1+ year stall on max dose: ideas?

For me personally, max dose gets limited by how much I can tolerate side-effect wise. Might be above or under the official trial max.
 
A year at max dose with 8 lbs remaining is set point defense - the body holds harder the closer to baseline. Options are a caloric adjustment, adding Reta's glucagon component, or extending the timeline rather than escalating.
 
first dose is brutal when your body's adjusting. hang in there, it's worth it. one tip: take your shot in the evening so you can sleep through the worst side effects. hydrate the day before, day of, and day after too.
 
on 2.5 first week and the appetite bounce came back around day 6, needed to eat a little more to stay full. normal move at the lowest dose. probably happens again at the higher steps. might prep some good snacks for end of week when it wears thin.
 
Ask your doctor to drop the dose to something you can actually tolerate. Maybe use other diabetes meds if needed. GI side effects were ongoing for me the first 2 years - psyllium helped slowly for loose stools but add it gradually. Pepto or Immodium when it's bad. Try to find a dietitian who knows GLP-1.
 
Grey market has real risk. Only way to know is get it tested or notice effects. I researched here first, looked for no controversial stuff and good reviews — but how do I know they labeled it right? Give it a month.
 
Exploring surgery after 6-7 years at max dose makes sense - conservative options are fully exhausted at that point. Worth getting a specialist opinion on what the specific pattern responds to.
 
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