14 months in and titration is still the thing I get wrong
Here it is: 14 months in and titration is still the thing I get wrong. One person, one log, no control group, so read it accordingly.
Hard numbers: 14 months. Anything softer than that is flagged as an impression.
What I would tell week-one me, in order of how much time it would have saved.
One: the first month is a tolerance check. You are finding out whether you can take this, not how much you will lose. Two: write down the dose, the day and the waist measurement. Three: a stall of under six weeks is weather, not climate. Four: reflux that arrives the day after the shot and fades by day four is the ordinary pattern and it usually settles at a stable dose.
None of that is advice about what you should do. It is the shape of the thing, which nobody explained to me and which the wiki explains better than I just did.
The appetite thing was the surprise. I expected to feel full. What I got was simply not thinking about food between meals.
Happy to answer the boring questions. Those are usually the ones worth asking.
best — the order this archive was captured in
STEP-1 ran 68 weeks and landed just under 15% mean body weight change on 2.4mg. It is an average of a wide distribution, not a target you have missed.
staying at 1.7mg for an extra month is a legitimate plan
nausea that arrives on day two and fades by day four is the standard shape
if 2.4mg is working there is no prize for going up
sema is weekly for a reason, the half-life does the smoothing
sulphur burps made the first fortnight rough at each step up, then flattened out. Predictable enough that I started planning around it.
Minor fix — the half-life is about a week, not about a day. The rest of your point stands.
Dropped my injection day by two days once because of travel. Nothing happened. The panic was worse than the effect.
stalling at 1.7mg is information, not a verdict
Sat at 1.0mg for four months because it was doing the job. Everyone told me to go up. The one time I did, the only thing that changed was the nausea.
Are you measuring anything other than weight? Waist is usually the one that keeps moving.
My stall was eleven weeks. Eleven. Then it moved again without me changing anything at all.
First month I lost almost nothing and nearly quit. Month two and three were where it all happened.
That reads like a titration plan and this board cannot give you one. Somebody who actually knows your history has to.
Kept a log from week one and the single most useful column turned out to be waist, not weight.
the first four weeks are a tolerance check, not a weight-loss phase
the first four weeks are a tolerance check, not a weight-loss phase
Adding one thing to this: the appetite effect and the scale run on separate clocks, so both halves can be true at once.
Yes — and the honest version is that most of the "it stopped working" posts turn out to be a normal fortnight of water weight.
The mental model that finally made this click for me: there are two curves, and people watch the wrong one.
The first is exposure, which is set by the dose and smoothed by a week-long half-life. It changes when you change the dose and then settles over about a month. The second is body weight, which is exposure filtered through appetite, food, water, sleep, training and the scale itself, and which moves in steps rather than a line.
Almost every "it stopped working" post is somebody watching curve two over a fortnight and drawing conclusions about curve one. If the appetite effect is still there, exposure is fine. Wait the month.
Standard reminder: no personal titration plans for other members, and no medical advice. Everything else is fine.
dose day drift of a day either way is fine, the curve barely notices
Correct, and worth adding: the trial average is an average. Half the people in it did worse than 15% and were still on the drug.
Weight change and appetite change are different endpoints on different timescales. Conflating them is where most of the confusion on this board starts.
Disagree. 2.4 is the top of the label, not the goal, and "everyone ends up there" is just survivorship in the posts you read.
Weight change and appetite change are different endpoints on different timescales.
Right, and the timescale is the bit that keeps getting lost. Judge a step at a month, not at a weekend.
Delayed gastric emptying is most pronounced early and attenuates with continued dosing, which is why the early fullness usually fades at a stable dose.
Week 95: 25kg down, fatigue basically gone since about week 7, and the honest headline is that nothing dramatic happened. It was boring and it worked.
- 1STEP-1 ran 68 weeks and landed just under 15% mean body weight change on…9 comments in this branch · started by u/tomas_kimani
- 2Correct, and worth adding: the trial average is an average. Half the people…6 comments in this branch · started by u/arne_amankwah