Tirzepatide weight loss log — 20 weeks, biweekly weigh-ins

Week 2 weigh-in: 243.8 lb. Down 4.4 lb. First shot the side effects hit harder than I expected — nausea for about 48 hours, no appetite at all for 4 days. Calm stomach by day 5. Second shot milder.

Normal experience. The first injection is always the worst. Keep the protein high, lots of water.

Slow down if the nausea stays. Better to stay at 2.5 an extra two weeks than to puke your way through 5.

Week 4: 239.1 lb. Down 9.1 total. Bumped to 5mg last week as planned. First 5mg shot was rough again — about 36 hours of nausea — but manageable. Appetite is just... gone. I'm eating because I know I need to, not because I want to.

Watch the protein. Real easy to under-eat protein on these because you're just never hungry. 1g/lb of goal bodyweight is the floor imo.

Week 6: 235.4 lb. Down 12.8. Sulfur burps are a thing and they are as disgusting as advertised. Pepcid AC seems to help.

Ha, the username is based on this specific symptom. Pepcid is the answer. Also: don't eat greasy food day-of-injection.

Bumping this — Greek yogurt in the morning has been my savior. Easy protein, sits fine on the stomach.

Week 8: 231.8 lb. Down 16.4. Bumped to 7.5mg this week. Honestly at 5mg I was still losing plenty, but I wanted to see if the higher dose keeps me moving. Will reassess at week 12.

I'd have stayed at 5 honestly. You were losing ~1.5 lb/week at 5mg, that's basically optimal. Chasing a bigger dose usually just brings more side effects for marginal extra loss.

Noted. If 7.5 doesn't move the needle vs 5 I'll drop back.

Week 10: 227.9 lb. Down 20.3. 7.5mg is noticeably rougher on side effects — constipation is a bigger issue now, fatigue in the 48h after injection. Losing at basically the same pace as 5mg. I'm going to drop back to 5 for the next phase.

Good call. Listen to your body.

Adjusting dose based on actual results instead of the protocol schedule is the right move. Most people just march up because 'that's the schedule' and burn themselves out.

Bump lifting to 3x/week if you can. Preserving lean mass on these meds is entirely about whether you're lifting enough to give your body a reason to keep it.

Week 12: 224.2 lb. Down 24. Back to 5mg, feel way better. Clothes noticeably looser, belt down two holes. Waist 41" (from 44"). Started lifting again twice a week — kept it light, focus on not losing too much muscle.

This is great. Be ready for a plateau around 25-30 lb mark, almost everyone hits it.

Week 14: 222.1 lb. Down 26.1. And there's the plateau you warned about. Lost only 2 lb in two weeks. Waist is still dropping though — 40.5". Lifting 3x/week now, strength actually creeping up.

Waist dropping while scale stalls = muscle coming back. This is a good plateau. Keep lifting, don't panic.

Week 16: 218.3 lb. Down 29.9. Plateau broken. Got labs redone — A1c 5.4 (was 5.9), fasting glucose 88 (was 104), ApoB 94 (was 118). Doc was surprised. BP 124/78.

ApoB drop of 24 in 16 weeks is huge. That's not just weight loss, that's cardiovascular risk meaningfully lower. Nice.

Out of pre-diabetic range. That alone is worth the cost of the meds.

Week 18: 215.0 lb. Down 33.2. Pace has slowed to about 1.5 lb/week which is fine. 15 more lb to goal. Thinking about how I taper off — not going to stop cold.

Plenty of people run a microdose (1-2.5mg biweekly) as a maintenance after hitting goal. Worth discussing with your doc.

Week 20 coming up, will post then. Also going to post a before/after once I actually hit goal.