Food noise is back - help!

The food noise returning after stopping is one of the clearest signals of what the medication was actually doing - it's very common to underestimate how loud it was until it comes back. The 10lb regain in that window is also typical. The relief of being back in control is real, and the 0.25mg plateau question is worth addressing because the effective dose window is individual - some people need to keep titrating past what feels like enough.

Coming off shows how much it was doing - noise comes back fast for most. Restarting usually gets you back within a month.

The suppression returning on the 0.25 bump after a strong first month is a common pattern - some people find 0.2 is the actual effective dose for them and the jump isn't needed. Staying where noise is controlled rather than chasing a higher number tends to give better long-term outcomes.

A year before trying GasX is such a relatable timeline for figuring out the simple fixes. Gas and bloating clearing up while nausea stays is exactly how people describe the pattern. Most common toolkit addition by the time they figure it out.

The smidge of Sema add-back when food noise creeps up on Tirz is actually a move a lot of people settle into. The 72-week plateau data is one of the most cited things on here and it's worth knowing going in. What that looks like for any individual varies a lot though - some people hit it earlier and some haven't seen it at 2 years.