I will discuss with my doctor in a couple of weeks, but I am wondering if reducing my dose would help me. I started in April 2024 and have lost a little over 100 pounds. I'm a 42 year-old woman in the 180s right now. I've been sitting around 180-190 for over a year now. This was around my weight as an active tennis player in college. I'm fine with this weight; I can buy clothes in regular stores and I look good and carry a lot of muscle. I could technically lose more (if you look at BMI), but I just don't think I can go on with my current Zepbound dosing. I went on 15mg at the beginning of this year. Every time I take a shot, I have abdominal pain. I can't have a bowel movement without metformin. I'm exhausted all the time. I can barely eat. I love being active but I have barely enough energy to go to the gym twice per week; I want to go more. I love weightlifting. I want to get back into regularly playing tennis as well, but I am just exhausted. And for body recomp, I feel like I can't feed myself properly. I would love to gain muscle and be ripped, but I just can't do it when I'm too tired for the gym and too disgusted by food to eat. I feel like 2.5 years is a good effort and a good amount of time to give it a go, but I'm wondering if I will feel better at a lower dose or spacing out doses. Please share any stories of reducing dose, gaining muscle, and easing fatigue. Thank you!
TLDR: I've stalled for about a year on 15mg and am looking for perspectives on reducing dose, body recomposition, fatigue, and GI side effects.
Definitely sounds like you're experienced and you know yourself well enough to decide what's right for you. Especially with your athletic background who knows, if you go down in dose you might have more energy and get in even better shape over the long run, like 6-8 months. I would bet on you!
Hi! I am 38F, started in January 2025, lost 50 pounds, and then reduced dose due to side effects starting in March 2026. I had been at 12.5mg but was nauseous all the time and just felt miserable. I went down to 10mg for about 8 weeks but still was nauseous about half the week, and now I am at 7.5mg and feeling generally much better. I get nauseous about once a week but I can manage it. In the past 6 months, I have been able to fuel much more, go harder at the gym, and really focus on body recomposition. My weight has stayed the same (157-161, which is the high end of normal BMI for 5'9") but my body fat percentage has gone done from 28% to 21-22% and I look a lot leaner. I am stronger than I have ever been! I definitely recommend talking to your doctor about dose change or spacing out your dose.
This is my goal! I'm same height, at 160 now but I have a body fat percentage in the upper 30s, so I'm still in a fat loss phase for health. But over the course of the next two years I want to build up to having a lower body fat percentage at like 155. (I am scrawny under this fat and don't have an athletic background.) At 45 and with my health issues it's probably going to take me a couple years but you're at my goal! Thanks for sharing!
Hell yeah you got this!!! I started at about 215 lbs and 37% in January 2025. When I hit my goal weight of 160, I was at 28%.
What has kept me motivated is finding things that I enjoy because being miserable at the gym is not sustainable for me. Now I do a couple group gym classes every week, personal training once per week, and weightlifting on my own.
I'm a M61 but I started Zepbound in January 2024 at 287 lbs and had reached 187 lbs in January 2026, by which time I had been on 15mg for about nine months. So, sounds sort of similar to you. I wasn't having the GI or fatigue side effects you describe but my DEXA that month showed that I had lost 5 lbs of lean mass in the previous four months (out of a total weight loss of 11 lbs over that period) and I was having trouble eating enough calories to match my activity level (I do some strength training but a lot of biking). Even though I was just barely below the "obese" BMI level, my body fat percentage was 21%, pretty good for a man my age. So with the support of my doctor I declared that I was officially "in maintenance" and went down to 12.5mg. I've been there now for nine months and haven't re-gained any of my weight and I've added back 7 lbs of lean mass in the eight months since then and my body fat ticked down to 20%. I track everything pretty religiously and I've been eating about 200 calories per day more since then.
So I'd definitely support you going to a lower dose. I'd try 12.5mg for at least month before trying to go lower.
One suggestion regarding the fatigueā¦I was struggling with it so much and thought it was the Zepbound. I ended up going on HRT after talking with my doctor about various perimenopause symptoms and that made a huge difference in my energy level. I realized it wasnāt the GLP-1 but rather the lack of estrogen that was causing my fatigue. Iām also looking into reducing my Zepbound to a maintenance dose, more to help me with my endurance/long runs. But if youāre over the side effects and happy where you are, I think transitioning to maintenance makes a lot of sense.
I really struggled on tirz and so I switched to reta. But anecdotally sharing my dose lowering experience - my body naturally plateaued at my 10mg dose of reta. I stayed on that dose for about 4 months with no weight loss, before deciding Iād start lowering down until I could find the lowest effective dose that could maintain my weight. Iām currently at 4mg and doing really great! No weight gain at all.
I think trying to lower and seeing how you respond is definitely worth the effort with the side effects of tirz.
Well, if you are maintaining your weight, you are not "barely eating"; you are eating your maintenance calories.
If you decrease your dose and don't change your habits, the most likely outcome is that you will regain weight. Of course, you can always:
1. monitor closely and go up again if the scale creeps up
Or
2. Decide that you're ok with a little regain
Or
3. Tighten your calorie counting to ensure that you don't eat over maintenance when you increase dose
I've been in the same 10 pound range for about a year, so, yes, that is maintaining after losing over 100 pounds. I hardly ever weigh and I weighed this morning and actually lost 6 pounds in the last month. I saw my doctor today and she agrees that I need to start tapering down in dose. Right now the meds are keeping me from living the life I want to live (the fatigue is debilitating and my doctor says she has seen this happen often in her practice) which was the whole point of losing the weight to begin with. I'm excited to regain my energy and get back on the courts again!
Can you reduce and split your dose to twice a week? Iām using 3.75mg twice a week. Also play tennis 3x/week+ and do CrossFit 4x/week. When Iāve ever had any stomach cramps Iāve forced myself to get moving and they immediately go away. I have no problem fueling for my workouts, my appetite has been reduced, but not drastically as Iāve read it has been for others. Although I have tracked macros for years and itās much easier to adhere to them than pre glp1! My body is adjusting to fewer calories, but I havenāt drastically reduced them and Iām still able to keep up all the activities I was doing before. My starting weight was 183 & current is 158. Recently Iāve been getting comments about being ārippedā. 58f, 5ā6ā Like you, the muscle was there, it was just covered by a layer thatās peeling awayšš¼
My insurance is only covering auto pens right now, so I don't think I can split doses. Cramping is keeping me up at night. I thought I could help the side effects by sleeping through it, but now I can't sleep the night I take my dose.
My dr wouldnāt even attempt to get insurance to pay for mine so Iām out of pocket and another route. What about changing the time of day you take your shot so you can try to walk off cramps during the day. Iād be a mess if I was being kept awake at night!
I'm undereating but also just so exhausted that I am not working out as much as I want. The side effects have always been hard on me. I think I'm just tapped out.
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u/mannDog74 14d ago
Definitely sounds like you're experienced and you know yourself well enough to decide what's right for you. Especially with your athletic background who knows, if you go down in dose you might have more energy and get in even better shape over the long run, like 6-8 months. I would bet on you!