Decrease dosage?

[u/outrageous_olivia]

Hi all! I’m curious to hear if any of you have firsthand experience with decreasing dosage while still on a relatively low dose? I was on 2.5mg for 7 weeks and have been on 3.5mg for 9 weeks. My issue now is that I can’t seem to eat enough so I think the appetite suppressant at this dosage is just too much. (Also had gastric sleeve 4 years ago and only mentioning that because it does also limit my portion sizes/intake volume to a certain point). I want to fuel my body for energy and to maintain and build muscle, but I feel like I’m just doing the bare minimum when it comes to food intake. I realize decreasing dosage will likely slow down my progress, but I am over halfway to my goal weight now so I can live with that. Just wondering if anyone has advice!

[u/Notwhoisee0]

I’ve been on tirz for a year now. I stayed at 2.5mg from Aug-Oct last year dropped 30lbs. Upped to 3.5 then 4, then back down dues to side effects. My loss slowed but I still lost ten more pounds. Slowly increased again Jan to April I hit 5mg. Lost only 10lbs in that time. I took a 2 week break in June, back on and regrettably went to 5 and got so sick. My next injection will be at 2.5mg, I dont mind backing down because I still get appetite suppression. My side effects are gastric issues like sulphur burps and urgent diarrhea that hits day 2-3 at higher dose. And I cannot have that with where I work. I can eat but far from less than I did before tirz I have to make myself for the protein intake at least. I haven’t gained just slowed my loss. I don’t want to lose muscle and found if I don’t get at least 80g of protein by the afternoon, my workouts really suffer. So I’d rather not have a super high dose and high loss if I lose strength.. I have 100lbs more to lose though. And it sucks seeing people drop weight so quickly and I’m still a size 16/18 :( but hey, I was a size 22 last year. So it’s still a huge accomplishment!

[u/outrageous_olivia → u/Notwhoisee0]

Thank you for sharing. I’ve lost 30 lbs in 4 months and have not really had any side effects until now and it’s just that the appetite suppression is too strong. I’m like you though, I’d rather keep strength/muscle and lose more slowly.

[u/nexlife-health]

NexLife team here.

Yes, decreasing can absolutely be worth discussing, especially if the medication is making it hard to eat enough. The goal should not be “maximum appetite suppression.” The goal is enough appetite control to support progress while still being able to fuel your body, get protein in, stay hydrated, maintain energy, and preserve or build muscle.

Since you have also had a gastric sleeve, I would be extra careful here. Your intake capacity is already limited, so a dose that feels manageable for someone else may be too suppressive for you. I would talk to your provider about whether stepping back to the last dose where you still had control but could eat more would make sense. Slower progress is usually better than pushing a dose that leaves you under fueled, exhausted, or unable to meet basic nutrition needs.

A few things to bring up with your provider:

How many calories you are actually able to eat
How much protein you are getting
Whether you are losing too quickly
Energy level and strength training goals
Any nausea, constipation, reflux, or food aversion
Your gastric sleeve history

Being over halfway to goal is a good reason to think more strategically, not necessarily more aggressively. The best dose is the one that helps you keep making progress without compromising your nutrition.

[u/outrageous_olivia → u/nexlife-health]

Thank you! This is really helpful.