Obligatory covering my ass disclaimer: This is not medical advice, nor is it endorsement of any treatment of any kind for any specific ailment. This has been my experience, but I would be remiss if I didn't remind you of Survivorship bias and that this is the perspective of one person with all of my biases and flaws. Please talk to your doctor, don't trust random internet stuff you find online.

There is a reason you need to go to school to be a doctor and it's not (only) because it's a racket to give people a status that makes them think they're better than everyone else and be part of the bloated healthcare industry of middlemen. It's also because they must learn the boring information you don't find in clickbait articles that will save your life when it comes to medical advice. Just one example being "when is a medication dangerous to prescribe?", the answers to which are numerous, ever-changing and scientifically nuanced.

My relationship with food

As far back as I can remember, I have had a poor relationship with food. I first broke 200lbs in middle school. I would have constant "food noise" where my thought patterns would be interrupted with thoughts about food. This continued for most of my life until I lived in a specific situation that made it possible (more like necessary) that I limit what I ate to one meal a day (lunch, during work). I successfully lost over 150lbs over 2 years, a feat I'm proud of. I essentially had what I would normally have for lunch, just no dinner and no snacking because I kept no food in the apartment.

I was able to keep the weight off for 3 or 4 years until I got hit with a Bipolar disease diagnosis. Once I was on those medications (plus getting thrown off my routine), I backslid up to over 315lbs. I tried diet, exercise, punishments, everything short of putting a lock on the fridge (but why bother when I'd always know where the key is?). I flew on a plane recently and I was reminded of my obesity when I took up more than the seat had to offer, spilled over into someone else's space and I had to ask for a seatbelt extender. Then a couple weeks ago I started Zepbound (Tirzepatide).

When everything changed

Since I started, my constant "food noise" of thinking about food often throughout the entire day stopped virtually entirely. I still feel hunger but it's true hunger, not "bored hunger" or "stomach is just empty" hunger.

A couple days after starting, effortlessly, I had a perfect food day. I ate 100% of my caloric goal and my macros were right on target. This blew my mind because in order to get a perfect food day before I started, I would have had to exercise strict self-discipline all day, successfully say no to food noise dozens of times, been miserable because I'd feel hungry all day, and even on my good days I still often went over by 20%.

The downside, of course, is the price. Most insurance won't cover it, and without coupons it's $1000/mo. That's astronomical. But while I'm gonna look for every way to make it cheaper (there's a coupon for if you have insurance but it's not covered that halves the cost for 13 months), I'm still gonna pay it. It's saving my life, literally. Some back of the napkin math on this site predicts a 4.5 year difference in life expectancy if I get down to a healthy BMI https://apps.goldensoncenter.uconn.edu/HLEC/. Plus, my quality of life will be higher as my body ages and doesn't have to work harder moving around, pumping blood, etc.

Where I am now

You can clearly see where I started taking Zepbound. I am early into my weight loss, so far I have only taken 2 doses (they are taken a week apart). I've lost roughly 7 pounds over two weeks, which is rapid weight loss. Being fat actually costs energy as well so when you restrict your intake, you lose weight according to the difference but you lose extra due to your body needing to maintain your existing fat stores. As time goes on, the loss will slow down.

I have noticed a strong drop in appetite, to the point that some foods aren't palatable to me. This is strongest for the 4 days after my dose, at which point some appetite and hunger come back. Some food noise may come back at this time too, but it's hard to be confident because I am paying such close attention to my appetite and hunger, it could be mistaken for a fixation on food. I still don't get food noise even through day 7, so sticking to my daily calorie goal is pretty easy.

What the future looks like

I love data and extrapolating, even if I have to add a huge asterisk to the result because of a small dataset or simplistic forecasting methods. With that said, I'm losing 3.5 pounds a week. I started February 29. I have 135 pounds to lose. That's 38 weeks at 3.5 pounds a week.

I would add about 30% extra to account for my weight loss slowing, possible backsliding and other things that might slow this down.

That's one year, or a little less than 3lbs average per week loss. It's dramatic, but not impossible.

Also, my birthday is in July - at this rate, I might be 250lbs by then. Just getting down to that weight would change so many things for me.

Stay tuned for updates on my progress!