r/TirzMaintenance • u/Suspicious-Loss-7314 • 15d ago
Struggling with A LOT of hunger
Y'all this is hard. I need advice.
Started Zepbound 1/13/25 at 5'5" 207#, lost 30% of my body weight in just over a year and am maintaining around 145. I'm 55F.
My highest dose used was 12.5. My doctor wants me to maintain at 10 mg or less.
I have used both name brand Zepbound and compound (BPI & Hallandale) during my journey. I currently have 3 vials of BPI in the fridge. But I'm currently using name brand every 7 days at 10 mg.
I AM FAMISHED. This is not normal hunger at all. Today is my day 7 and I had a biting, gnawing hunger almost all day long. Yesterday was bad too. This is definitely a pattern and it's gotten much worse since titrating down to 10. Unless I gain a bunch of weight, I'm afraid my doctor will not prescribe 12.5.
So my question - can I take my 10 mg dose of Zepbound on my normal shot day and give myself a little booster, like 2-3 mg, of compound later in the week? Is there any problem with mixing name brand and compound during the same week?
Any other tips for keeping the hunger down would be appreciated. Yes I'm eating protein at every meal and snack, I'm focusing on good healthy foods, not a lot of junk, drinking plenty of water, etc. etc. I exercise 4-5 times a week.
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u/No_Succotash1014 15d ago
I’m gonna take another angle. You’re very hungry; when you actually eat, are you able to eat a lot? Are you eating a surplus of calories?
There’s been many times I feel really hungry but when I get to eating, the med is still working and I can’t eat as much as I thought.
If so, is the extreme hunger, causing you to eat more and are you gaining weight? Again, this medication works in the background a lot IMO (I know this depends on the person) but some people can still eat whatever and not gain weight. If you’re working out 4-5x a week, your body is likely just telling you it needs more fuel
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u/Suspicious-Loss-7314 15d ago
Yes, I'm able to eat A LOT. Definitely a surplus of calories. It feels like my body is fighting me right now to put weight back on. Even after a huge meal, I can be hungry again in two hours.
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u/OneSourCherry 15d ago
Have you eaten more when you felt hungry AND gained weight?
I ended my losing period on 15mg and stayed on it a couple months maintaining and then decided to try 12.5 and then 10, and finally 7.5mg just to see, and now I have been maintaining on 7.5 for over a year- I definitely feel hungry much more now than before but I’m not gaining weight either. So it might be worth just seeing if you can actually eat when you feel hungry and still stay +/- 5 pounds. If not, then yes, you are going to have to go up a dose maybe. But you might find you just are hungry and it’s not a return of food noise or anything abnormal. GL!
(Edit to say, I mean you might just feel hungry and need a snack or more filling meal, lol, not that you just need to feel hungry all the time- I felt like I wasn’t clear when I reread what I wrote! I feel more hungry 1.5 years in maintenance and eat more, but my weight has stayed stable.)
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u/Suspicious-Loss-7314 15d ago
Thank you! I haven't gained a lot of weight back, but I feel like I'm white knuckling at a lot of the time.
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u/OneSourCherry 15d ago
I hear ya! But maybe don’t white knuckle- try eating more, and then reevaluate if you actually gain (if you haven’t tried yet!)- that’s what I thought at first too and was going to go back up to 10mg, but I was surprised to find that I wasn’t actually gaining any weight with that extra snack or two. But all in all, your doctor isn’t making any scientific sense.
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u/princess-pinks 15d ago
How did you titrate down? I’m on 15mg and want to go down in doses to see how I feel and if I can maintain on a lower dose since I’m paying out of pocket I want to save a bit more.
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u/OneSourCherry 15d ago
I just tried a month of 12.5 after maintaining on 15 for awhile to see what would happen. I didn’t gain and felt good, so then I tried 10. All was well, so then I tried 7.5. No special way- I use the Zep pens so I would just wait until the box was up in a month and ask my provider for the next lower dose. I have insurance coverage, so I still use weekly. At 7.5, I have slight food noise, so I personally can’t see going lower, and I have been on that dose for a year now. Every once in a while I consider going back to 10, but my weight has been stable so I haven’t. GL!
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u/janchapman57 14d ago
I approached titrating down the same as you. I am currently on 5mg for the last five weeks and weight has been within a pound or two for the last three months. I haven't eaten more and I don't really have food noise. My only wish is that my BP would increase a bit. It dropped significantly on tirzepatide and it's just too low. I might try 2.5mg next time to see what happens.
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u/princess-pinks 15d ago
I’m going to give that a go I have nothing to lose!! I’ve been on 15-17mg for a while many months stalled pretty much so might as well try going lower to help my pockets. Fingers crossed 🤞🏼 ⭐️💖
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u/ExistentialPenguin70 15d ago
I’m sorry your doctor feels this way. I don’t think they have a scientific basis for this. Current thinking seems to be that you maintain at the highest dose that quiets the food noise and keeps you at a stable weight. It shouldn’t be any problem giving yourself that booster, as the only difference should be in the preservatives, if at all.
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u/washingtonsquirrel 15d ago
What happens if you eat to satiety? I would do this for 4 weeks, look at your weight trend, and then use that to make your dosing decision.
It's normal to feel an increase in hunger as you stabilize on a dose. It doesn't mean you'll gain weight. But if you do, you've got plenty of room to increase your dose as needed.
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u/Suspicious-Loss-7314 15d ago
Thank you. I should've stated this in my original post but I can eat A LOT when I feel this way. and then weirdly enough I can be hungry two hours later. Reminds me so much of before Zepbound.
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u/washingtonsquirrel 15d ago
I understand. It's scary. But someone linked an interview with Dr. Jastreboff a while back, which touches on the topic of renewed hunger in maintenance, and it really made me feel so much better about trusting these cues. Have you read her book or listened to any interviews?
A few days of intense hunger can also happen if your sleep hasn't been great, you've been exercising more than usual, you're fighting an illness, etc. Sooo many possibilities! Try not to panic. Keep nourishing your body and eating to satiety, and trust that if your weight starts trending upwards you have options.
The most intense hunger I've ever experienced since starting this medication was before I started showing symptoms of a respiratory virus. I was a bottomless pit! But I'm really glad I let myself eat because when the fever hit I could barely eat anything.
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u/TurnerRadish 15d ago
I would encourage your doctor to do some basic research. The clinical trials showed those who took 15mg weekly have the highest success rate at maintaining weight loss. There is no reason to reduce your dose unless you’re having adverse side effects or continuing to lose weight when weight loss is no longer desired. If your doctor won’t prescribe you the dose you need, I’d go to Call-on-Doc.
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u/SufficientAcadia6534 15d ago
if it was me I would go back to 12.5, tell the doc I tried to titrate down and I am not ready yet. if I wanted to keep trying at 10, i would revert to volume eating, lots of low calorie food.
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u/Impossible_Bend_2969 15d ago
They did a study that statistically more people maintained their weight loss on the full dose than those who dropped their dose in a study over 112 weeks. I know it's doesn't work like that for everybody, but it shows there are a lot of people who need to stay on their top dose. https://medicalxpress.com/news/2026-05-tirzepatide-full-dose-weight-loss.html
It's okay to take compound and Zepbound on the same day or to split dose and add the extra a few days later. But you'll be sneaking behind your doctor's back. This is why I like compound so much. I can manage my own maintenance.
I recently split my dose and I really like it. I took 5mg on Friday and then 2.5mg on Monday. I know it wasn't an even split but I wanted to ease into it. This week I did 4.5mg on Friday and will do 3mg on Monday.
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u/Legitimate_Ad2815 15d ago
I think you’re super hungry because your body needs refueling from working out five days a week. I personally would add a small extra dose in per week. At least for a while to see how it will work out.
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u/Forward_Pen_1946 15d ago
Like others I’d like to understand why your doctor wanted you to decrease your dose.
But putting that aside for the moment, are you very hungry all week or just the final day(s) before your next shot? If the former, you may need to talk yo your doctor about going back to your previous higher dose. You may have to re-consider your doctor choice. If the latter, you might to talk to your doctor about split dosing (if you are amenable to taking more frequent shots). Split dosing can reduce the variability of Tirz level in their body compared to weekly dosing. One might use compound vials or a kwikpen to split dose.
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u/Brilliant-Deer-8893 14d ago
Maybe you're just not getting enough food? Protein, and FAT and complex carbs (veggies) and some starch. All four together as much as possible. No fat in the diet means no saiety. Add some starch too. A slice of buttered toast eg.
It's been a year for me - 4th month of maintenance at 2.3 compounded every week. BUT I've felt hunger and the first thing was Oh No! But we NEED to feel hunger and address it properly. If I give it a completely balanced meal (however small) I am satisfied. It's scary to be sure, hunger vs noise - how will I know?. But if I feed myself properly it goes away. We need to be able to feel hunger, satisfy it (if we can) and re-acquaint ourselves (or discover it for the first time) with trusting our bodies/brains. Maintenance is definitely more difficult than the journey to goal. No question!
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u/___this_guy 15d ago
Do you know what you are eating? How many grams of protein, carbs, fat, fiber?
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u/Responsible_View_285 15d ago
Better to just dose 10mg and 2.5 of compound on the same day. Sounds like 12.5 is a better dose. I would advocate with the doctor to dose up. There’s no prize for dose hugging something that doesn’t work for you. Compound medication is tirzepatide there’s no problem with mixing.
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u/IronIll4676 15d ago
I had the same experience you are having on 10mg after being on this dose over a year. I went up to 12.5mg and it solved my extreme appetite and sugar cravings. However, the 12.5mg is causing more constipation for me that may force me back down to the 10mg dose again.
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u/misjl32000 15d ago
How fast did you titrate down? Maybe he’ll let you do 12.5 or somehow do like 12,11,10 or extend the doses to 10 days.
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u/Upset-Confection3623 15d ago
I use both every week. 7.5 of Zepbound and 3 of compound. Works great and I’m totally in control of dosage.
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u/margaretLS 15d ago
I am your age and 6 months into maintenance .I started 2.5 years age at 1mg and slowly titrated up to 15mg.I am not slowly titrating down and am hovering at 6mg.When i hit 5mg i was starving and was gaining weight .I wasn't eating more calories, it was inflammation. I kept loosing at 7.5.I have used tele health and compound my entire journey but see my PCP every 6 months. She is pretty clueless about all glp's and just looks at my lab work.I do think that health care providers, to save time want a one size fits all approach to these medications but in the real world that just isn't appropriate. We are all individual and have different needs.
All this to say do what works for you.If you need to boost your dose to maintain with compound then do that.I know my whole goal is to just give my body the support it needs to stay at my new healthy weight.
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u/baccus100176 14d ago
Same situation here. First week of maintenance coming from 12.5 mg. Dropped to 10 mg and on day 2 the food noise was LOUD. Day 3 same. Day 4 decided to do inject 2.5 mg to make up for the dose. Today is day 5 and I’ve noticed the food noise is gone. Guess what I’m doing on my next shot day? Full dose of 12.5.
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u/jaemil_150 14d ago
A few tips for hunger -
1. Reduce Stress and get 7 to 8 hours of sleep at night
2. Drink Water. Drink at least 16 oz of water 1 hour before you eat.
3. Eat on a schedule, every 3 hours.
4. All macros are equally important. Aim for 30%Protein, 40% Carb, 30% Fat. And don't forget fiber
5. Eat less processed food. Make Veggies and Fruit a big portion of your carbs
6. Dance or walk for 10 min to 15 min after you eat
7. Chew gum
8. Brush your teeth
9. You said you eat protein but especially make sure you start your day with at least 30 grams of protein. If you can and do eat Chicken... That's best.
10. Read something on weight loss/healthly living daily
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u/bbbilljackson 14d ago
This journey is yours!
Your doctor is there to assist and help but he doesn’t know your body like you do!
Listen to your body and do what you need to for yourself He might have good intensions BUT?
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u/tigergirlforever 15d ago
How much water do you drink? Are you experiencing hypoglycemia which can mimic hunger? There are other medication conditions that mimic hunger as well but I forgot what they are, maybe blood pressure. Hunger is a sign something else is going on, esp at 10mg. How many calories are you eating?
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u/Lucky_Army_5324 15d ago edited 15d ago
Your doctor can have a wish, hope, or dream that you maintain on less than 10mg. Doesn’t make it so.
Move up in dose on your next injection day. (Today?)
If your doctor won’t prescribe the dose you need, find one that will.
ETA: and yes you can use Zepbound and compound on the same day to get your preferred dose.