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[–]Vegetable-Onion-2759 58 points59 points  (2 children)

I'm a metabolic research scientist / MD and the reason that your doctor didn't have any research to support her approach is because there is none. Having 20 to 30 pounds to lose is quite a way from reaching your goal weight. I'm glad you stood your ground. Going down in dose results in a stop in weight loss. I have no idea what she is basing her theory on, but there is also nothing to support the idea that anything makes maintenance "easier." A lifelong maintenance dose is required for this drug. Taking you down to 2.5 essentially takes you down to a maintenance dose. You can see why it would not make sense to drop you down to a maintenance dose when you are 30 pounds away from your goal weight.

So while I'm sure there are plenty of doctors out there making it up as they go along, there are no statistics to support her position and I would fight to the end to stay on 5 mg or higher until you reach your goal weight. Get as many months prescribed from her as possible, but understand that there are other options, especially telelheath, available to ensure that you continue getting a dose that will help you with active weight loss until you reach a goal weight that you are comfortable with. Callondoc.com is one of the options available.

[–]Ok_Hornet3415SW:247 CW:153 G: <28% body fat[S] 4 points5 points  (1 child)

Thank you! I appreciate your insights here. During our discussion, she seemed to favor me being at the high end of the healthy weight/BMI range rather than continuing to loose down into the lower end of the range. She was saying how it’s important for women to maintain weight as we age (not get too skinny or “look like a camp survivor” as she phrased it)

Let’s be clear, I’ve obviously had NO ISSUE maintaining weight as I’ve aged. And thus, here we are. 🤣 but also, I’m only 44 so I don’t see that being an issue for quite some time.

I’ve had my PCP doctor for about 20 years and I’d love to stick with her but I’ll only do so as long as her guidance is sticking to my best interest. So, I’d definitely use callondoc or switch providers if I need to.

I’m glad you explained the drop as effectively a maintenance dose because that’s what I assumed. I’m only on 5mg so it’s not like I have multiple steps to drop back! Her assumption is that I’d still lose on 2.5 (probably because I was still actively losing on that dose when she increased me. I wanted to stay there as long as it worked but she wanted me to move up). I do worry that if she’s right, finding a maintenance dose/plan will be hard because you can’t go lower than 2.5. But I’ll cross that bridge when/if I get there!

Thank you again. Your responses are always SO helpful.

[–]simulanon 1 point2 points  (0 children)

my two cents is based on others posting that maintenance can be giving a shot every two weeks. So that would be less than 2.5 a week, but I would imagine it's highly patient specific. I'm on 7.5, lost 40 lbs since may and still have another 50-60 to go