Go up a dose ?

[PolyVagalNerve]

Hey, really need your thoughts -
I have been on 2.5 for 5 1/2 weeks
I’ve lost 8kgs - down from 80kgs / BMI 30
the drop in inflammation / brain clarity was almost instant - very pleasant surprise
medexpress offering 5mg from 2nd pen -
im half way through 2nd pen of 2.5
no weight loss for just over a week -
eating around a 1k cals daily
exercise light
just added in weights as starting to see the sag abit - I’m mid 50’s ..
do I need to go up dose for next pen - or wait another month ??
thanks

The standard plan is to go up a dose each month

Yes, but I can’t work out if that is business model driven or clinical evidence based ?

The suggested dosing schedule is based on the clinical research which showed that statistically significant weight loss was achieved at 5mg, 10mg and 15mg with the amount lost being higher at each level. In the trials participants were moved up after 4 doses until they reached a level they couldn't tolerate and then were dropped back down to 5/10/15mg to continue on that for the rest of the trial. So, the suggested dosing schedule is what gets you to one of those doses the quickest, so that you will lose a significant amount of weight.

But of course what was best on average in the trials might not suit each individual, which is why it's a suggested schedule not a compulsory one. There is no "have to", it's what suits you.

If you are losing weight, not experiencing difficult side effects, and still having noticeable effects (feeling fuller longer, feeling full on smaller amounts etc) then I would stay on the same dose. If you are not losing weight for several weeks, and you are not getting the noticeable effects then you could move up a dose.

In your case, I think it's too early to say that you are not losing weight as it's only been 1 week, so I don't think it's clear cut that you need to move up.

@SilenceInside - thanks for taking the trouble for such a comprehensive reply 👍

If you are only managing 1000 calories a day there is no way you should be moving up. You are barely eating enough as it is.

I'm 15 weeks in on 2.5 mg and the general advice these days is stay on the lowest dose for as long as you can. If you're struggling to eat more than 1000 calories then I'd be staying put. If it's working in terms of weight loss each week then that's another consideration.

Going up will not increase weight loss but it may increase suppression that leads to not being able to eat much.

Hope this helps