u/BoundToZepIt

I'm fortunate that my PCP does believe in long-term maintenance, generally trusts me, and is pretty hands-off. In for my roughly annual visit. I've been in maintenance and holding the line fine between 150-157 for the last 4-5 months. Came in today with a weigh-in BMI of 21.7 (153#/5' 10.5"). After having started 2.5 years ago at 335# / 47.5 BMI. The tone of the visit though changed pretty sharply to "you're getting too thin, promise you aren't losing any more!". And I'm not tying to... but I also pretty heartily disagree that there's something abnormally thin about a 21.7 BMI! 47M here (so not geriatric), best shape of my life, doing amazing cycle touring. If a 22 is pushing too thin even to an MD, why do we call 18.5-21.9 BMIs 'normal'? Are they or aren't they? Doc is a fairly thin runner in her mid-50s and been thin as long as I've known her.

Ultimately, what I think I detected is a 'bias for change'. A common human thing. She wanted to change... something. In my tech career, the solution for managing managers is sometimes called a 'duck'. Some intentional error or unneeded feature that a project manager could latch on to feel like they contributed somewhere. In this case, I gave her a suggestion to lower my blood pressure drugs a bit (drop a diuretic I've been on for 20 years). She took the 'duck', did that, and renewed my Zepbound at 15 for now with the pinky swear that I'm not trying to lose any more.

My third Zepbound summer. And the same shocker as the last two as summer kicks into gear. Ninety degree day, jump off the lake dock... and... "holy hell!". Yeah, there's no floating happening. Didn't think it'd be as dramatic as the last two years... I've mostly been in the home stretch and maintenance. But the difference between 190#/22% body fat (last year) and 155#/14.5% bf is every bit as dramatic in the water as the bigger scale changes the past two. No, seriously, if you're like me and have 40 years of "of course I float on my back, easy", it's scary and even a bit dangerous!

47M. 1.79m/5'11"-ish. Started Zepbound (at 44) in December 2023 at 333 pounds. Fat little boy, from a long family history of obesity. Neither of my parents lived to 65, neither exactly due to obesity, neither helped by it. Lots of other family died young too. After college, I hovered around the 300-305 range pretty steadily through progressively more sedentary IT jobs. Covid lockdowns and home baking packed the extra 30 pounds on. At 44 it all started to catch up. Falling asleep sitting in my cubicle at 3 PM. And a MASH/F3 Fibrosis liver diagnosis (now totally resolved, yay).

The stuff worked! Never the record-setting fastest loser, but real, real steady. 333 -> 220 at the one year mark, which averages to 0.8% per week. Felt like I was stalling out there, which would have been a very solid clinical result and beyond life-changing if things stopped there. But also still obese. Exercised some in year one, but I'd say it was 80% Zepbound, 20% lifestyle.

Toward the latter half of year one, I bought the bicycle I always wanted. Road recumbent, partially for some specific male anatomical reasons... partially because I'm just that sort of contrarian dork. And boy did that make the difference for year two. Year two went from 220 -> 167. And I'd say that was 20% Zepbound, 80% lifestyle. Rode 3,700 miles in year two, including a couple organized tours and a couple 'century' (100 mile) days.

In year three, it's mostly maintenance. Have tapped at the door of my lower "red line" (150#, 21 BMI), but generally stay in the 155-160 range now. ~15% body fat. Of course I've lost some muscle. You can't lose 180 pounds and not lost some. Plus, I'm aiming more at a middle-aged cyclist/runner physique, not big muscle per se. I lift some at home and do a pull-up or two every time I pass the bar I mounted by the back door.

When I still had a decent bit of body fat, Zepbound was amazing. My intuitive sense of things is that before Zepbound, I'd do some fairly active thing. And, (A), I'd be dragging on the ground, worn out as all heck, and (B) starvin marvin when I stumbled home... and still wanting to inhale more food the next day. It was like "I've got 165 pounds of stored butter-density energy here... but I just can't access it"! But on Zepbound, I regularly could have a 4,000+ calorie burned day (~60 miles), eat 2,000, feel just fine and really not run out of steam. It was like Zepbound took the padlock off that stored body fat. That's how I explain the effect to my doctor and others.

The big challenge now is proper fueling. I'm signed up for several tours this summer. Over 1,500 miles in 2026 so far and will likely be well over 4,000 miles for the year. Still enjoying it. But, I ain't got that body fat to count on any more! If I burn 4,000 calories in a day, I really need to eat 4,000 calories. And some days, that's closer to 6,000! Which I can... appetite suppression isn't actually that bad for me... but it takes some clockwork eating and conscious counting the other way of what I've ever done. Also... glycogen is a sneaky deceiver! I can set off in the morning lightly fueled. And it's fine. And then you hit mile 15-20 and the glycogen is burned through. Oof. Learn to eat! Math if you have to. But the continued Zepbound sure helps me roll back to an appropriate 1,800-2,000 calorie diet once I'm off the bike. Which is great.

Self-paying vials, maintaining on MTD of 15 (and angel's share 😊) every 9 or 10 days. Fully intend to be a lifer, current doctor agrees thank deity. Can afford it no problem, but don't mind saving a little money. Took compounded tirzep for a while during the shortages, but prefer branded (at least in part as a LLY investor 😊). At my next visit, I'm going to ask that my doctor switch me to a 15 Kwikpen to try a half-shot more often for a more steady-state dose.