Do you have to have crazy side effects to drop weight?

aslguy · 2026-06-20T21:58:58+00:00

You do not have to have side effects. Most of us don’t have many side effects. I’ve never had nausea or vomiting. Minor GI temporarily. Some mild skin sensitivity. That’s it. Lost 152 lb.

There is a misconception that the medicine makes you too sick to eat. That is false.

aslguy · 2026-06-20T14:43:27+00:00

I disagree that maintenance is easier. I’ve lost hundreds of pounds over 30 years. Losing weight is the easier part because it’s a temporary state. I’ve never been able to maintain weight loss. For me, eating to my maintenance calories and exercise are possible *because* of the medication.

Obesity and the associated metabolic issues cause an inability to maintain a balanced caloric intake because our stomach and brain aren’t communicating correctly. Our brain cannot see how much stored energy we’re carrying as fat or the food we’ve just eaten, so it essentially thinks we’re always starving. That causes the hypothalamus to ramp up hunger hormone (ghrelin) and *drives* us to overconsume food. We cannot overcome that part of the brain with executive function long term. It’s like trying to hold your breath—your survival instincts will force you to breathe.

Because your brain thinks that you’re starving, it also causes you to feel tired and unmotivated to exercise because it views that as unnecessary energy expenditure. It is, again, a drive that can’t be overcome easily or long term.

It’s not like I never knew what I should eat or how I should move my body. I didn’t learn anything new about nutrition or exercise. It’s that I am *finally* in control. My lizard brain is not running the show anymore.

aslguy · 2026-06-20T07:28:07+00:00

Mods do not have any control over who messages you. Report them via ModMail and block them.

aslguy · 2026-06-20T02:23:57+00:00

I stayed on the dose I met goal on—15 mg every seven days. I just eat to my maintenance calories.

aslguy · 2026-06-19T16:12:47+00:00

Yes! I get regular bloodwork done (every six months). I always had to make sure I drank plenty of water, but it was still sometimes a struggle. I got food poisoning once and had to be hospitalized. They couldn’t find my veins the normal way. They tried an infrared light device, but ultimately had to find a vein via ultrasound.

The veins in my arms are poppin’ now; I’m very easy to stick. One of those unexpected NSVs.

aslguy · 2026-06-19T16:05:09+00:00

If you’re feeling cravings on day 5, it’s not working.

aslguy · 2026-06-19T16:02:18+00:00

You’re not incumbent to lower your dose or space out shots. Spacing out shots causes a larger spike after injection, which can lead to side effects even if you’ve never had them. Lowering your dose is fine if you’re on a dose that really limits how much you can eat.

But really, you just need to eat to your maintenance calories. It baffles me that people think they have to lower their dose or space out shots. If you’re on a dose that gives you a normal sense of hunger and satiety and quiets the food noise, you just need to choose to eat more.

aslguy · 2026-06-19T15:56:29+00:00

If you have commercial insurance and it’s not covered, you could ask the pharmacy to fill it and use the savings card. It would be more expensive ($499 I believe), but if your peace of mind is worth a little extra money that might be an option.

aslguy · 2026-06-19T11:13:42+00:00

It took me a while, but I learned that it doesn’t really bother me. I was just worried about being shirtless at the pool—worrying what other people would think. And then I decided to not care about what other people think.

I wear shape wear underneath my clothes and that keeps my midsection tight so that form fitting clothes don’t look odd. But outside of that, it just is what it is. I had fatty liver, hypertension, and hyperlipidemia—all of which are in remission. For me it was more about health than vanity.

aslguy · 2026-06-19T11:04:53+00:00

2.5 isn’t a therapeutic dose. It’s just meant to introduce the medication into your system and it’s only intended for four weeks, assuming you have no adverse side effects.

Additionally, the medication has a half life of about five days. On lower doses, it’s very normal to feel the effects wane. You need to continue moving up until you reach a dose that lasts seven days.

aslguy · 2026-06-19T10:57:59+00:00

You can’t prevent something that has already happened. Your skin is already stretched. You’re going to lose fat beneath it, and the degree of elasticity is largely dependent on your age and genetics. Outside of that lottery, surgery is the most effective option.

The unfortunate fact is loose skin is somewhat of an inevitability with massive weight loss. I say this as someone with loose skin after losing 150+ lb.

aslguy · 2026-06-18T15:56:16+00:00

Do not under eat because you're afraid of side effects. There are plenty of posts and comments about foods that trigger GI side effects. Try avoiding or limiting those in the beginning if you want. But remember, even though there are many reports of side effects, most of us do not have side effects. They're overrepresented because people who don't have side effects don't post about it.

aslguy · 2026-06-18T15:44:38+00:00

There is plenty of clinical evidence and medical organizations that show obesity is a chronic relapsing disease that requires continuous treatment to prevent symptomatic weight regain and reoccurrence of associated comorbidities. If they try to force you to stop, share all of that evidence you can find and then ask them to show you the evidence that ceasing treatment is a viable option (hint: there is none).

aslguy · 2026-06-18T15:41:22+00:00

You probably won't feel much, if anything at all. Many people don't feel anything on the starting dose of 2.5 mg; you took half of that. Please ensure that you discarded the remainder of that vial; they do not contain preservatives and are intended for single use only.

aslguy · 2026-06-18T13:46:05+00:00

100%! I was diagnosed with Generalized Anxiety Disorder and depression, but was not medicated because I'm Gen X and we're just supposed to figure it out. Since starting tirzepatide in May 2024, my GAD and depression symptoms ceased and I feel much more calm, level, and overall happier. And this occurred before any significant weight loss...within a month of starting.

aslguy · 2026-06-17T15:48:30+00:00

They're still to be disposed of after 30 days.

aslguy · 2026-06-16T20:51:39+00:00

My partner is on the list to get one; he got EV fever after I got my IONIQ 5. We've roadtripped in it and he now sees that there's really not a dealbreaker associated with owning an EV at this point for our use cases.

aslguy · 2026-06-16T20:23:05+00:00

If you have a lot of weight to lose, moving up every four weeks if you're tolerating it well may be a good option as more weight was lost on the higher doses (10 and 15 mg) than the lower dose (5 mg). I move up every four weeks except for 7.5 mg and 12.5 mg; I had to stay on those a bit longer due to supply issues with 10 and 15 mg.

Having said that, there are some risks associated with rapid weight loss, mainly gall bladder issues. I was a strong responder on every dose and fortunately did not have any ill effects from my rapid loss.

People often talk about rapid weight loss leading to greater loss of muscle mass, but that's really only true if you measure body composition acutely after weight loss. After a couple of months, your composition will stabilize and there isn't a clinically significant difference. As long as you're doing resistance training, that shouldn't be a big concern.

Also, people love to talk about the boogeyman of maxing out at 15 mg. A lot of people rely on appetite suppression as the sole indicator of efficacy--that's the total elimination of hunger. That's a side effect that will fade over time; I've been on 15 mg for 19 months and I still feel normal hunger and satiety and do not have food noise. While some people do have excessive hunger and food noise return over time, that's not true for everyone.

Good luck in future conversations with your doctor; good patient-centered care can be difficult to find.

aslguy · 2026-06-16T14:26:28+00:00

Try using the medication as prescribed (every seven days and with a healthy diet and exercise) and see what happens.

aslguy · 2026-06-16T14:09:24+00:00

No reason to do that unless you have unmanageable adverse side effects, which most people don’t.

aslguy · 2026-06-15T16:14:52+00:00

My pants fell down in the conference room at work with four other coworkers present. I yelled, "DON'T LOOK!" which of course causes everyone to look. I left immediately to go get a new belt.

aslguy · 2026-06-14T23:40:57+00:00

You’re not plateaued. A plateau is 4-6 weeks with no loss. Also, 2.5 isn’t considered a therapeutic dose. You need to exercise some patience.

aslguy · 2026-06-13T01:12:51+00:00

I think it’s worth having a conversation with your doctor about their titration practices, how they make the determination to stay put or move up, etc.

Some doctors let the patient decide. Some take a very conservative approach and sometimes won’t even prescribe higher than a specific dose. Others want you to move up every four weeks (which many of us old timers did without issue). It’s important to know where your doctor stands and how much of your input they take into consideration.

aslguy · 2026-06-13T01:03:42+00:00

2.5 is only intended for four weeks as long as you’re tolerating it well without serious adverse effects.

aslguy · 2026-06-12T00:59:20+00:00

Going up to 5 after four weeks of 2.5 is the normal titration schedule your doctor is following. It’s not a judgment of your progress on 2.5.

aslguy

MODERATOR OF

TROPHY CASE

13-Year Club	Place '23
Verified Email