Hi Docs. Not so much a question as a share. I’ve been struggling with my weight for most of my 70 years. I exercise, understand nutrition (I do best on a more ketogenic diet). After exercise and diet got me down about 10% from my high. I started Tirzepatide about three years ago, and I lost another 10-12%. I settled in with a balance of side-effects and benefits at about half the maximum dose (25ml at my dose). What I am noticing now is that satiety, hunger and food noise has crept back up. Nothing like where they were, but back. I’ve gained abou 5 lbs, and it is once a gain a struggle to maintain. Again, not as bad, but it’s back. If there is a question here, it is also a complaint. I could increase the dose, but the side-effects make it a challenge, and when I did an experiment, the increased dose didn’t really change things. Is this just another example of how hard the body fights to maintain a certain body-weight. Anyway, loved the podcast on obesity. Appreciate your thoughts.
I’m sorry to hear about the frustration here. We observe a wide range of responses in folks to these medicines, but a ~10-12% loss on Tirzepatide is a below-average response (although the “average” of ~20% is from the highest doses of ~15 mg weekly). Average weight loss also tends to be less in men compared with women, and less among those with diabetes compared to those without.
There are often strategies we can use to balance effectiveness and side effects, including things like twice-weekly split dosing (if feasible depending on the delivery method), and combination therapy with non-GLP-1 agents - hopefully you are working with an experienced clinician who is open to these “off-label” strategies.
Ultimately we are still optimistic that the approval of next-generation agents like Retatrutide and Eloralintide, hopefully within the next 6-12 months, will provide additional options to boost response rates and further improve outcomes.