Dr.ObesityLA said:

Energy expenditure increase from is not that straightforward in my experience

This is exactly right. Dr.ObesityLA articulated what I have been trying to explain to my doctor for months. The Energy expenditure aspect is the most important factor.

Reading this thread on Energy expenditure hits close to home. Night shift nurse — I started at 287 lbs and felt like I would tried everything.

13 months on tirz and I am a different person. Not just the 62 lbs lost — my energy, my mood, my relationship with food. All transformed.

If you are on the fence about Energy expenditure — take the leap. It was the best health decision I have ever made. ❤️

Dr.MetabolicMD — that is really helpful context on Energy expenditure. Follow-up question: what labs did your doctor order to monitor this?

I am in a similar situation (just started) and trying to set realistic expectations.

To answer newstart_MO's question specifically:

From a clinical standpoint, Energy expenditure increase is an area where we have good evidence.

The short answer: baseline labs + quarterly monitoring is the standard of care.

The longer answer involves understanding the mechanism of action at the receptor level, which I am happy to elaborate on if helpful.

Bookmarked 📌 The Energy expenditure info in this thread is essential. Coming back to this for sure.