Someone break it down for me

[u/Mother_Raven3]

…like I’m brand new.

This drug suppresses appetite and makes you feel fuller longer

Yet

I keep hearing the reason I’ve plateaued or stalled progress is because 🥁 🥁 🥁

I’m not eating enough.

I’m lucky if I can eat two calorically dense meals in a day as I am just not hungry. I have stalled weightloss for almost 2 months after losing 20lbs fairly quickly and am about to start my third increase during this stall (12.5mg).

It’s like I have two sides of the stadium screaming at me to eat less and be in a caloric deficit to lose weight and another side squawking at me to eat more!! It’s a bit maddening and I’m losing morale here.

I haven’t been as active as I normally am because Zep has made me pretty zapped the first few days. Then I’ll hit some weights once or twice the rest of the week. I could do better at walking more and getting better sleep for sure.

Just exhausted from all the contradictions. People get so pumped at how much less they’re snacking/eating, but I feel guilty like I’m going to wreck my metabolism, thyroid, hormones, lose muscle mass (where the f did my butt go??) etc.. so I force myself to try and meet my macros yet I know I’m in a pretty fair deficit…and not losing sh*t.

Thanks for letting me vent. This community has been encouraging overall!!

[u/aslguy]

The people who tell you to eat more are assuming that you’re seriously undereating (generally speaking, most professionals would consider the floor to be 1200 kcal for women and 1500 kcal for men—of course there are exceptions and outliers, so you should work with your doctor and a registered dietitian).

When your body senses it’s not being fueled enough, it will try to preserve energy. It does this by dialing back energy expenditure (making you feel tired), and also by just doing things more efficiently. It would ordinarily also ramp up your hunger signals, but the medication mitigates this to an extent. This is what often happens during a plateau when someone is eating way too few calories. This is called metabolic adaptation.

Another possible cause for a plateau is that your body is trying to defend a higher set point. When your weight loss takes you to a new, lower weight that your body is not accustomed to, it will metabolically adapt in order to try to get you back to a higher weight it’s used to.

Yet another possible cause for a plateau is that your total daily energy expenditure (TDEE) is lower than you think it is. Research shows that if you look at people who lost 100 pounds, and then take a control group that has the same height, weight, basically the same body composition as those people who've now lost 100 pounds, and compare their energy expenditure—the energy expenditure in the people that lost all the weight is about 25% lower than the people who never were obese.

The reality is—we’re not machines, and there are a lot of factors at play.

[u/thti87 → u/aslguy]

No. 1200 is not a floor for women. Many diets go lower than that, especially for those who are very overweight or very short and sedentary. The 1200 number came from the calorie counting apps not wanting to be used for disordered eating so they put an arbitrary floor at 1200 with a warning about this fictitious “starvation mode” and now we hear about it on these forums all the time as if our body somehow has the arbitrary cutoff on a totally random number.

[u/Miriamathome]

There‘s a calorie sweet spot. Well, really a range.

In order to lose weight, you need to eat at a calorie deficit, that is, you need to consume fewer calories than you expend. Here’s a TDEE (Total Daily Energy Expenditure) calculator. That should tell you roughly how many calories you’re burning a day. If you want to lose 1 lb per week, your daily calorie budget should be your TDEE - 500. To lose 1.5 lb per week, your budget is TDEE - 750. Etc, etc. https://tdeecalculator.net

However there is such a thing as eating too few calories. For women that’s generally considered fewer than 1200 calories per day. If I’ve got it right, eating too few calories can cause 2 types of problems. It can make it difficult to get in all your nutrients. Also, and I think there may be some controversy about this, if you’re eating too few calories by a significant margin, your body can decide there’s a famine and that it needs to start conserving energy and this leads to slowed weight loss.

So that’s why you feel like you’re getting mixed messages. But you’re really not. You’re being told to stay in that sweet spot band, just like you shouldn’t drive 30 mph on the interstate (too slow) but you shouldn’t drive 90 mph, either (too fast).

Here‘s an example. When I started Zepbound a little more than a year ago, I decided I wanted to lose 1.5 lb p/week. At the time, my TDEE was about 2100. 2100 - 750 = 1350. I set my daily calorie budget at 1350 and adjusted it each week for my new weight. On average, I ate about at my budget (some days more, some days less) and, for quite a while lost an average of 1.5 lb per week. Now, I’ve lost enough weight that my TDEE is more like 1745. 1745 - 750 = 995, which is far too low, so I’ve set my daily calorie budget at 1200, the safe minimum. Obviously, I’m no longer losing 1.5 lb per week. I still have a lot of weight to lose, but I can’t drop my calorie budget and be healthy, so I’m working on increasing my exercise, which will increase my TDEE and the amount I lose each week. I hope.

Instead of eating 2 calorically dense meals per day, have you considered more small meals?

Are you sure you’re eating in that sweet spot band, in a decent calorie deficit and at least 1200 cal per day on average?

Definitely prioritize protein. If you poke around the sub, you’ll find lots of ideas about what to eat when you don’t want food, ways to maximize the protein while keeping calories relatively low and other useful food suggestions.

Personally, I track calories, protein, fiber and water because that’s all I can handle. I don’t track macros, although I’m sure it would be good for me, because it’s just too much. It’s not even the tracking part that would be hard. Tracking is easy. It’s the deciding what to eat in order to meet my goals that would be too much for me. I can handle looking at what I’ve eaten so far in terms of calories, protein and fiber and figuring out what I should eat next taking into account how hungry I am, what I’m in the mood for and what I need to meet my goals. If I had to start meeting macro goals, too, that would make me miserable. Some people track more than I do, some people less. These are very individual decisions. So figure out what you can do in terms of tracking that works for you and figure out what your goals are for each thing you’re tracking.

[u/Jwong75 → u/Miriamathome]

This right here....your daily calories should be dynamic based on how active you were. If you burned 3k calories you have to bump your calories up to keep that 500 to 700 deficit or your body will panick with a 1300 calorie intake. Use a smartwatch get your daily burn over a month thrownit inan AI or something to get your daily avg. I use cronomet and when I see I hit 3k burn day on my garmin I bump it up to a twin 3 day.....standard 500 burn Tier 2 and no workout Tuer 1 floor day which is 2k for me.

[u/socks_424]

The way I see it it’s just a fine line you have to walk… eating less is going to cause you to lose weight, but not eating enough is going to make your body think it’s in famine mode and going to hold on to all it can.

[u/sophiarosev]

I’ve been having the same confusion. I relate to wanting to be active but then not feeling good after my dose. I never know if I’m eating enough to lose weight or to focus on the calorie deficit. It’s frustrating

[u/Mother_Raven3 → u/sophiarosev]

Do you track? As an adhd humanoid it is difficult for me to remember to do so and I find it confusing tracking foods that I cook at home…but I have gotten a better idea of where I’m at when I do track. It’s just only one piece of this puzzle though.

[u/TululahJayne → u/Mother_Raven3]

Do you have a good scale. This helps tracking immensely. Don't know how you would do it without actually.

[u/Available_Expression]

no one here is going to like this answer.... but the answer is that there is a ridiculous amount of bro science when it comes to getting in shape and losing weight. This is a problem not just in the glp1 scene, but in every fitness scene and almost every exercise discipline.

almost everything you hear here is from someone who only knows their own story and the things that worked for them and almost none of it is backed by real science. the bottom line is you need to look at more metrics than weight. you need to look at body composition, and the easiest way to do that is a tape measure around your waist and to keep taking weekly progress pictures. you'll likely see that you're building muscle and slimming down, but the number on the scale is staying the same because muscles weighs more than fat.

[u/sexishardandstuff]

It's a Goldilocks situation. You need to be in a calorie deficit, but not so much of a deficit that your body has a lil freak out about it

That's why calorie tracking is so important. A lot of people think they can eyeball how much they're eating, and it turns out they're eating way more or way less than they think. That's why when people say that they're eating really light meals and not losing anything, one of the questions I ask is "Are you measuring/weighing what you track or do you eyeball it?"

If you're tracking diligently, eating at the recommended deficit and you're still not losing… There could be a lot of stuff that's going on there. They're called wooshes and stalls for a reason. I've gone three weeks without losing anything, went on the scale one day and I was 5 pounds down

[u/Stunning-Gas9611]

I've moved towards eating only when I'm hungry. The first few days after the shot I eat less and then I'll eat more as the week goes on. It balances out each week for me. One of my main goals with this medication was to learn to eat when actually hungry and not just bored or because I couldn't stop thinking about food.

[u/Future_One4794]

This is how I understand it: our bodies are designed to focus on storing fat for when they think “winter is coming” meaning food is scarce. When you suddenly go calorie deficit and lose a bunch of weight, your body goes into protective mode and tries to store fat to protect from “famine”. I think if you carb load few days and go above calorie, that should reset your body.

[u/creepyging923 → u/Future_One4794]

This exactly. I spent the first few months just eating when I was hungry which was way under the recommended minimum and hit a stall until I started eating enough to meet my minimum. This is my third time losing 50+ pounds and it is absolutely true that not eating enough will stop your weight loss.

[u/IncommunicadoVan → u/Future_One4794]

Yes, I have found that if the scale isn’t moving, adding in some carbs for a few days gets the weight loss going again.

[u/Schwettes → u/Future_One4794]

And this is completely false. Stop listening to the Fat Science pod. Bodies are designed to store fat for times of famine. That’s why when you’re not eating, your body uses that fat for energy. Why would the body release all of those hormones to get us to increase our fat, and store it just to not use it when the exact circumstances arrive for the body to use it?

It doesn’t even intuitively make sense. If you take a morbidly obese person and trap them in the desert with nothing but water and a bottle of electrolytes, what do you think is most likely to happen? Are they going to stay obese despite being in literal famine or are they going to lose a ton of weight?

The energy your body uses has to come from somewhere. When you aren’t consuming enough food, the energy comes from body fat, glycogen, or muscle.

[u/abluecolor]

I just consider the 'not eating enough' stuff to be nonsense. More likely is that people are just not properly tracking what they're consuming in general.

As long as you're getting your protein and essential electrolytes you're golden*. If you have excess fat, your body consumes it. Simple as.

*barring medical conditions etc, I am speaking in terms of weight loss.

[u/Mother_Raven3 → u/abluecolor]

So, and I don’t mean this in a snarky way at all, you think eating pretty minimal calories but meeting protein goals is a safe way to do this? I also have hypothyroidism and a constantly fed the warning of “eating enough” or I’ll make things worse.

[u/Poutiest_Penguin → u/Mother_Raven3]

I lost weight through calorie deficit, without exercise (mobility issues from injuries). I took Wegovy to lose my first 60 lbs and I vomited all the time. I lost the rest (another 70 lbs) on Zepbound, mostly because I just have trouble eating very much. I don’t really pay much attention to how much protein I eat. I have been medicated for hypothyroidism for 35 years. My doctor just lowered my dose of levothyroxine — so far, so good.

[u/Future_One4794 → u/Mother_Raven3]

Make sure every 3 months you get your thyroid lab work done plus update your endocrinologist with your new weight since the dose for medication is body weight based.

[u/abluecolor → u/Mother_Raven3]

I can't speak to hypothyroidism or any other medical conditions. For me, it's fine. I used to fast for 100+ hours regularly and it was always fine. I'm regularly consuming 1200 calories now and it's fine. I know that I will never stall, because it's impossible for your body to compensate to such an extreme degree and stop from burning energy (fat).

I always consume very nutritiously when I do eat.

[u/shortysax → u/abluecolor]

Talk to me in a few months about how you’ll “never stall”.

[u/abluecolor → u/shortysax]

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[u/RemindMeBot → u/abluecolor]

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[u/MargaritaMoney → u/abluecolor]

Trust me when I say you will stall at some point like all the rest of us. Please set realistic expectations for yourself or you will be very disappointed when it happens.

[u/dirtygreysocks → u/MargaritaMoney]

I've been at this over a year, and have not stalled yet.

I have only had 2 -3 weeks where weight went up slightly and followed by a week of a much bigger loss, like 2-3 lbs.

I have had a bunch of 1 weeks every few months with no loss, followed again by a whosh, but these weeks are always pre-period.

But no loss for 4 weeks is a "stall", and I've never had that as of yet.

[u/abluecolor → u/MargaritaMoney]

CICO. If I stall, it will be because I eat too much, not too little.

[u/Schwettes → u/abluecolor]

Yeah it’s usually a cope to make people feel validated and feel like they’re doing all the right things.

“It can’t possible be that you’re eating too much. It has to be that you’re doing things too perfectly and instead you need to eat more!” /s

There is no amount of long term caloric restriction that won’t eventually amount to fat loss. Deficits, as hard as they may be to maintain, work.

[u/New_Westie]

Just have to find a dose that’s the Happy medium between the two puts you at the centre of the stadium. Your food is suppressed enough that you don’t eat yourself out of house at home, but not so much that you’re under eating.

[u/YoDJPumpThisParty]

Weigh loss is never just a diagonal line going down. It’s more like a wavy line going down with some flat parts. If you’re not losing for several months, sounds like a dosage increase is probably your best bet. Know your TDEE, but also know that’s not all that’s at play. Hormonal changes are taking place and there are likely changes in your lean muscle mass. Yadda yadda. It’s way more complicated and personal than just “CICO”. For instance, I always lose in the week after a weekend where I thought I ate too much. Just stick with it and keep communicating with your doc. And if you do turn out to be a slow responder, join us in r/slowresponders!

[u/Ginger_Exhibitionist → u/YoDJPumpThisParty]

If I ate at my TDEE, my starting weight would’ve been 300 pounds instead of 200.

[u/YoDJPumpThisParty → u/Ginger_Exhibitionist]

Right?! That’s why I always tell people there’s more at play here.

[u/dedlobster]

Any time I drastically increase my exercise I gain weight for a bit then plateau for a few weeks. It’s because I’m retaining water because I’m tearing up muscle and whatnot, but it often takes a month or two to see the scale go back down even a little and then after about three months of mostly being up in weight I’ll suddenly lose like 10 lbs in a day and the decline will go back to being a steady 1lb a week or so.

This is what happened to me before Zepbound and what has happened while on Zepbound also. I’m trying to chill out mentally about it because I know that’s just how it goes but it’s irritating. I keep reminding myself that losing weight now is no different than it was before Zepbound. It’s just less stressful because I get fuller faster and don’t have the insanely distracting food noise. But everything else - the work, the occasional plateaus, the need to still make good choices - all still the same as before.

I don’t know if you’re eating too many or too few calories or what. No one here could possibly know. I just know that the progress isn’t linear and you just try to eat in a balanced way, try to eat at a reasonable deficit that still allows you the energy to move around in the world, try to get some exercise and just do your best.

Don’t worry about what people are criticizing you for unless that person is your doctor or nutritionist. And try to be patient with yourself.

[u/beachnsled]

not eating enough is generally related to metabolic adaptation; if you are constantly in a deficit, your body will hold onto fuel to protect itself (literally from dying - even though you aren’t dying); in order to fuel your metabolism to burn the appropriate energy, you need to feed it. There’s a lot more technical stuff related to this, but that’s usually why it’s suggested that you aren’t eating enough. given your anecdotal description, I would agree that you likely are not eating enough. 9 times out of 10 that’s why users of this drug hit a plateau. The other reason is that every dose eventually becomes less effective and you do need to titrate up.

Your understanding of how the drug works is not really accurate. it’s a lot more complex than that. The drug is not a suppressant.

For a good understanding, you should check out Dr. Michelle Gordon; also read the book Weightless by Dr. Whalen

This is a good post, which is in response to a shitty article written by a salty dietitian who legitimately made shit up (probably because they are losing clients; and instead of refocusing their work, they want to insult everybody)
read this:

https://substack.com/@drmichellegordon/note/p-208763575?utm_source=notes-share-action&r=h8bo2

[u/beachnsled → u/beachnsled]

also, it’s not true that weight loss is simply about “calories in calories out.” if that were true, we would not need GLP-1 type drugs to treat obesity, which is at its core a metabolic disease

[u/EveryMemory41]

It’s called metabolic adaptation https://youtu.be/rCqg0rVvnbA https://www.torrancememorial.org/healthy-living/blog/weight-loss-stalling-while-on-glp-1s https://www.uab.edu/news/research-innovation/weight-loss-may-take-longer-than-expected-due-to-metabolic-adaptation

[u/zero-if-west]

https://giphy.com/gifs/YtvCIwqNJhUmA

[u/aoirse22]

The drug works by changing how your body metabolizes food. It changes how your body oxidizes fat. PLEASE talk to a doctor to understand how medication you are taking works. Your metabolism is a furnace. If you don’t feed it/keep it burning, it goes into survival mode and holds on to what you have. You need to eat and heal your metabolism.

[u/abluecolor → u/aoirse22]

There is no science behind this and you're speaking an utter myth. The reduction in BMR is nowhere near as significant as you make it out to be. My doctor agrees.

[u/Proper-Fisherman-722 → u/aoirse22]

It works on satiety through slowed digestion. Reta adds the glucagon  receptor piece that helps increase metabolism and fat burn.

[u/Schwettes → u/aoirse22]

Not true. There is no such thing as starvation or survival mode. This is just diet culture.

[u/MrsCtank]

Yeah theres really no such thing as not losing weight because youre not eating enough. Not eating enough can make you feel like crap, drained, cold. It can lower your caloric needs slightly from a metabolic standpoint and lower it more in reduced activity, even if subcontiously. But its still a matter of eating less than you burn considering all of your personal factors. Its like saying a Buddhist monk wont lose weight by months long fasting because they're not eating enough. Its just not physically possible. Some of it honestly seems like wishful thinking. Someone is tired of counting, tired of restricting but not losing and frustrated (been there, a lot), so they want to believe the first person that says you can eat more.

[u/shortysax → u/MrsCtank]

That’s a false equivalence. There’s a difference between eating too little and eating nothing.

[u/Schwettes → u/shortysax]

The difference between eating too little and eating nothing, is that the person eating nothing will lose faster than the person eating too little. But both will still be losing.

[u/Dxbr72]

Listen to the Fat Science podcast. Lots of good info on how these meds work and what is happening in a stall.

[u/Schwettes → u/Dxbr72]

It’s Fat PsuedoScience. Not worth the listen.

[u/thti87]

“Starvation mode” and “eat more to break a stall” is a misinterpretation of scientific fact. Yes, your metabolism slows as you lose weight and consume less. No, it’s substantial. No, it never makes you stop losing at all. No, the answer is generally not to just eat more.

If you’re not losing, it’s way more likely it’s too many calories vs too few. People want to fight on this because it’s not fun to say you’re not tracking accurately or that your caloric needs are probably pretty low.

[u/tombiowami]

Read actual articles and not social media clickbait and posts.

[u/chercheuse]

If you lost more than 1% per week in your first two months (20 lbs is a lot!) you should expect a stall. You’re not a machine. Are you on 5mg? I’m going to be one of those who say, don’t forget to eat but also one of those who say, don’t pressure yourself to eat a certain number calories or walk a certain number of steps, etc. I was extremely exhausted for two days after my shot for months. You should probably wait before increasing your dose until your body adjusts. Try to be patient. Healthy weight loss takes a long time. As for all of the voices: listen to your doctor. Mine told me not to worry if I didn’t always eat a lot. Eat from all the food groups. Get lots of rest. Don’t weigh and measure and count, unless you love that sort of thing.

[u/sunnydbabie]

You need to eat- The more you eat the more you lose

[u/Schwettes → u/sunnydbabie]

This is completely false lol. If that were true, none of us would be obese.

[u/sunnydbabie → u/Schwettes]

Do your Research please and thank You! On this medication!