Trying to decide between options regarding german private insurance (pkv) vs statutory and could use some input from people who have been there.

My situation: been on sema for 6 months considering a switch.

I have read the wiki and FAQ but real-world experiences would help me make a decision. What would you do in my position?

Dr.CardioMD's experience with German private insurance resonates deeply with mine. I went through almost the identical process — starting dose, titration timeline, side effects, everything.

The main difference: I titrated faster. But the overall trajectory has been remarkably similar. Down 68 lbs in 13 months.

One thing I would add that Dr.CardioMD did not mention: the relationship with food fundamentally changed.

Thanks for sharing this, Dr.CardioMD. A few questions about your German private experience:

1. What dose worked best for you?
2. How long before you noticed appetite suppression kicking in?
3. Did your endo have any specific recommendations about German private?

I am in a similar boat and trying to learn from others' experiences before my next appointment.

OP here — wow, did not expect this much response! Thank you all for the thoughtful replies on German private insurance.

To answer Dr.PulmRoch: yes, I am on compounded sema from a 503B pharmacy.

Quick update: things are still going well. Thanks again for the evidence-based discussion — this is exactly why I posted in a science-based community. 🙏

Relevant to German private insurance (PKV) — here is my latest bloodwork comparison:

Key improvements: A1C 7.6% → 5.5%, triglycerides 221 → 91 mg/dL, hsCRP 8.0 → 0.9 mg/L. All on tirzepatide for 13 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.