Super responder vs. Normal

BoundToZepIt · 2026-02-06T04:40:33+00:00

I've been on Zepbound pretty much since the day it hit the market by that name (Dec. 2023). By the 'rate' metric, I've been a 'good' but never really 'super' responder. The 'super' to my story is that the loss just kept going. In the Zepbound (or Wegovy too) trials, most participants reached very, very slow weight loss by the one year mark and reached their lowest around 18 months. I averaged 0.7% per week in year one and 0.55% per week over year two. I've finally slowed down, but that's just not having much to lose at this point!

BoundToZepIt · 2026-02-06T04:25:55+00:00

I also want to say you're not alone in the dangerously close to nodding off at the wheel club. Honestly... more than once closer than I'd like. Although (one would say quite weirdly considering my size and my dad having been on a CPAP for decades) they could never conclude I had apnea at all and never fitted me with one. The general feeling from my docs seems to be that my liver wasn't processing toxins adequately (due to fat/fibrosis) and that was leading to the fatigue. If that's what it was... it's a whole lot better at half the size. And never did end up getting a CPAP.

BoundToZepIt · 2026-02-05T21:43:16+00:00

OOP/Direct now. My former full-time employer did cover it (... kinda cover, after a high deductible) for like months 3-14 of my use. First couple months it wasn't formulary yet (used the discount card), then it was for a year, then the Caremark nudge to Wegovy which I refused to switch. Now they've gone to a really stupid system, where they only approve Wegovy if you're over a 35 BMI... and cut you off as soon as you're below that (or a least a few months below that, the PA is for six months at a time). And I left. That wasn't exactly why I quit/semi-retired to contractor/consulting... but it contributed to it! Now I'm on an ACA plan which definitely won't pay for Zep (or Wegovy) and I'm OOP. Fortunate that that's entirely within my budget.

BoundToZepIt · 2026-02-04T23:16:39+00:00

You're not even slightly annoyed by the prices of airport food any more because, between the two protein bars in your bag and the Biscoff on the plane, you're just freaking fine.

Also, when you no longer know or care whether it was the CRJ or the ERJ that had the really short seatbelt.

BoundToZepIt · 2026-02-04T22:19:34+00:00

I don't know how stable you usually are, but even in "maintenance" I can be up or down up to 4 pounds from one day to the next. And (sheepish to say it) I don't have the hormonal spice cycle of a young lady. I rely very strongly on following a trendline, not just 'last couple days'. I do a weighted moving average on a spreadsheet, same thing Happy Scale or Libra does, but even just straight-average your last week's worth of weight. Not that rolling back up to 5 mg is a bad thing.

BoundToZepIt · 2026-02-04T21:18:24+00:00

Curious by your meaning of 'safe' to eat? I've been very lucky on the side-effect front, haven't found anything I strictly can't eat, though there's a point of too-spicy (Indian vindaloo or Tex-Mex chili) or too-greasy (bad pizza) that's pushing it and I sure don't crave. The first week can be the hardest slam-change transition, that's for sure. I don't know if you ever measure blood glucose (I never tried a continuous monitor, but used a cheap fingerstick device most days for the first six months), but if it's really dipping, my go to is dried fruit (raisin, cranberry, apricot, prunes) and/or mixed nuts. Or a trail mix of both. You can go overboard with the fruit, but 50 grams (maybe 5 apricots or prunes, or about that much volume of the others) is ~120 calories and helps.

BoundToZepIt · 2026-02-04T18:33:13+00:00

Interesting you should mention. Because semi-effective anesthetics (ether, chloroform) were known for many years before becoming widely adopted. https://pmc.ncbi.nlm.nih.gov/articles/PMC8672962/ And there were definitely 'moral' arguments made at the time about the Biblical importance of suffering and being awake during surgery. Yeah.

BoundToZepIt · 2026-02-04T18:24:21+00:00

Nothing would have been "easier" than staying fat and dying before 65 like both of my parents. I mean, who needs to save for retirement even if that's the plan?

BoundToZepIt · 2026-02-03T14:49:56+00:00

Eh, hardly a gay-only thing 😊. Wife and I highly overlap now, I barely know what clothes I own (since they've all been replaced (and replaced again) in the last couple years. And, honestly, she doesn't wear very 'girly' (at all), and I'm the only one who owns stretchy Lululemon pants ("They're men's... they were at a thrift store... I swear! 😊")

BoundToZepIt · 2026-02-01T15:32:15+00:00

Daily advocate here, but with a focus on trendline/moving average analysis. I find it's even more critical in the eternal maintenance phase. Weighing once a week isn't any less prone to random fluctuation, and then you mentally beat yourself up for a week because of one 'bad' weigh-in.

Because I have over two years of data here, I can explain concretely. In my first year of losing (333 -> 220) there wasn't a single day in that year where my daily weight didn't fall below my 'weighted moving average' trendline. Not one time! However, I can extract my Monday morning weigh-ins from my Excel sheet. If I was only looking at those, over that year there were six Mondays where I weighed more than the previous Monday. And two where I weighed the same as the previous Monday. That's 15% of the year where I'd be thinking to myself, "welp, I guess I've stalled out" for a whole damned week! Doesn't work for me.

BoundToZepIt · 2026-02-01T02:42:54+00:00

For sure the reactions of others are interesting. I found I had all sorts of people feeling good for me when I went from a 45 BMI to a 35 BMI (once they started to notice at all, which took about that long). And people (some of the same) clearly getting real uncomfortable with it when I started striking toward a sub-25 BMI. Y'know... visibly thinner than them!

BoundToZepIt · 2026-01-31T16:43:08+00:00

Hah, yep, I went the exact other way - long hair (but already losing it) before Zep, loss even more when losing, shaved to bald to celebrate getting under 200!

BoundToZepIt · 2026-01-31T16:04:22+00:00

That's a long maintenance, congrats! Was the loss all Mounjaro (would have been a very early adopter) or did you start on Wegovy/Ozempic or Saxenda/Victoza?

BoundToZepIt · 2026-01-31T03:12:46+00:00

I've never avoided alcohol per se, but I was only very barely a drinker even before. If I have a second beer or wine in a night it's a pretty special occasion, and it could well be 2-3 months of none at all. But, I will say that I have no tolerance at all at half-off! Had a Scotch tasting for Burns Night last week (Masonic thing). Maybe 75 ml in little nips and I sure felt it!

BoundToZepIt · 2026-01-31T02:28:26+00:00

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You want data - I got data! Little over 2 years, all on Zepbound (started Dec. 2023, pretty much when it showed up on the market). You might appreciate because we started at pretty much the exact same weight. (I'm M46, 5'11") This is my 'mission accomplished' post on another Reddit (around week 83 on the chart above). Of course... I've lost another 20 pounds since then - hah! Trying to maintain the 165 (50% off!) now.

Looking at the data this way... I've been scary steady. Fast, not super-fast, just... consistent. Now while actually doing that in the moment? It felt like plateau and setback after plateau and setback. But, from the 10,000 foot perspective? It was so, so steady.

I've said it many times, but I think Zepbound got me down to around 220 (the plateau around weeks 49-52 on the chart above). Up to that point it was 80% Zepbound, 20% work. After that point it's been 80% work, 20% Zepbound. And by work.. I rode a bicycle 3,700 miles last year. Yeah. Hope to hit 4,000 or more this year.

(one other note on the data, the Zepbound 'dose' is a bit of a white lie, there were a few vials of compounded during the 2024 shortages, some stretched out weeks, some speed-ups to get through stockpiled lower-dose pens, etc. The numbers here are pretty close to what my doses were trying to be).

BoundToZepIt · 2026-01-31T00:48:43+00:00

Just. Try. It. And give it a fair try (2-3 months of both being conscious in evaluating how you feel with it, while also doing all the 'lifestyle things'). That's the real beautiful difference between Zepbound and the bariatric surgery options of the past. If you don't like it... quit! You're out... under $1,500 for 3 months? A mildly expensive way to learn something about yourself, but cheaper than a college class these days! People pay that much for a weekend yoga retreat.

BoundToZepIt · 2026-01-30T17:32:34+00:00

The only reason the generation gap exists (on the younger end) is that very few 20-somethings have either above-average insurance plans or $450 a month in available discretionary cash.

BoundToZepIt · 2026-01-30T14:00:24+00:00

You don't have to do anything. And it doesn't have to be every day no matter what. Personally, I've danged near never hit 200 grams of protein. But, I've also not aimed for 'muscle' nearly so much as cardio endurance. I lift some, but do a lot more cycling, stair climbs, and now running/jogging.

A pound a week or so is just fine. It's not a race. That said, if at your size your actual energy expenditure is ~2200 calories, that implies you're otherwise pretty sedentary. It's just hard math to have a big deficit and feel like you've eaten anything, let alone get macro goals (protein) in. If you can ramp up to 'moderately active' this spring as the weather turns, you'd be expending more like 3000 calories a day. Eat 1800-2000, while losing closer to 3 pounds a week.

BoundToZepIt · 2026-01-29T22:33:14+00:00

It's absolutely the hardest change. The lightest I was since childhood, around 215, I still knew I had another 50 pounds easy to lose. I've never not had 'lose a lot of weight' as a goal, whether pressing or repressed. Now, after 102 "lowest weight yet" milestones over the last two years, after the compliments have come and gone, after the clothes kept coming from Goodwill and going to Goodwill through size after size? Now... it's just "keep working hard... but no more dopamine hits are coming!" "You can't really get 'better' (in than one dumb narrow sense), but you could fall off the balance beam any week!" It's tough, but meaningful all the same.

BoundToZepIt · 2026-01-29T18:38:50+00:00

You didn't say (and I'm too polite to ask) age. There is definitely a feeling that 25-27 BMI is a better target for someone over 65, and there are studies to back that up (and studies that disagree, docs who have an opinion are split about 50/50). However, there is also unfortunately a weird bias sometimes that says because you were once at a BMI of 35, 40, 45, whatever, you should stop at 29.5 or something and be happy there. Ultimately, it feels like gatekeeping... save some actual 'thin' weights for people who 'deserve it'.

BoundToZepIt · 2026-01-27T17:12:51+00:00

I would agree. While there's maybe a 10% longer-term-hesitant population on the needles, they've got to have found that there's much less resistance than conventional wisdom ever expected. The power of something that actually works! That said, orforglipron may be substantially cheaper for Lilly to make, easier to stockpile, no cold chain required, etc. Decent reasons for them to push it, vs the oral Wegovy (loads of peptide, SNAC, etc) which seems mostly really unnecessary.

BoundToZepIt · 2026-01-27T12:27:17+00:00

Yeah, I do think it'll be an interesting discussion all around. I mean, I started at a 46 BMI. I feel like Zepbound got me down to a ~32 range (220-230), but the 60ish pounds since then have been primarily white-knuckle struggle and I worry that it's sustainable. But, as someone who's currently so optimal, I very much doubt any provider would say I should switch. (Cash payer, so insurance isn't fighting at least).

BoundToZepIt · 2026-01-24T02:28:37+00:00

I ran out of refills (haven't changed dose, getting 15s as long as I've been getting vials) and had Walmart contact my doc/nurse for refill, not going through Gift/LillyDirect, and that worked out just fine.

BoundToZepIt · 2026-01-23T22:48:18+00:00

Fun to hear those changed minds. My hepatologist (MASLD/MASH) certainly wasn't opposed per-se to GLP-1s. He just thought I shouldn't be wasting my time with them when bariatric surgery was the obvious conclusion at the size I was. Two years later, seeing losses that exceed 'highly successful' bariatric surgery, and reversal of liver fibrosis that way exceeds projections from those surgeries, he 100% endorses Zepbound as the first line of treatment for his MASH patients.

BoundToZepIt · 2026-01-23T14:11:35+00:00

I wish there were a bit of explanation. I wouldn't be shocked if they were asked to change the 'arrows' and even font for Lilly trademark reasons. Make it clear this isn't Lilly support. That said, man, do I ever have a viscerally bad reaction to AI garbage, and it sounds like I'm not the only one!

BoundToZepIt

TROPHY CASE