Just starting out... your advice?

Hey everyone, I'm brand new to this. I'm a 52 year old male, 5'11", currently weigh 302, and have type 2 diabetes. I start my third shot of 2.5mg tomorrow. So far, I mainly feel really full, have some heartburn, and I've been burping a lot late in the day on weekends. I haven't changed much of what I normally do. I've been able to drop weight before if I really concentrated for a few weeks or a month, but I'd always gain it back, and usually even more. I realize I eat too much at meals, and snack when I'm bored. I hear people talking about "food noise" but I'm not sure what that means. I guess I'll get it when it stops. How hard should I push myself right now, or wait to see what the meds do? Should I force myself to eat less like I used to, or hold tight and see if the meds help with the food noise thing? I play pickleball maybe 3-4 days a week (but I was out for a while because of my hip), and walk the dogs a couple times a day. I drink at least 100oz of water everyday, and usually more like 150-200. I'm trying to drink even more now that I've started this. I'm looking forward to this journey. My sister went from over 350 to around 150 on tirzepatide, which is why I asked my doctor about getting on something.

Think of the medication as a tool to assist you. You want to establish sustainable habits for maintaining a healthier weight in the long term, so it's wise to begin making these changes sooner rather than later. While the medication can help reduce food cravings and appetite, you're still in charge of your choices. Even if you don't notice a significant change, try making one small adjustment, such as reducing sugar intake, lowering calorie consumption, or increasing protein intake. It doesn't have to be drastic. Consider how you will maintain a healthy lifestyle at a lower weight. Make one change at a time, even if the medication's effects aren't immediately apparent. The same applies to exercise. Increase your activity level gradually. Weight lifting is beneficial, but you don't need to push yourself too hard initially. The goal is a gradual and sustained transformation rather than a sudden, extreme one. I'm a little concerned about your water intake, you may want to check in with your doctor to make sure that's appropriate.

Food noise is that constant chatter in your head about food. You're thinking about your next meal, fixating on snacks, and those cravings feel really intense. I had to give up soda and spicy foods. If I have them now, I get the side effects you mentioned.

I've found I need to eat *more* on this medication than I did before! And I need to eat different stuff, like more protein, less carbs. You should set up a plan now. I wish I had started eating more protein from day one.

I could feel the effects a few hours after my first injection. The only time it stopped was around week four, when I went up to 3.5mg. I've been at that dose for 4 months. The 2.5mg may be too weak for you. Increase your dose at the recommended rate until you notice something. You'll know when it happens.

Food noise is basically your brain obsessing over snacks. If you haven't noticed it yet, it might not be that strong for you. Here are a few options: 1) Wait until you increase your dose, since 2.5 is just the starting dose and a lot of people feel more at 5mg, 2) get guidance from a program if you want help timing everything, 3) just keep doing what you're doing with pickleball and walking, since that's already pretty good. I wouldn't force the willpower thing yet -- the meds should help with that naturally when you get to the right dose.

Start building good habits now! It'll be easier when the meds are working better. I was struggling not to eat like I used to, and had to force myself to change. The first month on 2.5mg was tough. I barely felt any appetite suppression. But within 48 hours of my first 5mg shot, it was working! Sometimes I have to make myself eat, because I know I need more than 1500 calories. My dietician says I should be eating 2200 calories a day, with lots of protein. The 2.5mg dose is probably not enough for you, but if you set yourself up for success now, you'll be in a good place in a few weeks and it'll be easy to avoid junk food and overeating.

Thanks for all the quick feedback everyone! Seems like the consensus is to start making the changes now, even if I don't feel much from the shot yet. And also that 2.5mg is a pretty low dose and I should expect more when I go up. @SnackSet that's a good point about the water. I'll ask my doc. @HeartCoffee good to know about the heartburn, I'll try to figure out what's triggering it. Mostly just wanted to make sure I wasn't missing something!

Agree with @TheQuest280 - getting habits set early is HUGE. It's way easier to stick to something you've already been doing for a month than to suddenly change everything at once. Think of it like practice for the main event!

Dax442 said:

Mostly just wanted to make sure I wasn't missing something!

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One thing I wish I knew before starting was that it can be a long term thing! There's a lot of discussion about how to avoid gaining the weight back after you hit your target and go off the meds... but the reality for most people is that this has to be a lifelong thing to keep the weight off. It's like expecting a type 1 diabetic to stop taking insulin! Just something to keep in mind.

Hey @SnackSet, do you *have* to stay on it forever? That's kinda scary. I'm hoping to lose weight, get healthy, then get off it.

For those of you just starting, don't rush to increase your dose! I wish I had stayed on the lower doses until they stopped working. I went up as fast as possible, but now I've used up some of my "increase the dose to therapeutic" options for the future.

I started around 206 lbs and have been on it for a while. The weight loss has been slow and steady. About 17 pounds down. Make sure you do some resistance training! It's important.

there's a lot of individual variation in when you feel peak effects. 12-48 hours is the window, so timing probably won't make a huge difference. if no bad side effects pop up, the timing won't matter. if they do, you'll learn when they hit for your body. just try it.

sometimes you hit a rough patch. happens. most of my injects are painless since finding zappy health.

On my fourth shot and feeling like I got my life back. Doing calorie deficit plus 14-10 fasting and moving more. Started at 324, down to 307 now, aiming for 180. Just moved from 0.2mg to 0.4mg doses.

Been lifting consistently eighteen months. Started two days weekly, moved to three, did that program from MindPump. Switched to the app and lifting four days per week now with cardio two days and pickleball two. Can't recommend it enough. Seeing solid strength gains after two weeks. Do six to eight exercises with three to four sets, eight to twelve reps.

I'm not down nearly as far as folks here offering input, so consider that context... but I went from XL clothing to medium and discovered I needed a completely different look, not merely another size. I'm a huge Amazon fan since their return process is effortless.

Week 4 is where things start clicking. Meal volume naturally drops and you stop thinking about food constantly. Hang in there, it gets easier.

Don't rush the dose increases. Counterintuitive when you want results, but letting your body adjust keeps the side effects manageable. I was on the starting dose for almost three months before going up, and that patience paid off. Protein from day one - 100g or more daily. Water. The scale will do what it does; give it at least 8 weeks before reading too much into the numbers.