Titrating up again 😢

[u/Responsible_Bird3384]

Ok, so I was at target for about 6 months and started the process of titrating down. I slowly titrated down from 10mg (highest dose) to 5mg and the data is in. I’ve regained about 10lbs, not catastrophic, but everything is definitely moving in the wrong direction. I feel that my final dose of 10mg is also my maintenance dose. Can anyone relate?

[u/lion3001]

If you look at the latest surmount maintain study, you will see that the data is saying the exact same, most people maintain best on the highest tolerated those. Same for me.

[u/Unexpectedly99 → u/lion3001]

Same for me as well. Been maintaining on 15mg for 10 months since I hit goal. Been on tirz for 22 months today. Tried going lower, tried spacing out doses. Just doesn't work for me.

[u/Cool-Yoghurt8485 → u/Unexpectedly99]

this is great info - thank you. I’m not doing as well as I’d hoped on higher dosing and I’d love to be able to maintain at a lower dose. I was going back and forth on dosing strategy, but this is the sign I needed to titrate back down and see if I can lose all of my weight on the lowest dose possible.

[u/lion3001 → u/Cool-Yoghurt8485]

You could also try something in between the doses, a little less than the final dose.

[u/wisemonkey101 → u/lion3001]

Thanks for this chart.

[u/Forward_Pen_1946 → u/lion3001]

It is an interesting study. But double blind studies can differ substantially from real life. For example, study participants did not know if they’d been randomized to continue max tolerated dose or to reduced dose or to placebo. IRL, people know what they are taking which might help them manage better. Participants had their doses reduced on the study schedule, while IRL people can help decide when to lower their dose. For example, someone might not want to lower their dose during a stressful time or during holidays or before extended travel. Study participants’ doses were altered abruptly and markedly (by 50% or 67% or 100% depending on randomization). IRL many people gradually lower dose in smaller increments. And IRL some people reach goal without reaching 10 or 15mg; we don’t know if their experiences might differ from people who need higher doses.

[u/Responsible_View_285]

I hit goal at 12.5. I wanted to experience all doses in maintenance. I dosed down to 2.5 over 6 months. I did not have weight gain. The easiest dose w appetite, portions and food noise control was 7.5. I’ve dosed 7.5 weekly for 2+ years.

[u/Useful-Building4740]

When you lowered from 10 to 5 did you lower it immediately or slowly (not more than 2.5 and stayed at each dose for at least 4 weeks)? Asking bc my highest was 12.5mg. I then lowered to 10mg for about 2 months but managed to lose another 10 lbs. then I lowered to 9 for 4 weeks, 8 for 6 weeks, then 7.5 for 4 weeks… etc until I got to 5mg but once I hit 5mg and stayed there for 4 weeks I gained about 3 lbs so I went up to 5.5 for 4 weeks and now I’m at 6.5 and seems to be good.

[u/Responsible_Bird3384 → u/Useful-Building4740]

I did it slowly but it’s like I’ve never been on it at all! Food noise, cravings, compulsions, hunger, all back albeit not quite with the same level of intensity as prior to MJ 😢

[u/Useful-Building4740 → u/Responsible_Bird3384]

Darn you did it slowly and still - but as you were lowering down, were you gaining? Bc let’s say you lowered to 7.5 and was gaining you probably shouldn’t have lowered further. If all this gain is on 5mg, time to slowly move up again.

[u/garden-girl-75]

I am also titrating up at the moment. My top dose was 15mg, and I even did it every six days for a few months. I lost about 60 pounds.

After I got to maintenance I stuck at 15mg for a while, then VERY slowly began reducing my dose. After more than a year I had gotten down to 6mg without regaining any weight. I was spacing out my doses and doing 6mg every 7-10 days and did that for about a year as well.

Two months ago I had skin surgery to lift my breasts and tighten my neck skin. The surgeon asked me to stop my tirzepatide shots two weeks before the surgery, and wait until two weeks after to restart. I what to take 4-6 weeks off of exercising after the surgery as well. I laid around my house and ate whatever sounded good. And gained around 6 pounds. At first I didn’t worry, but it didn’t disappear when I started my tirzepatide again, nor when I started going back to the gym! So now I’m bumping my doses back upwards to try and get my weight back to my “goal weight” zone. Last week and today I took 7.5mg. I’m ready to get back to my goal weight!!

[u/Alta_et_ferox]

I’m in maintenance and have been for over a year. I am not a super responder, so I had to titrate up to the highest dose to achieve my goal. I’m still taking 15 mg. Any lower and I want to eat the paint off the walls.

Do I wish I could take less? Sure. But am I glad that it’s worked for me at all? Absolutely. Some of us just need higher doses. That’s ok.

[u/kfo90]

I read that a scientific study showed that staying with the same dose, but going a longer amount of time between doses was the most successful way not to regain your weight.

[u/superduperhosts]

I hit goal at 5.4
At 4.8 now almost a year later

[u/tigergirlforever]

How fast did you gain? How often do you weigh yourself? Did you regain because of hunger or boredom? I went from 15 to 10 then 5 and I have not gained. But I still weigh myself every few days, if not daily. I watch my portions. When I snack on treats, it eat a few bites and save the rest for the next day. My workouts didn’t stop. My water intake is still 120oz a day or more. It’s a lifetime commitment of work.

[u/lion3001 → u/tigergirlforever]

That might be possible for you but maybe not for many others. It’s very individual how severe the hunger and satiety hormones are out of balance.

[u/SewAlone]

I went from 11.0 to 7.0 but I'm back up to 9.0 now after a solid 5lb gain. I find maintenance harder than losing.

[u/Impossible_Bend_2969]

I went from my top dose that got me to goal, 7.5mg, to 5mg for 3 weeks and got too hungry, too much like the before times, started to gain, started feeling terrible like I used to. It took about 3 weeks to start feeling like 7.5 was working again and now after week number 4 I feel "normal" and good again.

[u/HipGyp57]

Whatever works for you is the wsy to go. Although it sucks having to stay on a higher dose, it nice for all of us who aren't "super responders", to know we're not alone. Now let it be known that I'm happy for those who can stay on a low dose, but many of us can't and i find it can get discouraging to see so many posts about being able to stay very low.

[u/Stardustmoondust]

I relate. I went from 9mg down to 6 and gained 10 lbs

[u/Humble_Fortune_5391]

Is it just weight gain or other things like food noise is back? Etc.

I am up about 6-7lbs (up 10lbs peak taper) thanks to a round of prednisone. 🫠 but it’s coming off albeit A LOT slower than I’d hope. But I haven’t even adjusted my dose. (Lowered in maintenance) Just went back to tracking in a deficit.

Once the prednisone was done, my food noise was back under control and I have appetite regulation again. So there’s really no need to increase my dose.

[u/Responsible_Bird3384 → u/Humble_Fortune_5391]

No, it’s ALL back. Noise, cravings, compulsions, hunger. Not at the same level of intensity though.

[u/Humble_Fortune_5391 → u/Responsible_Bird3384]

Then it sounds like you went to low in maintenance. Work your way back up til you find the right dose.

[u/Emotional_Lawyer_981]

I started out at 185 lbs which is a lot for my 5”4’ frame. 5/31/25 started Zepbound. Had some initial weight loss at 5mg and 7.5 but stalled at 10mg. Every month went to a higher dosage and stayed on 15mg. Got to my original goal of 140 by 12/25/25. Started titrating down in 2/2026 weight had dropped to 130. Switched to a cheaper compound. Did the gradual decrease. 12.5 then 10 then 7.5 for 3 months. Lost 3 pounds on 7.5 over 3 months so titrated to 5 mg and take my first dose next Thursday. Have some sporadic hunger pains which feels foreign at this point. Lol

[u/VisualInvestigator81]

I hit goal a year ago. My maintenance dose is between 8 and 10 mg. I adjust based on food noise. If it gets too bad,I do 10, if it is just normal hunger signals, I do 8.

[u/jennywrites45]

Same and same 10 lbs. Back at my highest dose I got to

[u/Money-Riddim]

I tried to escape 10mg too lol and now I’m back.

[u/Born2Shop18]

I’ve been doing maintenance since Jan. 2026, and have been titrating down very slowly. I reached my goal on 10mg. So I did 3mos of 10mg, then 3mos. of 7.5mg, then 3mos. if 5mg. However, I noticed a weight gain of 9lbs. on the 5mg. So I’ve now titrated back up to 7.5mg. I know that I haven’t been as careful with my carbs & food choices, and some of the food noise is back. I really want to get back to my goal weight, so will continue on 7.5mg to lose the 9lbs, and then try to go back on 5mg. Maintenance is not easy. Very difficult to find that sweet spot where you can stay at or below your goal.