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c/tapering·posted 1 year ago by u/taper_off_tabitha

three years of appetite return threads, summarised so you do not have to read them

Trial Data Clean Column ×8

Thinking out loud about this: three years of appetite return threads, summarised so you do not have to read them.

Went back on after eight months away. Nobody here made me feel bad about it, which mattered more than I expected.

Had the conversation with a clinician before stopping rather than after. Considerably easier that way round.

Stopped abruptly once and gradually once. The gradual one was easier to interpret because I could see what was changing.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

1,230 up / 433 down74% upvoted28 commentsid if0qga1 Sep 2024

28 comments

25 in this archive, depth 4

best — the order this archive was captured in

u/zeynep_villalobos100 points·1 year ago

Interval stretching lowers the trough concentration while keeping the dose; dose reduction lowers the level while keeping the rhythm. They are different interventions with different subjective profiles.

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u/taper_off_tabitha51 points·1 year ago

What the evidence says about stopping, written plainly because the framing does real damage.

Withdrawal studies across this class consistently show substantial regain after discontinuation. Appetite typically returns first, well before weight changes. This is a finding about the pharmacology of a chronic condition, in the same way that blood pressure rises again when an antihypertensive is stopped.

People on this board quit in shame over an entirely predictable result, and then avoid coming back because they have interpreted it as a personal failure. It is not. Knowing that in advance is the single most useful thing this board can offer anybody planning to stop.

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u/coldchain_karencold chain42 points·1 year ago

What the evidence says about stopping, written plainly because the framing does real damage.

This is the sentence that reframes the whole board. Appetite first, scale later.

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u/quiet_reader_9914 points·1 year ago

coming back later is allowed and it is common

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u/ilias_kaufmann15 points·1 year ago

Stretched from seven days to ten to twelve over four months. Appetite told me where the limit was each time.

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u/ignacio_silva4 points·1 year ago

Push back: that is a taper schedule aimed at another member and this board does not host those.

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u/taper_off_tabithaOP22 points·1 year ago

a fortnight of nothing is not evidence that you are fine

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u/valeria_cardoso38 points·1 year ago

Withdrawal studies across this class consistently show substantial regain after discontinuation, with appetite typically returning before weight changes. That is a description of the pharmacology of a chronic condition.

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u/teodor_lokken25 points·1 year ago

Have you had the conversation with a clinician yet?

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u/taper_off_tabithaOP13 points·1 year ago·edited

Do you have a written baseline from before you started changing anything?

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u/anders_kuusela21 points·1 year ago

Yes — the withdrawal literature is consistent and it is a pharmacological finding, not a moral one.

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u/taper_off_tabithaOP30 points·1 year ago

Withdrawal studies across this class consistently show substantial regain after discontinuation, with appetite typically returning before weight chang

Agreed — and the exposure lag means the first fortnight tells you almost nothing.

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u/vial_math_verasyringe math0 points·1 year ago

Withdrawal studies across this class consistently show substantial regain after discontinuation, with appetite typically returning before weight chang

Disagreeing with this bit: stretching and reducing are different things and the post treats them as one.

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u/maintenance_mode_maxMOD27 points·1 year ago

Edited a comment framing regain as a moral failure. The documented outcome is not a character verdict.

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u/priya_weiss21 points·1 year ago

I would not treat appetite returning as a sign of doing it wrong. It is the expected sequence.

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u/janek_ferrari12 points·1 year ago

A written baseline — dose, date, weight, waist, and how appetite feels — taken before any change is what makes the following months interpretable rather than a series of impressions.

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u/nayeli_fonseca6 points·1 year ago

How long were you at the dose you are coming off?

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u/ilias_kaufmann18 points·1 year ago

Regained most of it over a year and spent that year assuming it was my fault. It was not; it is what the literature describes.

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u/rina_bergstrom12 points·1 year ago

Yes — have the conversation before rather than after. That is the one piece of process advice this board can give.

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u/preservative_free_p6 points·1 year ago

There is very little published guidance on stopping specifically, which is exactly why board consensus here should carry less weight than usual and a clinician conversation should carry more.

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u/marta_marchand8 points·1 year ago

What is prompting the decision — cost, supply, side effects, or something else?

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u/maintenance_mode_maxmaintenance0 points·1 year ago

What is prompting the decision — cost, supply, side effects, or something else?

Adding the one process step — write down where you are before you change anything.

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u/neha_mwangi10 points·1 year ago

Nothing on this board is a taper schedule, and no member can write one for another. What can be shared is what people watched and what they observed.

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[deleted]7 points·1 year ago

[deleted]

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u/cormac_erdogan3 points·1 year ago

nobody here can write you a taper schedule

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About c/tapering

Stopping on purpose: dose reduction versus interval stretching, what the discontinuation arms of STEP 1 and SURMOUNT-4 actually showed about regain, appetite return timelines, and the people who came off, regained, and went back on without treating it as a failure.

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