trying to diagnose this before my next telehealth appt because I’d rather walk in with a hypothesis than just “it stopped working.” the numbers:
- compounded sema, no polysorbate 80, week 18
- down 22 lb cumulative from 204
- weeks 14-17 averaged about 0.9 lb/wk on the weekly average
- last 3 weeks: 0.2, -0.1, +0.1. so basically flat
- dose unchanged through the stall, currently at the dose I titrated to at week 12
- food noise score still low (2-3 on injection-day, drifts to 4-5 by day 6)
- protein has actually been better, holding 130g floor in the 48hr post-injection window
- waist tape: down another 0.5 in across the stall. so the scale and the tape are telling different stories before anyone says “just bump the dose,” my NP is conservative about that and honestly I don’t think dose is the gap. the food noise is still suppressed. peak suppression on day 2-3 still feels like peak suppression. if I’d lost the molecule’s effect I’d expect the food noise score to climb first and it hasn’t. what I’m actually wondering: 1. is this the early water/glycogen drop washing out and the real lean-loss curve underneath being slower than the headline weekly average suggested. the tape-to-scale split widening points that direction. 2. cycle phase. I’m still cycling and the stall lines up almost exactly with luteal into early follicular across these 3 weeks. estrogen’s GI motility effects are real and trial pops don’t stratify well on this. could be 2-3 lb of water sitting on a real loss. 3. sleep. I had two genuinely bad weeks in there (kid stuff). cortisol-driven water retention isn’t exotic. 4. the boring one: I added strength training 3x/wk around week 15. some of the scale flatness could just be glycogen replenishment in muscle that wasn’t there before. what I don’t think it is: tolerance, tachyphylaxis, a bad batch (food noise pattern is unchanged), under-eating (tracked, I’m at a real deficit). the lever I’m choosing not to pull yet is a dose bump. I’d rather give it 2 more weeks at current dose with cycle phase shifted, see if the tape keeps moving, and then decide. for anyone who’s hit a stall around this window: did the tape-to-scale split resolve on its own, or was that the signal to actually change something? curious where people drew that line.
That tape-to-scale split you’re tracking often gets blamed on water, but on sema it’s usually signaling something more specific: you’ve moved past the early drop and your body’s partitioning loss differently now. fwiw Not suppression failing - the rate just shifted, water mixing in. If your deficit’s genuinely real and the food noise pattern hasn’t changed, the tape usually keeps moving through a full cycle.
The phase shift might sort it without changing dose. Most of the time it does resolve on its own. I’d wait.
Tape moving 0.5 in while the scale sits flat is the right frame to lead with at your NP appt, because fat loss and water retention operate on different timelines and the tape is the slower, less noisy signal. The luteal hypothesis has real support: progesterone’s secondary effect on aldosterone can hold 2-4 lb of fluid, and if your three-week stall lines up with late luteal through early follicular, a full phase shift should be diagnostic on its own. The new training stacks a glycogen replenishment variable on top of that, not instead of it. One thing worth having before your appt: any pre-sema weights tagged to cycle day, even a handful of data points, would let you anchor whether a 1-2 lb luteal swing was already in your individual baseline. If it was, you’re most likely looking at real fat loss sitting underneath a water signal the scale can’t see through yet. Food noise unchanged is also the right way to argue against tachyphylaxis, fwiw.
the partitioning shift framing is a useful one, and I want to steel-man it before I push on the one piece I’d hold loosely. the tape continuing to move through a full cycle as the disambiguation signal is roughly where I’ve landed too, with one caveat: I added strength work at week 15, so some of what’s sitting on the scale is almost certainly glycogen-and-water in muscle that wasn’t there before, and that overlay isn’t on the same clock as the cycle-phase water. they’ll resolve on different timelines, and if I conflate them I’ll either pull the dose lever too early or sit too long on a real plateau. what I’m doing in the meantime is logging waist tape and food noise on the same weekly cadence as the scale, with a journal note tied to each entry so a 4 on day 3 doesn’t get read the same as a 4 on peak suppression day. the dose-day reminder on sunday evenings is what’s kept the week count honest while the data sorts itself out. did your split resolve inside one cycle for you, or did it take two?
edit: typo
mine stayed flat on scale for 10-12 days into follicular, then moved again with tape still dropping steadily, so it didn’t read as the signal to change. food noise stayed low enough that glycogen resettling and cycle phase seemed sufficient. if you hit the same pattern next cycle, then the dose question makes sense.
dunno.