Max doses, have you tried them?

At 68 weeks the numbers were 26.4 percent at 9 mg versus 28.7 percent at 12 mg. That is diminishing returns rather than a true plateau. Higher doses raise the odds of bigger losses for more people without adding meaningful side effects. I want to reach 30-35 percent loss and am willing to go higher to improve those odds.

Are you shining with a radiance to match the sun?

I took 9 mg this morning. Think so? The trial showed 39 percent of people lost at least 30 percent and 24 percent lost at least 35 percent. My plan is to stack later if needed, but so far it looks like I could hit 30-35 percent in roughly ten months.

Assuming the three options are maximum tolerated dose, 12 mg, or stall, how far would you go if side effects were not a problem? I am not in any rush, just looking for straightforward discussion without the usual low-and-slow warnings.

It mainly depends on how much weight you need to lose. One milligram produced 9 percent loss over a year, so low doses work fine for modest overweight but not for obesity. If the goal is 25 percent or more, most people will probably need the higher doses. If a given dose produces steady loss with no side effects and eating is easy to control, there is no strong reason to increase further. The main argument for still going higher would be the direct long-term benefits on diabetes and heart disease prevention, which are stronger at higher doses. Those benefits are proven for semaglutide and tirzepatide when baseline risk is high.

I started at a BMI of 36.5 and had been as high as 39 in 2018. Labs were mostly good. Current BMI is around 29. I have gone well past 12 mg with no real side effects, feel fine, and am losing about 1 percent of body weight per week with single-digit lean mass loss over the last 34 pounds. I have blood work on Monday and another DEXA in the next couple of weeks.

No glow at 8 mg for now, and I live in the Sunshine State. Like someone else said, I have no side effects anymore. I do shots on Friday and used to feel fullness and heartburn at bedtime, but that has gone away.

I have not been to the gym in two and a half months and was mostly doing cardio. I keep saying I will get back to it. TRT probably helps the most with muscle, and HMB-FA is supposed to help too. I am not sure the GLP drugs are the main reason for my sleep efforts, though they probably contribute. I still sleep okay when I put the work in. DSIP alone seemed to mess up my sleep even though my ring showed plenty of deep sleep already. I stopped after five days and have been trying to recover my sleep debt. The recent bump and flatline started when I added creatine, which might push lean mass above my first scan. The graph leaves out the ten pounds lost on tirzepatide from mid-December to early January, but the overall weight data includes it. An annoying Shotsy quirk.

Another common claim is to just follow the trial schedule, but that schedule was never proven optimal. It was a guess applied to everyone the same way. We are still early in learning what doses actually work best. With any drug the lowest effective dose is usually smartest. There is always some downside, whether it is a rare side effect, extra cardiovascular stress, or something else. The key is whether it is still effective. If the current dose is doing what you need, there is no reason to increase just to increase. Increase when effectiveness drops. It is also not a race; faster is not automatically better.

Slower is not automatically better either. Efficacy right now does not guarantee long-term results, and efficacy itself is loosely defined. In the trials every dose plateaued on roughly the same timeline, which suggests time itself matters. It has not been studied whether raising a dose after a plateau produces meaningful extra loss compared with the trial schedules. The idea that there is always a downside also applies to going slow. Obesity itself has well-documented serious downsides. Plateaus happen over time. From someone who started quite heavy, the common dire downsides of these drugs are not obvious. Dropping 80-100 pounds in 8-10 months at 1 percent per week beats taking 16-22 months at half a percent. The plateau timing becomes relevant around 69-95 weeks.

The difference could be losing 10 percent of the weight from muscle versus 40 percent from muscle. Faster loss is almost always worse for keeping muscle. You might lose more total weight but end up with more fat and less muscle than if you had gone slower. High muscle loss with rapid weight loss is well documented. You can take steps to reduce it either way, but all else equal you lose more muscle going fast. I also do not see why you would plateau if you still had room to increase the dose. The idea of a fixed weight-loss window comes from the trial schedules.

How much are you losing per week?

About 0.6 kg a week.

That is 1.3 pounds. I still do not understand these low doses.

I do not have much to lose overall, just some stubborn weight that would not budge. It feels like a steady, healthy pace for me.

Like that stubborn pinch around the waist or belly?

No, still some belly fat, but I was never massively overweight. BMI was always toward the higher end of normal.

I think we share a similar view on dosing. What is your take on staying at 4-6 mg until it stops working versus titrating every month? I started at 1 mg every three days and am now at 2 mg every three days, which is 4.66 mg per week. I increased by 2 mg after the first month and that felt right. I have been at 4.66 mg for nearly a month and it is still very effective; I am struggling to eat near maintenance even when I try. How did you titrate, and do you think it is better to wait until suppression eases or keep increasing every month? My instinct is to hold at 4.66 mg until it loses some effect. I think I will know when it is time.

I remember my dad after the divorce desperately trying to lose that last bit of fat. He was eating huge bowls of cabbage and sauerkraut, juicing vegetables we could barely afford, and doing endless ab work. It looked miserable. I am glad that fifteen years later we have better options.

I did 2-4 mg for four weeks, stayed on 6 mg for seven weeks until loss stopped the last week, went to 7 mg for two weeks and started losing again, and just moved to 8 mg. I will check results on Friday. I have had zero side effects for about two weeks now and must be used to it. No more heartburn at night when I lie down.