This is exactly the approach I took with that particular medication. Anyone doing one meal a day should just make sure protein and hydration stay solid.
Currently at half a milligram of tirz, bumping up every four weeks. Just did shot number six this past Wednesday. Picked tirz specifically for the strongest possible appetite control. Started at 386, sitting at 360 right now, 6'2" and 55. Long way left to reach my target of 215, so wanted as much hunger suppression as I could get.