i’m down about eighteen pounds since january. took three weeks off in february for vacation, fully expected the appetite to creep back. it did. gained maybe four pounds, and here’s what I want to sit with: I was relieved. sounds backwards, right? but I’ve been in eating disorder recovery long enough to know the difference between hunger and the loud brain. when I paused the shot, I got actual hunger signals. I could feel it come and go. feed it, be satisfied, move on. no white-knuckling, no panic. the regain didn’t feel like a relapse. it felt like proof the medication was working, that my body wasn’t stuck in scarcity mode. when I restarted, the appetite went quiet again. I’m not chasing a number. I’m learning how my body talks when I’m listening
Something about the phrase “proof the medication was working” is where I’d gently push back, because the case for everything else you’ve described is genuinely strong. The emotional work you’re describing, being able to feel hunger arrive and leave without panic, that’s real and it matters enormously, especially with ED history in the picture. But hunger returning after three weeks off tirz isn’t quite evidence the medication was working correctly, it’s just pharmacokinetics doing what pharmacokinetics does. Half-life around five days means you’re largely cleared by week two, so appetite coming back is expected, not diagnostic. Four pounds across three weeks off actually suggests your appetite restoration was fairly brisk, which could mean the opposite of what you’re reading: your baseline hunger drive is still pretty active without the suppression. None of that changes the emotional meaning you took from it, and I’d never want to flatten that, particularly given the recovery context. But “my body wasn’t stuck in scarcity mode” might be doing more interpretive work than the data supports. The fact that you didn’t spiral when it happened, that’s the actual evidence of something important.
you’re right to separate the pharmacology from the emotional work. what i actually learned was what my hunger felt like when the loud brain finally quieted.
“what my hunger felt like when the loud brain finally quieted” - that framing maps onto the mechanism pretty cleanly, actually. the suppression on tirz isn’t purely gastric. it’s also central: GLP-1 and GIP agonism hits reward and craving circuitry, not just stomach fullness signals. so the hunger that came back during your break was probably a cleaner signal than what most of us had pre-medication, because the hedonic-drive noise was back but maybe at a lower baseline than where you started.
for me the Libre made this distinction more concrete than i expected. i can identify when my glucose is drifting into the low 80s and producing actual physiological hunger vs when the loud brain was firing independent of any real energy need. on tirz, i mostly just get the former now. the latter quieted around month two, and i didn’t fully notice until i tried comparing CGM traces from before. your three weeks off essentially proved those are separable systems in you specifically, and that you could feel and respond to the physiological one without the other hijacking the whole response. that’s not a small data point, especially given the context you mentioned. most people who pause just note the hunger returning, they don’t have the framework to interpret what kind of hunger it is.
“proof the medication was working” is actually a really underrated frame for this. most people would’ve spiraled at the four pounds and called the break a failure, but you’re reading it as signal, not noise. that’s doing the real work.
the case for reading the four-pound regain as “proof the medication was working” is real, and I don’t want to step on the part about hunger signals returning cleanly, because that’s a genuinely useful self-observation and the ED-recovery framing is yours to make. but four pounds in three weeks off-drug isn’t actually evidence the drug is doing the work in the way people usually mean. tirz has a ~5 day half-life, so by week 3 you’re maybe at 1-2% of steady-state. some of that regain is glycogen and water rebound from re-fed carbs on vacation, not adipose. the appetite quieting on restart is also partly the loading curve, not a clean on/off switch. none of which invalidates what you noticed about hunger texture, that part stands. just be careful about reading a short washout as a controlled experiment. if you actually want to see signal, logging hunger ratings daily across a longer pause is where the correlation view in whatever tracker earns its keep, ime.