Gaining back weight on sema/triz?

Stalling before reaching 6mg and weight holding flat while knowing calories should be tracked more closely is the version of the plateau where the behavioral piece is the lever. 185 to 169 and holding is not a regain situation yet - it's a 'how do I keep the momentum going' situation. Tracking for even two weeks tends to show exactly where the intake is landing relative to where it needs to be.

Titrating up on sema before switching to tirz is worth trying if you are not at the max dose yet. The regain pattern often reflects a dose that stopped working rather than the medication failing completely. The eating habits question matters - what has changed in the tracking since the early months when the loss was happening?

23 lbs in 3 weeks is on the high end but the water and inflammation explanation is actually the most likely factor for people who started with insulin resistance. 185 to 169 in the OP's timeframe is real movement. The question about gaining back is usually about whether the dose is still active or whether something changed in the diet side - how does the appetite suppression feel now compared to early on?