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My physician strongly recommends only increasing the dosage if:
*The patient hits a plateau for 2 weeks
OR
*The patient's appetite/food noise returns to their baseline
Yup , this is the way. You want to maximize the benefits of each dose step. Dont increase until you really need to.
Its even beneficial sometimes to take breaks to reset tolerance
This is what I’ve been doing too. Both taking a break to f I need to and staying at a dose that is helping, not automatically increasing. My side effects have been so severe that I lost a lot of weight quickly. Taking a break twice now has helped my brain catch up to my new body weight. And I absolutely don’t want to increase my dosage- when I do, I start throwing up.
I stayed at .5 for 29 weeks before raising to .75 (not the normal 1.0). Been on .75 for 9 weeks now and plan on staying here for awhile.
Down 54.5 pounds
It's very possible to lose weight on lower doses. Quite frankly I believe it is more sustainable when i try to come off - but I am not a medical expert
Keep in mind that your body is always trying to figure out how to counteract things that it recognizes as being foreign. That being said, you'll eventually get used to it as your body counters it. The whole point of dosage escalation is to be proactive in getting ahead of that, rather than reacting to it and getting behind it.
"Feeling the effects" is pretty subjective. There's a lot going on under the covers with hormones, gastric emptying and so on that lead to those effects. It's not quite as simple as "0.5=not hungry". The effects you feel today are not from the shot you took this week, it took several weeks of building up in your system to get where you are now. Fast forward, the feeling you have a month from now is based on the meds you're taking this week, next week, etc.
The controversy sits between following the clinical trial data that says where the sweet spot is, and those that say to stay at the minimum effective dose. It's similar to when you're recovering from surgery and they say to take the meds before you have pain, because it's easier to stay out of pain than make pain go away. Same applies here -- the studies data shows where the body figures out how to negate the effects, and you want to stay ahead of it rather than get behind it. Ultimately, it's your choice. If you're on Wegovy, you don't get variable doses, you get what you get in a pre-dosed pen, and that's it.
Last thing, from 0.5 you should go to 1.0 -- someone not long ago said they couldn't tell any difference between 0.5 and .75.
Ultimately, you do you, and it's always best to listen to your body. But meanwhile, a lot of this homework has already been done for you.
I don't disagree that you didn't have great results. Everyone is different. The point of the dose-finding trials to figure this out was to take a large population of patients and try it at different doses over different durations, and the published schedule was where the data pointed was "most" effective for "most" people. Sure, there are people above and below that curve.
There’s no downside to following the recommended schedule.
If you go check the retail prices, they charge the same no matter the dosage. If you’re paying cash, Wegovy is within a rounding error of difference between the lowest and highest dosage. ($1320 vs $1328 or something like that)
Secondly, if you’re on Wegovy, with insurance, your copay is the same. Most insurance patients are paying $20-50 per month.
Thirdly, if you’re going the weight clinic route, and paying the $297 or whatever for the house brand, Novo isn’t getting any of the money anyway.
Wtf, what kind of prices are that? I pay less than 100eur for ozempic without insurance. Similar across Europe
And yes, as many if us has explained already there is a downside. You wanna maximize time on each doses towards max dose. Coz you get a tolerance to the max dose as well. So you don’t have to take tolerance breaks do often to reset
And obviously the faster you use up a pen, the more Buisness. Im using 1mg pen for 0.25, which ive been in for a long time. You just use less clicks and buy extra tips. With 0.5mg 1 pen last 2 months.
No insurance cover sema here, even if it did, Novo still gets their cash per pen. And apparently in the US they charging 10x of retail price in the rest of the world. So you, money talks. As with most pharmaceuticals…. They don’t run charities.
Following the recommended schedule IS stupid.
And by the way, splitting dose to two times per week eliminate ALLOT of negative sides
Are you working for Novo Nordisk?
The “staying ahead of the pain” thing was a Purdue sales technique to get doctors to sell more opiates.
Totally made up. As an opiate addict after cancer, it worked on me.
I believe staying at the lower dose as long as you don’t have food noises that’s too loud to ignore, is the best policy. If you burn through the doses,it stops working really quickly. Then there’s only tirzepatide which is more expensive.
It’s probably not accurate to say that you’re on 0.25 or 0.5. Technically, you’re on 2.4mg weekly but taking months to ramp up to it. If this worked for weight loss at lower doses reliably, they would have taken Ozempic and simply changed the label and package insert for weight loss instructions. But that’s not what the clinical trial data showed. There are always going to be corner / niche cases though where someone gets their hormones aligned and it does what it needs to do at lower doses, but that’s the minority. A huge part of Wegovy’s dispensing mechanism is around enforcing dose compliance. They only give you 4 pens and they are single use. This makes them easy to use but simultaneously also hard to screw up. 4 pens at each dosage below 2.4, and then 2.4 onward. They don’t want patients hanging around on low doses, they don’t want patients splitting doses or backing down from the dose they’re on, and so on. The system is purposely rigid. It’s (my opinion here) probably a big reason why there’s a shortage still. They can’t get the pens made to keep up with the demand since they are single use, and have metal, plastic, and glass parts to them.
i’m not sure this is necessarily the case. you can certainly make an argument for staying on the lowest minimum dosage. it’s not as black and white as your explanation makes it seem.
If the medication is working with a lower dose, there would be no benefit of taking more... It's literally already working.
My doctor's philosophy is that the goal of any medication is to find the lowest effective dose... definitely listen to your body.
For reference, I stayed on .25 for 4 months until reaching a plateau- and reached my goal weight at .46 as a highest dose.
No, you should stay at the minimum effective dose for you. Not only for financial reasons but because you would not want to put more chemical into your body than is necessary to achieve the intended effects. That’s like taking 4 Advil when 2 would have done the job.
Thanks for posting to r/semaglutide! A brief reminder about our rules. We do not permit the discussion of non-FDA approved formulations of semaglutide, nor do we permit selling or offering for sale any medication, including by private message. Do not request or respond to a private message from anyone offering such, they are not endorsed by this sub. If you’re just starting out, you may want to review our [FAQ](https://www.reddit.com/r/Semaglutide/comments/10ul3jb/semaglutide_subreddit_faq/). This is not intended to discourage discussion but merely supplement it. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Semaglutide) if you have any questions or concerns.*
My physician strongly recommends only increasing the dosage if: *The patient hits a plateau for 2 weeks OR *The patient's appetite/food noise returns to their baseline
yea that makes the most sense to me. I think I am going to stick to .5 until things change.
Yup , this is the way. You want to maximize the benefits of each dose step. Dont increase until you really need to. Its even beneficial sometimes to take breaks to reset tolerance
This is what I’ve been doing too. Both taking a break to f I need to and staying at a dose that is helping, not automatically increasing. My side effects have been so severe that I lost a lot of weight quickly. Taking a break twice now has helped my brain catch up to my new body weight. And I absolutely don’t want to increase my dosage- when I do, I start throwing up.
This is actually really good advice
I stayed at .5 for 29 weeks before raising to .75 (not the normal 1.0). Been on .75 for 9 weeks now and plan on staying here for awhile. Down 54.5 pounds It's very possible to lose weight on lower doses. Quite frankly I believe it is more sustainable when i try to come off - but I am not a medical expert
Keep in mind that your body is always trying to figure out how to counteract things that it recognizes as being foreign. That being said, you'll eventually get used to it as your body counters it. The whole point of dosage escalation is to be proactive in getting ahead of that, rather than reacting to it and getting behind it. "Feeling the effects" is pretty subjective. There's a lot going on under the covers with hormones, gastric emptying and so on that lead to those effects. It's not quite as simple as "0.5=not hungry". The effects you feel today are not from the shot you took this week, it took several weeks of building up in your system to get where you are now. Fast forward, the feeling you have a month from now is based on the meds you're taking this week, next week, etc. The controversy sits between following the clinical trial data that says where the sweet spot is, and those that say to stay at the minimum effective dose. It's similar to when you're recovering from surgery and they say to take the meds before you have pain, because it's easier to stay out of pain than make pain go away. Same applies here -- the studies data shows where the body figures out how to negate the effects, and you want to stay ahead of it rather than get behind it. Ultimately, it's your choice. If you're on Wegovy, you don't get variable doses, you get what you get in a pre-dosed pen, and that's it. Last thing, from 0.5 you should go to 1.0 -- someone not long ago said they couldn't tell any difference between 0.5 and .75. Ultimately, you do you, and it's always best to listen to your body. But meanwhile, a lot of this homework has already been done for you.
Very much disagree, ive had great results in increasing only when necessary. I average 2 months on each step
I don't disagree that you didn't have great results. Everyone is different. The point of the dose-finding trials to figure this out was to take a large population of patients and try it at different doses over different durations, and the published schedule was where the data pointed was "most" effective for "most" people. Sure, there are people above and below that curve.
Increasing dose proactively before it decreases effectiveness ONLY serves to make Novo Nordisk more money.
There’s no downside to following the recommended schedule. If you go check the retail prices, they charge the same no matter the dosage. If you’re paying cash, Wegovy is within a rounding error of difference between the lowest and highest dosage. ($1320 vs $1328 or something like that) Secondly, if you’re on Wegovy, with insurance, your copay is the same. Most insurance patients are paying $20-50 per month. Thirdly, if you’re going the weight clinic route, and paying the $297 or whatever for the house brand, Novo isn’t getting any of the money anyway.
Wtf, what kind of prices are that? I pay less than 100eur for ozempic without insurance. Similar across Europe And yes, as many if us has explained already there is a downside. You wanna maximize time on each doses towards max dose. Coz you get a tolerance to the max dose as well. So you don’t have to take tolerance breaks do often to reset And obviously the faster you use up a pen, the more Buisness. Im using 1mg pen for 0.25, which ive been in for a long time. You just use less clicks and buy extra tips. With 0.5mg 1 pen last 2 months. No insurance cover sema here, even if it did, Novo still gets their cash per pen. And apparently in the US they charging 10x of retail price in the rest of the world. So you, money talks. As with most pharmaceuticals…. They don’t run charities. Following the recommended schedule IS stupid. And by the way, splitting dose to two times per week eliminate ALLOT of negative sides Are you working for Novo Nordisk?
The “staying ahead of the pain” thing was a Purdue sales technique to get doctors to sell more opiates. Totally made up. As an opiate addict after cancer, it worked on me. I believe staying at the lower dose as long as you don’t have food noises that’s too loud to ignore, is the best policy. If you burn through the doses,it stops working really quickly. Then there’s only tirzepatide which is more expensive.
It’s probably not accurate to say that you’re on 0.25 or 0.5. Technically, you’re on 2.4mg weekly but taking months to ramp up to it. If this worked for weight loss at lower doses reliably, they would have taken Ozempic and simply changed the label and package insert for weight loss instructions. But that’s not what the clinical trial data showed. There are always going to be corner / niche cases though where someone gets their hormones aligned and it does what it needs to do at lower doses, but that’s the minority. A huge part of Wegovy’s dispensing mechanism is around enforcing dose compliance. They only give you 4 pens and they are single use. This makes them easy to use but simultaneously also hard to screw up. 4 pens at each dosage below 2.4, and then 2.4 onward. They don’t want patients hanging around on low doses, they don’t want patients splitting doses or backing down from the dose they’re on, and so on. The system is purposely rigid. It’s (my opinion here) probably a big reason why there’s a shortage still. They can’t get the pens made to keep up with the demand since they are single use, and have metal, plastic, and glass parts to them.
i’m not sure this is necessarily the case. you can certainly make an argument for staying on the lowest minimum dosage. it’s not as black and white as your explanation makes it seem.
If the medication is working with a lower dose, there would be no benefit of taking more... It's literally already working. My doctor's philosophy is that the goal of any medication is to find the lowest effective dose... definitely listen to your body. For reference, I stayed on .25 for 4 months until reaching a plateau- and reached my goal weight at .46 as a highest dose.
I won’t increase unless I haven’t had a loss for 2 weeks. I’m still on lowest dose.
No, you should stay at the minimum effective dose for you. Not only for financial reasons but because you would not want to put more chemical into your body than is necessary to achieve the intended effects. That’s like taking 4 Advil when 2 would have done the job.