18 months in, my scale and CGM tell different stories

Health & Wellness Endocrine
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I’m 18 months out from my T2D diagnosis (A1c 8.4) and I’ve tracked everything from day one. In the beginning, I was obsessed with the scale.

It felt like the main scoreboard. But over time, I realized the scale and my actual metabolic health weren’

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The point where you realized “the scale and my actual metabolic health” were decoupling is the critical one. Most people stay stuck on the scale as the primary scoreboard long after it’s stopped being useful. I’d add a third axis to your model, beyond just weight and glucose: metabolic adaptation.
Your basal metabolic rate isn’t a static variable. Over an 18-month period of significant change, it has almost certainly downregulated as your body became more efficient with less mass to maintain. This means the relationship between your CGM data and your rate of fat loss has changed.
The same level of glycemic control that produced steady weight loss at month 3 might only produce maintenance at month 18, not because you’re doing anything wrong, but because the “energy out” side of the equation is fundamentally different. It’s a slow-moving confound that the two faster readouts won’t capture on their own.

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that feeling when you realize the “main scoreboard” you’ve been watching isn’t even the right game is such a distinct moment. I’m also about 18 months in, and I had a similar experience just last month. The scale had only moved down 2.1 lbs in four weeks, which felt like a frustrating stall after all this time.

But when I checked my other log, the one with my waist tape measurements, I saw I’d lost 0.8 inches in that same period. It sent me back to the body composition data from one of the SURMOUNT-1 substudies I’d read. It seems tirzepatide is particularly good at targeting visceral adipose tissue, which doesn’t always translate to big drops on the scale but has a massive impact on metabolic health.

For me, that was the click. The CGM graph and the tape measure are my scoreboards now; the scale is just one minor data point among many. It sounds like you’ve landed in the same place.

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