57 and 70+ lbs lighter!

hanging at 7.5. no side effects even going up in dose makes me wonder if it's working. i hate diarrhea but when i got it, i knew something was happening. gotta be more patient. expected steady loss, got stuck 2 weeks, that threw me off.

The percentages-over-pounds tracking is the right mental model for the long run - absolute pounds per week shrinks as bodyweight drops, but percentage loss stays relatively steady if the protocol holds. Starting at 222 in Sept 2023 and still going at 57 is the compounded return on the early decision to start.

55 lbs naturally before starting and then adding the medication from 385 is a very different starting advantage than most people have. At 2mg with diet and exercise already solid, the medication is filling in the appetite piece that was harder to maintain alone. How is the rate holding up and is there room to go higher if it plateaus?

The 7-hour eating window with protein front-loaded at meal one is a solid structure for maintaining muscle while the medication is suppressing appetite - the shake plus bar at 11 gives you a meaningful protein hit before the window opens for real food, and the 3-hour post-pin fasting window builds in the timing automatically. The two-snack structure within that window keeps the protein spread over the afternoon rather than loading it all into two large meals.

11 weeks at 2mg with results slowing and appetite control loosening is exactly when the 4mg bump makes sense. The 'not able to pass on the pizza' signal is more useful than the scale for knowing a dose adjustment is needed. How quickly has the suppression picked back up since moving to 4mg?

The 150g butter daily as the primary energy source on very low carb is an extreme but internally consistent keto approach - at that fat intake, hepatic ketogenesis is substantial enough to suppress hunger through the ketone signaling pathway rather than just through caloric reduction. The hunger elimination this produces is real, though the long-term cardiovascular profile of that fat ratio is worth monitoring with a prescribing physician.

the gradual ramp from 2mg to 12mg over that period is actually a useful titration map for someone starting at 222 and working toward a meaningful goal. the vial math driving the dose steps rather than a clinical protocol is something most people end up doing in practice. how is 12mg sitting compared to the previous levels on the side effect side?

Kicked off at 0.5 and have bumped the dose up by 0.5 every couple weeks; currently sitting at 2.5 and down 9 kg (19.8 lbs) so far.
Planning to stop increasing soon and settle on a maintenance amount that keeps me out of the fridge at odd hours.

Eased into this gradually, took 1 mg weekly for a full month, then moved to 2 mg weekly for another month. Three days later I did another shot at that same amount and by the next morning finally understood what everyone kept talking about! Didn't drop much weight those opening two months though, just 8 pounds overall, but month three, once I switched to twice-weekly 2 mg shots, things really picked up, 10 pounds gone that month alone! Currently sitting at 2.5 mg twice weekly and don't expect needing to climb further anytime soon. Did experience that prickly sensation, restricted to the inner part of my arms near the elbow. Also had one instance where my mouth's upper surface felt scalded sipping a protein yogurt drink, lol, effects seem to hit roughly a day after each shot, ease off by day three, then it's time to redose.
Weight at the outset: 222
Peak weight: 228
Weight now: 196.8
Goal: under 150 pounds or below 25% body fat

Just adding my thoughts here: you started at a fairly high weight, close to mine. Those initial 30 kilos came off quickly during the early months, even at low doses. Matches my own experience, loved how effective 3.75 was! Sounds like it's time to bump the dose, log calories daily, keep an eye on protein intake, and get into weight training to jolt your body out of what seems like a sluggish phase and back into active fat burning.

Never went past 2.5 because of how it affected me, I'd genuinely struggle to reach 800 calories some days. Just focus on getting protein in before anything else. Being vegetarian made that even tougher for me. Snacking on nuts, Greek yogurt, and strawberries throughout the day helped a lot. Smaller, more frequent meals beat three big ones for me. If you own a blender, a morning smoothie is an easy win, Greek yogurt, protein powder, berries, and a greens powder actually pack in a surprising amount, and drinking something is always easier to force down than eating when you're not hungry. Dropped 24lbs in the first 24 days, then it slowed considerably. Stayed on it five months total, lost 3.5 stone overall, then got pregnant after six years of trying. Didn't lose any hair, though I had a whole regimen of supplements going at the time.
Edit to add, my prescription is still written for the 5mg pen, and I just count clicks to pull out 2.5, easy enough and it cuts the cost dramatically!