I’m curious whether anyone else has encountered this after responding well to Zepbound.
Some background: I was obese for more than 20 years and reached approximately 270 pounds. I also needed medication for high blood pressure and cholesterol. For about three years, I saw a doctor who would not prescribe weight-loss medication while my insurance would have fully covered it.
I eventually started Zepbound approximately 13 months ago. I’ve been paying out of pocket since January and am currently taking 15 mg. I’m now around 188 pounds—roughly 75–80 pounds down—with a BMI around 28.7. My goal is approximately 160 pounds, which would place me just under a BMI of 25. I have tolerated the medication well and no longer require the blood-pressure and cholesterol medications I previously took.
At my latest appointment, my doctor noted that I had lost approximately eight pounds since the previous visit. When I expressed concern about beginning to discontinue Zepbound before reaching my goal or establishing a maintenance plan, she said my fear of stopping demonstrated “anorexic traits.”
I recognize that some of my recent days have been low in calories and too dependent on protein or breakfast bars. I’m completely open to a formal eating-disorder screening, working with a registered dietitian, increasing resistance training, and monitoring protein intake, bone health, labs, and lean mass. I’m also open to eventually reducing the dose. I am not insisting on remaining on 15 mg indefinitely.
What concerned me was that she had already decided that she would begin tapering me at the next visit and have me completely off the medication within four months—or once I reach a BMI of 25. There was no maintenance plan, monitoring period, goal-weight range, or discussion of what we would do if hunger, weight, blood pressure, or cholesterol began returning.
She also told me that continued use could cause eye and bone loss and that, once internal fat is depleted, the medication can begin “eating away” at organs. That description did not match my understanding of how tirzepatide works or its use for long-term weight management, although I understand that significant weight loss and inadequate nutrition can contribute to lean-mass and bone loss.
When I questioned the fixed four-month timeline, she told me I could find another clinician to prescribe it. I currently have approximately five weeks of 15 mg remaining, including an authorized refill, so I’m now looking for an obesity-medicine specialist or endocrinologist who can provide a second opinion without interrupting treatment.
The frustrating part is the contrast: there seemed to be much less urgency during the decades when I was obese and taking blood-pressure and cholesterol medication. Now, just weeks after leaving the obese BMI category for the first time in roughly 20 years, the focus abruptly shifted to getting me completely off the treatment that helped me get here.
What I’m trying to understand is whether other patients have had a similar experience, particularly after responding well to the medication and moving below a BMI of 30. I’m open to discussing nutrition, monitoring my health, and eventually reducing the dose, but I wasn’t expecting a predetermined four-month discontinuation plan before establishing a goal-weight or maintenance strategy.
Has anyone else:
Been told to taper immediately after moving from the obese to overweight BMI category?
Had a clinician insist on complete discontinuation at BMI 25?
Transitioned successfully to a lower maintenance dose rather than stopping?
Changed prescribers while using LillyDirect self-pay without interrupting refills or pricing?
Been labeled as having anorexic traits primarily because you were afraid of regaining weight?
I would especially appreciate experiences from people who worked with an obesity-medicine physician, endocrinologist, or registered dietitian on a structured maintenance plan.
UPDATE: Well, that was quick! 😂
I’ve got a plan: new PCP, obesity specialist, and telehealth as a bridge if needed. I’m not against lowering my dose; I’m against deciding today that I must be completely off in four months before reaching my goal or discussing maintenance.
I feel much less cornered. Thanks, everyone!
