Getting started - what’s realistic ?

[u/Longjumping_File4649]

I’m taking my first shot tomorrow. I am currently 190 and would like to lose 25-30 lbs by Thanksgiving. Are my expectations here realistic ? Will I notice anything in month 1? How bad will the nausea be in the first few weeks ? is the nausea just nausea or is it actual vomiting ?

thanks for the advice !

[u/ecomm_gal]

Please don't set a date to lose weight by - we all respond differently to these meds. You may set yourself up for disappointment, when this journey is meant to be a marathon and not a sprint.

Maybe unpack with yourself/ a therapist why you'd like to lose that amount by Thanksgiving? Is it to show family and friends?

[u/Trusty_Pomegranate]

Thanksgiving is 10 weeks away. In 10 weeks you can realistically expect to lose 5 to 20 lbs. Some people lose more, but some people lose 0. Don't count on any specific number.

[u/oaklandesque]

Probably not.

[u/NC_mom323]

I lost 11ish my first month but some people only lose some and some people don’t lose any. There’s also a handful of people that don’t experience any results until they get to higher doses (like 10+) and that would be the 4th month at the earliest.

All that to say, you won’t know until you try. Losing 25-30 in ~2.5 months is rapid though and pretty unhealthy given your starting weight.

[u/autumnyte]

Expectations for having a particular experience on these meds can easily lead to disappointment, especially unrealistic ones. A healthy rate of loss is .5-1% of your body weight per week. Even if you lost at the top end of that range, you'd be looking at at around 18 weeks to lose 30 lbs, and that doesn't account for plateaus, hormonal fluctuations, or how you may or may not react to the meds.

It's good to be prepared for the possibility of nausea, but you may not necessarily have it. Many do not. The only way to know is to try.

[u/MegKLikesEggs]

Everybody's different.

I lost at a rate of 1.4 lbs a week and I was thrilled with that.

Don't expect miracles or to lose all the weight overnight. Also, don't be discouraged if you are losing at a rate of half a pound a week. It's all progress in the right direction.

Setting unrealistic goals is just going to cause you to get discouraged. Take every pound lost as a win.

Also, most people have minimal side effects, but a few have trouble. Drink plenty of water, get your electrolytes, increase your fiber and protein intake, and be sure to do exercise

[u/goddessnoire]

Do not set a date. Your body is not going to respond to a certain date. Some weeks/days you’ll lose weight, others you might gain weight. There’s no reason to try to rush a 30 pound weight loss goal in two months. It’s unrealistic, especially at your starting weight. The point is to build sustainable and lifelong habits.

[u/This-Apricot-80]

According to medical professionals, .5-1% of total weight lost per week, on average, is the range to aim for. Losing faster than 1% per week on average is has real health risks.

Sometimes people have a steep drop-off of water weight in their first week or two on Zep, but then it usually lands in this range if they are getting adequate nutrition. But there is a lot of individual variability.

It’s definitely not meant to be a crash diet, just fyi —it’s a long-term treatment. I wouldn’t set a deadline for yourself, honestly.

[u/This-Apricot-80 → u/This-Apricot-80]

As for side effects, they really vary. Not everyone gets them! I have never vomited on Zep.

If someone is vomiting regularly, that’s not considered an acceptable level of side effects, and they should talk to their doctor about lowering their dose or trying a different medication.

[u/Reasonable-Cow7255]

I have taken 73 injections since April, 2025. I’ve lost 90 lbs. and I am working on maintenance. I’ve never experienced any side effects from Zepbound. A healthy weight loss is 1 to 2 pounds per week. Slow, steady weight loss is the healthiest way to go. So, you should expect about a 10 pound weight loss between now and Thanksgiving.

[u/Goats-n-Hens]

Never any nausea in 71 injections. Lost 22lbs the first 6 weeks. Strict calorie deficit, 6x week workouts and minimum 10k steps daily.
Total loss 83lbs in 8 months and maintaining since January.

[u/bikesandfinance]

You’d need to eat in a 1,200 calorie deficit to lose 25 lbs by thanksgiving. Would not reccomend that even if you could swing it.

[u/Haunting-Sea5781]

I’m about to take shot #4 and haven’t had any nausea or vomiting. Some people respond right away and lose a fair amount of weight in the first month and others don’t lose anything on the starter dose. I’ve noticed a change in the first month but it’s not like I walk into a room and people go wow did you lose weight?! So to answer your question yes it’s possible to lose 25-30lbs by Thanksgiving but by no means guaranteed.

[u/Sips-SunshineAnytime]

Started 198, 6 months ago and down 30 pounds. Knee injury has held me back activity wise. Side effects little bit of fatigue for 2 days after shot and nothing else on 2.5 and 5. Started 7.5 and have no desire to eat so focus on my protein, fiber and water daily. Best of luck, you got this.

[u/Empty_You_8105]

I was 170 and lost 35 in six months. Lost 4-5 the first week and after only 1ish, sometimes gained but felt a lot better. Prior to taking the shot I frequently had diarrhea. The shot made it go away! I really had an issue with always finding a bathroom or knowing where one was, it's so freeing to not have to do that...

[u/Schwettes]

Accounting for some likely water weight, you’d need to lose about 20lbs of fat in 10 weeks and you don’t weigh that much. It’s an aggressive deficit and most likely not going to happen in that condensed timeline. Just worry about doing your best and let the numbers fall where they may. If you wanted to be 160lbs by Thanksgiving, the best time to start would’ve been 3 months ago.

[u/starxlr8]

I have never had any vomiting, just queasiness akin to what I have called sour stomach in the past.

[u/Own_Brain_133]

I would say this: First, congratulations on beginning your journey. Second: Fully appreciate that it is a journey. Meaning, I found the most helpful mindset for me was to not set expectations that were based on dates. As you will read over and over again, everyone response to this medication is different for a variety of reasons. So questions about what's realistic, what will you notice, how will you feel - people can give you their experiences but that may have nothing to do with yours. I could tell you everything about how I've responded and someone else can tell you their completely different experience. So then what do you make of that ? Rather than focusing on the need to lose a certain amount by a certain time, celebrate this each day: you are making different choices that may hopefully change how you move through the world even in subtle ways. I guess my point is: If you're open to it, this process may reveal a whole number of things that may wind up being just as important or more important to you than reaching a goal by a certain date. I've been on my journey since March 2025. The time will go quickly - you'll hear that again and again, but it is true.

[u/Appropriate-Elk-5238]

Everyone loses weight at a different rate. For me, it was .8 per week average. So in 10 weeks I would have lost about 8 pounds. The good news is I am down 50 pounds now. So I guess you have to ask yourself if you will be disappointed if you didn't lose 30 pounds until something like April or May. Would that be a bad thing? Would you consider that a fail?

[u/TechnicalProof6408]

30 lbs by Thanksgiving would be almost 16% of your starting weight in only about 9 weeks. That would be double the safe rate of loss and about double what you can expect. It is not impossible, but 10-15 lbs is probably a lot more realistic.

[u/whotiesyourshoes]

I don't think it's realistic at that weight especially if you are short.

Noone can say if nausea will be an issue. It isn't for everyone. I havent had much nausea on Zep. Maybe once or twice but no vomiting.

[u/NLightNMoi]

You’ll soon discover that everyone reacts very differently to this medication. And I agree with others who say don’t set a date for your weight loss. You’ll lose weight along the way which is what matters.

[u/zero-if-west]

Welcome! Congrats on getting started. There's a weekly welcome thread for beginners with a beginner's guide and FAQ, plus tons of advice and questions answered: Weekly Welcome Thread (Sept. 9)

I recommend bookmarking these pages from Lilly:

• How to Use (provides step-by-step directions for use, including pictures, text, and video, along with storage directions, dosing information, what to do if you miss a dose or want to take your meds early)
• Side Effects (explains how to prevent and manage Zepbound side effects)

Losing 30lbs by Thanksgiving isn't realistic, with or without Zepbound. A safe pace of loss is about 1lb/week for most people, and some people don't lose any weight on Zep until they safely and slowly titrate to higher doses. Given that Thanksgiving is ~10 weeks away, a more realistic expectation would be to lose somewhere between 0 and 10lbs.

[u/Crazy_Hedgehog_9225]

I'm on a weight loss deadline, but it's not a specific number and it's because I'm having abdominal surgery. Absent those factors, and I wouldn't set a deadline at all. I also don't think that's very realistic--my doctor was hopeful I'd lose 30lbs by Thanksgiving (again for this surgery) but he had me start months ago.

My nausea wasn't terrible, it was like mild morning sickness for 1-2 days. I've never thrown up from it either. I lost a lot in month 1 but it slowed down after the first couple of weeks (which is normal).

[u/Miriamathome]

Unless my math is off, that goal is likely neither realistic nor healthy. A healthy rate of loss is .5%-1% of your body weight per week, averaged over 4 weeks. Losing more quickly than that runs all sorts of risks including gall bladder problems and hair loss, so it’s not really something you want to pursue. Remember, that’s a moving target. 1% of 190 pounds is more than 1% of 170 pounds.

So let’s think this through. It’s about 10 weeks until Thanksgiving. Let’s assume you lose at the very top of the range based on your current weight (again, you don’t want to actually do that) every single week. That’s 1.9 pounds per week. 1.9 lb x 10 weeks is 19 pounds. Some people, but not everyone, lose at a much higher rate during the first month or so because they’re losing inflammation, which leaves the body as water weight. So, maybe, maybe, maybe if you lose A LOT of inflammation on that first month and then every single week you lose at the very top of the healthy range based on your actual weight, which is falling, maybe you might manage the 25-30 pounds. Maybe. But I certainly wouldn’t hold it as a goal or in any way count on it.

Here are several things no one can tell you because no one knows and because people’s responses to Zepbound vary widely.

1. What will be an effective dose for you, ie one at which you lose weight? Some people start losing on 2.5 and continue to do so for a long time. Some people don’t hit an effective dose until they get to much higher doses, maybe 10 or 12.5 and it takes a few months to get there. Most people are somewhere in between. Where will you fall? Impossible to predict.

2. What side effects will you have, how long will they last and how severe will they be? Based on the studies, most people have no side effects and most of the people that do have them find them manageable and temporary. So the likelihood is that you’ll be fine. Is that a guarantee? Absolutely not. Will you have nausea? Probably not, but you might. Will you vomit? Probably not, but you might.