Zepbound Dosage Increase – 2.5 mg to 3.5 mg

So here’s something I learned about GLP-1 medications about a month ago that I wish I had known sooner: appetite suppression is apparently a side effect (vs an intended result of taking it), and it wears off, typically within 6 months of starting a dosage level.

At least that explains why just before Thanksgiving (right at the 6 month mark since Memorial Day), I was suddenly STARVING all of the time. I hadn’t changed what I was eating or drinking, and the food noise was still under control, but I was getting hungry within a couple of hours of eating. And this wasn’t just mental “boredom hunger” or “emotional eating.” It was physical hunger; as in, my stomach was growling loudly enough for my husband to hear it from several feet away.

I really didn’t want to try going up in strength again from 2.5 mg to 5 mg after losing my sense of taste the last time we tried that. I *especially* didn’t want to mess with it right before Christmas! But the thought of going into the holiday season with this level of uncontrolled hunger was also scary. I had the idea of perhaps using the vials that are now available directly from Lilly and using partial doses out of them, and my doctor thought it was a good idea to try. Yes, they are not cheap, but they are cheaper than the pens, and spread out over several months (vs 4 weeks), the cost isn’t too bad, since I’m using them as a supplement to the pens I get via my insurance company. Yes, it’s two injections instead of 1, but I don’t find them to be a big deal. (Advantages of growing up with a nurse for a mom; I’m much less bothered by medical things – including needles and blood – than most people. Plus I’m using a 31G needle, which I can barely feel during the injection.)

So right now, I’m taking a 2.5 mg pen, plus an additional 1 mg from a vial, for a total of 3.5 mg. I just took my third dose at that strength this week, and it has helped tremendously! I feel like I’m back in control again, not watching the clock waiting to be able to eat again. Plus, since we’re moving up slowly, I can hopefully “sneak up” to 5 mg over time without my body taking offense to the increase and keep my sense of smell and taste along the way. So far, no issues there. Whew!!

I am so grateful that Lilly offers the vials, and that we are in the position to afford them to supplement my Zepbound usage in a way that is very effective for me. (I realize not everyone is so fortunate.) I really hope I can get several more months out of this 3.5 dosage before moving up again, though I expect to be at 5 mg (if not higher) by the end of 2025. Hopefully, I’ll be pretty close to my goal by then and can be considering what approach to take with maintenance. And it blows my mind that I can even type that sentence! A year ago, I genuinely never thought I would be under 300 lbs ever again, much less approaching 250. That’s still 100+ pounds from where I want to be, but it’s also 1/3 of the journey. 50+ lbs in 7 months. Never in my wildest dreams did I think that was possible. I know this rate of loss will slow as I continue to lose. I know my body will resist more and more as I get smaller and smaller. But every pound is a step in the right direction.

This all assumes, of course, that my insurance will continue to cover this medication. Many people in the Zepbound Facebook group I belong to are getting letters from their insurance companies saying that weight loss medication of any kind (injectables, pills, none of them) will not be covered in 2025. At all. For anyone. For any reason. And some companies are including bariatric surgery in that as well. I have not yet received a letter of that type, but my prior authorization expires in late January 2025, and there is always the possibility they will not renew it. If that happens, I don’t know that we can afford the $600-$1200 per month out of pocket. I’m trying not to fret about it, since worrying won’t change anything, but it’s hard. I hate to think I have come this far with something that works so well, and that might be taken away from me. So please cross your fingers and toes for me that I am allowed to continue on this journey with this amazing medication that is helping me so much!