My First Four Weeks on Tirzepatide

Written by Marcia Cripe, RN

On May 10, 2024, Dan and I started tirzepatide. I weighed about 230 pounds.

I had read about the medication. I knew what it was supposed to do, I knew appetite suppression was part of the equation, and I knew people were losing substantial amounts of weight on it. So after that first injection, I waited to feel something.

I expected there to be a moment when I could say, Okay. There it is. The medication is working.

That isn't how my first month happened. The beginning was surprisingly uneventful.

The First Dose

I didn't take my first injection expecting magic, but I was definitely paying attention. When you start a medication specifically because you want it to change something you experience every day—hunger, eating, weight—it's almost impossible not to monitor yourself.

Am I hungry? Am I less hungry? Did I eat less than usual? Is that the medication, or would I have done that anyway? Do I feel sick? Is the scale moving?

I was looking for evidence.

I also expected side effects because nausea had become almost synonymous with GLP-1 medications in the way people talked about them. Instead, my early side effects were minimal.

That was obviously a good thing, but it also meant there wasn't a strong physical sensation announcing that I had taken a powerful medication. I had given myself an injection. Now I had to wait and see what happened.

Week One: Mostly Watching

The first week wasn't dramatic. I didn't suddenly hate food, forget that eating existed or walk around stunned because my appetite had disappeared.

If anything, the experience was subtler than I had expected. I was paying attention to hunger and portions and whether I felt full sooner. I was also watching the scale because, of course, I wanted to know whether this was actually going to work.

There wasn't one unmistakable moment I can point to during that first week and say, That's when everything changed. It hadn't.

At the time, I also didn't have the vocabulary I have now for separating hunger, appetite, food noise, satiety and wanting. I was asking a much simpler question:

Am I eating less?

The Next Few Weeks Blurred Together More Than I Expected

I wish I could give you a perfect diary of Day 9 versus Day 16 versus Day 23, but I can't. I wasn't taking notes because I had no idea this experience would eventually become something I would write about publicly.

I was just taking a medication and trying to lose weight.

What I remember clearly is the overall character of those first four weeks. The changes were real enough to keep going, but they weren't yet extraordinary. My body was tolerating the medication well, I wasn't battling significant nausea, and I was beginning to experience the effects I had expected from a weight-loss medication.

And I was watching my weight.

That mattered enormously to me then. Today I can talk about GLP-1 receptors, satiety signaling, reward circuitry and why these medications can change eating behavior, but back then I wanted the number on the scale to go down.

That was my scoreboard.

I Was Still Thinking Like Someone on a Diet

This may be the biggest difference between my first month and what came later. During those early weeks, I was still evaluating tirzepatide through the framework I already understood: eat less, lose weight and try not to regain it.

In that framework, the medication simply made the eating-less part easier.

That made perfect sense to me. I'd dieted before and I'd lost weight before. I knew what restricting food felt like, and I knew what it was like to want something and decide not to eat it.

So when people described GLP-1 medications as reducing appetite, I interpreted that through experiences I already had. I assumed this was going to be a much more effective version of something familiar.

I didn't yet understand that there was another experience waiting for me.

Four Weeks In, I Was Ready to Keep Going

By the end of that first month, there was no question in my mind that I was continuing. I was tolerating the medication, I was focused on losing weight, and nothing about the experience had scared me away from moving forward.

What I didn't feel was some profound sense that food itself had changed.

Not yet.

That's important because when I describe what happened later, it can sound as though I took tirzepatide and immediately became indifferent to eating. I didn't. There was a beginning before that, and for me the beginning was quieter.

Then I Moved to 5 mg

This is where the story changes.

After those first weeks, I moved up to 5 mg, and what happened next was qualitatively different from what I had experienced during the first month. This wasn't simply I'm a little less hungry or I can stop after a smaller portion.

And it definitely wasn't I'm being really disciplined with my diet.

The drive to eat began disappearing in a way I had never experienced before. That distinction would eventually become one of the most important things I learned during my entire GLP-1 journey.

Hunger isn't the same thing as wanting food. Wanting food isn't the same thing as enjoying food. And enjoying food isn't the same thing as being driven to seek it.

I didn't understand any of that during my first four weeks, and I didn't need to. I was still standing on the other side of the line.

The first month taught me that tirzepatide could help me lose weight.

What happened at 5 mg would eventually make me question almost everything I thought I understood about why we eat.

But that's the next part of the story.

Continue the Journey

The first month was subtle. The next dose increase was not.

In the next part of my journey, I explain what changed when I moved to 5 mg tirzepatide and why it was the first time I understood that this medication was doing more than simply making me less hungry.

Continue reading: When 5 mg of Tirzepatide Changed Everything

Sources

This article is a first-person Journey account based on Marcia Cripe's recollection of her life and experiences before beginning tirzepatide on May 10, 2024. It does not make clinical claims about tirzepatide or establish that the medication caused subsequent changes.