protocol_deep_dive for the number of people just starting tirzepatide and asking what to expect. The scale is the least interesting variable in the first few months, imo. What matters more is getting a proper baseline before your first shot
Getting a proper baseline is absolutely the right call, but I have to push back on the idea that “the scale is the least interesting variable”. For anyone starting tirzepatide after bariatric surgery and regain, that number is one of the most important early signals you can get. When you’ve spent years post-op watching the scale creep back up, that first 5-10lb drop on tirz isn’t just weight, it’s confirmation that this tool is working on a different mechanism than the one that was failing. It’s a massive psychological relief.
That said, it’s not the only variable. The other things I tracked from day one that have been more useful long term are: * Protein grams per meal. non-negotiable for post-sleeve patients. * Side effect timing relative to injection hour, not just day.
My sulfur burps showing up at the dose hold instead of the dose jump told me a lot about how my sleeve was handling sustained gastric emptying slowdown. * Morning fasting glucose. * Injection site notes (any redness, welts, etc). I track all this in my log so i can see the patterns over time.
i use careclinic for it, and honestly the fact
such an important point to make. The scale can really mess with your head in those first few months when so much is changing. If I could add one thing to the tracking list, it would be a CGM, even if just for the first month or two.
Seeing your own glucose line flatten out after a high-protein breakfast teaches you more about what’s happening than a dozen weigh-ins ever could. It connects the “what you eat” to the “how you feel” with actual data, not just vibes. I’d also suggest making a note of how you feel the day of your shot vs.
the day before your next one. You’ll start to see a personal
hmm the “proper baseline” is where so many docs miss the mark for pcos patients. it’s not just a general metabolic panel, you need fasting insulin, homa-ir, and free testosterone to track actual progress, not just the scale.
Getting a proper baseline is absolutely the right call, but I have to push back on the idea that “the scale is the least interesting variable.” For a lot of people, and especially for post bariatric patients dealing with regain, that number is the entire reason they’re starting a GLP-1. It’s the primary signal that the biological process of regain is happening and that the original tool isn’t sufficient anymore. Calling it uninteresting misses the psychological weight that number carries for us. imo the problem isn’t tracking the scale, it’s tracking only the scale.
A better baseline for the first 12 weeks would be the scale, yes, but also:
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Body measurements. The 30lbs I regained post-sleeve sat completely differently on my frame than the same weight pre-surgery. - A subjective “food noise” score from 1-10 for a week straight. That’s the first thing that changes for many, often before the scale moves.
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Photos. You won’t see the day to day change but the
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“the scale is the least interesting variable” is the right frame. scale weight is a proxy for a proxy, collapsing body composition into a single number that skirts the actual lean mass question
fasting insulin and trig:hdl are the baseline numbers that matter most, imo.