Losing a bit of Weight

I have had a near life long struggle with my weight. I tried to dodge and “accept” the gains but there were some points I just could not get past:

• Having the largest “normal” size (40″ waist) no longer comfortably fit. I was not going to go to the big and tall sections or stores.
• Buying new downhill ski boots last fall and having a hard time reaching around my belly to put them on and buckle.

There were many others, but the I could not drop weight significantly until after these 2 decision points. 3 years ago, I hit my peak weight of 260lbs. I was down to 1 pair of jeans and 2 pair of shorts I could squeeze into and my shirts were tight. Additionally I had gone to visit old co-workers who were amazed at how I had grown out. So at that point, I decided to eat healthier and over several months was able to drop 20 lbs. However as much as I tried, I could not get much lower. At my last year annual checkup, I asked for a prescription to Zepbound but was counseled that I basically did not have enough co-morbidities to get insurance approval (just obesity and high blood pressure). Sure enough, the insurance coverage was denied. I could not afford the $1200/ month it would cost (for life). So it was back to trying to eat better and exercise more…

When we were about to come back from Fiji in March, I saw the announcements that Lilly was going to offer it direct for cash sales at $499/mo ($349 for the “intro” month doses). We had been really good on vacation (even losing a pound against all odds with the wonderful food offered at the dive resort). I was able to request the prescription again and after a few false starts, get it to Lilly Direct and start on Zepbound (tirzepatide, a GLP-1+GIP drug). This was at the beginning of April. By this time, I had read everything I could on the medication and its side effects (including the physician prescribing info). So I hoped I knew what I was getting into. At this point, I was at 240 lbs. I decided to use “mini goals” along the way to track my progress (incremental weight loss, clothes sizes, increased stamina for yard work and on bike rides).

As I went through the injections, the first introductory dose (2.5mg) month is pretty easy. Appetite diminished and marginal nausea.

Second month we increased to 5 after some fits with getting the prescription straight (yes, we are self injecting via vial and syringe – Teal enjoys doing it rather than the much more expensive auto injector pens and the $499/month cash price is only for the vials not the auto injectors). Some mild nausea but greatly reduced appetite for the first 4 days post injection.

3rd month increase to 7.5 mg. Side effects are bit more pronounced (but I said “tolerable” when asking for an increase the next month). First major weight loss mile stone was hit in the first week. The weight on my drivers license was no longer “aspirational” as I went down past it (for the first time in probably 30 years). Now I was under 225lbs! The first of my mini-goals was met.

4th month the dose increased to 10mg. In retrospect this was probably a bit premature. Nausea and general discomfort hit quite a bit and we were on vacation. However, I was down to 210 at the end of July. So I decided to stay at this dose for a while. Each month it gets easier. September was the start of the slower weight loss.

Now in November I have dipped below 200lbs. This is where I was as a high school senior / college freshman. However the muscle to fat ratio is still not the same (my legs were huge back then due to biking >3Kmiles/ yr and skiing 40-50 days / year at that time). So I still have more work to do. More biking and strength exercises in addition to the cardio (elliptical) I have been doing for years.

What are the other things that change with the loss?

• I have had issues with high blood pressure and cardiac arrythmias (PACs – a.k.a. heart palpitations) over the last few years and was on 3 medications for this. The first noticeable change came in June and July when I was light headed some mornings. Apparently BP of 90/50 with a heart rate in the low 50s is not high enough. So after consulting with my doc, I was weaned off the relatively low dose of Losartan I was on. BP improved into the 100-110 range. This was nice. The same thing happened again in August. This was around the time of my annual cardiology check up. We discussed what was going on and then took the Metoprolol off. I had only had one heart palpitation for a couple of seconds in over 6 monthsThis again needed to be weaned off over a couple of weeks but it is great! My BP and resting heart rate increased a little. Metoprolol is a beta blocker which limits your heart’s response to exertion and for me basically placed a “speed limit” of 120BPM on me. That sucked, limiting my exercise capability, endurance and just generally making me feel “weak”. Once off of that, my exercising improved and on bike rides I could once again hit 150bpm! Now my legs would get sore on a 25 mile ride, rather than just leaving me feeling tired overall. So this is empirical evidence that losing weight can reduce blood pressure and medication dependency (in addition the many peer reviewed studies such as: https://pmc.ncbi.nlm.nih.gov/articles/PMC9917722/). Diet changes also helped with the arrhythmias /palpitations, but that will be another article.

• I did get to work over my wardrobe, but my timing was not ideal. I started out in April wearing size 38-40 pants. In July we filtered through the clothes that I had and weeded out the largest items to donate or discard and found some of the smaller ones (36s) with end of season close-out price tags still attached from 8 years ago when I did a couple of sprint triathlons. Belts got new holes and the ends trimmed shorter on the leather ones. New swimsuits were needed (no need to moon everyone). New shorts were needed as well (working on a ladder 3 stories up in summer heat with my shorts sliding down to my knees was not a recommended experience). However, at this time there were slim pickings as back to school / fall clothes were in stock, but I snagged a few 36s and a month later some 34s on close out (jeans as well). One of the clothes shopping highlights this past month was getting a new ski jacket and pants (my olde ones were 25 plus years old and frayed at the edges). I dropped from a XXL to Large for both the Jacket and pants (high school sizes for me). I used the waist size reduction as another goal metric, celebrating each size drop. I have not bought many shirts yet as I have an over-abundance of those that were too tight or had shrunk a bit and are now comfortable to baggy.

Why am I writing this?

• Dealing with weight is a touchy issue socially. This is despite nearly 10% of the country being on some sort of weight loss medication. This article really triggered me to write this: https://www.npr.org/sections/shots-health-news/2025/10/28/nx-s1-5587805/glp-1-ozempic-zepbound-gallup-obesity-rate
• There are a number of folks I have seen recently after not seeing them for months or years and I get the “once over” look (sometimes twice). But, most folks are too polite to ask if I had lost weight (and at my age of 67, it may not be for a “good” reason). It is sort of like the opposite of asking a woman if she is pregnant. You “just don’t go there” . Even when I notice the “once over look”, I am reticent to say I have lost a bunch of weight (or it may seem like bragging).
• With some close friends and family that are on the GLP1s we do discuss this and compare notes.
  • What to eat is a big one. My portion sizes have literally been cut in half vs a year ago. I purposely downsize my plates and bowls as the urge to fill it up still is there (and then the guilt of not being able to eat what I took). So portion reduction is big one. The dark side of this is it is very easy to come up short on protein consumption. You need the protein (and exercise) to avoid muscle loss when losing this much weight. Tracking daily protein consumption just becomes another task, but fitting it into the diet can be challenging. My target is 70-100 grams / day.
  • Ensuring you get enough exercise is another thing. There is sort of a dual benefit where if I am exercising hard (including doing yard work such as pulling and cutting lots of buckthorn). The first few days post injection, I get accelerated weight loss IF I am exercising strenuously. The rest of the week , the weight may stay the same or rebound slightly, but those first post injection days are key for me. Those first few days unfortunately are when you may not feel great. Push through it, the results are definitely worth it.
  • At this point, I am not going to increase the Zepbound dose. There are 2 higher levels (12.5 and 15mg) available, but I don’t want more side effects and losing a few pounds a month is sustainable.
  • Donating blood or platelets (as I do), the day after injection seems to exacerbate the side effects (nausea and tiredness). Shifting by a few days helps a lot.
  • Another side benefit is that with the portion control and better diet, my wife Teal has also lost over 12lbs (no meds).

Here I am, still on the weight loss journey. I would like to lose another 20 lbs. I also want to see that when I go for my annual physical next month that the red “patient is obese” is removed from my health record. It is yet another incremental goal. If the rumors of further pricing reductions come true, that would be an added bonus, as this is a life long commitment if I don’t want the weight to rebound.