lowest effective dose — 2 things I got wrong before I got it right
The title is the argument: lowest effective dose — 2 things I got wrong before I got it right. Here is the rest of it. Stretched from seven to ten days and then to twelve over about four months. Appetite told me where the limit was before the scale did. Been at maintenance for 17 months on 12.5mg. Nothing happens.…
Chased the last three kilos with a dose increase and got a fortnight of reflux and no change in the number.
Standing reminder that regain after stopping is a documented pharmacological outcome, and posts framing it as a moral failure get edited.
Small fix — you have described interval stretching and called it a dose reduction. The exposure profiles differ.
Appetite returning before the scale moves follows from the mechanism: the appetite effect is the proximal one and weight is the lagging integrated outcome.
Withdrawal studies in this class consistently show substantial regain after discontinuation. That is a pharmacological finding about a chronic condition, not a statement about anyone’s discipline.
Body weight varies by a couple of kilos over days in stable people through fluid, glycogen and gut content. A range is not a trend.
find the dose that holds, then stop optimising
Did you decide what maintenance would look like before you got here?
That reads like a taper schedule and this board cannot hand those out.
Weigh monthly now. Best change I made in the whole run and it cost nothing.
Maintenance is the phase with the least published guidance and the most individual variation, which is precisely why board consensus here is worth less than usual.
Maintenance is the phase with the least published guidance and the most individual variation, which is precisely why board consensus here is worth les
nikhil_lindqvist is right that stretching and reducing are different levers. Worth separating in every one of these threads.