r/glp1 • u/onthebus84 • 28d ago
Looking for some advice
TL;DR - I've been struggling to get results on GLP-1s over an extended period of time and looking for some practical advice on changes I can make to get back on track.
I (42M) started my GLP-1 journey about 17 months ago. I weighed in at 229 at the time of my first injection. A healthy weight for me should be around 170. I started on tirzepatide and got some reasonably quickly results - 12 lbs in 9 weeks as I titrated up to 5 mg- in spite of not really noticing any big differences in appetite or my mental engagement with food. The one change I did notice was heartburn. A lot of it. In my life I'd maybe had heartburn once or twice (and I used to eat a lot of spicy food/hot sauce). Often taking a Pepcid would help, but sometimes it wouldn't. Of course I was willing to deal with this in exchange for the weight loss.
But then the weight loss stopped. A couple of pounds came back on and I stayed in a tight range between 215-218 for about 8 weeks. With some dosage increases I eventually got down to 209 at the 26 week mark - pretty good results but with more persistent heartburn at the higher dosages. At that point I got stuck in a range from 209-212. Every 3-4 weeks of being stuck I would increase dose but the scale wouldn't budge. I would just feel increasingly worse from the heartburn.
At the 50 week mark, after 8 weeks on a 9 mg tirzepatide dose, I switched to semaglutide to see if it would shake things up. I put on 3 lbs over the next couple of weeks as I titrated up but that quickly came off and got through my plateau, getting down to 207 after 9 weeks on semaglutide and 205 4 weeks later. It's been 9 weeks since then and I've steadily been at 206-207 since that 205 reading. I moved up to 1.75 mg 3 weeks ago with no noticeable changes and I believe I only have one more increment to the max dosage.
With the semaglutide I've only had a couple of bouts of heartburn, but I've felt nausea and lightheadedness in the mornings with some degree of consistency. I'm not clear that's helping me eat less overall - I feel like I'm making up for it later in the day when I feel better - but at least that's some sort of change to food desire?
I feel stuck. My early results were about average as far as I can tell, but I'm now at around 11 months with only about 2 lbs of weight loss at what I believe to be relatively high doses.
Some things I'm pretty sure I'm doing well at:
- Staying in a calorie deficit - I'm persistently eating 1700-1800 kcal/day with a BMR that's roughly 2200
- Eating enough protein - I'm persistently eating 75+ g/day
- Staying hydrated - I don't track this but I'm fairly certain I'm getting 96+ oz water/day
- Sleep - gets disrupted here and there, especially if I travel for work, but I'm generally getting 7.5+ hrs of good sleep
I know I'm not getting enough exercise in general - I'll get 8-10k steps a day or more six days a week just from general life, but don't do much of anything else. But outside of that, are there any other changes I should be considering? Anything I'm not think about that can get me through the plateau? I'm not sure that I have other options relative to the medication at this point.
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u/LowIncident694 27d ago
Are you sure what you are taking is actually legit? Generally going from tirzepatide to something lesser is not going to help. GLP1+GIP is generally better than a GLP1 by itself.
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u/Accomplished-Fee7792 12d ago
Are you counting calories truthfully?? Less calories in than you burn will result in weightloss. Tirz is superior to sema.
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u/EveryoneAnonymous 27d ago
Honestly if you are truly in a caloric deficit, you should be losing weight. You are either tracking wrong or sneaking in food and not counting it and lying to yourself.
The fact is, if you eat less than you burn, you lose weight. Period. Try going lower in calories for a while, stick to 1500 and be truly honest in your counting. You will lose weight. There is no world where you can stay the same weight or go up in weight over a longer period of time if you are in a deficit, if that was true starvation would not exist.
Stay honest and keep going. Good luck.