Not seeing progress in 2 weeks.

I responded quickly at the lower doses, so the sudden change after opening the new vial feels like I am only getting half the strength. When you say four to six weeks for full effects, do you mean at each specific dose? The official schedules move people up every four weeks, which seems to contradict that timeline. It is odd that 7.5 mg produced a plateau when lower amounts worked well.

I can stay at 7.5 mg. The lack of any side effects after the increase makes me doubt it is still working, though. I used to count the stomach trouble as proof the medication was active. I need to be more patient instead of expecting steady drops every week.

Yes I am a woman. I know I am in a deficit from past tracking; I hold weight around 1800-2000 calories and lose below 1500. Lately I have been well under that and usually eat only dinner plus a snack. I have been having mostly salmon or chicken. I should spread meals out more to avoid feeling worn out.

You really should track intake with a free app. Enough protein helps with fatigue and can reduce hair loss that sometimes occurs with rapid weight loss.

Yes, four to six weeks at each dose. The timing of the stall with the new vial could be coincidence. It is not officially a stall until four weeks anyway. You also lost weight quickly at first. Double-check your mixing and dosing numbers. Guidelines use four weeks because most people reach near-steady levels by then. I personally feel the full effect closer to five weeks. Keep the protein but add some carbs and fats too.

I mixed the 60 mg vial with 2 ml of bacteriostatic water and draw 25 units on a 100-unit syringe for the 7.5 mg dose, following the calculator I use.

You do need a minimum number of calories to lose weight safely and keep your metabolism from slowing. Very low intake can trigger adaptive thermogenesis, muscle loss, fatigue, and hormone changes that make further loss harder. Several sources describe the same pattern.

I used that tool a few weeks ago and will start checking it again. Thanks!

I know the risks of unhealthy weight loss from experience. Years ago during a bad depression I dropped 40 lbs in three months without trying and lost most of my hair, which made everything worse. It has grown back but the episode was rough.

That sounds really difficult. I hope things have improved since then.

I am recovered now. It was tied to a marriage issue we resolved. Thanks.

I was only stressing the need for adequate protein, not extra food in general. Drinking three protein shakes a day even when appetite was gone helped me avoid muscle and hair loss. Malnutrition is a real risk if you ignore nutrition while appetite is suppressed.

There is no medical agreement that three meals a day are required, especially for people who are already overweight. Some doctors support intermittent fasting and report benefits. I do not think telling someone in a plateau to eat more is helpful advice. I have also lost a lot of hair after a stressful period but gained weight during that time instead of losing it.

I agree stress was a big factor in my hair loss, but the rapid unintentional weight loss also caused deficiencies that probably added to it. When I did eat it was usually junk like pop-tarts or ice cream, so nutrition was poor overall.

The earlier comment was not insisting on three meals for everyone; it was pointing out that insufficient calories can stall loss and create other problems. You seem to accept that a minimum calorie level exists.

I am not convinced a minimum calorie floor is required for everyone. I have eaten between 50 and 700 calories on some days with rest periods at 1000-1200 and saw no negative effects after the first few weeks. I am not recommending it to others because individual health conditions vary. The claim that too few calories stalls loss needs stronger study evidence than personal opinion articles.

The person in question was fasting most of the day and feeling low energy, which goes beyond occasional skipped meals. The studies I linked discuss adaptive thermogenesis after very low calorie intake. I cannot change how the research was designed.

The first study abstract notes that resting energy expenditure differences disappeared by week 24 after refeeding. The second link references the Biggest Loser data where participants ate 1200 calories, not true fasting. It may be showing that any weight loss triggers adaptation rather than extreme restriction alone. The third study on alternate-day fasting also seems to limit how much extra adaptation occurs beyond normal dieting.

I never claimed low intake causes more stalls than moderate restriction. The studies you posted actually supported my view once I read the abstracts. Instead of updating your position you posted a dismissive reply and left the thread.

Thanks for the earlier reply; I missed it at first. Your explanation lines up with what happened. For context I am 5'7" with an athletic but overweight frame. In the sixteen days since posting I have lost additional weight, confirming the fluid readjustment idea. Starting weight 207, current 181. Waist went from roughly 36-38 inches down to 32.5. I also deal with autoimmune fatigue and collagen issues. Total loss is now 25 lbs in just over eleven weeks. I plan to remain at 7.5 mg because it is clearly working. My weight gain had been rapid after years of being in the low 180s.

I do not see solid evidence that a smaller calorie deficit produces greater fat loss. Studies that measure actual energy use generally find the numbers add up once you account for the drop in expenditure that follows weight loss and for inaccurate calorie logging. Severe deficits can cause faintness, tiredness, electrolyte problems, and gallstones. Energy expenditure falls after weight loss for several reasons, mainly the loss of tissue itself.

Glad the explanation matched what you experienced.

I value your input in the community, but insisting on a perfect double-blind trial may not be realistic here because such a study would be unethical. We already have evidence that very large deficits increase muscle loss, so researchers avoid deliberately creating that harm. The pattern seen with rapid GLP-1 weight loss supports keeping deficits moderate even without one ideal trial.

This old debate resurfaced. I am busy for the next few days but plan to look deeper into the research on calorie intake and adaptation. A reminder in a week would help.