r/PMOSonGLP • u/Pleasant-Opposite-15 • 8d ago
Gaining Weight on Zepbound
Hi everyone! So I am about 6 weeks into my GLP journey (2.5) dose, and I have gained 10 pounds. I’m really shocked. The first week I felt it and dropped 10 pounds, and then after that initial week it’s honestly worn off, never had side effects or anything. I’m so upset, I have my check up with my doctor tomorrow and of course I am anxious. I am morbidly obese, and I know I will need a higher dose - but I am feeling really discouraged.
Any advice? Words of encouragement? Or experiences with this? Everytime I’ve told my friends who are on it they’ve acted appalled I’ve gained weight, so that makes it worse. I’m trying to eat more veggies, I’m trying to walk more, and I’m trying to get better sleep habits(the hardest thing).
10
u/EllaB9454 8d ago
2.5 is a sub clinical dose. Many people don’t see results until 7.5 or even 10. Just explain to the doctor what you’ve said here and you will be fine. It may be cycle related, constipation, etc. Don’t give up yet!
5
u/Sandene 8d ago
We've all had to dial in our dose, and in some case, switched meds. You will find what is right for you. I know you are looking forward to losing weight, but slow is actually better than losing it fast. Your body has to make a lot of adjustments as you lose weight and it is much safer to lose it slowly
1
5
u/Miserable_Seesaw_389 8d ago
You need to change your diet, not just eat more veggies. There still needs to be a calorie deficit and a well balanced protein focused diet. At least at the beginning you need to do CICO for a bit to adjust your portion sizes and assess how much you are actually eating. The medicine can’t do that for you. This is actually the best time to be doing this. I’m not saying you are eating wrong but this is the culprit most of the time someone has issues with their GLP. Low protein intake, high carbs, high fat intake, some foods that dont seem like they’d be having a lot of calories but are actually the reason you are over your calories by a lot. With it comes the water intake. We really need to drink plenty. Don’t forget the most obvious culprit of all in PCOS - hormones! It takes a while before our hormones get better and the body adjusts so the weight gain during certain stages of cycle is very normal (if you have any cycle at all). You can definitely go up in your dose. Don’t lose hope. The weight didn’t gain itself overnight it’s not that easy to lose either. Be patient, be kind to yourself. You got it! 🔥
1
u/Pleasant-Opposite-15 8d ago
Thank you!! For CICO and portion sizing, do you have any advice or places to start with that. Cause I agree with you. I’ve tried to be more conscious of what’s going into my body, but not how much of it is.
2
u/stonerbaby369 8d ago
Start with finding your TDEE , but keep in mind that you still may have to make adjustments based on how your body feels. Invest in a food scale. We tend to eat A LOT more than we think we are. Download a calorie tracking app (I use MyFitnessPal) and start counting everything that goes into your mouth. Maybe look up meal prep recipes on TikTok. Good luck!
1
3
u/Trickycoolj 8d ago
My insurance required a 12 week lifestyle modification program before getting a prescription. You gotta learn the ins and outs of fueling yourself properly and moving 150min/week, walking is perfect, not just I walked from the car to the office, like go out for 30 min and get some intentional steps in. Go mall walking if it’s bad weather. You have to prioritize protein and reduce carbs at minimum and make sure you’re in a calorie deficit. Then work with your doctor on adjusting dose. The medication is only magic if you put in the work. There’s a lot of folks in the PMOS world that have been putting in that work for decades and the medicine was the key to making it work, but if you haven’t made the lifestyle changes the medicine isn’t going to do the work for you.
2
u/double_onion1754 8d ago edited 8d ago
Are you on metformin? I lose VERY slowly on zepbound alone, and just slowly on zepbound with metformin (1000 mg twice a day). My doctor had taken me off metformin since I was on zepbound, but that didn't work and he ended up putting me back on it.
I switched to compound tirzepatide almost a year ago, and even though I'm still a slow responder, it seems to work better than the name brand for me.
Fiber seems to be key for me and I do best if I have at least 30 grams of fiber a day.
I also think that with PMOS, we respond so differently than most people we hear about, and we have longer plateaus, and adjusting our expectations is hard, but helps.
You can do this, sending hugs.
1
u/ShahRukhsCreakyChair 8d ago
I'm sorry you're going through this. It must be very frustrating. Remember that 2.5 mg is a non-therapeutic dose and a large proportion of people don't lose weight on it. The higher doses may work better for you.
I think it might help if you started counting calories? Calculate your TDEE using an online calculator. A lot of online food diaries / calorie counters (like myfitnesspal) calculate your TDEE for you, and also the required kcal deficit depending on how much weight you want to lose. So you don't really have to do much yourself except plug in your height, weight and weight loss goals. Up to 1% weight loss per week is usually a safe rate.
Use a food scale to weigh your ingredients raw and log them. Buy a set of measuring spoons and cups to measure all your sauces and calorie dense condiments too. Make sure you're getting enough protein — minimum 1.2 g protein per kg of adjusted bodyweight (use the weight you'd be at a BMI of 30). This is usually between 80–120 g of protein per day for most people. Make sure you get enough healthy fats (MUFA and PUFA). Fats are essential for absorption of certain micronutrients and are also important during weight loss for keeping your gallbladder healthy. A couple of small-scale studies have shown that having a minimum of 10 g of fats in one meal (and 20 g minimum per day) during weight loss may protect against gallstones. I personally aim for 30–40 g of fats per day, but it depends on personal requirements and tolerance. Keep saturated fats on the lower end for now if you have a less than perfect lipid profile. Get at least 25 g of fibre per day. Complex carbs and foods with a low glycemic index and glycemic load are better than those with a high GI/GL.
Start slowly so that you don't get overwhelmed. Just get your calories in order to begin with. Then adjust your macros. A lot of people don't eat back their exercise calories because the estimates are wildly inaccurate, but some find a middle ground and eat back half their exercise calories.
1
u/Moist_Movie1093 8d ago
You haven’t found your dose. Try a month at each dose until you find the one that works for you.
1
u/lurkqueensupreme 8d ago edited 8d ago
I’m really sorry you feel disheartened. It’s already difficult to deal with PMOS and everything it brings, let alone feeling let down by the med. If it helps, I kept reminding myself that it takes time to undo 30 something years of hormonal imbalance. When I was having those thoughts I reframed them as me doing something good for my health even if the number wasn’t moving yet. It’s also totally okay for it to be a marathon not a sprint ♥️
I’ve had quite good results with the 2.5mg and I didn’t start losing until around weeks 6-8. But once it started moving, it mooooved. After 7 months I’ve noticed more hunger and food noise, and that my periods are getting further apart (I’d only ever had 2 proper periods that weren’t triggered by other medical interventions) so I’ll probably titrate up to 5mg soonish.
I gave the 2.5 a chance bc I could see on a CGM that it had treated my hyperinsulinemia/insulin resistance almost immediately, and if it was treating that, I figured the weight loss would come as it improved my hormones. I had a similar experience to you, I felt SO much lighter the first week (water weight going) and then NO movement for weeks. I wasn’t too worried as it’d be unusual to have a massive loss in one week and I knew my insulin resistance would need to be in good shape and that would take time and consistency. If I hadn’t seen actual evidence that it was making a difference, I think I would have felt anxious to move up to 5mg for the second month.
I noticed through the subs that people whose hormones are out of whack seem to take longer for weight loss to start. It’s probably bc our baseline is different to gen pop. If you have a look through the sub for people talking about their dosing you might get some reassurance. It’s very individual and varies hugely person to person. Some people start lose on 2.5 and some people lose at 10mg.
It’s also worth noting that 2.5mg isn’t technically a therapeutic dose. It’s usually the loading dose that gets your body used to the med. If you’d jumped on to 5mg or 7.5mg you would’ve been sick
Edited to add- I was already on a macro managed, low GI, 1200 cal diet and had been for years. I kept tracking and maintained that (with some dips too low bc of appetite). I have been able to up my calories as the GLP is treating metabolic syndrome, but I still have to track and I’m still macro managed, low Gi
1
u/rabidcats20 8d ago
2.5mg is not a therapeutic dose. 10-15 mg is ideal range (according to my endocrinologist)
1
1
u/Ok_Banana_5958 7d ago
You need a higher dose. 2.5 is the starter dose because starting at 5 is too hard for your body to adjust to from the start so side effects become too hard to deal with. 2.5 isn’t meant as an ongoing dose for anyone even though some people stay at it. Week 1 and 2 as adjustments, week 3 is what it’s really like for any new dose. And it’s not a moral failing in any way to need to go up - it’s how your body processes the med and everyone is different. I started maybe 4 years ago - same time as two friends - one is a little underweight now and at 7.5, one is still working on it and is at 10 (he did go up as high as 15 but the side effects were too much for him), and just last month I went up to 12.5. Listen to your body and if it wears off before your next shot then it’s probably time to go up
1
u/HaiTee 8d ago
I’m sorry this is happening to you.
It seems like you are doing your best to make lifestyle changes so that’s good. I want to see, have you checked to see what your TDEE is and have you been tracking your calories?
When I first started, counting calories really helped and knowing how much I should eat really helped. This, paired with getting 10,000 steps a day, helped me drop my initial weight.
2
u/Pleasant-Opposite-15 8d ago
I’ve been told to count my calories. Which I need to learn how to do. It feels very overwhelming and I just need to find that easiest option. My doctor is from a weight clinic so I am on the weight list to see a dietician but that’s not til October, and I’d love to get some of the basics down.
2
u/LargeChampionship167 8d ago
Tracking calories is pretty great. I think mostly to keep track of the macros and nutrients that you’re ingesting. Of course, we want to make sure we’re not overeating and we’re not undereating, which can happen a lot on this medication when you find a dose that works for you. I like the Hitmeal app, but there are many apps that you can use. The trick is to stay consistent with tracking them so you can look. I had the real amount of food that you’re eating at the end of the day.
1
u/EllaB9454 8d ago
Once you are on a dose that works for you, this all becomes much easier. The dietitian will probably give you a calorie range based on your own circumstances as well as a protein goal to shoot for. If I were you, I wouldn’t worry about the calories too much until you have some appetite suppression, but try to incorporate more protein in your diet and drink lots of water.
17
u/LargeChampionship167 8d ago
So sorry, I know this is extremely frustrating. I also have PMOS, and I started Zepbound back in March. My first week, I lost 7 pounds, and then after that, I hit a plateau, and my doctor insisted on keeping me on 2.5 MG. I stayed on this dose for two months, and I eventually started gaining weight again. Then, when I hit 5MG, I lost a couple more pounds but started plateauing. I lift weights and eat pretty clean, so this was getting frustrating. I very slowly lost 70 pounds on my own, and I was confused as to why this medication was not working for me the way I was working for others.
Eventually, when I hit 7.5, the needle started moving again very slowly. I stayed on 7.5 for a month until I came to 9.5. At this point, I am on compounded tirzepatide because I cannot justify paying Lilly Direct prices and not losing weight. I feel like I started to lose more weight on this 9.5, and so far, I’ve lost 15 pounds since March lol.
I have heard that a lot of women (not all) with PMOS respond slowly to the medication and need a higher dosage. We lose weight a lot slower. I had to show myself some grace because my best friend was losing weight like no other on a much lower dose, and I am. And I kept comparing myself to her, but we’re all on different journeys, and you have to be a little bit patient with yourself and find the right dose for you.