Appetite Suppression via GLP-1 / GIP Agonists - Tirzepatide & Semaglutide [FULL USAGE GUIDE]

[Aeu]

Spoiler: Legal Disclaimer

This guide is for informational purposes only and does not constitute medical advice. Consult a licensed physician before using either compound. The authors accept no liability for misuse. This guide assumes you are an adult making an informed decision about your own body.

---

[GLP-1 / GIP Agonists] [Appetite Suppression]
TIRZEPATIDE & SEMAGLUTIDE
FULL USAGE GUIDE
​

What They Are & Function Identity and biological role of Tirzepatide and Semglutide​

Tirzepatide and Semaglutide are injectable peptides that were originally developed for type 2 diabetes. They simply work by mimicking hormones your gut releases after eating, which then signals your brain that you're full, resulting in your hunger basically getting turned way down. Yes, I mean that your hunger signal is blunted. I am not exaggerating when I say that people on these drugs often forget to eat.

Two receptors are targeted by these drugs:

1. GLP-1 (Tirzepatide & Semaglutide)
2. GIP (Tizepatide only)

Tirzepatide is newer and, on average, stronger than Semaglutide. Both are injected once a week subcutaneously, meaning into the fat layer just under your skin.

Who this is for:

You're carrying enough extra weight that it's affecting your face, jaw definition, or overall physique. Say, you've tried eating less and maybe it worked for a couple of weeks. Your hunger is the problem, and these drugs fix exactly that. That's the entire point of this guide.

Also, you do NOT need to be clinically obese to use any of these drugs. If you're sitting at 20%+ body fat and struggling to keep a caloric deficit because you're hungry all the time, this thread would also be relevant to you.

I don't want people to think that these are fat-burning compounds. They are not. They simply suppress your appetite so hard to the point that you'll have no other choice but to eat at a deficit almost automatically.

Who should not attempt this:

1. Personal or family history of medullary thyroid carcinoma (MTC)
2. Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
3. History of pancreatitis
4. Under 18
​

Picking Your Compound Choosing between the two​

​

TIRZEPATIDE Brand: Mounjaro / Zepbound Peptide: GIP + GLP-1 dual agonist​	SEMAGLUTIDE Brand: Ozempic (diabetes) / Wegovy (weight) Peptide: GLP-1 agonist​
Average weight loss (72 weeks) ~20.9% body weight (SURMOUNT-1 trial)​	Average weight loss (68 weeks) ~14.9% body weight (STEP-1 trial)​
Injection frequency Once weekly​	Injection frequency Once weekly​
Starting dose 2.5 mg/week​	Starting dose 0.25 mg/week​
Max dose 15 mg/week​	Max dose 2.4 mg/week (Wegovy); 1 mg/week (Ozempic)​
Mechanism Dual GIP + GLP-1 receptor agonist. Has a much more effective appetite suppression lever than semaglutide.​	Mechanism GLP-1 receptor agonist only. Even though it is slightly milder, it is extremely well-studied​

​

SURMOUNT-1 · Jastreboff et al., 2022 · New England Journal of Medicine 2,539 adults without diabetes, BMI ≥30 (or ≥27 with weight-related comorbidities). Randomized, double-blind, placebo-controlled. 72 weeks of weekly tirzepatide (5 mg, 10 mg, or 15 mg) vs placebo. Participants on a 500 kcal/day deficit diet with lifestyle counseling. The 15 mg group lost a mean of 20.9% body weight. 57% of the 15 mg group lost ≥20% of their body weight. DOI: 10.1056/NEJMoa2206038​

STEP-1 · Wilding et al., 2021 · New England Journal of Medicine 1,961 adults without diabetes, BMI ≥30 (or ≥27 with comorbidity). Randomized, double-blind, 68 weeks. Weekly 2.4 mg semaglutide vs placebo + lifestyle intervention. Mean weight loss: 14.9% in the semaglutide group vs 2.4% placebo. 86% of semaglutide participants achieved ≥5% weight loss. DOI: 10.1056/NEJMoa2032183​

As you can see by the studies I showed above, Tirzepatide, number-wise, is clearly the winner. But that is only IF you can access it and tolerate will it then be the stronger choice for you. But, to be really honest, either one will work for appetite suppression.

So:
​

Choose Tirzepatide if...​	Choose Semaglutide if...​
1. You want the maximum appetite suppression​	1. You want the more accessible option​
2. You can source Mounjaro / Zepbound​	2. You can get Wegovy or Ozempic more easily​
3. You have more fat to lose overall​	3. You want a slower titration / milder start​
4. Cost is not a big deal​	4. You have a tighter budge​

​

Products & Sourcing Available forms and where they come from​

Tirzepatide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
Picture of Mounjaro​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved for T2D​
Picture of Zepbound​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved (specifically for weight loss)​
Picture of Compounded Tirzepatide​	Vial + syringes (drawn manually)​	Variable (concentration usually set by the pharmacy)​	Way cheaper than any of the other products. Sources: Hims, Nuvation, Mochi​

Semaglutide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
Picture of Wegovy​	Single-dose autoinjector pen​	0.25, 0.5, 1, 1.7, 2.4 mg​	FDA-approved (specifically for weight management)​
Picture of Ozempic​	Multi-dose pen (clicks to dose)​	0.25, 0.5, 1 mg per dose​	FDA-approved for T2D​
Picture of Compounded Semaglutide​	Vial + syringes​	Variable​	Same situation as tirzepatide. Cheaper. Sources: Telehealth NOTE: Confirm it's semaglutide base and NOT semaglutide sodium or acetate salt (different bioavailability)​

​

Dosing Schedule How usage is structured over time​

Tirzepatide Titration​

WEEKS​	DOSE​	​
1-4​	2.5 mg​	Starting dose (Non-negotiable)​
5-8​	5 mg​	First actual appetite suppression for most people​
9-12​	7.5 mg​	Increase only if tolerating 5 mg well. Stay at 5 mg longer if needed​
13-16​	10 mg​	Strong suppression for many people. Sweet spot would be between 5-10 mg​
17-20​	12.5 mg​	(Optional) Only increase if you've plateaued and are tolerating well​
21+​	15 mg (max)​	Maximum dose. Not everyone needs to reach this​

Semaglutide Titration​

WEEKS​	DOSE​	​
1-4​	0.25 mg​	(Introductory dose) Basically, just introducing the drug to your system​
5-8​	0.5 mg​	You'll start to notice the effects on appetite​
9-12​	1 mg​	Appetite suppression is a lot for most people at this dose​
13-16​	1.7 mg​	(Wegovy-specific dose step) Skip if using Ozempic (max 1 mg with standard pen)​
17+​	2.4 mg (max)​	(Wegovy maintenance dose) Maximum approved dose for weight management​

YOU DON'T NEED TO BE AT MAX DOSE TO SEE RESULTS

You can literally keep great appetite suppression at about 5-7.5 mg tirzepatide or 1 mg semaglutide. You need to find your own personal minimum effective dose and just stay there.

Higher doses = more side effects with diminishing returns past a certain point for YOUR personal response.
​

Injection Instructions How to correctly give the dose​

Supplies you need (compounded vial method)
​

1. Insulin syringes Picture of Insulin syringes 1 mL / 29-31 gauge / 4mm (5/32") or 6mm (1/4") needle length​

​

2. Alcohol swabs Picture of Alcohol swabs​

​

3. Your compounded vial​

​

4. Sharps disposal container Picture of a sharps disposal container Or, another good alternative would be a thick plastic bottle with lid as a DIY sharps container​

For autoinjector pens (Mounjaro, Wegovy, Ozempic), skip steps 1-3 below. The pen basically handles everything.

Subcutaneous injection: step-by-step

Step 1: Wash your hands
Common sense. 20 secs minimum.

Step 2: Pull the vial from the fridge
You'd want to let it sit for about 15-20 mins.
Room temperature injection is considerably more comfortable. Trust me, cold liquid going in subcutaneously stings like fuck.

Step 3: Wipe the vial top with an alcohol swab
Let it air dry for 5 seconds before inserting the needle.

Step 4: Draw your dose
You'd want to pull back the syringe plunger to your dose volume (see concentration math below), insert the needle into the vial, and then flip the vial upside down, and draw.
Remove any bubbles by flicking the syringe and pushing air out slowly.

Step 5: Pick your injection site, swab with alcohol
Abdomen (2 inches away from navel), outer thigh, or upper outer arm. Let the swab dry before injecting.

Step 6: Pinch the skin
You'll have to insert at different degrees depending on the needle length.​

4mm needles​	6mm needles​
Go straight in (90°)​	Pinch the skin and go at 45°​

You're going into the subcutaneous fat layer and not muscle. Inject slowly. Takes about 5 seconds. Release the pinch, and then pull out.

Step 7: Press gently (DO NOT RUB)
Apply light pressure with a clean swab for like a few seconds. If you do rub, it can irritate.

Step 8: Dispose of the needle immediately in your sharps container
Again, common sense, but do not recap and reuse. Use once and dispose.

Autoinjector pen method (Mounjaro / Wegovy / Ozempic)

Step 1: Check the pen
Confirm the dose window. For Ozempic, you would have to dial it your dose. For Mounjaro/Wegovy single-dose pens, it really isn't required.

Step 2: Remove the pen cap(s)
You just have to follow the specific pen instructions included in the packaging. Mounjaro has an outer cap and a needle cap. Wegovy has a base cap.

Step 3: Swab your injection site, let it dry
Similar to before. Avoid the navel within 2 inches.

Step 4: Press the pen flat against your skin, hold the button
You'll hear some type of click when the injection starts. Just hold the pen in place for the full count (usually 10 seconds). A second click or indicator confirms that it's delivered.

Step 5: Remove, cap, dispose
Again, similar to before, do not reuse.

Injection site rotation

Example of the recommended injection sites

Rotate sites every week + do not inject the same spot (can lead to lipohypertrophy)

Concerntration math (compounded vials)

The specific compounded vial you have usually comes labeled with concentration (e.g., 5 mg/mL or 10 mg/mL).

Formula:​

Volume to draw (mL) = Desired dose (mg) ÷ Concentration (mg/mL)​

Example:

Let's say you want 2.5 mg tirzepatide. Your vial is labeled 5 mg/mL.

2.5 ÷ 5 = 0.5 mL

You would then draw to the 0.5 mL line on a 1 mL syringe.

On a U-100 insulin syringe (which reads units and not mL): 0.5 mL = 50 units on the syringe markings.
​

"When should I inject?"​

It really doesn't matter. It just has to be the same day every week. Pick any and just stick to it consistently. Set a recurring phone reminder.
And, yes, if you miss a dose or have irregular timing, it will reduce the effectiveness of the drug.
​

Storing Your Medication How to keep it stable and usable​

​

Mounjaro / Zepbound pens (UNOPENED) Refrigerate at 36-46°F (2-8°C). DO NOT FREEZE. Shelf life until expiry date on label.​	Mounjaro / Zepbound pens (IN USE) Room temperature up to 86°F (30°C) for up to 21 days.​
Ozempic / Wegovy (IN USE)​ Ozempic​ Room temp up to 56 days after first use​ Wegovy​ Single-dose, use immediately.​	Compounded vials Refrigerate at 36-46°F, but this depends on your specific pharmacy's label, so make sure to check it.​

DO NOT:​

Freeze any form of either drug​

Expose to direct sunlight for long periods​

Use if the solution looks cloudy, discolored, or has particles​

Use past the expiry or stability date​

​

Side Effects & Management What to expect and mitigation strategies​

Of course, for every medication used, there will always be side effects, and in the case of Gl, they're extremely common (especially in the first 4-8 weeks of using it and at every increase of the dose).

This is the main reason why a lot of people tend to quit so early. So, managing them should also be apart of your protocol.
​

Nausea (VERY COMMON)​ Eating bland, low-fat foods​ Smaller, slower meals​ 4mg Ondansetron (if it gets bad)​	Vomiting / Diarrhea​ High-fat meals​ Keep fat moderate​ Hydrate (a lot)​
Constipation​ Increase fiber and water​ Miralax (polyethylene glycol) 17g/day​ Magnesium citrate 200-400 mg/night​	Injection site reactions​ Let the medication reach room temperature before injecting​
Fatigue​ Eat enough protein despite reduced appetite​	Muscle loss ("Ozempic face/body")​ 0.7-1g protein per lb of bodyweight​ Resistance training​

​

Diet On GLP-1s How eating patterns interact with the drug​

Considering that you'll naturally eat less on these drugs, your biggest priority should be making sure that every meal needs to count nutritionally.
​

PROTEIN PRIORITY​ 0.7-1g per lb of bodyweight daily (even if you have to force it)​ Protein shakes, greek yogurt, eggs, cottage cheese, chicken breast, and whey protein​

FOODS THAT FUCK YOU UP ON GLP-1S​ High-fat meals (fast food, fried food, heavy cream sauces)​ Alcohol​ Carbonated drinks​ Large food portions​

It's really not necessary to follow a specific diet protocol (if you do, that's also fine). The only rule is to eat protein first at EVERY meal + don't eat past the point of discomfort.
​

Coming Off the Drug What happens when use stops​

Obviously when you stop, your appetite returns. These drugs aren't meant to be permanent fixes.

If your entire reasoning as to using these drugs is to basically reset your eating habits and lose a target amount of fat, then you just stop once you've achieved that and build your own habits around your new appetite norms you can sustain.

If your appetite returns by a lot after stopping, you can either:

1. Resume the drug
2. Step down to a lower maintenance dose
3. Accept that you just need to manually and actively manage your own intake without the need the need of these drugs
​

"But, what about tapering?"​

As of now, protocols don't exist. I would consider it to be more arbitrary than anything. A lot of people stop using the drugs abruptly and experience zero issues.
​

---

Thank you for reading! ​

 

[primal_shitmuncher]

mirin high effort, bookmarked, will read every molecule

 

[teddy101]

peak will read

 

[i_blamegamertag]

DNR but seems very high iq

 

[Deleted member 4067]

View attachment 4962780

Spoiler: Legal Disclaimer

This guide is for informational purposes only and does not constitute medical advice. Consult a licensed physician before using either compound. The authors accept no liability for misuse. This guide assumes you are an adult making an informed decision about your own body.

---

[GLP-1 / GIP Agonists] [Appetite Suppression]
TIRZEPATIDE & SEMAGLUTIDE
FULL USAGE GUIDE
​

What They Are & Function Identity and biological role of Tirzepatide and Semglutide​

Tirzepatide and Semaglutide are injectable peptides that were originally developed for type 2 diabetes. They simply work by mimicking hormones your gut releases after eating, which then signals your brain that you're full, resulting in your hunger basically getting turned way down. Yes, I mean that your hunger signal is blunted. I am not exaggerating when I say that people on these drugs often forget to eat.

Two receptors are targeted by these drugs:

1. GLP-1 (Tirzepatide & Semaglutide)
2. GIP (Tizepatide only)

Tirzepatide is newer and, on average, stronger than Semaglutide. Both are injected once a week subcutaneously, meaning into the fat layer just under your skin.

Who this is for:

You're carrying enough extra weight that it's affecting your face, jaw definition, or overall physique. Say, you've tried eating less and maybe it worked for a couple of weeks. Your hunger is the problem, and these drugs fix exactly that. That's the entire point of this guide.

Also, you do NOT need to be clinically obese to use any of these drugs. If you're sitting at 20%+ body fat and struggling to keep a caloric deficit because you're hungry all the time, this thread would also be relevant to you.

I don't want people to think that these are fat-burning compounds. They are not. They simply suppress your appetite so hard to the point that you'll have no other choice but to eat at a deficit almost automatically.

Who should not attempt this:

1. Personal or family history of medullary thyroid carcinoma (MTC)
2. Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
3. History of pancreatitis
4. Under 18
​

Picking Your Compound Choosing between the two​

​

TIRZEPATIDE Brand: Mounjaro / Zepbound Peptide: GIP + GLP-1 dual agonist​	SEMAGLUTIDE Brand: Ozempic (diabetes) / Wegovy (weight) Peptide: GLP-1 agonist​
Average weight loss (72 weeks) ~20.9% body weight (SURMOUNT-1 trial)​	Average weight loss (68 weeks) ~14.9% body weight (STEP-1 trial)​
Injection frequency Once weekly​	Injection frequency Once weekly​
Starting dose 2.5 mg/week​	Starting dose 0.25 mg/week​
Max dose 15 mg/week​	Max dose 2.4 mg/week (Wegovy); 1 mg/week (Ozempic)​
Mechanism Dual GIP + GLP-1 receptor agonist. Has a much more effective appetite suppression lever than semaglutide.​	Mechanism GLP-1 receptor agonist only. Even though it is slightly milder, it is extremely well-studied​

​

SURMOUNT-1 · Jastreboff et al., 2022 · New England Journal of Medicine View attachment 4953594 2,539 adults without diabetes, BMI ≥30 (or ≥27 with weight-related comorbidities). Randomized, double-blind, placebo-controlled. 72 weeks of weekly tirzepatide (5 mg, 10 mg, or 15 mg) vs placebo. Participants on a 500 kcal/day deficit diet with lifestyle counseling. The 15 mg group lost a mean of 20.9% body weight. 57% of the 15 mg group lost ≥20% of their body weight. DOI: 10.1056/NEJMoa2206038​

STEP-1 · Wilding et al., 2021 · New England Journal of Medicine View attachment 4953769 1,961 adults without diabetes, BMI ≥30 (or ≥27 with comorbidity). Randomized, double-blind, 68 weeks. Weekly 2.4 mg semaglutide vs placebo + lifestyle intervention. Mean weight loss: 14.9% in the semaglutide group vs 2.4% placebo. 86% of semaglutide participants achieved ≥5% weight loss. DOI: 10.1056/NEJMoa2032183​

As you can see by the studies I showed above, Tirzepatide, number-wise, is clearly the winner. But that is only IF you can access it and tolerate will it then be the stronger choice for you. But, to be really honest, either one will work for appetite suppression.

So:
​

Choose Tirzepatide if...​	Choose Semaglutide if...​
1. You want the maximum appetite suppression​	1. You want the more accessible option​
2. You can source Mounjaro / Zepbound​	2. You can get Wegovy or Ozempic more easily​
3. You have more fat to lose overall​	3. You want a slower titration / milder start​
4. Cost is not a big deal​	4. You have a tighter budge​

​

Products & Sourcing Available forms and where they come from​

Tirzepatide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
View attachment 4954184 Picture of Mounjaro​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved for T2D​
View attachment 4954316 Picture of Zepbound​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved (specifically for weight loss)​
View attachment 4954343 Picture of Compounded Tirzepatide​	Vial + syringes (drawn manually)​	Variable (concentration usually set by the pharmacy)​	Way cheaper than any of the other products. Sources: Hims, Nuvation, Mochi​

Semaglutide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
View attachment 4954398 Picture of Wegovy​	Single-dose autoinjector pen​	0.25, 0.5, 1, 1.7, 2.4 mg​	FDA-approved (specifically for weight management)​
View attachment 4954413 Picture of Ozempic​	Multi-dose pen (clicks to dose)​	0.25, 0.5, 1 mg per dose​	FDA-approved for T2D​
View attachment 4954435 Picture of Compounded Semaglutide​	Vial + syringes​	Variable​	Same situation as tirzepatide. Cheaper. Sources: Telehealth NOTE: Confirm it's semaglutide base and NOT semaglutide sodium or acetate salt (different bioavailability)​

​

Dosing Schedule How usage is structured over time​

Tirzepatide Titration​

WEEKS​	DOSE​	​
1-4​	2.5 mg​	Starting dose (Non-negotiable)​
5-8​	5 mg​	First actual appetite suppression for most people​
9-12​	7.5 mg​	Increase only if tolerating 5 mg well. Stay at 5 mg longer if needed​
13-16​	10 mg​	Strong suppression for many people. Sweet spot would be between 5-10 mg​
17-20​	12.5 mg​	(Optional) Only increase if you've plateaued and are tolerating well​
21+​	15 mg (max)​	Maximum dose. Not everyone needs to reach this​

Semaglutide Titration​

WEEKS​	DOSE​	​
1-4​	0.25 mg​	(Introductory dose) Basically, just introducing the drug to your system​
5-8​	0.5 mg​	You'll start to notice the effects on appetite​
9-12​	1 mg​	Appetite suppression is a lot for most people at this dose​
13-16​	1.7 mg​	(Wegovy-specific dose step) Skip if using Ozempic (max 1 mg with standard pen)​
17+​	2.4 mg (max)​	(Wegovy maintenance dose) Maximum approved dose for weight management​

YOU DON'T NEED TO BE AT MAX DOSE TO SEE RESULTS

You can literally keep great appetite suppression at about 5-7.5 mg tirzepatide or 1 mg semaglutide. You need to find your own personal minimum effective dose and just stay there.

Higher doses = more side effects with diminishing returns past a certain point for YOUR personal response.
​

Injection Instructions How to correctly give the dose​

Supplies you need (compounded vial method)
​

1. Insulin syringes View attachment 4955158 Picture of Insulin syringes 1 mL / 29-31 gauge / 4mm (5/32") or 6mm (1/4") needle length​

​

2. Alcohol swabs View attachment 4955170 Picture of Alcohol swabs​

​

3. Your compounded vial​

​

4. Sharps disposal container View attachment 4955175 Picture of a sharps disposal container Or, another good alternative would be a thick plastic bottle with lid as a DIY sharps container​

For autoinjector pens (Mounjaro, Wegovy, Ozempic), skip steps 1-3 below. The pen basically handles everything.

Subcutaneous injection: step-by-step

Step 1: Wash your hands
Common sense. 20 secs minimum.

Step 2: Pull the vial from the fridge
You'd want to let it sit for about 15-20 mins.
Room temperature injection is considerably more comfortable. Trust me, cold liquid going in subcutaneously stings like fuck.

Step 3: Wipe the vial top with an alcohol swab
Let it air dry for 5 seconds before inserting the needle.

Step 4: Draw your dose
You'd want to pull back the syringe plunger to your dose volume (see concentration math below), insert the needle into the vial, and then flip the vial upside down, and draw.
Remove any bubbles by flicking the syringe and pushing air out slowly.

Step 5: Pick your injection site, swab with alcohol
Abdomen (2 inches away from navel), outer thigh, or upper outer arm. Let the swab dry before injecting.

Step 6: Pinch the skin
You'll have to insert at different degrees depending on the needle length.​

4mm needles​	6mm needles​
Go straight in (90°)​	Pinch the skin and go at 45°​

You're going into the subcutaneous fat layer and not muscle. Inject slowly. Takes about 5 seconds. Release the pinch, and then pull out.

Step 7: Press gently (DO NOT RUB)
Apply light pressure with a clean swab for like a few seconds. If you do rub, it can irritate.

Step 8: Dispose of the needle immediately in your sharps container
Again, common sense, but do not recap and reuse. Use once and dispose.

Autoinjector pen method (Mounjaro / Wegovy / Ozempic)

Step 1: Check the pen
Confirm the dose window. For Ozempic, you would have to dial it your dose. For Mounjaro/Wegovy single-dose pens, it really isn't required.

Step 2: Remove the pen cap(s)
You just have to follow the specific pen instructions included in the packaging. Mounjaro has an outer cap and a needle cap. Wegovy has a base cap.

Step 3: Swab your injection site, let it dry
Similar to before. Avoid the navel within 2 inches.

Step 4: Press the pen flat against your skin, hold the button
You'll hear some type of click when the injection starts. Just hold the pen in place for the full count (usually 10 seconds). A second click or indicator confirms that it's delivered.

Step 5: Remove, cap, dispose
Again, similar to before, do not reuse.

Injection site rotation

View attachment 4959810
Example of the recommended injection sites

Rotate sites every week + do not inject the same spot (can lead to lipohypertrophy)

Concerntration math (compounded vials)

The specific compounded vial you have usually comes labeled with concentration (e.g., 5 mg/mL or 10 mg/mL).

Formula:​

Volume to draw (mL) = Desired dose (mg) ÷ Concentration (mg/mL)​

Example:

Let's say you want 2.5 mg tirzepatide. Your vial is labeled 5 mg/mL.

2.5 ÷ 5 = 0.5 mL

You would then draw to the 0.5 mL line on a 1 mL syringe.

On a U-100 insulin syringe (which reads units and not mL): 0.5 mL = 50 units on the syringe markings.



It really doesn't matter. It just has to be the same day every week. Pick any and just stick to it consistently. Set a recurring phone reminder.
And, yes, if you miss a dose or have irregular timing, it will reduce the effectiveness of the drug.
​

Storing Your Medication How to keep it stable and usable​

​

Mounjaro / Zepbound pens (UNOPENED) Refrigerate at 36-46°F (2-8°C). DO NOT FREEZE. Shelf life until expiry date on label.​	Mounjaro / Zepbound pens (IN USE) Room temperature up to 86°F (30°C) for up to 21 days.​
Ozempic / Wegovy (IN USE)​ Ozempic​ Room temp up to 56 days after first use​ Wegovy​ Single-dose, use immediately.​	Compounded vials Refrigerate at 36-46°F, but this depends on your specific pharmacy's label, so make sure to check it.​

DO NOT:​

Freeze any form of either drug​

Expose to direct sunlight for long periods​

Use if the solution looks cloudy, discolored, or has particles​

Use past the expiry or stability date​

​

Side Effects & Management What to expect and mitigation strategies​

Of course, for every medication used, there will always be side effects, and in the case of Gl, they're extremely common (especially in the first 4-8 weeks of using it and at every increase of the dose).

This is the main reason why a lot of people tend to quit so early. So, managing them should also be apart of your protocol.
​

Nausea (VERY COMMON)​ Eating bland, low-fat foods​ Smaller, slower meals​ 4mg Ondansetron (if it gets bad)​	Vomiting / Diarrhea​ High-fat meals​ Keep fat moderate​ Hydrate (a lot)​
Constipation​ Increase fiber and water​ Miralax (polyethylene glycol) 17g/day​ Magnesium citrate 200-400 mg/night​	Injection site reactions​ Let the medication reach room temperature before injecting​
Fatigue​ Eat enough protein despite reduced appetite​	Muscle loss ("Ozempic face/body")​ 0.7-1g protein per lb of bodyweight​ Resistance training​

​

Diet On GLP-1s How eating patterns interact with the drug​

Considering that you'll naturally eat less on these drugs, your biggest priority should be making sure that every meal needs to count nutritionally.
​

PROTEIN PRIORITY​ 0.7-1g per lb of bodyweight daily (even if you have to force it)​ Protein shakes, greek yogurt, eggs, cottage cheese, chicken breast, and whey protein​

FOODS THAT FUCK YOU UP ON GLP-1S​ High-fat meals (fast food, fried food, heavy cream sauces)​ Alcohol​ Carbonated drinks​ Large food portions​

It's really not necessary to follow a specific diet protocol (if you do, that's also fine). The only rule is to eat protein first at EVERY meal + don't eat past the point of discomfort.
​

Coming Off the Drug What happens when use stops​

Obviously when you stop, your appetite returns. These drugs aren't meant to be permanent fixes.

If your entire reasoning as to using these drugs is to basically reset your eating habits and lose a target amount of fat, then you just stop once you've achieved that and build your own habits around your new appetite norms you can sustain.

If your appetite returns by a lot after stopping, you can either:

1. Resume the drug
2. Step down to a lower maintenance dose
3. Accept that you just need to manually and actively manage your own intake without the need the need of these drugs



As of now, protocols don't exist. I would consider it to be more arbitrary than anything. A lot of people stop using the drugs abruptly and experience zero issues.
​

---

Thank you for reading! ​

Reta or LDAR

 

[Aeu]

Reta or LDAR

Fortunately, Tirzepatide + Semaglutide mog (according to the literature)

 

[Lonely]

Tirz mogs

 

[Aeu]

Tirz mogs

As stated in the guide

 

[Firstname.Lastname]

Quality post. I've used all 3 injectable GLP's and reta is best imo. Mostly because provides a noticeable increase in energy levels.

I didn't notice a big different between triz/sema. When I switched from sema to triz. I was able to max out on about 12.5mg of triz with minimal side effects. Now i'm taking about 8mg of reta broken into 2 injections a week.

Although injectable glp can be done just once a week. 2 injections a week seem to reduce side effects and keep the appetite at a more stable level.

I can eat quite alot still if its carbs/fat. But trying to eat 200g of protein for me is absolutely brutal on these meds.

 

[telegraph221]

ur the goat i just got wegovy. does injection site matter?

 

[Aeu]

ur the goat i just got wegovy. does injection site matter?

No.

Whether you inject it into your abdomen, thigh, or your upper arm really just changes tiny pharmacokinetics, which don't affect the actual appetite suppression in any way.

 

[telegraph221]

No.

Whether you inject it into your abdomen, thigh, or your upper arm really just changes tiny pharmacokinetics, which don't affect the actual appetite suppression in any way.

anything i should pair with it

 

[teddy101]

my breakdown and tips
they also make food move slower making you "full" for longer
the under 18 is usually larp is because such drugs are only test in adult population but its not recomened just idont think its a big deal
tho you say triz is better it seems semaglutide with cagrilintide has more effect than its in this study you could have cover that

Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis - PubMed

PROSPERO CRD42022342845.

pubmed.ncbi.nlm.nih.gov

the diffrence is like 14kg and 7 kg thats alomst double you could have covered that
idk about inection and other stuff this stuff is good but you could do more research
but the formatting is peak will inspire my next threads love it bro good thing i invested
(my perosnal feedback)

 

[Aeu]

tho you say triz is better it seems semaglutide with cagrilintide has more effect than its in this study you could have cover that

Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis - PubMed

PROSPERO CRD42022342845.

pubmed.ncbi.nlm.nih.gov

The thing is, with Tirz, compared to Cagrisema, it's actually a drug that people can actually go get and use. Not only is it not approved, but it's also not available to the public, so the average user isn't able to just walk into a compounding pharmacy and order next week. It's still in trials.

If I were to include it in this guide, it would just be telling someone like "actually the best option is this thing you cannot have", which really helps no one at the end of the day.

I would say that, within available compounds, the ranking still holds.

But, I genuinely appreciate the feedback, though

 

[teddy101]

The thing is, with Tirz, compared to Cagrisema, it's actually a drug that people can actually go get and use. Not only is it not approved, but it's also not available to the public, so the average user isn't able to just walk into a compounding pharmacy and order next week. It's still in trials.

If I were to include it in this guide, it would just be telling someone like "actually the best option is this thing you cannot have", which really helps no one at the end of the day.

I would say that, within available compounds, the ranking still holds.

But, I genuinely appreciate the feedback, though

i didnt know that i was trying to give more feedback and improvements
seems like it a well made thread(I still think it could be better it not my expertise but you are defo smart) also tag me when you make thread nigga if you need any help i am here( i am actually high iq have 2 threads in BOTB)
@Histism @Navity looks at this wonderful nigga

@Chad @Gengar’s Ghost @tuberculosisinmybal pin this thread really well made deserves way more

 

[Histism]

View attachment 4962780

Spoiler: Legal Disclaimer

This guide is for informational purposes only and does not constitute medical advice. Consult a licensed physician before using either compound. The authors accept no liability for misuse. This guide assumes you are an adult making an informed decision about your own body.

---

[GLP-1 / GIP Agonists] [Appetite Suppression]
TIRZEPATIDE & SEMAGLUTIDE
FULL USAGE GUIDE
​

What They Are & Function Identity and biological role of Tirzepatide and Semglutide​

Tirzepatide and Semaglutide are injectable peptides that were originally developed for type 2 diabetes. They simply work by mimicking hormones your gut releases after eating, which then signals your brain that you're full, resulting in your hunger basically getting turned way down. Yes, I mean that your hunger signal is blunted. I am not exaggerating when I say that people on these drugs often forget to eat.

Two receptors are targeted by these drugs:

1. GLP-1 (Tirzepatide & Semaglutide)
2. GIP (Tizepatide only)

Tirzepatide is newer and, on average, stronger than Semaglutide. Both are injected once a week subcutaneously, meaning into the fat layer just under your skin.

Who this is for:

You're carrying enough extra weight that it's affecting your face, jaw definition, or overall physique. Say, you've tried eating less and maybe it worked for a couple of weeks. Your hunger is the problem, and these drugs fix exactly that. That's the entire point of this guide.

Also, you do NOT need to be clinically obese to use any of these drugs. If you're sitting at 20%+ body fat and struggling to keep a caloric deficit because you're hungry all the time, this thread would also be relevant to you.

I don't want people to think that these are fat-burning compounds. They are not. They simply suppress your appetite so hard to the point that you'll have no other choice but to eat at a deficit almost automatically.

Who should not attempt this:

1. Personal or family history of medullary thyroid carcinoma (MTC)
2. Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
3. History of pancreatitis
4. Under 18
​

Picking Your Compound Choosing between the two​

​

TIRZEPATIDE Brand: Mounjaro / Zepbound Peptide: GIP + GLP-1 dual agonist​	SEMAGLUTIDE Brand: Ozempic (diabetes) / Wegovy (weight) Peptide: GLP-1 agonist​
Average weight loss (72 weeks) ~20.9% body weight (SURMOUNT-1 trial)​	Average weight loss (68 weeks) ~14.9% body weight (STEP-1 trial)​
Injection frequency Once weekly​	Injection frequency Once weekly​
Starting dose 2.5 mg/week​	Starting dose 0.25 mg/week​
Max dose 15 mg/week​	Max dose 2.4 mg/week (Wegovy); 1 mg/week (Ozempic)​
Mechanism Dual GIP + GLP-1 receptor agonist. Has a much more effective appetite suppression lever than semaglutide.​	Mechanism GLP-1 receptor agonist only. Even though it is slightly milder, it is extremely well-studied​

​

SURMOUNT-1 · Jastreboff et al., 2022 · New England Journal of Medicine View attachment 4953594 2,539 adults without diabetes, BMI ≥30 (or ≥27 with weight-related comorbidities). Randomized, double-blind, placebo-controlled. 72 weeks of weekly tirzepatide (5 mg, 10 mg, or 15 mg) vs placebo. Participants on a 500 kcal/day deficit diet with lifestyle counseling. The 15 mg group lost a mean of 20.9% body weight. 57% of the 15 mg group lost ≥20% of their body weight. DOI: 10.1056/NEJMoa2206038​

STEP-1 · Wilding et al., 2021 · New England Journal of Medicine View attachment 4953769 1,961 adults without diabetes, BMI ≥30 (or ≥27 with comorbidity). Randomized, double-blind, 68 weeks. Weekly 2.4 mg semaglutide vs placebo + lifestyle intervention. Mean weight loss: 14.9% in the semaglutide group vs 2.4% placebo. 86% of semaglutide participants achieved ≥5% weight loss. DOI: 10.1056/NEJMoa2032183​

As you can see by the studies I showed above, Tirzepatide, number-wise, is clearly the winner. But that is only IF you can access it and tolerate will it then be the stronger choice for you. But, to be really honest, either one will work for appetite suppression.

So:
​

Choose Tirzepatide if...​	Choose Semaglutide if...​
1. You want the maximum appetite suppression​	1. You want the more accessible option​
2. You can source Mounjaro / Zepbound​	2. You can get Wegovy or Ozempic more easily​
3. You have more fat to lose overall​	3. You want a slower titration / milder start​
4. Cost is not a big deal​	4. You have a tighter budge​

​

Products & Sourcing Available forms and where they come from​

Tirzepatide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
View attachment 4954184 Picture of Mounjaro​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved for T2D​
View attachment 4954316 Picture of Zepbound​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved (specifically for weight loss)​
View attachment 4954343 Picture of Compounded Tirzepatide​	Vial + syringes (drawn manually)​	Variable (concentration usually set by the pharmacy)​	Way cheaper than any of the other products. Sources: Hims, Nuvation, Mochi​

Semaglutide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
View attachment 4954398 Picture of Wegovy​	Single-dose autoinjector pen​	0.25, 0.5, 1, 1.7, 2.4 mg​	FDA-approved (specifically for weight management)​
View attachment 4954413 Picture of Ozempic​	Multi-dose pen (clicks to dose)​	0.25, 0.5, 1 mg per dose​	FDA-approved for T2D​
View attachment 4954435 Picture of Compounded Semaglutide​	Vial + syringes​	Variable​	Same situation as tirzepatide. Cheaper. Sources: Telehealth NOTE: Confirm it's semaglutide base and NOT semaglutide sodium or acetate salt (different bioavailability)​

​

Dosing Schedule How usage is structured over time​

Tirzepatide Titration​

WEEKS​	DOSE​	​
1-4​	2.5 mg​	Starting dose (Non-negotiable)​
5-8​	5 mg​	First actual appetite suppression for most people​
9-12​	7.5 mg​	Increase only if tolerating 5 mg well. Stay at 5 mg longer if needed​
13-16​	10 mg​	Strong suppression for many people. Sweet spot would be between 5-10 mg​
17-20​	12.5 mg​	(Optional) Only increase if you've plateaued and are tolerating well​
21+​	15 mg (max)​	Maximum dose. Not everyone needs to reach this​

Semaglutide Titration​

WEEKS​	DOSE​	​
1-4​	0.25 mg​	(Introductory dose) Basically, just introducing the drug to your system​
5-8​	0.5 mg​	You'll start to notice the effects on appetite​
9-12​	1 mg​	Appetite suppression is a lot for most people at this dose​
13-16​	1.7 mg​	(Wegovy-specific dose step) Skip if using Ozempic (max 1 mg with standard pen)​
17+​	2.4 mg (max)​	(Wegovy maintenance dose) Maximum approved dose for weight management​

YOU DON'T NEED TO BE AT MAX DOSE TO SEE RESULTS

You can literally keep great appetite suppression at about 5-7.5 mg tirzepatide or 1 mg semaglutide. You need to find your own personal minimum effective dose and just stay there.

Higher doses = more side effects with diminishing returns past a certain point for YOUR personal response.
​

Injection Instructions How to correctly give the dose​

Supplies you need (compounded vial method)
​

1. Insulin syringes View attachment 4955158 Picture of Insulin syringes 1 mL / 29-31 gauge / 4mm (5/32") or 6mm (1/4") needle length​

​

2. Alcohol swabs View attachment 4955170 Picture of Alcohol swabs​

​

3. Your compounded vial​

​

4. Sharps disposal container View attachment 4955175 Picture of a sharps disposal container Or, another good alternative would be a thick plastic bottle with lid as a DIY sharps container​

For autoinjector pens (Mounjaro, Wegovy, Ozempic), skip steps 1-3 below. The pen basically handles everything.

Subcutaneous injection: step-by-step

Step 1: Wash your hands
Common sense. 20 secs minimum.

Step 2: Pull the vial from the fridge
You'd want to let it sit for about 15-20 mins.
Room temperature injection is considerably more comfortable. Trust me, cold liquid going in subcutaneously stings like fuck.

Step 3: Wipe the vial top with an alcohol swab
Let it air dry for 5 seconds before inserting the needle.

Step 4: Draw your dose
You'd want to pull back the syringe plunger to your dose volume (see concentration math below), insert the needle into the vial, and then flip the vial upside down, and draw.
Remove any bubbles by flicking the syringe and pushing air out slowly.

Step 5: Pick your injection site, swab with alcohol
Abdomen (2 inches away from navel), outer thigh, or upper outer arm. Let the swab dry before injecting.

Step 6: Pinch the skin
You'll have to insert at different degrees depending on the needle length.​

4mm needles​	6mm needles​
Go straight in (90°)​	Pinch the skin and go at 45°​

You're going into the subcutaneous fat layer and not muscle. Inject slowly. Takes about 5 seconds. Release the pinch, and then pull out.

Step 7: Press gently (DO NOT RUB)
Apply light pressure with a clean swab for like a few seconds. If you do rub, it can irritate.

Step 8: Dispose of the needle immediately in your sharps container
Again, common sense, but do not recap and reuse. Use once and dispose.

Autoinjector pen method (Mounjaro / Wegovy / Ozempic)

Step 1: Check the pen
Confirm the dose window. For Ozempic, you would have to dial it your dose. For Mounjaro/Wegovy single-dose pens, it really isn't required.

Step 2: Remove the pen cap(s)
You just have to follow the specific pen instructions included in the packaging. Mounjaro has an outer cap and a needle cap. Wegovy has a base cap.

Step 3: Swab your injection site, let it dry
Similar to before. Avoid the navel within 2 inches.

Step 4: Press the pen flat against your skin, hold the button
You'll hear some type of click when the injection starts. Just hold the pen in place for the full count (usually 10 seconds). A second click or indicator confirms that it's delivered.

Step 5: Remove, cap, dispose
Again, similar to before, do not reuse.

Injection site rotation

View attachment 4959810
Example of the recommended injection sites

Rotate sites every week + do not inject the same spot (can lead to lipohypertrophy)

Concerntration math (compounded vials)

The specific compounded vial you have usually comes labeled with concentration (e.g., 5 mg/mL or 10 mg/mL).

Formula:​

Volume to draw (mL) = Desired dose (mg) ÷ Concentration (mg/mL)​

Example:

Let's say you want 2.5 mg tirzepatide. Your vial is labeled 5 mg/mL.

2.5 ÷ 5 = 0.5 mL

You would then draw to the 0.5 mL line on a 1 mL syringe.

On a U-100 insulin syringe (which reads units and not mL): 0.5 mL = 50 units on the syringe markings.



It really doesn't matter. It just has to be the same day every week. Pick any and just stick to it consistently. Set a recurring phone reminder.
And, yes, if you miss a dose or have irregular timing, it will reduce the effectiveness of the drug.
​

Storing Your Medication How to keep it stable and usable​

​

Mounjaro / Zepbound pens (UNOPENED) Refrigerate at 36-46°F (2-8°C). DO NOT FREEZE. Shelf life until expiry date on label.​	Mounjaro / Zepbound pens (IN USE) Room temperature up to 86°F (30°C) for up to 21 days.​
Ozempic / Wegovy (IN USE)​ Ozempic​ Room temp up to 56 days after first use​ Wegovy​ Single-dose, use immediately.​	Compounded vials Refrigerate at 36-46°F, but this depends on your specific pharmacy's label, so make sure to check it.​

DO NOT:​

Freeze any form of either drug​

Expose to direct sunlight for long periods​

Use if the solution looks cloudy, discolored, or has particles​

Use past the expiry or stability date​

​

Side Effects & Management What to expect and mitigation strategies​

Of course, for every medication used, there will always be side effects, and in the case of Gl, they're extremely common (especially in the first 4-8 weeks of using it and at every increase of the dose).

This is the main reason why a lot of people tend to quit so early. So, managing them should also be apart of your protocol.
​

Nausea (VERY COMMON)​ Eating bland, low-fat foods​ Smaller, slower meals​ 4mg Ondansetron (if it gets bad)​	Vomiting / Diarrhea​ High-fat meals​ Keep fat moderate​ Hydrate (a lot)​
Constipation​ Increase fiber and water​ Miralax (polyethylene glycol) 17g/day​ Magnesium citrate 200-400 mg/night​	Injection site reactions​ Let the medication reach room temperature before injecting​
Fatigue​ Eat enough protein despite reduced appetite​	Muscle loss ("Ozempic face/body")​ 0.7-1g protein per lb of bodyweight​ Resistance training​

​

Diet On GLP-1s How eating patterns interact with the drug​

Considering that you'll naturally eat less on these drugs, your biggest priority should be making sure that every meal needs to count nutritionally.
​

PROTEIN PRIORITY​ 0.7-1g per lb of bodyweight daily (even if you have to force it)​ Protein shakes, greek yogurt, eggs, cottage cheese, chicken breast, and whey protein​

FOODS THAT FUCK YOU UP ON GLP-1S​ High-fat meals (fast food, fried food, heavy cream sauces)​ Alcohol​ Carbonated drinks​ Large food portions​

It's really not necessary to follow a specific diet protocol (if you do, that's also fine). The only rule is to eat protein first at EVERY meal + don't eat past the point of discomfort.
​

Coming Off the Drug What happens when use stops​

Obviously when you stop, your appetite returns. These drugs aren't meant to be permanent fixes.

If your entire reasoning as to using these drugs is to basically reset your eating habits and lose a target amount of fat, then you just stop once you've achieved that and build your own habits around your new appetite norms you can sustain.

If your appetite returns by a lot after stopping, you can either:

1. Resume the drug
2. Step down to a lower maintenance dose
3. Accept that you just need to manually and actively manage your own intake without the need the need of these drugs



As of now, protocols don't exist. I would consider it to be more arbitrary than anything. A lot of people stop using the drugs abruptly and experience zero issues.
​

---

Thank you for reading! ​

WHAT THE ACTUAL FUCK BROOOO

GODLY FORMATTING , AWESOME THREAD
HIGH IQ

INB4 BOTB

@Randomized STICK TS FRFRF

 

[Gengar’s Ghost]

i didnt know that i was trying to give more feedback and improvements
seems like it a well made thread(I still think it could be better it not my expertise but you are defo smart) also tag me when you make thread nigga if you need any help i am here( i am actually high iq have 2 threads in BOTB)
@Histism @Navity looks at this wonderful nigga

@Chad @Gengar’s Ghost @tuberculosisinmybal pin this thread really well made deserves way more

Looks very neat! I’m pinning this. Probably the nicest thread I’ve seen.

 

[Gengar’s Ghost]

Some other Jewish mod beat me to it.

 

[inversions]

I like the formatting.

 

[Firstname.Lastname]

Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis - PubMed

PROSPERO CRD42022342845.

pubmed.ncbi.nlm.nih.gov

This is just a meta analysis not a study itself. Its conclusions seem really unlikely and it does not provide the 76 studies it aggerated. It seems very unlikely they are talking about comparable studies despite aggregating them as if it's so.

It does not even bother to provide starting weights or % of body lost.

CagriSema (semaglutide with cagrilintide) resulted in the highest weight loss (mean difference -14.03 kg (95% confidence interval -17.05 to -11.00); high confidence of evidence), followed by tirzepatide (-8.47 kg (-9.68 to -7.26); high confidence).

This meta analysis is also completely inconsistent triz clinical trials.


From Actual clinical trials.
https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

For the efficacy estimand, the mean change in weight at week 72 with tirzepatide was −16.0% (95% CI, −16.8 to −15.2), a weight reduction of 16.1 kg (35.5 lb), with the 5-mg dose; −21.4% (95% CI, −22.2 to −20.6), a reduction of 22.2 kg (48.9 lb), with the 10-mg dose; and −22.5% (95% CI, −23.3 to −21.7), a reduction of 23.6 kg (52.0 lb) with the 15-mg dose

 

[Aeu]

WHAT THE ACTUAL FUCK BROOOO

GODLY FORMATTING , AWESOME THREAD
HIGH IQ

Thank you, bhai

 

[teddy101]

This is just a meta analysis not a study itself. Its conclusions seem really unlikely and it does not provide the 76 studies it aggerated. It seems very unlikely they are talking about comparable studies despite aggregating them as if it's so.

It does not even bother to provide starting weights or % of body lost. The meta analysis is also completely inconsistent triz clinical trials.




From Actual clinical trials.
https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

because it not the full meta analysis and meta analysis is a study you are talking about clinical trials / rct randomized control trials
bro and i am talking about a combo(Cagrisema and SEMAGLUTIDE ) i dont want to hate but educate your self a bit you dont know meta analysis is a type of study and even op know it i was just wrong and didnt know the other substance wasnt available yet
not hating

 

[Sayori]

View attachment 4962780

Spoiler: Legal Disclaimer

This guide is for informational purposes only and does not constitute medical advice. Consult a licensed physician before using either compound. The authors accept no liability for misuse. This guide assumes you are an adult making an informed decision about your own body.

---

[GLP-1 / GIP Agonists] [Appetite Suppression]
TIRZEPATIDE & SEMAGLUTIDE
FULL USAGE GUIDE
​

What They Are & Function Identity and biological role of Tirzepatide and Semglutide​

Tirzepatide and Semaglutide are injectable peptides that were originally developed for type 2 diabetes. They simply work by mimicking hormones your gut releases after eating, which then signals your brain that you're full, resulting in your hunger basically getting turned way down. Yes, I mean that your hunger signal is blunted. I am not exaggerating when I say that people on these drugs often forget to eat.

Two receptors are targeted by these drugs:

1. GLP-1 (Tirzepatide & Semaglutide)
2. GIP (Tizepatide only)

Tirzepatide is newer and, on average, stronger than Semaglutide. Both are injected once a week subcutaneously, meaning into the fat layer just under your skin.

Who this is for:

You're carrying enough extra weight that it's affecting your face, jaw definition, or overall physique. Say, you've tried eating less and maybe it worked for a couple of weeks. Your hunger is the problem, and these drugs fix exactly that. That's the entire point of this guide.

Also, you do NOT need to be clinically obese to use any of these drugs. If you're sitting at 20%+ body fat and struggling to keep a caloric deficit because you're hungry all the time, this thread would also be relevant to you.

I don't want people to think that these are fat-burning compounds. They are not. They simply suppress your appetite so hard to the point that you'll have no other choice but to eat at a deficit almost automatically.

Who should not attempt this:

1. Personal or family history of medullary thyroid carcinoma (MTC)
2. Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
3. History of pancreatitis
4. Under 18
​

Picking Your Compound Choosing between the two​

​

TIRZEPATIDE Brand: Mounjaro / Zepbound Peptide: GIP + GLP-1 dual agonist​	SEMAGLUTIDE Brand: Ozempic (diabetes) / Wegovy (weight) Peptide: GLP-1 agonist​
Average weight loss (72 weeks) ~20.9% body weight (SURMOUNT-1 trial)​	Average weight loss (68 weeks) ~14.9% body weight (STEP-1 trial)​
Injection frequency Once weekly​	Injection frequency Once weekly​
Starting dose 2.5 mg/week​	Starting dose 0.25 mg/week​
Max dose 15 mg/week​	Max dose 2.4 mg/week (Wegovy); 1 mg/week (Ozempic)​
Mechanism Dual GIP + GLP-1 receptor agonist. Has a much more effective appetite suppression lever than semaglutide.​	Mechanism GLP-1 receptor agonist only. Even though it is slightly milder, it is extremely well-studied​

​

SURMOUNT-1 · Jastreboff et al., 2022 · New England Journal of Medicine View attachment 4953594 2,539 adults without diabetes, BMI ≥30 (or ≥27 with weight-related comorbidities). Randomized, double-blind, placebo-controlled. 72 weeks of weekly tirzepatide (5 mg, 10 mg, or 15 mg) vs placebo. Participants on a 500 kcal/day deficit diet with lifestyle counseling. The 15 mg group lost a mean of 20.9% body weight. 57% of the 15 mg group lost ≥20% of their body weight. DOI: 10.1056/NEJMoa2206038​

STEP-1 · Wilding et al., 2021 · New England Journal of Medicine View attachment 4953769 1,961 adults without diabetes, BMI ≥30 (or ≥27 with comorbidity). Randomized, double-blind, 68 weeks. Weekly 2.4 mg semaglutide vs placebo + lifestyle intervention. Mean weight loss: 14.9% in the semaglutide group vs 2.4% placebo. 86% of semaglutide participants achieved ≥5% weight loss. DOI: 10.1056/NEJMoa2032183​

As you can see by the studies I showed above, Tirzepatide, number-wise, is clearly the winner. But that is only IF you can access it and tolerate will it then be the stronger choice for you. But, to be really honest, either one will work for appetite suppression.

So:
​

Choose Tirzepatide if...​	Choose Semaglutide if...​
1. You want the maximum appetite suppression​	1. You want the more accessible option​
2. You can source Mounjaro / Zepbound​	2. You can get Wegovy or Ozempic more easily​
3. You have more fat to lose overall​	3. You want a slower titration / milder start​
4. Cost is not a big deal​	4. You have a tighter budge​

​

Products & Sourcing Available forms and where they come from​

Tirzepatide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
View attachment 4954184 Picture of Mounjaro​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved for T2D​
View attachment 4954316 Picture of Zepbound​	Single-dose autoinjector pen​	2.5, 5, 7.5, 10, 12.5, 15 mg​	FDA-approved (specifically for weight loss)​
View attachment 4954343 Picture of Compounded Tirzepatide​	Vial + syringes (drawn manually)​	Variable (concentration usually set by the pharmacy)​	Way cheaper than any of the other products. Sources: Hims, Nuvation, Mochi​

Semaglutide Products​

PRODUCT​	FORMS​	DOSES AVAILABLE​
View attachment 4954398 Picture of Wegovy​	Single-dose autoinjector pen​	0.25, 0.5, 1, 1.7, 2.4 mg​	FDA-approved (specifically for weight management)​
View attachment 4954413 Picture of Ozempic​	Multi-dose pen (clicks to dose)​	0.25, 0.5, 1 mg per dose​	FDA-approved for T2D​
View attachment 4954435 Picture of Compounded Semaglutide​	Vial + syringes​	Variable​	Same situation as tirzepatide. Cheaper. Sources: Telehealth NOTE: Confirm it's semaglutide base and NOT semaglutide sodium or acetate salt (different bioavailability)​

​

Dosing Schedule How usage is structured over time​

Tirzepatide Titration​

WEEKS​	DOSE​	​
1-4​	2.5 mg​	Starting dose (Non-negotiable)​
5-8​	5 mg​	First actual appetite suppression for most people​
9-12​	7.5 mg​	Increase only if tolerating 5 mg well. Stay at 5 mg longer if needed​
13-16​	10 mg​	Strong suppression for many people. Sweet spot would be between 5-10 mg​
17-20​	12.5 mg​	(Optional) Only increase if you've plateaued and are tolerating well​
21+​	15 mg (max)​	Maximum dose. Not everyone needs to reach this​

Semaglutide Titration​

WEEKS​	DOSE​	​
1-4​	0.25 mg​	(Introductory dose) Basically, just introducing the drug to your system​
5-8​	0.5 mg​	You'll start to notice the effects on appetite​
9-12​	1 mg​	Appetite suppression is a lot for most people at this dose​
13-16​	1.7 mg​	(Wegovy-specific dose step) Skip if using Ozempic (max 1 mg with standard pen)​
17+​	2.4 mg (max)​	(Wegovy maintenance dose) Maximum approved dose for weight management​

YOU DON'T NEED TO BE AT MAX DOSE TO SEE RESULTS

You can literally keep great appetite suppression at about 5-7.5 mg tirzepatide or 1 mg semaglutide. You need to find your own personal minimum effective dose and just stay there.

Higher doses = more side effects with diminishing returns past a certain point for YOUR personal response.
​

Injection Instructions How to correctly give the dose​

Supplies you need (compounded vial method)
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1. Insulin syringes View attachment 4955158 Picture of Insulin syringes 1 mL / 29-31 gauge / 4mm (5/32") or 6mm (1/4") needle length​

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2. Alcohol swabs View attachment 4955170 Picture of Alcohol swabs​

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3. Your compounded vial​

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4. Sharps disposal container View attachment 4955175 Picture of a sharps disposal container Or, another good alternative would be a thick plastic bottle with lid as a DIY sharps container​

For autoinjector pens (Mounjaro, Wegovy, Ozempic), skip steps 1-3 below. The pen basically handles everything.

Subcutaneous injection: step-by-step

Step 1: Wash your hands
Common sense. 20 secs minimum.

Step 2: Pull the vial from the fridge
You'd want to let it sit for about 15-20 mins.
Room temperature injection is considerably more comfortable. Trust me, cold liquid going in subcutaneously stings like fuck.

Step 3: Wipe the vial top with an alcohol swab
Let it air dry for 5 seconds before inserting the needle.

Step 4: Draw your dose
You'd want to pull back the syringe plunger to your dose volume (see concentration math below), insert the needle into the vial, and then flip the vial upside down, and draw.
Remove any bubbles by flicking the syringe and pushing air out slowly.

Step 5: Pick your injection site, swab with alcohol
Abdomen (2 inches away from navel), outer thigh, or upper outer arm. Let the swab dry before injecting.

Step 6: Pinch the skin
You'll have to insert at different degrees depending on the needle length.​

4mm needles​	6mm needles​
Go straight in (90°)​	Pinch the skin and go at 45°​

You're going into the subcutaneous fat layer and not muscle. Inject slowly. Takes about 5 seconds. Release the pinch, and then pull out.

Step 7: Press gently (DO NOT RUB)
Apply light pressure with a clean swab for like a few seconds. If you do rub, it can irritate.

Step 8: Dispose of the needle immediately in your sharps container
Again, common sense, but do not recap and reuse. Use once and dispose.

Autoinjector pen method (Mounjaro / Wegovy / Ozempic)

Step 1: Check the pen
Confirm the dose window. For Ozempic, you would have to dial it your dose. For Mounjaro/Wegovy single-dose pens, it really isn't required.

Step 2: Remove the pen cap(s)
You just have to follow the specific pen instructions included in the packaging. Mounjaro has an outer cap and a needle cap. Wegovy has a base cap.

Step 3: Swab your injection site, let it dry
Similar to before. Avoid the navel within 2 inches.

Step 4: Press the pen flat against your skin, hold the button
You'll hear some type of click when the injection starts. Just hold the pen in place for the full count (usually 10 seconds). A second click or indicator confirms that it's delivered.

Step 5: Remove, cap, dispose
Again, similar to before, do not reuse.

Injection site rotation

View attachment 4959810
Example of the recommended injection sites

Rotate sites every week + do not inject the same spot (can lead to lipohypertrophy)

Concerntration math (compounded vials)

The specific compounded vial you have usually comes labeled with concentration (e.g., 5 mg/mL or 10 mg/mL).

Formula:​

Volume to draw (mL) = Desired dose (mg) ÷ Concentration (mg/mL)​

Example:

Let's say you want 2.5 mg tirzepatide. Your vial is labeled 5 mg/mL.

2.5 ÷ 5 = 0.5 mL

You would then draw to the 0.5 mL line on a 1 mL syringe.

On a U-100 insulin syringe (which reads units and not mL): 0.5 mL = 50 units on the syringe markings.



It really doesn't matter. It just has to be the same day every week. Pick any and just stick to it consistently. Set a recurring phone reminder.
And, yes, if you miss a dose or have irregular timing, it will reduce the effectiveness of the drug.
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Storing Your Medication How to keep it stable and usable​

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Mounjaro / Zepbound pens (UNOPENED) Refrigerate at 36-46°F (2-8°C). DO NOT FREEZE. Shelf life until expiry date on label.​	Mounjaro / Zepbound pens (IN USE) Room temperature up to 86°F (30°C) for up to 21 days.​
Ozempic / Wegovy (IN USE)​ Ozempic​ Room temp up to 56 days after first use​ Wegovy​ Single-dose, use immediately.​	Compounded vials Refrigerate at 36-46°F, but this depends on your specific pharmacy's label, so make sure to check it.​

DO NOT:​

Freeze any form of either drug​

Expose to direct sunlight for long periods​

Use if the solution looks cloudy, discolored, or has particles​

Use past the expiry or stability date​

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Side Effects & Management What to expect and mitigation strategies​

Of course, for every medication used, there will always be side effects, and in the case of Gl, they're extremely common (especially in the first 4-8 weeks of using it and at every increase of the dose).

This is the main reason why a lot of people tend to quit so early. So, managing them should also be apart of your protocol.
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Nausea (VERY COMMON)​ Eating bland, low-fat foods​ Smaller, slower meals​ 4mg Ondansetron (if it gets bad)​	Vomiting / Diarrhea​ High-fat meals​ Keep fat moderate​ Hydrate (a lot)​
Constipation​ Increase fiber and water​ Miralax (polyethylene glycol) 17g/day​ Magnesium citrate 200-400 mg/night​	Injection site reactions​ Let the medication reach room temperature before injecting​
Fatigue​ Eat enough protein despite reduced appetite​	Muscle loss ("Ozempic face/body")​ 0.7-1g protein per lb of bodyweight​ Resistance training​

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Diet On GLP-1s How eating patterns interact with the drug​

Considering that you'll naturally eat less on these drugs, your biggest priority should be making sure that every meal needs to count nutritionally.
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PROTEIN PRIORITY​ 0.7-1g per lb of bodyweight daily (even if you have to force it)​ Protein shakes, greek yogurt, eggs, cottage cheese, chicken breast, and whey protein​

FOODS THAT FUCK YOU UP ON GLP-1S​ High-fat meals (fast food, fried food, heavy cream sauces)​ Alcohol​ Carbonated drinks​ Large food portions​

It's really not necessary to follow a specific diet protocol (if you do, that's also fine). The only rule is to eat protein first at EVERY meal + don't eat past the point of discomfort.
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Coming Off the Drug What happens when use stops​

Obviously when you stop, your appetite returns. These drugs aren't meant to be permanent fixes.

If your entire reasoning as to using these drugs is to basically reset your eating habits and lose a target amount of fat, then you just stop once you've achieved that and build your own habits around your new appetite norms you can sustain.

If your appetite returns by a lot after stopping, you can either:

1. Resume the drug
2. Step down to a lower maintenance dose
3. Accept that you just need to manually and actively manage your own intake without the need the need of these drugs



As of now, protocols don't exist. I would consider it to be more arbitrary than anything. A lot of people stop using the drugs abruptly and experience zero issues.
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Thank you for reading! ​

Water, but its a very high effort thread

I understand how painfull it is rereading studies for a thread

 

[goku21]

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