5 Months on a GLP-1: Before, After, and What Came Next

Zepbound taught me what full actually feels like, even with a hormone deficiency working against me the whole time. What happened after I stopped taught me a lot more.

There is something weirdly moral about weight loss in America. Lose weight by eating less and exercising more, and people tell you how disciplined you are. Use medication to help accomplish the same thing, and suddenly there are questions about whether you earned it. Was it a shortcut? Were you cheating? Did you actually do anything? Apparently there's a minimum suffering requirement before smaller pants become ethically acceptable.

I'm not imagining that attitude. A 2026 study across the US, UK, and Belgium found that people using anti-obesity medications were perceived as putting in less effort — and, because of that, were judged as less deserving, less moral, less competent, and less warm.¹ That study is a big part of why I finally sat down to write this.

I used Zepbound. It worked. I stopped taking it. Months later, I've maintained almost all of the weight I lost. Before anyone calls that "easy," I should mention that the side effects were fucking ugly — nausea, reflux, constipation, fatigue, and a fullness so total that eating sometimes felt like another item on my to-do list. Tirzepatide delays gastric emptying, and gastrointestinal effects like nausea, constipation, dyspepsia, reflux, and belching are well documented.² I also threw up more than once from getting too full — a lesson that comes back around later in this story. There were stretches where my days landed around 900 to 1,000 calories, not because I was heroically resisting hunger, but because getting enough food in became the actual challenge. If suffering is somehow required to earn weight loss, there you go. I think that's a pretty stupid standard for healthcare.

This wasn't my first attempt, either. My highest weight was around 213 pounds.

This wasn't my first attempt, either. I went vegan in 2018 and lost more than 40 pounds without medication — I knew what calories were, I knew how to cook, I ate plants voluntarily. That weight loss was real and it worked. But effort isn't infinite, and my weight had a range it liked. By the fall of 2025 I kept finding my way back to 186.6 pounds, no matter what I did on top of the baseline the vegan diet had already given me. I called that my "set point," a term I was using pretty loosely at the time.

By 2024, I was still living inside that range — better than 213, worse than where I wanted to be, and my knees were letting me know about it constantly, cracking and popping while doing even simple tasks or going on hikes that shouldn't have been that hard for someone who'd already done the work of overhauling her diet years earlier. I felt fine otherwise and wasn't going to stop me from being active. That's the part that made the whole Zepbound decision make sense to me later: I wasn't looking for an easy way to lose weight. I'd already proven I could do that the hard way. I was looking for something that could get me over a hump that seven years of effort hadn't moved. Researchers actually have a few models for why body weight stabilizes...

My biology has an extra wrinkle: I have Growth Hormone Deficiency. In adults, growth hormone isn't about height — it plays a real role in body composition, bone health, exercise capacity, and metabolism, and adults with GHD tend to carry more fat mass, less lean mass, and often lower energy.⁴ That mattered for two reasons. I wondered whether a drug like this would even behave normally in my body, and I was genuinely afraid of losing muscle. Weight loss on these drugs isn't only fat loss — in a body-composition substudy of the SURMOUNT-1 trial, roughly 74% of the weight lost with tirzepatide was fat mass and about 26% was lean mass.⁵ Lean mass isn't exactly the same as muscle, but it's close enough to what people worry about. I already had a condition associated with lower lean mass. I did not want to get smaller by getting weaker.

So, naturally, I researched the hell out of it. Once I actually started the medication, I turned it into a running log — food, weight, water, symptoms, digestion, stress, activity, whatever my body was doing that week. The calorie and protein numbers weren't lab-grade; the value was consistency, having weeks of comparable data instead of trying to remember what I ate three Tuesdays ago, and making sure I was still getting enough protein while my appetite disappeared. It became a useful tool. My body was doing the experiment — the chatbot just helped me keep the notebook.

The whole thing started almost by accident. I'd enrolled in a high-deductible insurance plan and missed how much my employer was contributing to my HSA — I found out I had way more sitting in that account than I thought, while thinking about a medical bill. That led to can I use an HSA for Ozempic?, which led to Zepbound, the brand name for tirzepatide. It's often lumped into the GLP-1 category, but it actually activates receptors for two hormones — GIP and GLP-1 — and that dual action is part of what changes appetite and food intake.² I didn't find evidence that tirzepatide is uniquely suited to GHD, and I still wouldn't claim that. I chose it because, after comparing the options, its mechanism and results made the most sense to me.

I went through Lemonaid, partly because I could pay with my HSA and partly because I didn't have to commit to buying six months of a medication I'd never put in my body. Other programs were cheaper per month but wanted a multi-month commitment up front — which made no sense to me, since the standard Zepbound titration schedule already assumes you might not tolerate the first few doses.² And it wasn't cheap: Lilly's direct-pay vial prices were $349 for 2.5 mg and $499 for 5 mg when I started, dropping to $299 and $399 on December 1, 2025.⁶ Of course the price improved right as I was finishing up.

I started October 1, 2025, at 186.6 pounds and 2.5 mg. The scale moved, then it didn't — and only a few weeks into a process that would eventually take off almost 35 pounds, I was already annoyed it wasn't happening faster. My instinct, every time, was is this not strong enough anymore? Having months of logs helped me slow that instinct down. Before assuming I needed a higher dose, I'd walk through what else was going on: appetite, food intake, water, constipation, sleep, stress, activity. It became less about staring at the morning number and more about figuring out what else was happening in my body.

One early-October day, I ate breakfast-burrito filling with no tortilla, protein coffee, a handful of nuts, a protein bar, a quarter of a Chipotle bowl, and some chips — somewhere around 900 to 1,000 calories and 55 to 65 grams of protein. I could barely eat. This is where the image of someone taking a "skinny shot," sitting on the couch, and losing weight while changing nothing else falls apart completely for me. The medication profoundly changed my appetite. My job became making sure I didn't wreck my nutrition while it did that.

I stayed around 2.5 mg for two months. My prescription moved to 5 mg in December, but I wasn't ready — I titrated slower than the schedule, using about 3 mg in December, 4 mg in January, and finally 5 mg in February. My PCP knew how I was approaching it; this is a description of what I did, not instructions for anyone else, and the labeled schedule is different.² I wasn't racing to increase the dose because I was already full. Why would I want more appetite suppression just because the scale hadn't moved in three days?

It did move, eventually, just not in a straight line. Around 180 by November 1, 172 by November 30, 164.4 by January 16 — with days in between where I'd eat 900 calories and wake up exactly the same weight, which you can understand intellectually and still take personally. Digestion was one obvious reason: tirzepatide was slowing mine down substantially, and there were days the scale sat stubbornly high until I finally used the bathroom and a different number showed up. I hadn't burned fat sitting on the toilet — the scale measures mass, and mass is fat, food, water, muscle, glycogen, and whatever your colon hasn't released yet. That sounds obvious, sure, but feels a lot less obvious after weeks of treating the morning weigh-in as a grade on yesterday's behavior.

Stress was another variable. A few times I'd been losing steadily, hadn't changed my intake, and then everything stopped for days — and the stressful event usually hadn't happened the day before the stall, but two or three days earlier. I'm careful about overstating this: I wasn't measuring cortisol, so I can't tell you one bad Wednesday caused a specific number on Saturday. But research does support relationships among stress, sleep, appetite, the HPA axis, and the effectiveness of weight-loss efforts, even if it's not a one-hormone explanation.⁷ What my logs told me was simpler — stressful periods repeatedly came before short stalls — and that was enough to stop me from assuming every plateau meant I needed more medication.

January was when the weight loss got more noticeable, and also when I became more aware of what appetite suppression was costing me. Some days were 900 calories, some 1,100 or 1,200, occasionally more. I'm 4'11", so my calorie needs aren't comparable to a six-foot man's, but 900-calorie days still weren't something to celebrate. There were nights I reached dinner still full. I once went more than 20 hours without eating and still wasn't especially interested in food. It worked. It was also unpleasant. Both things are true.

I'd expected to be done by February; I stretched my supply because of the slower titration and took my final dose in late March. My ending weight was 151.9 pounds — down 34.7 pounds, about 18.6% of my starting body weight. I wanted to see something under 150 before I stopped and missed it by 1.9 pounds. Rude.

What I didn't fully appreciate at the time was that I was also getting more physical. I've always lost five or ten pounds every summer just from naturally being more active — gardening, working outside, doing things I actually want to do. That started early in 2026. By March I was shoveling clay soil, hauling wheelbarrows in the rain, filling gopher holes, building raised beds, moving rocks, leveling pathways — the kind of work people call "gardening" when they want it to sound more peaceful than it is. By the time I stopped Zepbound, I was already noticeably more active, not because I'd joined a gym, but because my life was asking more of my body.

About three weeks after my last dose, I was fluctuating between roughly 153 and 155.5 pounds. I'd kept one final 5 mg vial in case I needed it. I never used it, and finally threw it out in August. That matters, because weight regain after stopping tirzepatide is common. In the SURMOUNT-4 randomized withdrawal trial, people who'd been on tirzepatide (generally 10–15 mg) for 36 weeks and then switched to placebo regained substantial weight over the following year, while those who stayed on the drug kept losing.⁸ My experience doesn't disprove that trial. It shouldn't be read as see, you can just take this for five months and stop — my dose, duration, and life afterward were all different from that study's.

What it should prove, instead, is that outcomes vary — and that the variation has a lot more to do with what someone does with the time a medication buys them than with the medication itself. Weight-loss medication can be a crutch or it can be a stepping stone. Assuming everyone using it is leaning on it forever is a gross generalization based on one subset of a much bigger group. What matters is what happens after: whether you use that window to build something that holds up once the drug is gone, or not.

My life was about to get a lot more physical, and not by design. My regular job ended earlier that year. I took a course, started building a business, worked on writing projects with my husband, and eventually the runway got short enough that optimism stopped being legal tender. Being low vision, I was determined not to go back to commuting, and I didn't want to sit at a desk all day again for a number of reasons. I'd also gotten used to babysitting my grandson two days a week, so I was determined to get our business going while doing something part-time to help make ends meet.

I got a nursery assistant job at a nearby farm. Not a fitness plan — I needed money. I love gardening, and I'd just finished two months of digging up my property, rerouting our stone path, and hauling wheelbarrows of dirt into gardens I'd created. I was in better shape than I'd been a few months earlier and thought it would be a fun learning opportunity. Farm work turned out to be an entirely different level of repetitive physical labor.

My ass and legs complained first — I already deal with sciatica from over twenty years at a desk job, and a lot of the work happened low to the ground, on a tiny hard stool or in the dirt with the bugs. After the first week, I usually picked the bugs. Gardening, physical therapy, and yoga had already built a stronger core, so the lower-body pain eased faster than I expected. Then came weed eating and weed barrier and hours of reaching, gripping, and pulling in positions my body wasn't conditioned for, and the pain moved north — upper back, neck, both arms, wrists and hands aching and going numb, occasional electric-shock sensations, days my grip was bad enough that I dropped things.

I need to be clear: for part of that summer, I hurt, badly. Not the pleasant kind of sore after a workout. The farm made me stronger, but it also overworked parts of my body — some things adapted well, others made it very clear there's a difference between conditioning and repeatedly aggravating an existing problem. It was starting to look like I might need carpal tunnel release surgery, but I couldn't get it checked out — we'd lost our health insurance, didn't qualify for Medicaid, and couldn't afford anything on the exchange. I don't recommend celebrating major weight loss by grabbing a weed eater and finding out which nerve gives up first.

Around the same time, the scale started climbing, and I panicked — regain, the thing I'd been bracing for. So I started logging closely again, except the pattern didn't line up with fat gain at all. Three physically demanding days, and my pain and stiffness got worse while my weight went up or stuck. A couple of days off, and the pain eased — and by the day before I went back, I'd be peeing constantly, sometimes ten or eleven times a day. Then I'd weigh in and the extra weight would be gone. Unaccustomed, strenuous exercise can cause muscle damage accompanied by soreness, swelling, and an inflammatory response that peaks and resolves over several days.⁹ I don't have the lab data to say exactly how many ounces of any given Tuesday were inflammation, glycogen, or water — but that explanation is a lot more plausible than gaining several pounds of fat doing manual labor and losing it again on my days off.

Same lesson as the Zepbound months, just louder: the scale reports what you weigh, not why. And while it bounced around, my body was changing. Usually summer takes another five or ten pounds off me; this time I'd already lost 35 going into it, and instead of losing more scale weight, I mostly held steady while getting stronger. I don't have before-and-after body composition scans, so I can't tell you exactly how much muscle I gained — a bathroom scale can't distinguish muscle from fat, and I won't pretend it can. What I can tell you: my weight stayed roughly the same, my clothes fit differently, my proportions changed, and I was demonstrably stronger doing physical work than I'd been before. I landed around a women's 7/8 and started fitting into things my kids wore as teenagers. There was a shirt with a waist tie I'd bought when I was heavier — I cinched it, my husband said it looked cute, and then I couldn't get it back over my chest without untying it first. I genuinely don't remember having that specific problem as an adult. There's no app that tracks that.

My husband eventually changed jobs, our finances loosened up, and he told me to stop beating myself up for a farm paycheck and put my energy back into our business and writing. I wasn't hard to convince — by then I'd proven whatever I apparently needed to prove about whether I could do hard physical work. The answer was yes. Should I keep doing this until my arms fall off? Absolutely not. I'm grateful for the experience, and I left that job just a week ago, staying as long as I needed to. I'll miss that place, and the owner and I — now genuine friends — plan on staying in touch.

Here's where my relationship with food after Zepbound gets a little strange: I'm still hungry, sometimes all the time. The drug didn't permanently erase my appetite. What it taught me was what full actually feels like.

Before Zepbound, like most people who take it, fullness wasn't much of a stop sign for me — I kept eating out of habit, because food was left, because it tasted good, because that was the portion I'd served myself. On Zepbound, satiety became impossible to miss, sometimes painfully so, and I learned exactly what happened if I ignored it: I felt awful, got nauseated, threw up. Associations are a motherfucker. Now, when I get what I call the bat signal, I stop — even with food still on the plate — and if I'm hungry again an hour later, I eat again. I probably will be. The difference is I no longer treat hunger and fullness as opposites where one meal has to carry the next six hours.

That showed up clearly at the farm. I'd eat half a breakfast burrito in the morning because a full one made me sluggish before physical work, then be ravenous four or five hours later and eat again. Turns out repeatedly lifting and hauling things requires fuel. Groundbreaking, I know.

hat's what I mean by calling Zepbound a reset rather than a fix. I'm not claiming it permanently changed my metabolism — I have no evidence for that, and the discontinuation research would make it a reckless thing to claim.⁸ What it reset was how I understood my own body. For five months, hunger was turned down far enough that fullness became obvious, and I learned how much food I actually needed, what happened when I ignored that signal, and why protein mattered even when I was eating less overall. I learned a three-day plateau doesn't mean the treatment failed, that a stressful week can show up on the scale days later, that constipation can impersonate a failed diet, and that strenuous physical work can make me weigh more while I'm sore and then "lose" it once the soreness resolves and I pee eleven times. Mostly, I learned the number on the scale carries a lot less information than I spent most of my life giving it credit for.

If you'd shown me the whole next year before that first shot, I honestly don't know if I'd have done it — not because I regret it, but because parts of this were hard, and gross, and painful. Months of nausea and overfullness. Worrying about whether I was eating enough. Tracking protein out of fear of losing muscle. Constipation and vomiting. Then finishing the medication and working myself half to death in the garden, taking a farm job because I needed the money, fighting weed barrier, running a weed eater, hurting from my neck down both arms, and spending half the summer unsure whether I was getting stronger or dismantling myself in installments. If I'd known all of that going in, I might have chickened out. I'm very glad I didn't — because the thing I never imagined was becoming this muscular afterward.

I thought the prize was going to be being smaller. It wasn't. The thing I actually care about now is that I can do things. Garden for hours. Shovel. Carry things. Work outside. Build a food business. Write. Keep up with a life I'd been trying to build for years while feeling too tired to fully show up for it. Growth Hormone Deficiency has real energy and exercise-capacity consequences for some adults,⁴ and tired had been part of my baseline for so long I didn't realize how much of my life I'd built around it. Now I notice the difference.

I don't spend much time thinking about whether I can get to 145. My weight generally lives around 150 to 153 now, occasionally dipping into the high 140s when I'm particularly depleted, but that's not the target anymore. I'm more interested in what happens next.

Was Zepbound a crutch? I don't really care anymore. Crutches are tools — we don't congratulate people for refusing a useful one just because struggling without it looks harder. But that's not really how it felt to me anyway. If I need a metaphor, it was scaffolding. I used it for a while to change something I'd spent years struggling to change, paid attention while it was there, and then took it away. What happened next wasn't what I expected: I got stronger, I got hungrier, I learned to stop eating when I was full, I built muscle instead of chasing another five pounds off the scale, and I started doing the things I'd wanted the energy to do all along.

This is just one person's story. The last year was hard. It was also worth it. And the picture of me holding a shovel — that's my after picture. Not because I look smaller. Because I never imagined I'd become that woman.

Now I get to find out what else she can do.

Sources

1. Tissot, T.T., & Roth, L.H.O. (2026). Anti-obesity medication use sparks effort-based sanctions and social penalties. Scientific Reports.

2. U.S. Food and Drug Administration. ZEPBOUND (tirzepatide) Prescribing Information. accessdata.fda.gov

3. Hall, K.D., & Guo, J. (2017). Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology.

4. Endocrine Society. Evaluation and Treatment of Adult Growth Hormone Deficiency: Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism.

5. Look, M., et al. (2025). Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study. Diabetes, Obesity and Metabolism.

6. Eli Lilly and Company. Lilly lowers the price of Zepbound single-dose vials. December 1, 2025.

7. Geiker, N.R.W., et al. (2018). Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obesity Reviews.

8. Aronne, L.J., et al. (2024). Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA.

9. Stožer, A., Vodopivc, P., & Križančić Bombek, L. (2020). Pathophysiology of Exercise-Induced Muscle Damage and Its Structural, Functional, Metabolic, and Clinical Consequences. Physiological Research.