I think the main decision I need to make at this stage is how quickly to increase the dose.
I've mentioned this a few times, but when I was on Ozempic, I increased the dose every month as recommended and ultimately couldn't tolerate the side effects. The appetite suppression wasn't good either. My own capacity to make lifestyle changes wasn't really there at the time, but some of the side effects I experienced were:
Extreme fatigue
Constipation and diarrhoea
Eggy burps
Blurred vision, poor memory and mood swings
Very frequent periods, sometimes just a few weeks apart
I honestly felt like I was constantly either drained, PMSing or having period. I only averaged around 1 kg weight loss per month over six months, so I eventually stopped.
I also need to be realistic about calorie intake. Reducing my daily intake by another 200 calories would only give me an additional 2.4 kg loss over three months, and it would significantly increase the likelihood of fatigue. I only managed three weeks at that level right at the beginning, before I had already months of calorie deficit behind me.
I've skipped one period recently, and the other came a little earlier than expected, so I think taking things slowly will also give me a chance to see how my cycle settles.
I have only experienced some minor eggy burps over the last few weeks, since I increased to dose over 4 (50 clicks of 5 pen) which I can manage.
On the pro increase quicker side, I do have to rely on a lot more willpower now, however I still have no food noise. It would be nice to get that little boost again for the first few weeks, which I seem to experience every time I increase the dose but is it worth it?
One thing that is also in my favour is that, at least until the end of the year, I have considerably more flexibility at work. I can work from home much more often and I also have some time off planned. That means my capacity to manage changes, monitor how I feel and deal with any potential side effects is actually quite good at the moment. So, while I don't want to rush things, I do have a bit more room to navigate a dose adjustment if needed.
Ultimately, my gut feeling is to take it slowly. It would be devastating to go through the same side effects I experienced on Ozempic again and feel forced into making choices I don't want to make just to manage them. I prefer slow down and using more willpower but feeling little more certain. If it wasn't for the past history I probably would be going up quicker.
I'm not particularly keen on reducing my calorie intake much further, especially when I'm currently eating at a level that I don't find excessively difficult to maintain and my energy is like someone who has sustain calorie deficit, but manageable.
Long post, but I am sharing as I feel others could have similar internal debates.