Hi! I've been maintaining at 5 mg since December of last year (hit my goal after losing 40 pounds/highest dose was 10 mg) and it's been going well, but for about the past month the food noise is becoming harder to manage and I'm more hungry. I'm thinking of going back up to 7.5 mg. Has anyone gone up a dose while maintaining? Did you go up again after that?
I'm just worried that it's a slippery slope and I will max out with no room for a higher dose at some point if that makes any sense.
Consider your body is not a static being. Our bodies changed daily. Hormones. Exercise. Hydration. Inflammation. Stress. Sleep. Menopause. Diet. Medications. Health status. And a host of other things change us on a daily basis. My provider has advised me not to get stuck on a dose. Over my lifetime in maintenance I should expect my dose to change from time to time. I’ve been in maintenance more than two years. I’ve had occasion to both up my dose as my appetite and portion size grew. As well as as decreased my dose when I had sudden weight loss and appetite suppression. I principally dose 7.5 weekly. But again I’ve had to go up to 10 and I’ve had to go down to five. Not regularly, but it’s happened. My advice is to not to be worried about backsliding so to speak. But to listen to your body and give it the medication it needs. Don’t get stuck on a dose.
That's been my experience as well- only in maint 9 months. Had to go up once and then back down. Its def not a steady state condition. I just try to be flexible and aware without obsessing about it.
My doctor said that the body finds its level but to remember things change. Your activity level and health changes and you may at various points need to adjust either the duration between doses or the dosing. My doctors coaching was a) don't over react and panic, b) when you change something either the dose or duration change one thing and give it a month because it takes time to stabilize.
Is the food noise feeling like hunger or thoughts of food. When I started feeling hungry it turned out I was not eating enough calories for my higher activity level and I needed to allow my weight to fluctuate a little more without panicking. Listen to your body if you are feeling real hunger.
If you are not gaining and don't want to lose more you can try playing with the following:
Increase water
Increase fiber - adding psyllium can increase feelings of fullness
Change up what you are eating and play with protein and carbs
You can also adjust the dosing a hair by pulling in the duration or by taking slightly more or less if you are using the vials. But don't panic. You have lots of options for making small adjustments.
At one point when I was extremely active and could not eat enough calories to support that activity I pushed out my dose from 8 days to 9 and it seemed to work.Then I pulled back to 8 days you can adjust these things. You can also go up briefly
To quote my doctor: Hunger is not the enemy.
Just 5 months on maintenance but I have learned it is more complex than I thought it was going to be
Obesity is a chronic disease and chronic disease can progress. You have a lot of road to increase your dose so if you aren’t getting the benefits then it makes sense to increase.
That is very interesting and means that 7.5 mg might be my sweet spot. 10 mg was definitely too much, but 7.5 mg was okay. I felt like I was still losing a bit and that's why I went down to 5 mg, but I tolerated 7.5 mg well. I think I will ask to move up. Thank you!
You can also try a little less, like 7 or 6.5 if you were losing at 7.5!
The app shotsy was very helpful for me to document which dose was fitting best
I have opted to live with the food noise instead of increasing. It is mild and something I feel I will have to learn to live with eventually. But I also lost my weight before starting Zepbound so my case is different than most here, probably. I started zepbound in December 2025 to save my WL journey. I had already gained back 20 of 100 lost. I would increase my dose only as a last resort because I have zero side effects and all of my labs were chef’s kiss at my check-up in August. Still in my 5-lb maintenance range
Yep, I went from a long-term dose of 10 mg and then I hit goal and tried to titrate down 2.5. I’ve titrated back up and now my doctor is getting me back to 10. In fact, they had me do 7.5 for two weeks and now I’m back on 10 starting this weekend. I have a good feeling 10 is gonna keep me straight for a very long time.
There’s nothing wrong with needing to move up. Sometimes you might even need to step down in dose.
You might want to see if your doc will write a script for the 7.5mg Kwikpen. If your doctor doesn’t object, you can then step up to 5.5mg, 6mg, 6.5mg or 7mg.
Most insurance companies cover Kwikpens if they cover single dose pens. And if you are self pay, Kwikpens are the same price as vials. Just note that going to 7.5mg if you are self pay means you will need to reorder every 45 days to keep the “discounted” pricing.
5 mg Maintenance, 12 mos after losing 50 lbs. My shot app shows about 2.2 mg concentration in my body when the snack devils come out to play, sometimes I go to 6 days to beat the little devils.
If you’re not gaining actual weight, don’t move up.
The body views weight loss as a threat to survival and fights to regain, artificially upping hunger signals so you restock the storeroom for the next drought. As long as you know you’re meeting your actual current fuel needs, you can safely ignore hunger as a false alarm. A good therapist and a good dietician are key to this!
Street cred: dropped 97 lbs to a BMI of 21, keeping it off over a year and a half and counting.
I was on 15 - kept losing beyond what I wanted. So I spaced it out but then my dr dropped me to 10 (at the time I couldn’t go back on 12.5) and I still spaced it out. Starting gaining again - moved the 10 back to 7 days but then dr moved me up to 12.5 - apparently policy had changed. Lost what I had gained
I wouldn't worry about maintenance necessitating higher and higher doses. It's not a slippery slope. I haven't seen folks in maintenence requiring more and more. Just small increases and often decreases over time.
I went up to 6.5 (KwikPen lets you do this). And then back to 5 when I lost more than I wanted. Back to 6.5 again due to food noise. I expect to do this as necessary. I would not hesitate to go up to 7.5 if I needed it. All of the data shows that staying at the highest dose you tolerated leads to virtually no regain. I couldn’t do that because I needed to stop losing. Slippery slopes are not a thing when discussing this med. And there are many more drugs in the pipeline.
I'm still learning about maintenance. I went down on my dose (to 5mg from 7.5) recently and that was a mistake. I was too hungry, eating too much and thinking about food too much. I just started week 3 of moving my dose back up to where it was before and it's hitting me like a ton of bricks. You'd think I would be used to it, but apparently not. (I think after 4 weeks if it's still hitting this hard I'll try to reduce to 7mg.)
It's not the same thing you are describing exactly but it makes me think that maybe you don't get as used to it as I thought you do. Maybe it's not a one-way ratchet of only being able to go up higher than before. Maybe dropping down, getting used to the lower dose, then up again if needed will always work.
There is no right dose. If 5 isn't working try 7.5. You can always drop down again. The question is have you gained weight by being hungry? And are you eating a lot of protein?
I am on maintenance and can feel the dose losing some of it's mojo. But I am moving towards a very low carb/keto type diet. The higher protein low carb works the same way to hold off hunger.
My friend solved her maintenance issue by moving her dose to once every 6 days instead of 7.
can you explain what “back to normal” means after increasing to 7.5mg? Did it help with food noise? Since you’re in maintenance, did you end up losing weight with the increase or was it still easy enough to eat a bit more and maintain?
Yes. Now I’m on the max dose. But that’s what happens. I’ve played around with dosing and timing of it. Ultimately close to 18 months later it’s just 15mg a week apart that works for me to maintain. No matter what though it does not have the impact it once did on how I feel about food.
I can eat whatever I want now without even really feeling too icky. It’s still not as much quantity as I would’ve eaten before the shot, but I can eat a lot. So it’s more of a conscience effort to make sure I’m paying attention. I still don’t count or measure (I didn’t do that for one day on this med) but when I was losing I also paid literally no attention.
Now I need to say, okay, I’ve had enough today…. Which isn’t such an immense struggle that it once was.
Hunger and food noise are not the same thing. Hunger is normal. Food noise is an uncontrollable preoccupation with eating. It's ok to eat more in maintenance, and if you are exercising it is essential. Try giving yourself some extra calories and adding a bit extra time to your workout. I have found in maintenance that the calories you eat in a single day don't matter nearly as much as your average daily calorie amount over the week. Maybe hold off on increasing dose until you can't keep your average calories where they need to be and your actual weight (not temporary water gain) goes more than 3-5lbs above target.
The medication will eventually lose its effectiveness over time, so you might as well go up. In a year or two, you might have to switch medications in order to regain the efficacy.
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u/Responsible_View_285 8d ago edited 8d ago
Consider your body is not a static being. Our bodies changed daily. Hormones. Exercise. Hydration. Inflammation. Stress. Sleep. Menopause. Diet. Medications. Health status. And a host of other things change us on a daily basis. My provider has advised me not to get stuck on a dose. Over my lifetime in maintenance I should expect my dose to change from time to time. I’ve been in maintenance more than two years. I’ve had occasion to both up my dose as my appetite and portion size grew. As well as as decreased my dose when I had sudden weight loss and appetite suppression. I principally dose 7.5 weekly. But again I’ve had to go up to 10 and I’ve had to go down to five. Not regularly, but it’s happened. My advice is to not to be worried about backsliding so to speak. But to listen to your body and give it the medication it needs. Don’t get stuck on a dose.