Why We Don't Just Start You at the Max Dose...

Hey everyone –

I get a form of this question all the time. "Daryl, why not just start me higher so I lose weight faster?"

Let us be straight with you, like always — because faster (or more) is not better with GLP-1 medications. I know that from running this clinic, and I know it from taking Tirzepatide myself.

When Jen and I started in March 2024, we started at 2.5mg. I remember thinking the same thing everyone thinks: "Is this even going to do anything?" But within a week, the food noise started to quiet down. I'd feel full after eating a little bit and just... push the plate away. No "2nd lunch" like I use to do.

A month later we titrated up to 5mg, and that's where a lot more appetite suppression kicked in. That's how it's suppose to work — gradually. Not all at once.

GLP-1's turn down the food noise so you feel full sooner and stop thinking about eating every waking minute. But those same effects — slower stomach emptying, appetite changes — can also cause nausea, bloating, reflux, constipation. Starting low gives your body time to adjust before things get more potent. A high dosage before you're ready usually means MASIVE unpleasant side effects.

The schedule is pretty simple — increase about every four to eight weeks. Some patients stay at a lower dose longer. Others never need the maximum to see meaningful progress. And here's the part people miss: the highest dose is not always the best dose. If you're losing steadily and side effects are manageable, there may be no reason to rush upward. If you've stalled and hunger is coming back, an increase makes sense. Good treatment is responsive. It's not automatic.

A slower schedule is not a failure. It's often the smarter decision. If you're vomiting, can't eat enough protein, or side effects are affecting your daily life — pushing upward may backfire. We've had patients losing weight perfectly well at a lower step. No reason to force the next increase.

Between shots, what you do matters just as much as the dose. Eat smaller meals. Prioritize protein. Stay hydrated. And if constipation shows up — and it probably will — talk to us early, not after you're miserable.

The scale matters, but it's not the whole story. Scales can be diabolical. That's why we do free Styku 3D scans every month — the scan tells the holistic story. Some weeks are faster, some are flat. What matters is the trend.

If something feels off, don't wait for your next check-in. And if you're discouraged because you're not losing fast enough — you're probably not failing. It might be a dose timing question or a nutrition gap. That's what we're here for.

-Daryl

Pacific Northwest Medical Group

6622 112th ST E, Puyallup WA 98373

253-340-2270

www.pnwmedicalgroup.com <- Click There!

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