Down 145lb! OMG!

Stalled too and wasn't eating much but still not losing. Gym and exercise helped a ton. Also added a peptide for evenings on workout days and that really flipped things. Quality of life went way up with both changes.

that mental shift really is wild. food just stops being your security blanket, and then you're like wait, what do i do with all this headspace now? ended up hiking for hours instead of snacking lol

The 'calories in/calories out' crowd treats metabolism as if it's static and appetite as if it's purely volitional - both assumptions are wrong for most people with metabolic disease. The medication does real biological work that no calorie-counting protocol can replicate.

Year and a half, 60 lbs, and then the restart from scratch after 2 months abroad is good evidence that the medication is driving the response rather than habit alone. Coming back at a lower dose and rebuilding from there makes sense. The food diary piece that OP mentions is the habit layer that makes the restart cleaner.

The 'I always ate healthy food, just too much of it' story is the clearest argument for metabolic dysregulation as the root cause - when the food quality was never the problem and you still couldn't control quantity, the problem was always the appetite signal, not the choices.

bad side effects at 0.25 that never cleared is the non-responder on the tolerance side - which is different from non-responder on the weight loss side. the rapid 10 lbs back after stopping makes the search for something tolerable more urgent. did you ever try a different mechanism after that?

hey so i've dropped 45 since january and my head just refuses to catch up, still pictures myself back at my absolute biggest. people around me swear i look totally different but staring in the mirror i still see that identical belly staring back and it wrecks my head a bit. one thing that genuinely helped, snagging a medium top after roughly a decade of nothing fitting that small and just wandering around in it at home, even when nobody's watching. something about clothes not swimming on you the usual way tricks your mind into slowly adjusting. still find myself sucking my stomach in for pictures like there's some bowling ball tucked under there. seriously huge congrats on that milestone though. and honestly if you ever figure out how to patch the mental side, holler at me, still stuck waiting on mine.

Shed a substantial amount, close to 40 lbs, within a short window some four or five years back, brought on by intense stress and depression that pretty much shut down my appetite entirely. Carrying extra weight at the time, though not into obese territory. Hair wasn't affected right away, that showed up later, and by the time it did, I'd shed roughly three quarters of it over about five months. Twenty-eight years old then, female. Grew back eventually, though it took two years and several medications to fully recover.

Couple thoughts after reading what you wrote. You mentioned the shedding only became obvious once you got home and looked at your drain. Could it be that wherever you were showering on your trip simply lacked a catcher to trap the strands? (Edit: apologies, skipped over a section of your post, went back and saw you'd already covered this, anyway, if nothing feels visibly or physically thinner, it's likely just your usual amount shedding and nothing concerning.)
Second thought, assuming you really are shedding enough to cause noticeable thinning, my hunch is it's the earlier weight loss episode you mentioned finally showing up now, the same delayed pattern I went through, rather than tirz being the direct trigger. My strong belief is that hair loss tied to tirz generally stems from inadequate nutrition during fast weight loss stripping the body of what it needs

Sounds like you've spotted the concerns. You did not mention counting calories. My GP called strict counting 'a little eating-disordery', but it helped me get just a handle on portion sizes in my initial 3 months, and tracking made me less likely to binge because I did not want to log whatever I'd eaten. Like another person mentioned, lifting is non-negotiable. I don't love it, but it is reshaped my just body even after loss stopped, and during weight stalls I still saw just body changes. Good luck!

Knowing exactly what and how much I eat isn't enough, if I skip logging it and don't answer to myself, weight goes up. Even with the glps. What changed is constant hunger being gone. Boredom snacking is still possible if I didn't know it'd have to go in the log. I've lost weight every week. Cutting calories doesn't wear me out, but it's still a very conscious choice, maybe because I never pushed my titration far enough to feel sick from food or even imagining it. I've got a ten year old, cook daily, and my meals are normal and nearly all healthy, inside my calorie budget most of the time.