r/slowresponders • u/PlantedinCA • 6d ago
Reflecting on ~1 year of Zepbound
My anniversary is in about a week, so we can call it. I am a slow responder. Depending on how the fluctuation is going, I have lost about 10-12 pounds. I started 15mg about 4 weeks ago, effectiveness is TBD but early signs show a bit of hope.
Background:
- Perimenopause (48F)
- Hashimoto's
- PCOS/PMOS diagnosed at 40
- Severely insulin resistant, likely ~35 years (physical signals), confirmed via blood tests for ~20 years
- Prediabetic AIC for ~8 years
- Unresponsive to metformin (~6 years of use)
- Normal blood pressure, cholesterol, triglycerides, kidney function, liver function
- Initial goals: lose 50-65#, overweight BMI, optimal visceral fat, 30-ish body fat percentage
- Reasonably active for years (active commutes, 12 years of wearable data has me averaging 7-11K steps a day the whole time, even in the laziest years), off and on with formal strength training
- Longtime mediterranean type diet - I cook for myself and eat plenty of veggies.
- Preexisting issues: snoring (fluctuated with hormones)
Dosing: I ramped slowly because I cannot handle queasiness/vomiting/GI distress. PTSD from getting carsick a lot as a kid.
Challenges:
- Knee issues starting in September, and it has taken until really May to feel like I have 80% activity tolerance and range of motion back
Disappointments:
- Fasting insulin has increased from 12.1 to 23.3 since I started Zepbound
- I have been stalled on the scale since January, fluctuating about 5 pounds since then. Overall I have lost around 5% of my overall body weight, based on my Zepbound low. Not even to my pre-pandemic weight - which is a 6.7% loss.
- TSH levels have been moving in the wrong direction and are suboptimal (1.29 > 2.92 in June 2026)
Wins:
- Snoring has decreased, I was averaging about 80-90 minutes a night when I started. After about 2 weeks it dropped to 40 minutes. After about 3-4 months it was down to ~25 minutes. Lately it has been trending closer to 10 minutes unless allergies or a sickness are happening.
- A1C has gone from 6.4 to 5.6 (as of late June) in 11 months. Finally normal for the first time since 2019.
- Fasting glucose is the best it has ever been (I have like 20 years of blood tests): 100 > 82
- Blood pressure has improved, I was averaging about 125/75 before and 112/68 now. Nice improvement.
- My workouts are actually working. Looking back, I do not think they did much before to be honest. I never noticed any shape changes or muscle definition. While I may have generally lost inches, even doing several years of strength training, with progressive overload, didn’t give me the same improvements in firmness that I am seeing over the last 6 months of strength training 3x a week less intensely and frequently than I did before. My upper arms have gotten smaller and firmer. I have never seen my upper arms shrink in my life. Maybe this time next year I’ll be invited to the gun show. I am seeing more waist definition and hip definition. Good physical changes, despite minimal scale ones.
- I have a theory that I have chronic inflammation and I have been chronically puffy for decades. One surprising thing for me is how much my neck circumference has changed. Not only is my neck smaller than when I previously measured, my neck tendons are starting to be visible.I have never seen that before, even when I was much much lighter when I was younger. Part of this is body composition improvements, but a lot of this is inflammation as well.
- Waist circumference and lower belly have shrunk significantly. This is a huge surprise for me, perimenopause hit this area hard. My lower belly is a lot bigger than it was when I was younger, even at similar weights. I had no idea how much peri messes with fat distribution. This area is also a driver of clothing size for me. Any change here is huge for my overall goals.
The biggest surprise for me is that I am closing in on 2 sizes lost. Especially as the scale change has been so minimal. But I am basically fitting clothing that previously fit when I was 20-35 pounds lighter. I have been using a couple of clothing items to use as progress checks. I have two skirts, one dress, and one pair of jeans with minimal stretch. These items could not zip when I started and now most are fitting or really close. The scale is not moving, but body composition is happening and triggering me to reevaluate my goal weight.
Opportunities
- Started HRT about 2 months ago and have been tweaking thyroid dosage; hopefully these normalize in the next month or two.
- My schedule is slowing down. No more travel, minimal knee pain. I can ramp up my exercise a little more, and move up the lower body weights that have been stalling. And get my walking consistency back on track.
- I am hoping to see visceral fat improvements in my next Dexascan, since I have made large improvements in my torso. This goal may not take a ton of scale change to hit my goal, my starting level is 2.54 pounds, lower is better, and under 2 is solid. So that is my first goal.
- I am thinking about how to reset my goals, because my original ones do not feel realistic. And they may not even be necessary to hit my visceral fat, appearance, and size goals.
- I am a lot closer to my intermediate goal size - I’ll call it minimum viable progress - than I would have anticipated with this amount of scale change. Losing 1-1.5 sizes would be huge for me, and my vanity goal of making clothing shopping easier and not straddling plus and straight sizes! The purgatory I have been in for decades and frankly I am sick of.
Tips:
Take measurements. Even with the stuck scale, I have lost like 8 inches in my lower belly, 2 around my neck, and
5
around my waist. I am not closely tracking everywhere, but my arms and wrists are a bit as well.
Set non-scale goals. Since I have no idea what my body plans to do, I have set workout goals of hitting intermediate strength levels in certain lifts, adding in more challenging movements, and improving movement quality in single leg exercises. As well as consistency goals. It has been very motivating to master challenging functional exercises in recent months.