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c/tirzepatide·posted 3 days ago by u/dose_creep_dan· stickied

going up faster doesn’t get you there faster, it just gets you sicker faster

Titration Long Haul ×7 Slow Clap ×3

Learned this one the expensive way. Went up because the scale stalled, not because I actually needed to, and all I bought myself was two rough weeks and no extra loss to show for it.

Writing it up because I see the same impulse in this sub weekly: scale stalls, person assumes it's a dose problem, person goes up early, person gets sick, scale still stalls for another two weeks anyway because stalls are usually noise, not a dose signal.

1,161 up / 246 down83% upvoted50 commentsid f0rli127 Jul 2026

50 comments

15 in this archive, depth 5

best — the order this archive was captured in

u/plateau_patrol167 points·3 days ago

your plateau was four weeks old when you jumped. that's not a plateau, that's a Tuesday. this happens constantly.

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u/dose_creep_danOP82 points·3 days ago

yeah in hindsight four weeks of flat scale is nothing, I panicked

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u/graph_it_gary51 points·2 days ago

the scale is noisy day to day, water/sodium/hormones/everything. a 7-day rolling average is the only line worth reacting to and four weeks of that flat is a genuinely different signal than four weeks of raw numbers flat.

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u/spreadsheet_gremlindata38 points·2 days ago

this. raw daily weight has like a 1-2kg noise band for a lot of people, a monthly "stall" can be entirely inside that band

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u/dose_creep_danOP24 points·1 days ago

going back and rolling-averaging my own data now, mildly annoyed at past me

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u/incretin_ivypharmacology121 points·2 days ago

pharmacologically this tracks. GI side effects scale pretty directly with how fast the dose ramps, not just the dose itself — SURPASS-2 and the tirz dose-finding work both show discontinuation clustering around escalation steps, not around any particular absolute dose.

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u/receptor_bias_rick47 points·2 days ago

right, it's a rate-of-change problem more than a magnitude problem for most people's GI tolerance

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u/micro_bump_mick58 points·3 days ago

doing the arithmetic on why this feels so bad: going from 2.5mg to 5mg is a 100% jump in one step. going 2.5 → 3.75 → 5 with an extra rung is two ~50% jumps instead of one 100% jump. same destination, half the shock per step, that's the whole rationale for the smaller bumps.

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u/units_not_mgsyringe math33 points·3 days ago

good way to put it in numbers instead of vibes, saving this explanation

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u/week_four_wall44 points·2 days ago·edited

lived this exact arc, dose up, three bad days, stall continued for another 9 days regardless, then broke on its own. the dose change bought me nothing but nausea. edit: checked my log, it was 9 days not "about a week" like I first said.

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u/downvote_magnet-19 points·2 days ago

this is survivorship bias, plenty of people go up and it does resolve the stall, you're just assuming correlation was never causation for anyone

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u/plateau_patrol62 points·2 days ago

nobody said never. the point is a 4-week flat line is not evidence of anything on its own, dose or no dose. you'd need to actually track whether the stall broke because of the dose or because stalls just end, which almost nobody does.

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u/downvote_magnet21 points·2 days ago

ok that's a fairer version of the argument than the one I was reacting to, retracting some of that

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[removed]0 points·3 days ago

[removed by moderator]

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u/gastric_emptying_g29 points·3 days ago

delayed gastric emptying is most of the GI story here and it's also dose-and-rate dependent, so "go slower" is doing real pharmacological work, not just psychological comfort

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Tirzepatide-specific discussion: the dual-agonist pharmacology, the 2.5 → 15mg ladder, the appetite profile people describe as different from semaglutide, and the SURMOUNT/SURPASS trial programme. Comparisons with semaglutide are welcome as long as they are specific about dose equivalence being unknown.

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