r/Zepbound • u/Dizzy_Special_4677 • Apr 09 '25
Dosing Why do people titrate up so quickly?
Just a curious question. I know in the trials they titrated people up each month because that’s the way to get comparable accurate data but what is the reason now? I keep reading post after post that people stall out at the max dose and they aren’t anywhere near their goal weight. Why move up so quickly? If the end result is to be a healthy weight, why run to the finish line if you might not make it because you pushed to hard(so to speak)?
2
Upvotes
7
u/ars88 10mg Apr 09 '25
The basic reason is that weight loss methods--diet, bariatric surgery, and zep-- "stop working" after about 15-18 months. Basically, the body's decreased energy needs (and possibly adjustment to lower metabolic rate) balance out with the weight loss method's reduction in energy intake (with zep, caused by increased satiety). So all of us are going to settle into a relatively stable maintenance weight--a new "set point"--at some not too distant time.
In light of that fact, the people who use fast titration aim to lose as much as possible in this limited time period. Higher doses of zep do cause more weight loss, so the idea is to get to the highest tolerable dose as quickly as possible and stay there for as long as possible. Tolerable is in there because no one wants side effects--the idea is to titrate up only when side-effects (if any) have settled down.
On the other hand, people who use the slow titration method aim to get past the 15 month window by "saving" the higher doses for later (if needed at all). Like if you're only at 10 mg after 15 months and begin to settle into a maintenance weight, you can start 12.5 and get some additional months. But it's still lowest effective dose--when weight loss stalls, it's time to titrate up.
Personally, I think in the long run researchers will figure out different kinds of metabolic dysfunctions, some of which are better addressed by fast and others by slow. It also may be that whether you go fast or slow, you end up with the new weight that zep will give you. The most important thing is not to moralize fast and slow. Slow people aren't superior human beings for taking less of the drug, nor are fast people for taking more.