses was that appetite suppression sat at 0.0. Thankfully, these days I eat in a fairly nutritious and controlled way, so I can manage, though 10MG has been good in that regard. Before GLP1s, food noise and bad cravings weren’t something I dealt with. Maybe I’ll simply have to wait it out until my body adjusts. Time will tell. Multidose pens would be amazing. Thanks for the input. Appreciate it.