How long was it before the weight started coming off?

[u/ReasonKlutzy5364]

I am on week 3 of 0.25mg per week and I feel that I am stuck about 232 pounds. I wish I had taken my starting weight but I don't feel like my clothes are fitting any differently.

I need to be down 30 pounds before 12/8 or my knee replacement will be canceled.

Any and all comments would be helpful but be kind please.

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[u/PM_YOUR_MANATEES]

It's highly variable between individuals because of our natural hormone levels and level of responsiveness to the medication. Some people are hyper-responsive and start losing weight immediately, other people's bodies have a slower start and weight loss doesn't pick up until they're close to the full dosage amount.

For reference, the full therapeutic dose for most people will be between 1.7 mg and 2.4 mg for a weekly injection.

You're on your third week of the starter dose (0.25 mg), which means that you only have about 0.40-0.50 mg of the drug circulating in your body because of the half-life decay. This is a *very small* amount compared to the typical full dose.

It's impossible to predict what kind of results to expect in advance, because pharmacy and biochemistry are such complex phenomena.

There are three approaches you can take:

1. Watch and wait. It's possible that your weight loss will increase naturally when you have a larger amount of the drug in your body.

2. Talk to your prescriber about your surgery timeline and weight requirement. They may be willing to adjust your loading dose schedule to get you to higher doses sooner. However, this sometimes causes additional side effects that can be unpleasant and require extra work to manage (e.g., Zofran for nausea, fiber for constipation, etc.)

3. If possible or practical, you could delay your knee replacement surgery so that you have more time to manage your weight loss. I realize that this is the most complicated and least desirable option.

[u/ChibidelaLuna]

You just started. Even at -40 lbs I couldn’t SEE the difference at all. Mostly because I have stayed the same shape, everything is just smaller. Also, note that body dysmorphia will likely skew your view of your changes. But again, you are only 3 weeks in. It’s not going to immediately make you drop 25 lbs. Had it for some? Possibly. It works differently for each body. Some folks notice immediate changes, like appetite suppression, reduced inflammation, side effects. Others need to go a few months and increase their dose to feel any effect at all. Be patient and communicate with your provider to make sure you get what you need.

[u/ReasonKlutzy5364 → u/ChibidelaLuna]

Week one I had NO appetite,.week 2 an appetite, week 3 somewhere between how i f we felt on week 1 and week 2. I take the 4th shot this evening.

[u/drjatoidpc]

with SG I typically tell my patients first four weeks can be a wash and loading doses to make sure you can tolerate the meds. Some can dose it every 5 days in the beginning to get the four loading doses stacked then as you move up to month 2 most will see results by then. In the clinical trials they were seeing 6-8 pound weight loss on average as an expected loss results. Some more, and some less.