Sema just not cutting it?

BugMom253

BugMom253

Active member
Okay, so I've been using sema for a while now, and I've managed to drop around 28 pounds. But honestly, it didn't really kick in until I hit 1.7mg. I know that's pretty normal. You really feel it at the higher doses. The thing is, that feeling of fullness and not constantly thinking about food only lasts a day, maybe two. It’s always been like this, it hasn't just stopped working recently. I've got some ideas, but I'm curious to hear what you all think:
1) Increase the dose again?
2) Add cagrilintide?
3) Split the dose (but the lower doses didn't do anything, so I don't see the point of splitting it)?
4) Or... has anyone gone HIGHER than the max recommended dose of 2.4mg?
 
Assuming you're handling it okay, maybe try 1.2mg twice a week? Give it like, a month to build up in your system? I don't think tirz or reta are as good for dealing with food noise as sema (because of sema's higher GLP-1 receptor affinity). If that doesn't work after a month, then maybe add cagri?
 
If I'm unsure, I usually lean towards increasing the dose, sometimes even after just a week. But in your situation, it seems like the obvious choice, unless you're experiencing bad side effects or still losing a pound or two per week. And, of course, tirzepatide is always there waiting, haha.

Regarding doses higher than 2.4mg of semaglutide:

thepharmaletter, Semaglutide 7.2mg achieved 20.7% weight loss in STEP UP obesity trial (Jan. 17, 2025)

Personally, I've only used tirzepatide so far, but I have semaglutide and retatrutide on the way, mainly to have them on hand. Cagrilintide does seem to stack well with other things, but I haven't felt the need for it yet.
 
I've been on sema for a few years. I don't get the same fullness or reduced food cravings as I did when I started, and I've seen lots of posts in maintenance forums that say hunger eventually comes back. Remember that suppressing appetite isn't the only way these meds work.

It's being tested in trials at doses up to 7.2mg. Is sema the only thing you're taking? I'd try maxing out on one before adding another. Splitting the dose might help. Maybe add cagri, since that's supposed to be just for appetite.
 
I can totally relate. I didn’t feel a thing until I hit 1.7mg. It was like my body just ignored the lower doses. I’m at 2.0mg now, and the appetite suppression is there, but like you said, it barely lasts a day or two. Then it’s back to normal cravings and food noise. It's super frustrating.
 
I've heard that some people feel cold all the time after starting sema. Is that a thing? I'm thinking about starting, but I already get cold easily.
 
Charlie1989 said:
I've heard that some people feel cold all the time after starting sema. Is that a thing? I'm thinking about starting, but I already get cold easily.
Click to expand...

Yes, being cold all the time is a super common side effect. It could be the meds, the calorie deficit, or just losing some insulation... possibly all of the above!
 
Thanks for the input, everyone! I think I'll try splitting the dose first, and if that doesn't work, I'll talk to my doctor about going higher than 2.4mg. I'm not losing a ton of weight right now, so I'm not happy with where I'm at. I appreciate the link Dakota1976!
 
I didn't get cold when I was on sema, but I DO get all the other nasty side effects. Nausea, vomiting, the works. I'm just saying, don't ignore those if you get them, Charlie1989. Some people can't tolerate it.
 
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