10 ms·

I started Tirzepatide 3-4 weeks ago. (Mostly as an experiment to understand the hype around GLP's... I don't have diabetes and only very slightly overweight at

by cj 2y ago

I started Tirzepatide 3-4 weeks ago. (Mostly as an experiment to understand the hype around GLP's... I don't have diabetes and only very slightly overweight at 20% body fat). Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month: - Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat. - No more feelings of hunger. At all. This is somewhat depressing. Eating is no longer enjoyable and feels like a chore. I woke up hungry for the first time in a while a couple days ago and was excited - jumped out of bed and ran to eat something just for the pure joy of it. I've only felt that a few times in the past few weeks, compared to every day off the drug. - I completely stopped drinking. Have you ever been to a bar after eating a big meal at a restaurant, and had trouble drinking because you were too full from your meal? That's how I feel all the time. 1 or 2 beers and it becomes uncomfortable to have anymore. - Normally I go grocery shopping and within 3-4 days, all the "good stuff" (snacks) I bought are eaten. Now, since I stopped snacking and eating much less, groceries simply last way longer. <-- $$ saved in groceries significantly offsets the monthly price of the medication - My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks). - Haven't noticed anything regarding impulse control outside of food. No anecdata to share on that point... After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice (choosing not to take the drug). The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day). I'm the kind of person that used to be able to order just about anything on a restaurant menu and clean my plate completely. Now I simply can't do that. It's actually kind of embarrassing being at a restaurant with friends and being completely uninterested in the food.

devmor 2y ago
> Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat. This is the largest of several reasons I hesitate to try it for myself. I am a very big guy (I would be about 184lbs if I had 0% bodyfat at my current musculature level). From the experiences I hear, I would not only struggle to have enough energy to do any kind of rigorous exercise, but struggle to consume the amount of protein I require to even maintain my current muscle mass. I do have issues with overeating and the prospect of a drug that prevents me from consuming too many calories is attractive, but the side effects sound counterintuitive to any kind of natural fitness.
- meroes 2y ago
  I’m somewhat the same. I need to be active for other health reasons (physical therapy, etc) and not eating enough saps my ability to push forward physically.
- cj 2y ago
  I’ve been hyper aware of the muscle loss caveats and I think it’s the most important thing to know when starting the drug. You really need to prioritize protein intake and make sure your calorie deficit isn’t extreme. Losing too much weight too quickly, with or without the help of a drug, can be very unhealthy. I drink 4 protein shakes a day (160g total) in addition to regular food. If it weren’t for the protein shakes I definitely would be protein deficient. You’re 100% spot on with decreased energy at the gym. I’ve had to pull back 4x weekly cardio to 1-2x weekly. Then again, anyone who’s in a calorie deficit has lower energy. It’s not a unique phenomenon of the drug, just a side effect of weight loss.
  - ForTheKidz 2y ago
    > Then again, anyone who’s in a calorie deficit has lower energy. Presumably if you're trying to lose weight, you have energy to burn you carry around with you. A calorie deficit doesn't imply lack of calories to burn. Presumably you're trying to trigger ketogenesis. Granted, this is a lot less easy to access than simply eating simple carbs right before a workout and likely a lot less comfortable.
    - TeMPOraL 2y ago
      > Presumably you're trying to trigger ketogenesis. Only if you're actually on a keto diet; most weight loss routines run a calorie deficit without triggering ketogenesis. Also there's this whole thing about set points - you probably got to your weight somehow, and if it wasn't through consistently making stupid choices over many years, chances are this is what the body learned to consider an equilibrium state. Which means that, if you start running a calorie deficit, it's going to fight you every step of the way. It will happily scale down performance to conserve energy instead of burning the accumulated fat, so you'll just be slow and groggy but not lose weight. There's been reported cases where people got mental illness-level obsessive thoughts about food, which appeared when they were hungry, and stopped when they ate enough. The degree of this problem varies between people, but it's generally not that easy to effectively lose weight, and some people simply lost the genetic/environmental lottery on this.
saurik 2y ago
> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month... So they are going to force you onto a higher dose?!
- willis936 2y ago
  Yes, up to 15 mg. Maintenance levels at 5, 10, and 15. If you cannot tolerate a maintenance level you can still get it, but insurance will not cover it ($1000/mo rather than $15/mo.) This is not an unreasonable situation. https://www.goodrx.com/zepbound/dosage https://www.goodrx.com/zepbound/dosage
  - cj 2y ago
    Luckily during the “shortage” you can currently get GLP-1’s in vials rather than injection pens. The brand name GLP’s you can’t control the dose. But when you get it in a vial from a compounding pharmacy you can inject however much or little you want. Not looking forward to ever using the brand name version specifically for this reason
    - dghlsakjg 2y ago
      The injection pen I have see has two marked dosages, but there is nothing stopping you from injecting more or less. Basically it is a ratcheting mechanism where after ~10 clicks you get .25 mg dosage and 20 clicks gets you .50. Basically, no doctor is going to endorse it, but you can dial a dose to whatever amount you want.
    - blackeyeblitzar 2y ago
      Aren’t any states like California trying to ban compounding pharmacies? It’s an unfortunate attack on individual freedom, but I am not sure if we will still have them 20 years from now.
      - dragonwriter 2y ago
        > Aren’t any states like California trying to ban compounding pharmacies? No. California has not banned compounding pharmacies, nor is there a significant movement to do so in the legislature, among the people (who could do so by ballot measure), or a proposal by the governor to do so. California does require additional licensure for sterile compounding, but that is very much not a ban on sterile compounding or compounding more generally. Relevant to GLP-1s, though, several state pharmacy boards (not California’s, as far as I know) have raised issues that compounded GLP-1 drugs that they have seen appear to be illegal, because they use a form other than the FDA-approved base form of semaglutide (which is only available from Novo Nordisk), and th3 form used is not itself approved for human use, and have taken steps to crack down on that. But that's also not banning compounding, but enforcing existing rules on compounding.
willis936 2y ago
Yes well your PCP / pharmacist should not have prescribed you an appetite suppressant when you have below average body fat %. The effects are very worth it for people weighing them against heart disease and mobility issues. It's not a Faustian bargain, it's all right on the tin. When you stop taking it the effects go away. If you want to be indulgent and it fits your lifestyle you can reversibly make that decision. The power to make that decision is difficult to overstate.
- smallmancontrov 2y ago
  Why is it only appropriate for people with heart disease / mobility issues but not for someone who is merely overweight? This feels like finger-wagging for the sake of finger-wagging.
  - willis936 2y ago
    It isn't. 20% body fat is 6% below average. That isn't "merely overweight", it's likely underweight. No, I don't think underweight people should take appetite suppressants and I don't think that qualifies as a hot take. I think anyone who is medically overweight (which is a very modest BMI qualifier for anyone with any amount of muscle) should have the choice. Many US medical systems and insurers agree, which is a good place to be.
    - MostlyStable 2y ago
      >it's likely underweight. The only way this can possibly be correct is if you think that the "correct" weight is whatever the population average happens to be which is just...wild to me. If we assume commenter is male (a statistical likelihood), then 20% is the high end of normal, and could very safely be halved. In the less likely case that they are female, then it is right in the middle of the normal range, and could safely be reduced by 5-10% at least.
      - toast0 2y ago
        > The only way this can possibly be correct is if you think that the "correct" weight is whatever the population average happens to be which is just...wild to me. The medical definition of overweight is basically if you're some number of standard deviations above the average from whenever they ran the stats, so population average = correct weight seems like as reasonable a standard.
Judgmentality 2y ago
[flagged]
- cj 2y ago
  You can get wegovy generic for $299/mo and Zepbound generic for $399/mo currently through telemedicine via compounding pharmacies, without insurance.
  - dghlsakjg 2y ago
    Maybe they are in Canada. Name brand Ozempic is $230 CAD or $160 from Costco up here
    - SoftTalker 2y ago
      [flagged]
      - dghlsakjg 2y ago
        What a take. I have no idea what Americans overpaying for healthcare has to do with a Danish drug company participating in the Canadian Healthcare market. I’d rather thank the Canadian government for having a drug pricing review process. If these companies don’t want to sell their drugs here, no one is making them. They are still here, so I think it’s safe to assume that they are still making money.
        twoodfin 2y ago
        I don’t think it should be controversial to say that if the US imposed a Canadian-style price control regime on more than the handful of drugs currently regulated by Medicare, the future number of drugs developed and commercialized would drop significantly. It’s just basic addressable market vs. development cost math.
        phatfish 2y ago
tasty_freeze 2y ago
I resonate with your comment about appetite loss. It is surprising how much it has affected my happiness, to have this few times a day pleasure taken away. A month ago I suffered through a norovirus infection, the first time for me. In three days I lost six pounds (my BMI is 21.2 now). At first I wasn't surprised or worried -- after all, I had emptied out my digestive tract and was dehydrated. But a month has gone by and my appetite has been AWOL. I've lost another pound (5'11" @ 152 lbs). I have an appointment next week with my doctor's PA to see if something else is going on. The taste of food is the same, but the craving is lacking. When I eat, my guts are telling my brain it is time to stop eating, as if I had eaten a pound of mashed potatoes only an hour ago.
- raincom 2y ago
  Maybe, Norovirus affected GIP and GLP-1 hormones. This could be a new research avenue for weight loss. GIP and GLP-1 are product of the research about the Gila monster lizard, which eats three or four times a year and survives.
ForTheKidz 2y ago
> That late night trip to McDonalds will have you feeling like shit the next day I've never had this reaction to fast food before. I only eat mcdonalds every few months and yea it's not the highest quality food, but I don't think there's anything in it to make you sick any more than other burger places have. I imagine you'd have to have restricted fast-food nutrition for quite some time before you feel a difference. I'd like to see a study comparing people who ate mcdonalds who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic, or how much of the craving for mcdonalds is rooted in feeling like crap in the first place. (Granted, I've never had an issue with maintaining my appetite before, in fact I have issues keeping weight on, so I might have a fundamentally different relationship with food.)
- _diyar 2y ago
  The way I read it, i think the original commenter would usually agree with you, but the effect of the drug turns the post-fast food / treat satiation from joy to pain.
  - ForTheKidz 2y ago
    I believe you're correct. Apologies for the confusion.
- WarOnPrivacy 2y ago
  >> That late night trip to Mcs will have you feeling like crap the next day > I've never had this reaction to fast food before. I do. Because of it, I eat fastfood when I'm willing to pay that price, ~5x/decade. > I'd like to see a study comparing people who ate mcs who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic. The notion that our psychology could be holding us back from fastfood completeness is one that never occurred to me. I like how novel it is.
  - ForTheKidz 2y ago
    I believe you, but what do you think it is in the food that causes such severe reactions for you but doesn't affect me at all? Humans lived through periods of extreme starvation and other forms of malnutrition—our genetics are extremely clear on this, as is our tendancy to cannibalize our muscles when they're underused. It seems absurd to me a slightly different selection of nutrients could cause acute distress. (Hence my recourse to psychology—which would map well with the shift towards the moralization of nutrition these past few decades.)
ctrlp 2y ago
I've heard similar accounts and it sounds pretty wild. I'm not overweight and don't take anything but I do enjoy food. It would be horrible to me to lose the enjoyment of such a primal pleasure. If the choice is between being overweight and giving up the pleasure of eating altogether, I can imagine plenty of gourmands who would rather carry the extra weight for the physical and social pleasures of food. I've heard anecdotal reports of people losing their enjoyment of food permanently, even when discontinuing the drug. Canot confirm but that would be a high cost to pay, imho.
- dghlsakjg 2y ago
  Counter-anecdote. I have not lost my appreciation for good food, I just eat less of it. I used to be unable to leave any food on my plate regardless of how good or bad it was, now I’m perfectly happy to leave something uneaten if it isn’t to my taste.
  - alabastervlog 2y ago
    Same, I'm on one of them and I still love and enjoy eating and am perfectly capable of eating my beloved junk food. I'm just highly likely to feel done after a few bites instead of... dozens and dozens of bites. Losing the pleasure of food was one of my main concerns starting it, and it hasn't been an issue whatsoever. Meanwhile, I'm back down to my healthy weight range, which I haven't seen since 2021, which was about the third time I'd been at that weight and then ballooned up. I was just about at the top of that range after two months, down about 30 pounds, and it took no effort whatsoever. I feel amazing. Muscle mass is also doing fine, and I'm well into middle age so any protective properties of youth are largely gone, still having no problems there.
  - cm2187 2y ago
    Same for me, I don't recognise those symptoms (loss of taste, loss of impulses). My understanding is that all it does it to replicate the signal the stomach sends when it is full, and so you just feel full / a bit burpy, even on an empty stomach. But you do enjoy the same taste than before the drug. That being said side effects vary and lots of people mention it gives them nausea. I can easily imagine how that would interfere with taste.
fallingknife 2y ago
That's interesting. I started ozempic about 3 months ago and the effects are really not dramatic at all. Is Terzepatide supposed to be more powerful?
- loeg 2y ago
  Tirzepatide is supposed to be more powerful, but GP also just appears to be relatively sensitive to the drug.
throwaway657656 2y ago
The above describes me but it is the consequence of my behaviors/habits. Being a workaholic, I learned long ago to ignore the leash that pulls me to the refrigerator. It seems by brain no longer sends me a "you need to eat" signal similar to the way free divers can become oblivious to the "you need to breath" signal. I wonder if with time, you can learn from this drug, form the helpful habits/behaviors and then stop taking it.
- gg82 2y ago
  Probably not. If it suppresses your hunger response, you will likely lose the ability to deal with hunger when you go off it.
blitzar 2y ago
Cocaine makes you feel really good and heroin is fun.
loeg 2y ago
I started in November and am down ~25 lb. > Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month Uh, you're allowed to stay there as long as you want. I was on 2.5 for two months and asked my Dr to up the dose, as progression kind of stalled in the second month. I've been hanging out around 3.5-4.5mg/week since then losing ~5 lb/month steadily. Sounds like you're pretty sensitive to it, which is nice. You can lower the dose even further if you think it's too strong at 2.5mg/week. It is definitely a game changer.
api 2y ago
Does it have any impact on focus or motivation to get work done, do hobbies or recreational activities, engage in human relationships, sex, intellectual curiosity, etc.? It would be fascinating and almost too good to be true if we found a way to suppress only largely harmful (in our current environment) urges but leave the good ones intact. Something like that becoming widely available could change the world, and mostly for the better. It would refocus our entire economy on much more constructive pursuits instead of gambling, addiction, and pandering to transient urges.
- davoneus 2y ago
  I've never had any lack of focus or motivation to get anything done since I started Tz. I did have some energy loss, especially at first, but I assume that was because my body was struggling to cope with a lack of carbs. However, after a couple of weeks that for the most part disappeared.
asveikau 2y ago
> My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks). Starbucks food is especially calorie dense. I realized this when I lost a bunch of weight in 2018 and I noticed the calorie counts on the printed cards that some stores have. Even for junk food, Starbucks junk food is more calorific than average for the same items. I started to consider that for a typical customer's consumption, McDonald's might actually be healthier than Starbucks. Which totally goes against the image people have of both places. People think if they are "going for coffee", it's better for you than having a milkshake and following it with candy. But it's essentially what they're doing.
- Taikonerd 2y ago
  "Starbucks's greatest trick was convincing grown-ups it was OK to have a milkshake for breakfast." (I heard this somewhere on the internet, about the Frappucino.)
cm2187 2y ago
I am 8 months in, you do develop a tolerance over time to the drug (and why you need to increase the dosage progressively). I have gone up slower than the prescibed steps but still, this drug is to help doing diets, I don't think it would work as a long term medication. And as far as I can tell, when you get off the drug or have become tolerant to the current dosage, it is easy to gain back some weight if you are not careful. So the point being I don't think it will suppress completely obesity, but it will certainly help people make a time limited effort to go down to a lower weight.
- raincom 2y ago
  Some doctor advised a protocol: stay on GLP-1 for 3 months, then take metformin for a month or two; then repeat the cycle. I have to dig out the source for this.
- jmpman 2y ago
  I’ve been on it for over 2 years now. Yes you plateau, and if you go off of it (as I had periodically), you will regain weight. Hoping my weight loss resumes now that I’m back to the maximum dosage for a few weeks. As it’s 5pm and I just ate for the first time today, I can confidently confirm that my appetite is well suppressed.
- jasonfarnon 2y ago
  "I don't think it would work as a long term medication" It seems like there is a lot of disagreement on this very basic point. Surely there must be data from the decade or so it was prescribed for diabetes.
- __turbobrew__ 2y ago
  Interesting, what is the end game then if you need to be on the drug to keep the weight off but you also develop resistance to it over time? I wonder how the body reacts after being on the drug for years at a time and then you cut it off, are the cravings stronger than before you started the drug?
  - cm2187 2y ago
decryption 2y ago
I've been on tirzepatide for 8 weeks (2.5mg then 5mg) and have a very similar conclusion as you. I started off at 160kg 8 weeks ago and now I'm down to 145kg. No other change in my lifestyle except eating radically less. Two 500-calorie-ish meals a day and some fruit as a snack, that's about it. For decades I've struggled with diets but tirzepatide is the only thing that's made me stick with it. Will power alone wasn't enough, but with tirzepatide I'm very confident I'll get down to a under 100kg for the first time since I was a teenager, within a few months.
- bobsmooth 2y ago
  You lost 35kg in 2 months? That's insane. Any issues with loose skin so far?
  - lossolo 2y ago
    160 - 145 = 15kg
silverlake 2y ago
This is me without any drugs. I’m very interested in food, but I only want a few bites to taste.
wileydragonfly 2y ago
Be careful with all this. At one point I had gone 72 hours without eating or drinking anything and one beer by the pool had me on the floor. I keep hydrated these days but sometimes it’s an effort.
- wkearney99 2y ago
  Atkins-ish diet caused the same thing for me with a car accident back in the 90's. Sudden uptake of carbs with the alcohol resulted in lost memory of over 13 hours, a '68 De Ville convertible that got totaled and 2 months spent with a wired jaw.
crazygringo 2y ago
I'm curious -- do you have any brain fog? Are you able to exercise? When you exercise, do you wind up eating more, i.e. the caloric amount that you exercised? I've never had any psychological difficulty with losing weight. I don't care if I'm hungry. But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget about it -- my blood sugar is going to my muscles and I'm unproductive for hours afterwards as I just can't think. Also, if I go to the gym, my muscles take a week to recover instead of a couple of days, because they're just not getting the glucose they need to repair themselves. I don't hear any of these complaints from GLP users though, which baffles me. Not eating enough affects us in lots of ways besides just being hungry. How has it been for you?
- op00to 2y ago
  No brain fog. I walk at a very brisk pace ~6 miles a day. My calories are far less than before I started. I have to be very careful to have enough protein. When I exert myself, the recovery period is the same time as before.
  - crazygringo 2y ago
    Do you have any idea of how many calories you eat per day? I get so confused because the small amounts of food that people talk about eating on GLP, don't seem like enough to sustain themselves long-term. Are they exaggerating? Or do they talk about not eating dinner, but that's because they had 1,700 calorie lunch at the burger place? Or is that just during weight loss, and then once a target weight is hit, they're eating like a normal (healthy-weight) person again? I just genuinely don't understand how people are surviving with the diets they describe.
    - op00to 2y ago
      Yes, I calorie track around 1900 calories average. Maybe up to 2000? They are probably losing muscle mass!
deleted 2y ago
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fire_lake 2y ago
Since you are not terribly overweight you could reach a healthy weight with relatively minor lifestyle and diet adjustments. Isn’t this preferable to the side effects (some probably unknown) involved in these drugs? Genuine question.
op00to 2y ago
The effects seemed to wane slightly for me, but it vastly changed my relationship with food. I was raised in a family with plenty of food, but food was used as a weapon of manipulation and thus I was taught to eat as much as I can else it might be taken away. With Zepbound I now eat appropriate portions. Can’t really stand more than a single beer. I don’t mind being at a restaurant and not really eating. I’ll have a bite of this or that and be happy. My shits, however, have been glorious since starting the drug. Truly pleasant steamers that rocket right out.
SubiculumCode 2y ago
Where did you purchase it?
herpdyderp 2y ago
> Eating is no longer enjoyable and feels like a chore I used to view eating as a chore and it was great. Then (no joke) I got into tech and everywhere I work they have fancy food or frequent team lunches or something of that nature. I wish I could go back.
anal_reactor 2y ago
I understand that on population level we can't just tell everyone "get on a diet", but when talking to you in particular, why couldn't you... just get on a diet? Personally, I love food. I can't live without stuffing candy in my mouth. But I also have a tendency to get fat, so I weight myself every day, and based on that I either have a diet day or a cheat day. Moreover, I do a lot of physical exercise every day. The idea of having to depend on a drug to live is scary to me. Having said the above, I'm sure that one day we'll create a drug that makes life of majority of population better, and we'll be able to administer it to everyone without major consequences.
valunord 2y ago
Thanks for experimenting with your body. I'll be sure to check back in about ten years to see how all this shakes out. Keto + intermittent fasting are my magic pill right now and have been for some years.
- no_wizard 2y ago
  Ozempic has been in use for diabetic patients for at least a decade if you want to look at the research of its long term results in that population - which is fairly large to constitute a good sample sizing.
  - valunord 2y ago
    So that means we'll have a good twenty years of data to finally look at, which is what I was saying. I do not trust any medicine unless it has far more data than what we have in this regard at this point. I work in a related field and I can simply say most things we trust should not be trusted and should require far more testing.
    - ValleZ 2y ago
      Then wait another 50 years, easy.
- homebrewer 2y ago
  I'm pretty sure keto has not been extensively studied for anything but the management of epilepsy in children that do not respond to medication. So tbh this is an odd comparison.
  - valunord 2y ago
    Keto and such diets have been used for millennia. Our bodies are MADE to use keto... Lol.
- borgdefenser 2y ago
  I am much more daring in my will to experiment but I do agree. Keto, fasting and also breaking the "foodie" culture that eating and going out to eat becomes a hobby. I didn't order/dine in at all from a restaurant in 2024. It is much easier to not over eat the boring keto meals I make myself. My "cheating" is eating basmati or jasmine rice with a stir fry instead of cauliflower rice. There is actually not enough known side effects for me to take GLP-1s. They are either complete miracle drugs or side effects we don't currently understand haven't come out in the wash yet. We have a pretty good track record when a new powerful medication like this is introduces of doing things quite wrong. There are probably risk mitigation strategies we will learn in the coming decades that we simply can't know right now. Otherwise, these are basically free lunch miracle drugs. That seems an easy short.
no_wizard 2y ago
I’m not going to lie all this sounds like heaven to me. I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons. My insurance only recently started to cover these weight loss drugs, and I have been looking into them over the last month because I think I’m an ideal candidate for it. If it gives this kind of control over cravings and appetite I’m really looking forward to how this can genuinely make my life better
- Henchman21 2y ago
  I'm a few months into this drug as well, and I have to say, it doesn't offer control. What it offers is a lack of cravings & appetite. That is different, remarkably so. Control would mean I might still feel hungry. Ever. Or that I could decide to eat heavily at one meal, but I don't and as long as I take the drugs, I won't. That doesn't feel like control, it feels like I've had something removed. I guess it's a matter of perspective? I don't know if its a common sentiment but this drug treatment is the hardest thing I've ever done for my health. I'm not sure I'll be able to continue though. It's like I've robbed myself of the one joy I had left and now I have none. Tread carefully.
  - no_wizard 2y ago
    The difference here may simply be in how our mental health relates to food. It sounds to me like it brings you enjoyment you miss. I respect that. Food for me isn’t that. The lack of cravings and appetite means I would be firmly in the drivers seat with it. It means I can eat exactly the amount I’m suppose to and not feel like I must have more
  - fragmede 2y ago
    Note that if you're doing this treatment at home (aka bought a vial and a syringe off the Internet and are injecting yourself), you can simply give yourself slightly less next injection. It's not a binary "hunger (y/n)" but more of a spectrum. (anecdotally)
  - 2y ago
creer 2y ago
Thanks for the report! Aside from the loss of interest in food, what other side effects have you noticed or not noticed? (other N=1 reports welcome!)
maleldil 2y ago
> being overweight will be a choice Not everyone can take these drugs. Some people will have severe side effects. It's very common to have nausea, vomiting, etc., and some people will experience these frequently enough that the prescribing doctor will rescind the prescription.
- abirch 2y ago
  gastroparesis is a real side effect two, it’s where the food in your digestive tract stops moving. As in 30% of food is present after 4 hours The rate is over 1% which isn’t a lot nor is it nothing https://jamanetwork.com/journals/jama/fullarticle/2810542 https://jamanetwork.com/journals/jama/fullarticle/2810542
  - cyberax 2y ago
    It looks like it's mostly caused by having too high doses of GLP-1 too soon.
    - abirch 2y ago
      I’m not about the root cause. I’m on a GLP-1 and while doing a premortem on my medication I saw that this, vomiting, and burps were common.
      - cyberax 2y ago
        I've been using GLP-1 agonists since before Ozempic, and by now I have no side effects from them. My doctor said that she now titrates the dose up slower than the recommended monthly increments and the side effects are less frequent. Another problem is that GLP-1 drugs seem to synergize with other drugs that can cause GI issues.
- taurath 2y ago
  I tried, I got some results but it meant that my entire body’s digestive system felt like it stopped working. Constipation, nausea at the drop of a hat, finding I’d have to take a fast acting prescription anti nausea multiple times a day. I’m not that overweight, and I felt like my body was getting far less healthy and like I was starving myself. This is on the lowest starter dose, too! It just… yeah, it works as I’d expect an extreme appetite suppressant would.
okdood64 2y ago
How long before it started taking effect when you started?
jrochkind1 2y ago
Any negative side effects?
justinator 2y ago
> The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day). But the late night trip to McD's always makes you feel like shit the next day, it's just that we then forget and do it again. (Same with drinking).
- Clubber 2y ago
  The best description of drinking I've heard is, "you're stealing joy from tomorrow for today."
deleted 2y ago
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temptemptemp111 2y ago
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LostMyLogin 2y ago
> being overweight will be a choice (choosing not to take the drug) This may be an ignorant take and if it is I apologize, but isn't it a choice anyway? A calorie deficit and minimal exercise will have you cutting body fat. Or am I missing something here?
- thisisnotauser 2y ago
  It's possible your personal experience with food is different than other people's, and it is easier for you to make that choice than others.
  - LostMyLogin 2y ago
    That is fair. Most people in my circle are some form of endurance athlete, climbers, etc so I live in a bubble but some of the comments I see feel alarming- like an over correction in the opposite direction.
- aaronblohowiak 2y ago
  People aren’t computers. Eating fixation and compulsion empirically override the more rational mind in millions of people. One of the effects of these drugs is making eating a more “impersonal” or “detached” kind of decision, so it feels like a real choice rather than something that you think you have a say in but really the more base instincts will override.
Mistletoe 2y ago
How did you get it? I've wanted something similar.
TylerE 2y ago
One thing this comment ignores is the very non-zero chance, which increases with dose and time on the drug, of developing gastropwresis. Gastropwresis will ruin your life to the point where you may never be hale to eat normal solid food ever again.
bcoates 2y ago
I don't have a published study to back this up, but in my 10 < n < 100 experience, the alcohol suppression effect is limited to occasional-to-moderate drinkers. Giving a GLP-1 to a heavy drinker/alcoholic results in a skinny alcoholic. Given that the overwhelming majority of alcohol is consumed by heavy+ drinkers this isn't the gamechanger people think it is.
- fragmede 2y ago
  N = 14 053 for https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827069 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... , which looked at if GLP-1 RA use was associated with lower incidence and recurrence of alcohol use disorder.
- throwaway-1010 2y ago
  I'm a heavy drinker (1.5 bottles of wine a day -or the equivalent- everyday, for at least 5 years). I started a GLP-1 at 2.5mg two weeks ago after the most recent study was released[1]. In just the two weeks at that low dose it's been quite effective. In fact the only reason I'm replying to your comment is because instead of being a bottle deep in front of the TV at this point in the evening I got bored after one glass and decided to noddle around on the internets. Ask any heavy drinker/alcoholic and they will tell you that one doesn't just have 'one' drink and then move on with something else. One is always too much, and never enough. Now it feels like enough. Happy the share more if you like :) 1. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2829811 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
mlboss 2y ago
What are the side effects ? I heard these drugs just freezes the intestine.
- wincy 2y ago
  Depends. I tried Ozempic and felt fine but every time I bumped up the dose I’d feel a vague feeling of dread, until I got to the max dosage then I didn’t lose any weight but also felt like I was going to die at any moment. It was bad. I discontinued usage then immediately went back to 300 pounds from 260. Zepbound/Mounjaro on the other hand has been fantastic. I just noticed I was hurting my muscles a lot and realized it was because I was losing muscle mass. I started taking protein shakes and that seems to have fixed it. Wish I’d realize it sooner as I’ve hurt my hip joint and can’t ride my bike which was primarily how I was exercising, so I need to go to physical therapy. I’m on 10mg and frozen at 260, have an appointment to go to the next dosage on Monday. Hopeful I’ll keep losing weight and get down to around 200.
  - davoneus 2y ago
    Absolutely understand. Never had joint issues, but after being on Tz for a couple of months, I had knee and hip pain. I'm convinced it was muscle loss, because after I boosted my protein intake and exercise, they started to go away. All but gone now (thankfully).
j-bos 2y ago
This sounds like my whole life, I've always been trim and have never understood the joy people get from food. Facinating to see there's a drug that recreates that physiology.
- L-four 2y ago
  +1 this has been my life experience.
diebeforei485 2y ago
I think the appetite reduction is too effective for you because you didn't previously have an overeating problem. For those who do, it makes them have a normal appetite. Additionally, it seems to make junk food taste less appealing and real food more appealing.
- sedgjh23 2y ago
  I was in the overeating column (4000+ calories a day, no sugar drinks) and going into month 3 I am fighting to hit 1500 every day except the day before shot day and shot day. YMMV of course, but it is very effective for me so far.
petesergeant 2y ago
> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month ... what? Get a better medical provider, you can stay on 2.5mg as long as it's effective. Your hunger will come back. Going up every month is poor practice if you have hunger-suppressing effects, whatever the manufacturer says: speak to an endocrinologist who's experienced with prescribing it instead. The first couple of weeks I had no appetite, but I stayed on 2.5mg for three months and had a healthy appetite by the end, and continued to take it slow. Lost about 1kg a week, and enjoyed my food just fine. Respectfully, you're in week 3, I think it's worth giving it a few months before you start sharing your experiences of it on the internet. The much more common experience of this drug -- when you've been on it a little while and you've found a good dosage -- is you enjoy food, you have an appetite, you're just not ALWAYS thinking about food. There is enough anecdata in the many subreddits to constitute actual data about what a typical experience taking any of these things feels like.
vjk800 2y ago
It's weird that I've never been overweight and you describe basically how I normally feel. I've never felt hungry in the morning. I've never eaten a lot. When I was younger, I often forced myself to eat more, because I felt bad about how I wasn't "big enough" (which feels silly now as a proper adult). Impulse buying food and snacking is something I only do if I haven't eaten for a long time, i.e. if I'm actually very hungry. If I go out drinking, I also make a point not to eat very much before or during the drinking, because otherwise I just feel sick after like one beer.
- jredwards 2y ago
  I used to feel that way in my 20s. Things changed a lot when I hit 40.
crossroadsguy 2y ago
Two years ago I was some 7-8kg beyond my target weight range. I started calorie cutting, and filling myself with salads etc before each meal. Also added some more changes like taking longer times to eat. I used to, and sadly back to it, eat in a flash. Initially it was hard so increased a bit and then a bit and then in a few days it was stabilised at a calorie intake point which was still significantly below my normal need. And in next few days it dropped further. So next 3-4 months when I was watching calories and trying to keep in check - I didn't have to worry about eating less calories, but I had to worry about taking sufficient calories. Because surprisingly I stopped feeling hungary even eating lesser calories. I am talking about being okay in 900-1000 while my normal need was ~2500 and nutritionist had suggested to target around 2000 for first few weeks then bring it down to 15-1600 and then slowly bring it up near normal as weight settled. But by the end of 2nd week or 3rd I was struggling to finish 900-1000. I used to kinda force eat. There was no medication involved in any way (not for this purpose; not for anything else).
aenis 2y ago
Awesome stuff. Envious, here (NL) its impossible to get a prescription. For an alternative approach for comparison: My wife and I eat low carb and fast every other day for a year now. Around the 2nd month mark we got the exactly same outcome: food became a chore. We sometimes dont eat for 2-3 days when travelling or busy. I dont remember feeling hungry in about a year. We do sports - I sure have less peak power, but can sustain moderate efforts for longer (I use a power meter and Hr strap - my vo2max dropped). I feel significantly sharper mentally and managed to learn a new language (Dutch, from zero to B2) in a year - while working a cto job. Not eating easily gives 3hr extra a day, incl. what I get from waking up early. Saves us a ton on groceries and eating out. The only thing we do watch out is carbs - I can eat a kebab or two tacos but dont eat any sweets, eat bread or drink beer/soda. Weight stabilized at my high school level. Not sure if I can recommend it as it is a bit tricky to practice, especially while having a job that requires routine socializing, but - it does work. The only really difficult thing is to start and endure the first two weeks or so.
- wert7886 2y ago
  That sounds very intriguing, are you a bit concerned about the dropping vo2max ? Do you eat a lot more meat than before?
  - aenis 2y ago
    No, I eat a lot less in general and a whole lot of veggies. I followed the same routine 4 years ago, then I stopped and when I started eating carbs my vo2max recovered overnight. I think one cant have it all - either you run on stored energy which caps the power to weight ratio - or on readily available glucose and glycogen. Its fine, I am not an athlete, I do sports to feel good. I dont see an impact on raw strength - just on anaerobic performance.
    - maxerickson 2y ago
      Do you mean aerobic performance in the last sentence?
DannyBee 2y ago
The feeling of no hunger at all will dissipate in a few months, even as you increase dose. You will probably land on "not often hungry". The feeling of being full very quickly when you do eat will stay
novok 2y ago
There is a segment of people where GLP-1 medications just don't work, 68% stop within a year, and dosing keeps on escalating up and up. It will help a lot of people, but it is not going to be the panacea early results show.
thefz 2y ago
> After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice It already is.
- cj 2y ago
  Yes. In the same way addiction is a choice.
  - thefz 2y ago
    Stopping opioids or alcohol cold turkey can kill you; stopping food will not, for a very long time depending on how much fuel you carry around.
kobenni 2y ago
Interesting, this sounds like my normal state. I cope by only eating tasty calorie-dense meals and snacks, never skipping meals or snacks, and weight lifting to increase my appetite. Otherwise I become significantly underweight.
jredwards 2y ago
How exactly does one get a prescription for that without any apparent need for it?
amelius 2y ago
Did you experience trouble drinking non alcoholic beverages or just plain water?

by cj 2y ago

devmor 2y ago

> Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat. This is the largest of several reasons I hesitate to try it for myself. I am a very big guy (I would be about 184lbs if I had 0% bodyfat at my current musculature level). From the experiences I hear, I would not only struggle to have enough energy to do any kind of rigorous exercise, but struggle to consume the amount of protein I require to even maintain my current muscle mass. I do have issues with overeating and the prospect of a drug that prevents me from consuming too many calories is attractive, but the side effects sound counterintuitive to any kind of natural fitness.

meroes 2y ago
I’m somewhat the same. I need to be active for other health reasons (physical therapy, etc) and not eating enough saps my ability to push forward physically.
cj 2y ago
I’ve been hyper aware of the muscle loss caveats and I think it’s the most important thing to know when starting the drug. You really need to prioritize protein intake and make sure your calorie deficit isn’t extreme. Losing too much weight too quickly, with or without the help of a drug, can be very unhealthy. I drink 4 protein shakes a day (160g total) in addition to regular food. If it weren’t for the protein shakes I definitely would be protein deficient. You’re 100% spot on with decreased energy at the gym. I’ve had to pull back 4x weekly cardio to 1-2x weekly. Then again, anyone who’s in a calorie deficit has lower energy. It’s not a unique phenomenon of the drug, just a side effect of weight loss.
- ForTheKidz 2y ago
  > Then again, anyone who’s in a calorie deficit has lower energy. Presumably if you're trying to lose weight, you have energy to burn you carry around with you. A calorie deficit doesn't imply lack of calories to burn. Presumably you're trying to trigger ketogenesis. Granted, this is a lot less easy to access than simply eating simple carbs right before a workout and likely a lot less comfortable.
  - TeMPOraL 2y ago
    > Presumably you're trying to trigger ketogenesis. Only if you're actually on a keto diet; most weight loss routines run a calorie deficit without triggering ketogenesis. Also there's this whole thing about set points - you probably got to your weight somehow, and if it wasn't through consistently making stupid choices over many years, chances are this is what the body learned to consider an equilibrium state. Which means that, if you start running a calorie deficit, it's going to fight you every step of the way. It will happily scale down performance to conserve energy instead of burning the accumulated fat, so you'll just be slow and groggy but not lose weight. There's been reported cases where people got mental illness-level obsessive thoughts about food, which appeared when they were hungry, and stopped when they ate enough. The degree of this problem varies between people, but it's generally not that easy to effectively lose weight, and some people simply lost the genetic/environmental lottery on this.

saurik 2y ago

> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month... So they are going to force you onto a higher dose?!

willis936 2y ago
Yes, up to 15 mg. Maintenance levels at 5, 10, and 15. If you cannot tolerate a maintenance level you can still get it, but insurance will not cover it ($1000/mo rather than $15/mo.) This is not an unreasonable situation. https://www.goodrx.com/zepbound/dosage https://www.goodrx.com/zepbound/dosage
- cj 2y ago
  Luckily during the “shortage” you can currently get GLP-1’s in vials rather than injection pens. The brand name GLP’s you can’t control the dose. But when you get it in a vial from a compounding pharmacy you can inject however much or little you want. Not looking forward to ever using the brand name version specifically for this reason
  - dghlsakjg 2y ago
    The injection pen I have see has two marked dosages, but there is nothing stopping you from injecting more or less. Basically it is a ratcheting mechanism where after ~10 clicks you get .25 mg dosage and 20 clicks gets you .50. Basically, no doctor is going to endorse it, but you can dial a dose to whatever amount you want.
  - blackeyeblitzar 2y ago
    Aren’t any states like California trying to ban compounding pharmacies? It’s an unfortunate attack on individual freedom, but I am not sure if we will still have them 20 years from now.
    - dragonwriter 2y ago
      > Aren’t any states like California trying to ban compounding pharmacies? No. California has not banned compounding pharmacies, nor is there a significant movement to do so in the legislature, among the people (who could do so by ballot measure), or a proposal by the governor to do so. California does require additional licensure for sterile compounding, but that is very much not a ban on sterile compounding or compounding more generally. Relevant to GLP-1s, though, several state pharmacy boards (not California’s, as far as I know) have raised issues that compounded GLP-1 drugs that they have seen appear to be illegal, because they use a form other than the FDA-approved base form of semaglutide (which is only available from Novo Nordisk), and th3 form used is not itself approved for human use, and have taken steps to crack down on that. But that's also not banning compounding, but enforcing existing rules on compounding.

willis936 2y ago

Yes well your PCP / pharmacist should not have prescribed you an appetite suppressant when you have below average body fat %. The effects are very worth it for people weighing them against heart disease and mobility issues. It's not a Faustian bargain, it's all right on the tin. When you stop taking it the effects go away. If you want to be indulgent and it fits your lifestyle you can reversibly make that decision. The power to make that decision is difficult to overstate.

smallmancontrov 2y ago
Why is it only appropriate for people with heart disease / mobility issues but not for someone who is merely overweight? This feels like finger-wagging for the sake of finger-wagging.
- willis936 2y ago
  It isn't. 20% body fat is 6% below average. That isn't "merely overweight", it's likely underweight. No, I don't think underweight people should take appetite suppressants and I don't think that qualifies as a hot take. I think anyone who is medically overweight (which is a very modest BMI qualifier for anyone with any amount of muscle) should have the choice. Many US medical systems and insurers agree, which is a good place to be.
  - MostlyStable 2y ago
    >it's likely underweight. The only way this can possibly be correct is if you think that the "correct" weight is whatever the population average happens to be which is just...wild to me. If we assume commenter is male (a statistical likelihood), then 20% is the high end of normal, and could very safely be halved. In the less likely case that they are female, then it is right in the middle of the normal range, and could safely be reduced by 5-10% at least.
    - toast0 2y ago
      > The only way this can possibly be correct is if you think that the "correct" weight is whatever the population average happens to be which is just...wild to me. The medical definition of overweight is basically if you're some number of standard deviations above the average from whenever they ran the stats, so population average = correct weight seems like as reasonable a standard.

Judgmentality 2y ago

[flagged]

cj 2y ago
You can get wegovy generic for $299/mo and Zepbound generic for $399/mo currently through telemedicine via compounding pharmacies, without insurance.
- dghlsakjg 2y ago
  Maybe they are in Canada. Name brand Ozempic is $230 CAD or $160 from Costco up here
  - SoftTalker 2y ago
    [flagged]
    - dghlsakjg 2y ago
      What a take. I have no idea what Americans overpaying for healthcare has to do with a Danish drug company participating in the Canadian Healthcare market. I’d rather thank the Canadian government for having a drug pricing review process. If these companies don’t want to sell their drugs here, no one is making them. They are still here, so I think it’s safe to assume that they are still making money.
      - twoodfin 2y ago
        I don’t think it should be controversial to say that if the US imposed a Canadian-style price control regime on more than the handful of drugs currently regulated by Medicare, the future number of drugs developed and commercialized would drop significantly. It’s just basic addressable market vs. development cost math.
        phatfish 2y ago

tasty_freeze 2y ago

I resonate with your comment about appetite loss. It is surprising how much it has affected my happiness, to have this few times a day pleasure taken away. A month ago I suffered through a norovirus infection, the first time for me. In three days I lost six pounds (my BMI is 21.2 now). At first I wasn't surprised or worried -- after all, I had emptied out my digestive tract and was dehydrated. But a month has gone by and my appetite has been AWOL. I've lost another pound (5'11" @ 152 lbs). I have an appointment next week with my doctor's PA to see if something else is going on. The taste of food is the same, but the craving is lacking. When I eat, my guts are telling my brain it is time to stop eating, as if I had eaten a pound of mashed potatoes only an hour ago.

raincom 2y ago
Maybe, Norovirus affected GIP and GLP-1 hormones. This could be a new research avenue for weight loss. GIP and GLP-1 are product of the research about the Gila monster lizard, which eats three or four times a year and survives.

ForTheKidz 2y ago

> That late night trip to McDonalds will have you feeling like shit the next day I've never had this reaction to fast food before. I only eat mcdonalds every few months and yea it's not the highest quality food, but I don't think there's anything in it to make you sick any more than other burger places have. I imagine you'd have to have restricted fast-food nutrition for quite some time before you feel a difference. I'd like to see a study comparing people who ate mcdonalds who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic, or how much of the craving for mcdonalds is rooted in feeling like crap in the first place. (Granted, I've never had an issue with maintaining my appetite before, in fact I have issues keeping weight on, so I might have a fundamentally different relationship with food.)

_diyar 2y ago
The way I read it, i think the original commenter would usually agree with you, but the effect of the drug turns the post-fast food / treat satiation from joy to pain.
- ForTheKidz 2y ago
  I believe you're correct. Apologies for the confusion.
WarOnPrivacy 2y ago
>> That late night trip to Mcs will have you feeling like crap the next day > I've never had this reaction to fast food before. I do. Because of it, I eat fastfood when I'm willing to pay that price, ~5x/decade. > I'd like to see a study comparing people who ate mcs who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic. The notion that our psychology could be holding us back from fastfood completeness is one that never occurred to me. I like how novel it is.
- ForTheKidz 2y ago
  I believe you, but what do you think it is in the food that causes such severe reactions for you but doesn't affect me at all? Humans lived through periods of extreme starvation and other forms of malnutrition—our genetics are extremely clear on this, as is our tendancy to cannibalize our muscles when they're underused. It seems absurd to me a slightly different selection of nutrients could cause acute distress. (Hence my recourse to psychology—which would map well with the shift towards the moralization of nutrition these past few decades.)

ctrlp 2y ago

I've heard similar accounts and it sounds pretty wild. I'm not overweight and don't take anything but I do enjoy food. It would be horrible to me to lose the enjoyment of such a primal pleasure. If the choice is between being overweight and giving up the pleasure of eating altogether, I can imagine plenty of gourmands who would rather carry the extra weight for the physical and social pleasures of food. I've heard anecdotal reports of people losing their enjoyment of food permanently, even when discontinuing the drug. Canot confirm but that would be a high cost to pay, imho.

dghlsakjg 2y ago
Counter-anecdote. I have not lost my appreciation for good food, I just eat less of it. I used to be unable to leave any food on my plate regardless of how good or bad it was, now I’m perfectly happy to leave something uneaten if it isn’t to my taste.
- alabastervlog 2y ago
  Same, I'm on one of them and I still love and enjoy eating and am perfectly capable of eating my beloved junk food. I'm just highly likely to feel done after a few bites instead of... dozens and dozens of bites. Losing the pleasure of food was one of my main concerns starting it, and it hasn't been an issue whatsoever. Meanwhile, I'm back down to my healthy weight range, which I haven't seen since 2021, which was about the third time I'd been at that weight and then ballooned up. I was just about at the top of that range after two months, down about 30 pounds, and it took no effort whatsoever. I feel amazing. Muscle mass is also doing fine, and I'm well into middle age so any protective properties of youth are largely gone, still having no problems there.
- cm2187 2y ago
  Same for me, I don't recognise those symptoms (loss of taste, loss of impulses). My understanding is that all it does it to replicate the signal the stomach sends when it is full, and so you just feel full / a bit burpy, even on an empty stomach. But you do enjoy the same taste than before the drug. That being said side effects vary and lots of people mention it gives them nausea. I can easily imagine how that would interfere with taste.

fallingknife 2y ago

That's interesting. I started ozempic about 3 months ago and the effects are really not dramatic at all. Is Terzepatide supposed to be more powerful?

loeg 2y ago
Tirzepatide is supposed to be more powerful, but GP also just appears to be relatively sensitive to the drug.

throwaway657656 2y ago

The above describes me but it is the consequence of my behaviors/habits. Being a workaholic, I learned long ago to ignore the leash that pulls me to the refrigerator. It seems by brain no longer sends me a "you need to eat" signal similar to the way free divers can become oblivious to the "you need to breath" signal. I wonder if with time, you can learn from this drug, form the helpful habits/behaviors and then stop taking it.

gg82 2y ago
Probably not. If it suppresses your hunger response, you will likely lose the ability to deal with hunger when you go off it.

blitzar 2y ago

Cocaine makes you feel really good and heroin is fun.

loeg 2y ago

I started in November and am down ~25 lb. > Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month Uh, you're allowed to stay there as long as you want. I was on 2.5 for two months and asked my Dr to up the dose, as progression kind of stalled in the second month. I've been hanging out around 3.5-4.5mg/week since then losing ~5 lb/month steadily. Sounds like you're pretty sensitive to it, which is nice. You can lower the dose even further if you think it's too strong at 2.5mg/week. It is definitely a game changer.

api 2y ago

Does it have any impact on focus or motivation to get work done, do hobbies or recreational activities, engage in human relationships, sex, intellectual curiosity, etc.? It would be fascinating and almost too good to be true if we found a way to suppress only largely harmful (in our current environment) urges but leave the good ones intact. Something like that becoming widely available could change the world, and mostly for the better. It would refocus our entire economy on much more constructive pursuits instead of gambling, addiction, and pandering to transient urges.

davoneus 2y ago
I've never had any lack of focus or motivation to get anything done since I started Tz. I did have some energy loss, especially at first, but I assume that was because my body was struggling to cope with a lack of carbs. However, after a couple of weeks that for the most part disappeared.

asveikau 2y ago

> My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks). Starbucks food is especially calorie dense. I realized this when I lost a bunch of weight in 2018 and I noticed the calorie counts on the printed cards that some stores have. Even for junk food, Starbucks junk food is more calorific than average for the same items. I started to consider that for a typical customer's consumption, McDonald's might actually be healthier than Starbucks. Which totally goes against the image people have of both places. People think if they are "going for coffee", it's better for you than having a milkshake and following it with candy. But it's essentially what they're doing.

Taikonerd 2y ago
"Starbucks's greatest trick was convincing grown-ups it was OK to have a milkshake for breakfast." (I heard this somewhere on the internet, about the Frappucino.)

cm2187 2y ago

I am 8 months in, you do develop a tolerance over time to the drug (and why you need to increase the dosage progressively). I have gone up slower than the prescibed steps but still, this drug is to help doing diets, I don't think it would work as a long term medication. And as far as I can tell, when you get off the drug or have become tolerant to the current dosage, it is easy to gain back some weight if you are not careful. So the point being I don't think it will suppress completely obesity, but it will certainly help people make a time limited effort to go down to a lower weight.

raincom 2y ago
Some doctor advised a protocol: stay on GLP-1 for 3 months, then take metformin for a month or two; then repeat the cycle. I have to dig out the source for this.
jmpman 2y ago
I’ve been on it for over 2 years now. Yes you plateau, and if you go off of it (as I had periodically), you will regain weight. Hoping my weight loss resumes now that I’m back to the maximum dosage for a few weeks. As it’s 5pm and I just ate for the first time today, I can confidently confirm that my appetite is well suppressed.
jasonfarnon 2y ago
"I don't think it would work as a long term medication" It seems like there is a lot of disagreement on this very basic point. Surely there must be data from the decade or so it was prescribed for diabetes.
__turbobrew__ 2y ago
Interesting, what is the end game then if you need to be on the drug to keep the weight off but you also develop resistance to it over time? I wonder how the body reacts after being on the drug for years at a time and then you cut it off, are the cravings stronger than before you started the drug?
- cm2187 2y ago

decryption 2y ago

I've been on tirzepatide for 8 weeks (2.5mg then 5mg) and have a very similar conclusion as you. I started off at 160kg 8 weeks ago and now I'm down to 145kg. No other change in my lifestyle except eating radically less. Two 500-calorie-ish meals a day and some fruit as a snack, that's about it. For decades I've struggled with diets but tirzepatide is the only thing that's made me stick with it. Will power alone wasn't enough, but with tirzepatide I'm very confident I'll get down to a under 100kg for the first time since I was a teenager, within a few months.

bobsmooth 2y ago
You lost 35kg in 2 months? That's insane. Any issues with loose skin so far?
- lossolo 2y ago
  160 - 145 = 15kg

silverlake 2y ago

This is me without any drugs. I’m very interested in food, but I only want a few bites to taste.

wileydragonfly 2y ago

Be careful with all this. At one point I had gone 72 hours without eating or drinking anything and one beer by the pool had me on the floor. I keep hydrated these days but sometimes it’s an effort.

wkearney99 2y ago
Atkins-ish diet caused the same thing for me with a car accident back in the 90's. Sudden uptake of carbs with the alcohol resulted in lost memory of over 13 hours, a '68 De Ville convertible that got totaled and 2 months spent with a wired jaw.

crazygringo 2y ago

I'm curious -- do you have any brain fog? Are you able to exercise? When you exercise, do you wind up eating more, i.e. the caloric amount that you exercised? I've never had any psychological difficulty with losing weight. I don't care if I'm hungry. But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget about it -- my blood sugar is going to my muscles and I'm unproductive for hours afterwards as I just can't think. Also, if I go to the gym, my muscles take a week to recover instead of a couple of days, because they're just not getting the glucose they need to repair themselves. I don't hear any of these complaints from GLP users though, which baffles me. Not eating enough affects us in lots of ways besides just being hungry. How has it been for you?

op00to 2y ago
No brain fog. I walk at a very brisk pace ~6 miles a day. My calories are far less than before I started. I have to be very careful to have enough protein. When I exert myself, the recovery period is the same time as before.
- crazygringo 2y ago
  Do you have any idea of how many calories you eat per day? I get so confused because the small amounts of food that people talk about eating on GLP, don't seem like enough to sustain themselves long-term. Are they exaggerating? Or do they talk about not eating dinner, but that's because they had 1,700 calorie lunch at the burger place? Or is that just during weight loss, and then once a target weight is hit, they're eating like a normal (healthy-weight) person again? I just genuinely don't understand how people are surviving with the diets they describe.
  - op00to 2y ago
    Yes, I calorie track around 1900 calories average. Maybe up to 2000? They are probably losing muscle mass!

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fire_lake 2y ago

Since you are not terribly overweight you could reach a healthy weight with relatively minor lifestyle and diet adjustments. Isn’t this preferable to the side effects (some probably unknown) involved in these drugs? Genuine question.

op00to 2y ago

The effects seemed to wane slightly for me, but it vastly changed my relationship with food. I was raised in a family with plenty of food, but food was used as a weapon of manipulation and thus I was taught to eat as much as I can else it might be taken away. With Zepbound I now eat appropriate portions. Can’t really stand more than a single beer. I don’t mind being at a restaurant and not really eating. I’ll have a bite of this or that and be happy. My shits, however, have been glorious since starting the drug. Truly pleasant steamers that rocket right out.

SubiculumCode 2y ago

Where did you purchase it?

herpdyderp 2y ago

> Eating is no longer enjoyable and feels like a chore I used to view eating as a chore and it was great. Then (no joke) I got into tech and everywhere I work they have fancy food or frequent team lunches or something of that nature. I wish I could go back.

anal_reactor 2y ago

I understand that on population level we can't just tell everyone "get on a diet", but when talking to you in particular, why couldn't you... just get on a diet? Personally, I love food. I can't live without stuffing candy in my mouth. But I also have a tendency to get fat, so I weight myself every day, and based on that I either have a diet day or a cheat day. Moreover, I do a lot of physical exercise every day. The idea of having to depend on a drug to live is scary to me. Having said the above, I'm sure that one day we'll create a drug that makes life of majority of population better, and we'll be able to administer it to everyone without major consequences.

valunord 2y ago

Thanks for experimenting with your body. I'll be sure to check back in about ten years to see how all this shakes out. Keto + intermittent fasting are my magic pill right now and have been for some years.

no_wizard 2y ago
Ozempic has been in use for diabetic patients for at least a decade if you want to look at the research of its long term results in that population - which is fairly large to constitute a good sample sizing.
- valunord 2y ago
  So that means we'll have a good twenty years of data to finally look at, which is what I was saying. I do not trust any medicine unless it has far more data than what we have in this regard at this point. I work in a related field and I can simply say most things we trust should not be trusted and should require far more testing.
  - ValleZ 2y ago
    Then wait another 50 years, easy.
homebrewer 2y ago
I'm pretty sure keto has not been extensively studied for anything but the management of epilepsy in children that do not respond to medication. So tbh this is an odd comparison.
- valunord 2y ago
  Keto and such diets have been used for millennia. Our bodies are MADE to use keto... Lol.
borgdefenser 2y ago
I am much more daring in my will to experiment but I do agree. Keto, fasting and also breaking the "foodie" culture that eating and going out to eat becomes a hobby. I didn't order/dine in at all from a restaurant in 2024. It is much easier to not over eat the boring keto meals I make myself. My "cheating" is eating basmati or jasmine rice with a stir fry instead of cauliflower rice. There is actually not enough known side effects for me to take GLP-1s. They are either complete miracle drugs or side effects we don't currently understand haven't come out in the wash yet. We have a pretty good track record when a new powerful medication like this is introduces of doing things quite wrong. There are probably risk mitigation strategies we will learn in the coming decades that we simply can't know right now. Otherwise, these are basically free lunch miracle drugs. That seems an easy short.

no_wizard 2y ago

I’m not going to lie all this sounds like heaven to me. I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons. My insurance only recently started to cover these weight loss drugs, and I have been looking into them over the last month because I think I’m an ideal candidate for it. If it gives this kind of control over cravings and appetite I’m really looking forward to how this can genuinely make my life better

Henchman21 2y ago
I'm a few months into this drug as well, and I have to say, it doesn't offer control. What it offers is a lack of cravings & appetite. That is different, remarkably so. Control would mean I might still feel hungry. Ever. Or that I could decide to eat heavily at one meal, but I don't and as long as I take the drugs, I won't. That doesn't feel like control, it feels like I've had something removed. I guess it's a matter of perspective? I don't know if its a common sentiment but this drug treatment is the hardest thing I've ever done for my health. I'm not sure I'll be able to continue though. It's like I've robbed myself of the one joy I had left and now I have none. Tread carefully.
- no_wizard 2y ago
  The difference here may simply be in how our mental health relates to food. It sounds to me like it brings you enjoyment you miss. I respect that. Food for me isn’t that. The lack of cravings and appetite means I would be firmly in the drivers seat with it. It means I can eat exactly the amount I’m suppose to and not feel like I must have more
- fragmede 2y ago
  Note that if you're doing this treatment at home (aka bought a vial and a syringe off the Internet and are injecting yourself), you can simply give yourself slightly less next injection. It's not a binary "hunger (y/n)" but more of a spectrum. (anecdotally)
- 2y ago

creer 2y ago

Thanks for the report! Aside from the loss of interest in food, what other side effects have you noticed or not noticed? (other N=1 reports welcome!)

maleldil 2y ago

> being overweight will be a choice Not everyone can take these drugs. Some people will have severe side effects. It's very common to have nausea, vomiting, etc., and some people will experience these frequently enough that the prescribing doctor will rescind the prescription.

abirch 2y ago
gastroparesis is a real side effect two, it’s where the food in your digestive tract stops moving. As in 30% of food is present after 4 hours The rate is over 1% which isn’t a lot nor is it nothing https://jamanetwork.com/journals/jama/fullarticle/2810542 https://jamanetwork.com/journals/jama/fullarticle/2810542
- cyberax 2y ago
  It looks like it's mostly caused by having too high doses of GLP-1 too soon.
  - abirch 2y ago
    I’m not about the root cause. I’m on a GLP-1 and while doing a premortem on my medication I saw that this, vomiting, and burps were common.
    - cyberax 2y ago
      I've been using GLP-1 agonists since before Ozempic, and by now I have no side effects from them. My doctor said that she now titrates the dose up slower than the recommended monthly increments and the side effects are less frequent. Another problem is that GLP-1 drugs seem to synergize with other drugs that can cause GI issues.
taurath 2y ago
I tried, I got some results but it meant that my entire body’s digestive system felt like it stopped working. Constipation, nausea at the drop of a hat, finding I’d have to take a fast acting prescription anti nausea multiple times a day. I’m not that overweight, and I felt like my body was getting far less healthy and like I was starving myself. This is on the lowest starter dose, too! It just… yeah, it works as I’d expect an extreme appetite suppressant would.

okdood64 2y ago

How long before it started taking effect when you started?

jrochkind1 2y ago

Any negative side effects?

justinator 2y ago

> The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day). But the late night trip to McD's always makes you feel like shit the next day, it's just that we then forget and do it again. (Same with drinking).

Clubber 2y ago
The best description of drinking I've heard is, "you're stealing joy from tomorrow for today."

deleted 2y ago

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temptemptemp111 2y ago

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LostMyLogin 2y ago

> being overweight will be a choice (choosing not to take the drug) This may be an ignorant take and if it is I apologize, but isn't it a choice anyway? A calorie deficit and minimal exercise will have you cutting body fat. Or am I missing something here?

thisisnotauser 2y ago
It's possible your personal experience with food is different than other people's, and it is easier for you to make that choice than others.
- LostMyLogin 2y ago
  That is fair. Most people in my circle are some form of endurance athlete, climbers, etc so I live in a bubble but some of the comments I see feel alarming- like an over correction in the opposite direction.
aaronblohowiak 2y ago
People aren’t computers. Eating fixation and compulsion empirically override the more rational mind in millions of people. One of the effects of these drugs is making eating a more “impersonal” or “detached” kind of decision, so it feels like a real choice rather than something that you think you have a say in but really the more base instincts will override.

Mistletoe 2y ago

How did you get it? I've wanted something similar.

TylerE 2y ago

One thing this comment ignores is the very non-zero chance, which increases with dose and time on the drug, of developing gastropwresis. Gastropwresis will ruin your life to the point where you may never be hale to eat normal solid food ever again.

bcoates 2y ago

I don't have a published study to back this up, but in my 10 < n < 100 experience, the alcohol suppression effect is limited to occasional-to-moderate drinkers. Giving a GLP-1 to a heavy drinker/alcoholic results in a skinny alcoholic. Given that the overwhelming majority of alcohol is consumed by heavy+ drinkers this isn't the gamechanger people think it is.

fragmede 2y ago
N = 14 053 for https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827069 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... , which looked at if GLP-1 RA use was associated with lower incidence and recurrence of alcohol use disorder.
throwaway-1010 2y ago
I'm a heavy drinker (1.5 bottles of wine a day -or the equivalent- everyday, for at least 5 years). I started a GLP-1 at 2.5mg two weeks ago after the most recent study was released[1]. In just the two weeks at that low dose it's been quite effective. In fact the only reason I'm replying to your comment is because instead of being a bottle deep in front of the TV at this point in the evening I got bored after one glass and decided to noddle around on the internets. Ask any heavy drinker/alcoholic and they will tell you that one doesn't just have 'one' drink and then move on with something else. One is always too much, and never enough. Now it feels like enough. Happy the share more if you like :) 1. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2829811 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

mlboss 2y ago

What are the side effects ? I heard these drugs just freezes the intestine.

wincy 2y ago
Depends. I tried Ozempic and felt fine but every time I bumped up the dose I’d feel a vague feeling of dread, until I got to the max dosage then I didn’t lose any weight but also felt like I was going to die at any moment. It was bad. I discontinued usage then immediately went back to 300 pounds from 260. Zepbound/Mounjaro on the other hand has been fantastic. I just noticed I was hurting my muscles a lot and realized it was because I was losing muscle mass. I started taking protein shakes and that seems to have fixed it. Wish I’d realize it sooner as I’ve hurt my hip joint and can’t ride my bike which was primarily how I was exercising, so I need to go to physical therapy. I’m on 10mg and frozen at 260, have an appointment to go to the next dosage on Monday. Hopeful I’ll keep losing weight and get down to around 200.
- davoneus 2y ago
  Absolutely understand. Never had joint issues, but after being on Tz for a couple of months, I had knee and hip pain. I'm convinced it was muscle loss, because after I boosted my protein intake and exercise, they started to go away. All but gone now (thankfully).

j-bos 2y ago

This sounds like my whole life, I've always been trim and have never understood the joy people get from food. Facinating to see there's a drug that recreates that physiology.

L-four 2y ago
+1 this has been my life experience.

diebeforei485 2y ago

I think the appetite reduction is too effective for you because you didn't previously have an overeating problem. For those who do, it makes them have a normal appetite. Additionally, it seems to make junk food taste less appealing and real food more appealing.

sedgjh23 2y ago
I was in the overeating column (4000+ calories a day, no sugar drinks) and going into month 3 I am fighting to hit 1500 every day except the day before shot day and shot day. YMMV of course, but it is very effective for me so far.

petesergeant 2y ago

> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month ... what? Get a better medical provider, you can stay on 2.5mg as long as it's effective. Your hunger will come back. Going up every month is poor practice if you have hunger-suppressing effects, whatever the manufacturer says: speak to an endocrinologist who's experienced with prescribing it instead. The first couple of weeks I had no appetite, but I stayed on 2.5mg for three months and had a healthy appetite by the end, and continued to take it slow. Lost about 1kg a week, and enjoyed my food just fine. Respectfully, you're in week 3, I think it's worth giving it a few months before you start sharing your experiences of it on the internet. The much more common experience of this drug -- when you've been on it a little while and you've found a good dosage -- is you enjoy food, you have an appetite, you're just not ALWAYS thinking about food. There is enough anecdata in the many subreddits to constitute actual data about what a typical experience taking any of these things feels like.

vjk800 2y ago

It's weird that I've never been overweight and you describe basically how I normally feel. I've never felt hungry in the morning. I've never eaten a lot. When I was younger, I often forced myself to eat more, because I felt bad about how I wasn't "big enough" (which feels silly now as a proper adult). Impulse buying food and snacking is something I only do if I haven't eaten for a long time, i.e. if I'm actually very hungry. If I go out drinking, I also make a point not to eat very much before or during the drinking, because otherwise I just feel sick after like one beer.

jredwards 2y ago
I used to feel that way in my 20s. Things changed a lot when I hit 40.

crossroadsguy 2y ago

Two years ago I was some 7-8kg beyond my target weight range. I started calorie cutting, and filling myself with salads etc before each meal. Also added some more changes like taking longer times to eat. I used to, and sadly back to it, eat in a flash. Initially it was hard so increased a bit and then a bit and then in a few days it was stabilised at a calorie intake point which was still significantly below my normal need. And in next few days it dropped further. So next 3-4 months when I was watching calories and trying to keep in check - I didn't have to worry about eating less calories, but I had to worry about taking sufficient calories. Because surprisingly I stopped feeling hungary even eating lesser calories. I am talking about being okay in 900-1000 while my normal need was ~2500 and nutritionist had suggested to target around 2000 for first few weeks then bring it down to 15-1600 and then slowly bring it up near normal as weight settled. But by the end of 2nd week or 3rd I was struggling to finish 900-1000. I used to kinda force eat. There was no medication involved in any way (not for this purpose; not for anything else).

aenis 2y ago

Awesome stuff. Envious, here (NL) its impossible to get a prescription. For an alternative approach for comparison: My wife and I eat low carb and fast every other day for a year now. Around the 2nd month mark we got the exactly same outcome: food became a chore. We sometimes dont eat for 2-3 days when travelling or busy. I dont remember feeling hungry in about a year. We do sports - I sure have less peak power, but can sustain moderate efforts for longer (I use a power meter and Hr strap - my vo2max dropped). I feel significantly sharper mentally and managed to learn a new language (Dutch, from zero to B2) in a year - while working a cto job. Not eating easily gives 3hr extra a day, incl. what I get from waking up early. Saves us a ton on groceries and eating out. The only thing we do watch out is carbs - I can eat a kebab or two tacos but dont eat any sweets, eat bread or drink beer/soda. Weight stabilized at my high school level. Not sure if I can recommend it as it is a bit tricky to practice, especially while having a job that requires routine socializing, but - it does work. The only really difficult thing is to start and endure the first two weeks or so.

wert7886 2y ago
That sounds very intriguing, are you a bit concerned about the dropping vo2max ? Do you eat a lot more meat than before?
- aenis 2y ago
  No, I eat a lot less in general and a whole lot of veggies. I followed the same routine 4 years ago, then I stopped and when I started eating carbs my vo2max recovered overnight. I think one cant have it all - either you run on stored energy which caps the power to weight ratio - or on readily available glucose and glycogen. Its fine, I am not an athlete, I do sports to feel good. I dont see an impact on raw strength - just on anaerobic performance.
  - maxerickson 2y ago
    Do you mean aerobic performance in the last sentence?

DannyBee 2y ago

The feeling of no hunger at all will dissipate in a few months, even as you increase dose. You will probably land on "not often hungry". The feeling of being full very quickly when you do eat will stay

novok 2y ago

There is a segment of people where GLP-1 medications just don't work, 68% stop within a year, and dosing keeps on escalating up and up. It will help a lot of people, but it is not going to be the panacea early results show.

thefz 2y ago

> After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice It already is.

cj 2y ago
Yes. In the same way addiction is a choice.
- thefz 2y ago
  Stopping opioids or alcohol cold turkey can kill you; stopping food will not, for a very long time depending on how much fuel you carry around.

kobenni 2y ago

Interesting, this sounds like my normal state. I cope by only eating tasty calorie-dense meals and snacks, never skipping meals or snacks, and weight lifting to increase my appetite. Otherwise I become significantly underweight.

jredwards 2y ago

How exactly does one get a prescription for that without any apparent need for it?

amelius 2y ago

Did you experience trouble drinking non alcoholic beverages or just plain water?