Community β€Ί Dosing & Titration

Would you titrate up?

37 replies18 peopleJun 20, 2026β˜† Follow
Summary

Should I increase my tirzepatide dose when losing only about a pound a week at 1300 calories and 264 pounds?

The thread shows mixed advice on whether to raise the dose right away. Some say stick with the current level longer since one pound weekly is normal and stalls happen, while others suggest the low calories may be slowing metabolism and that more food plus patience at 10 mg could help. Several users share their own slow periods followed by progress after waiting or adjusting intake rather than rushing higher doses. Overall the group leans toward tracking trends over weeks before deciding.

What this discussion establishesWhere people disagree

Whether to titrate up immediately versus waiting several weeks or first raising calories to avoid metabolic slowdown.

Still open

How long any stall will last and the exact calorie level needed for steady loss at this weight.

Nothing here is advice.

37 replies Β· 18 people
SlowAnchor19archiveopening postJun 20

Would you move up in dose? I went ahead and did it. I wonder how others would handle this situation. Current weight 264. Average daily calories last week just under 1300 and from last week I lost 0.4 pounds hahahhahahaaa fuk. I am seeing roughly one pound a week loss and in my view with the calories and my weight that is not enough.

AmberCinder18archiveJun 20

Typical weight loss runs between half a pound and two pounds weekly so one pound is decent. I do not move up unless nothing has come off for several weeks and hunger signals return. People vary but 7.5 did not work well for me while 10 felt better. Still you are dropping a pound a week so I would stay put a little longer and check if last week was just a one-off or the start of slower progress.

SharpTimber40archiveJun 20

Early on I had a three to four week stretch with no change. Overall I have dropped 33 pounds in three and a half months. Plateaus occur. Unless you have been under a pound a week for a full month I would wait it out. Also are you weighing your food or estimating? Many people are surprised how much they undercount calories. It is very unlikely 1300 would produce such slow loss.

CopperMeadow83archiveJun 20
↳ replying to @AmberCinder18

Exactly this. There is nothing wrong with moving up on the usual schedule if that matches your goals. Are you on reta or tirz? Either way reaching the top dose is fine. The positive is elora is out now so once you hit max on either you can add a little elora on top to keep moving toward goal.

SlowAnchor19archiveJun 20
↳ replying to @SharpTimber40

I weigh and measure everything. I keep two digital scales one at home and one at work and I even log vegetables fruit and supplements. Ten calorie energy drinks get tracked too. Anything that goes in my mouth gets recorded.

SlowAnchor19archiveJun 20

I am on Tirzepatide sorry I left that out.

CopperMeadow83archiveJun 20
↳ replying to @SlowAnchor19

Then you might even have a third option later if needed by switching to reta once you plateau. But tirz plus elora should cover it if you need extra help down the line.

GreyAlder39archiveJun 20

You just started 10 mg so wait until you have taken four doses and reached steady state before deciding. Tirz did not do much for me on blood sugar or weight until I hit 10 mg. Between 800 and 1200 calories my weight stayed flat because my metabolism had slowed from constant restriction. That changed once I added Reta. Also drink plenty of water you should pee about once an hour and the color should be light straw yellow. Do not obsess over daily numbers or it will drive you nuts. Use a scale with an app that shows a graph. We do not stare at speed numbers the whole drive so why do it with weight. Look at the overall direction.

SlowAnchor19archiveJun 20

I agree this is making me crazy. I looked back and I weigh the same today as I did on May 4th. It has been the same five pounds going up and down for the last seven weeks. I stay well hydrated I pee often and the color looks right. I should probably stop daily weigh ins because it messes with my head but I like having the data and it keeps me honest with the calorie app.

WarmHarbour28archiveJun 20

Welcome to my world. I have weighed the same since May 10. I went through a vacation two illnesses a rodeo and a total mess. Just getting over food poisoning now. Did you know gastric slowing makes food poisoning last longer? Joyful words cannot express this.

PatientHarbour23archiveJun 22

If you do titrate up do it by the smallest step possible so if you are on 25 units now go to 27 or 28 and see how it feels.

NorthWillow72archiveJun 22

I only weighed once a week at the same time. I only moved up when needed even after a week with a gain. Here is how I titrated to goal. One pound a week is fine if you are losing you are winning. I would add steps or resistance training before going higher on the medication since you are doing okay and will reach your goal this way. My only regret is not watching muscle loss sooner I have since added four to six pounds with resistance work and high protein.

LevelBeacon74archiveJun 22
↳ replying to @NorthWillow72

You are killing it. I started at 220 on Easter Monday and am down to 194 now. I would love to reach the 160s like you especially with football season coming up. It is my nemesis.

NorthWillow72archiveJun 22
↳ replying to @LevelBeacon74

Sounds like you are on the right track. My goal was 185 I had not been below that in over 35 years. When this medication works and you work with it it feels like a miracle. Good luck.

PatientFenwick39archiveJun 22
↳ replying to @SlowAnchor19 (opening post)

1300 calories at that weight is way too low. Your body thinks it is starving and you are slowing your metabolism which works against weight loss. Find your maintenance level probably around 2600 then subtract no more than 500 and hold there for the next three or four months. Trust me on this.

WarmLedger43archiveJun 22
↳ replying to @WarmHarbour28

As an ER nurse I love hearing these details though I am sorry you are going through it. Besides surgical delays I had not thought about longer GI symptoms with these medications for patients with stomach issues like food poisoning but it makes complete sense. On the bright side at least your real life experience will help my ER patients know what to expect. Joyful words indeed.

SlowAnchor19archiveJun 22
↳ replying to @PatientFenwick39

No for real. Without the medication my goal was 2200 calories but that was 40 pounds ago. I agree with you. My lower intake lately came partly from a soft foods diet the last few weeks because of gut problems and from changing my meal timing. I am noticing the same pattern now. I am eating around 1300 but I know I need more and I do not want to harm my body by under eating. I would like to be around 2000. TDEE calculators show 2200 but those sites are often on the low side. Thanks for the comment.

PatientFenwick39archiveJun 22
↳ replying to @SlowAnchor19

Those sites are just guesses at best educated ones. Measure your actual maintenance. Start at a slightly higher number like 2400 and watch the scale for two or three weeks weighing daily. If you see an upward trend cut by 200 to 250 and repeat. After that you will know your real number.

LevelAlder29archiveJun 22

Same here I weigh the same as a month ago and it is really frustrating. I just titrated up two weeks ago so fingers crossed. Your calorie tracking is super diligent good job. Looks like you just started 10 mg so I would stay there another three weeks before deciding on another increase but I think you made the right call to move up on shot day mine is also Saturdays cheers. The titration guide I like best asks if your weight is at least 2 percent lower than four weeks ago. You can also swap that for is my weight at least 1 percent lower than two weeks ago. Hope the scale moves soon and your attitude is great by the way.

LevelAlder29archiveJun 22

Sure thing, wow! This came from an online discussion board and it looks like a helpful straightforward illustration that removes feelings from making the choice. (Props to your avatar showing two interests I really enjoy: felines and that desert city - the nearby canyon area stands out as one of my absolute top locations on earth!)

SlowAnchor19archiveJun 22

Red Rock is pretty spectacular one of my favorite spots around here.

SlowSparrow49archiveJun 22
↳ replying to @PatientFenwick39

This. 1300 is way too low. It sounds like you are trying to eat more but struggling to reach the 2000 calories you should be eating. Moving up in dose is the wrong move in my opinion because it will probably make you eat even less. It is common for people to stall and think the answer is a higher dose but here it might make things worse. You mentioned gut issues do they line up with a prior dose increase or something else. Personally I would look for calorie dense foods to add and see what happens closer to 2000. If you like chicken try thighs instead of breasts they have about 25 percent more calories per ounce. Adding a couple protein shakes can give extra protein and calories without filling you up as much as solid food. In all honesty if you have been struggling to eat or if the gut issues started after

LevelWillow41archiveJun 22

If you have been stalled for a month or so then it is reasonable to raise the dose a bit. It happened to me recently. I was stuck around 220 to 225 from May 14 until mid June. I increased and my interest in food is completely gone for now.

SlowAnchor19archiveJun 22

Thanks for the reply. My gut issues go back about two decades. The problem was I like to fast in the morning and eat two larger meals plus a snack later. That stopped working well because of GERD and delayed gastric emptying. I have no trouble eating even now. I had a diverticulitis flare that meant softer foods for a while to rest my sigmoid colon. I eat lots of raw vegetables and fruit so I switched to smaller more frequent meals and stopped eating by 4 or 5 pm since I get up early. I am a night snacker so after years of saving calories for evening and then changing the schedule I am still figuring out how to spread calories with more frequent earlier eating to help my gut. Protein shakes are a good idea and I already use them but maybe adding peanut butter would boost calories and it tastes great. I have been on a lean protein high fiber plan for a while so switching to higher calorie meats is worth trying. I just started adding walking I have done some here and there but I want to raise activity without increasing

SlowSparrow49archiveJun 22
↳ replying to @SlowAnchor19

Good to hear the stall looks like it is easing. I used to fast and eat a few big meals too but had to switch to smaller more frequent ones because I fill up faster now. Protein shakes are a nice way to get calories and protein after a walk to fuel the muscles. That is how I usually start my day take the dog for a walk then have a shake when I get back.

SlowAnchor19archiveJun 22

It's true that liquid-based calories assist well. Your feedback and insights mean a lot to me πŸ™‚

CopperSignal27archiveJun 23
↳ replying to @SlowAnchor19 (opening post)

I do not see height or age listed which would help. Assuming side effects are manageable I would increase aiming for 15 mg a week if tolerated. Based on 260 pounds plus the 40 already lost it still sounds like significant obesity even without height. This forum always pushes staying on the lowest dose as long as possible and that may be fine for mild overweight but with more severe long term obesity the highest doses are often needed anyway and they have the best data for long term health. I am not suggesting raising doses when loss is already fast or sides are bad but that does not seem to be the case here. Over time fluid shifts will cause ups and downs on the scale. If calories are the same as before when loss occurred it is probably still happening even if the scale is flat. Weighing less often or tracking waist measurement can help.

SlowAnchor19archiveJun 23
↳ replying to @CopperSignal27

45 year old female 5 foot 6 BMI 42.3. GLP start weight 285 on 3/27/26 first 20 pounds came off in weeks 1 and 2 with a highest weight of 400 pounds 115 lost naturally through diet and exercise. No side effects even after moving to 10 mg Tirz. This is exactly why I titrated up. I did raise calories to 1750 yesterday and still lost so moving to 10 mg was the right step. Thank you for the comment and insight.

PlainAlder11archiveJun 23
↳ replying to @NorthWillow72

Looks and sounds like me. I started at 215 and began first week of January at 2 mg. Those first two weeks were 5 and 4 pounds probably water. I pretty much stayed four weeks on each level but did six weeks on a couple that were working well and I am currently at 9 mg. I had a 170 to 175 goal but have reset it lower. I averaged 2.2 pounds a week. I had a couple weeks with nothing and a few with small gains. I need to start thinking about a maintenance dose and plan. I plan to stay on it as long as I can. I only weigh one day a week too. This is all Reta.

SharpHarbour92archiveJun 25
↳ replying to @PatientFenwick39

Monitoring all food intake really shows commitment and you've handled it well. I think more calories make sense here too. Raising intake to 1800 should bring extra energy and let the body stop acting like it's deprived so the pounds start coming off faster.

CopperSignal27archiveJun 25
↳ replying to @SharpHarbour92

It would be interesting to locate some study that backs the claim of eating extra calories leading to greater fat reduction. That notion seems appealing yet clashes with typical body functioning during everyday conditions or during the poorly studied phase of shedding pounds and the lower burn rate that follows. My own burn rate declined slowly across twelve months while dropping seventy kilograms. The identical daily food amount produced six kilograms lost each month until reaching around ninety from one hundred forty five then tapered off and halted near seventy five after roughly twelve months at the unchanged level of sixteen hundred to eighteen hundred daily. Weight then held steady between seventy five and eighty three across the following twelve months and one more while using a medication at low dosage. Small upward shifts in food amount triggered clear gains on the scale with even one or two hundred extra producing several kilograms of change across a few months. Physiology operates this way. I certainly failed to shed additional mass through higher consumption while already in a lowered burn state. No studies have appeared showing that the extended drop in burn rate after weight reduction can be altered except by regaining mass or greatly boosting activity levels. Duration remains uncertain with reports differing on whether the effect fades across several years or stays fixed once at the new lower mass. For me the change has continued unchanged across three years since the loss so that holding weight steady requires the same sixteen hundred to eighteen hundred range whether or not medication is involved. I suspect this lowered burn state after loss begins and ends gradually across multiple months and depends on body mass rather than food amount so any rise in burn requires added mass first since the adaptation aims to preserve some reserves during harsh periods like food shortages and helps survival then though it offers little benefit in present surroundings.

IronLedger45archiveJun 25
↳ replying to @SlowAnchor19 (opening post)

I boosted my protein consumption to no less than 1.2 grams for each kilogram of lean body weight. I also added extra electrolytes and stepped up my physical activity. The typical progression runs from 2.5 through 5, 7.5, 10, 12.5 and up to 15, which left me plenty of room for later increases. I held off on raising the dose any sooner than every four weeks, skipped any jump that brought on too many side effects, and avoided changes once my hunger signals were already quiet. That simple routine delivered great results in my situation.

CopperSignal27archiveJun 25
↳ replying to @SlowAnchor19

It seems there's a complication worth noting even if I'd rather not mention it, since the initial mass ought to be taken from before any reduction happened rather than the number recorded when treatment began. That changes how much total reduction seems realistic or when plateaus are likely to appear, though the interval until one occurs might still be counted from the most recent increase. I wouldn't expect a full additional year of gradual reduction just by moving up a few milligrams though. The real problem arises because dropping from such a high starting point down to the current level required an extended stretch of restricted intake, which lowers daily energy use both through the reduced mass itself and through the ongoing calorie limit. As a result the point where intake matches output arrives earlier or at a heavier level than it would if the process had begun at a lower number. A genuine plateau happens once energy needs have dropped and appetite has risen from the lost mass, yet the medication still curbs hunger enough to avoid regaining while no longer driving further loss, and that stage often shows up around the one-year mark. Individual reactions vary quite a bit, with many here reporting reductions well beyond typical figures, and it appears both of you are seeing steady progress without noticeable side effects that would force a lower amount. Other compounds could be added later if progress slows. Holding the new weight long term will probably mean continuing the medication, and even if the scale stops moving short of the goal, keeping the pounds off remains the biggest step toward avoiding future health issues, since remaining at a lower level carries far less risk than the original higher figure.

SlowAnchor19archiveJun 25

This is helpful. So I started losing weight around 2016 at 400 pounds using various diets and exercise to get down to 285 where I maintained for a couple of years on a loose low carb approach. I would lose and regain the same 10 pounds month after month. In 2020 a friend suggested a diet that would drop the weight fast. I did a bodybuilding prep style diet basically no carbs and no fat for 30 days and reached 240. It was extremely restrictive and triggered a binge cycle I could not stop. After restricting carbs for so long and not wanting that same mindset around food I spent the next few years trying to fix my relationship with eating which took me up to 330 and into depression by 2023. In mid 2024 I started focusing on nutrition again without strict dieting just being mindful no foods off limits everything in moderation. Without trying my body went back to 285 no active calorie counting needed. I was eating lots of fruit and vegetables by default and listening to my body wanting to be as healthy as possible and tracking micros. The medications have been great for hunger control and where I might have overeaten before I can now portion and feel satisfied. Thanks for the comments and for sharing part of your story too. I guess we will all see how it goes together.

CopperSignal27archiveJun 25

I was assuming the 400 pounds was more recent than 2016 so the effect is probably less than if it had been last year. Maybe 330 is a more realistic recent reference point but if you were not gaining at 285 without deliberate calorie control then 285 might be accurate too. I started losing in 2022 reached 75 kg in 2023 and the calorie intake needed to stay weight neutral has stayed about the same ever since around 1600 to 1800 kcal per day so it has remained lower than standard calculators suggest for my age and activity for three years but much of the drop in expenditure comes from the lost weight itself. I asked ChatGPT about this and the answer is no one really knows if energy expenditure stays lower long term or returns to normal and the research conflicts. I never really had the experience of using them only to lose then trying to make daily life easier keeping it off so I did not have to always stop eating while still hungry or avoid food when hungry if it risked too many calories.

SlowAnchor19archiveJun 25

I already consume plenty of produce regularly and pay attention to what my body tells me. Staying well matters a lot, so I enjoy tracking my nutrient intake closely. Those medications really helped control my appetite too, letting me portion out my food and feel content without going back for more like I used to. Appreciate the feedback and thoughts, plus the bit about your experience. It'll be interesting to watch how everything unfolds for everyone 😊

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