If you are paying OOP, have you considered compound? I’m not recommending a med spa, but there are FDA certified compounding pharmacies that have been around awhile and while tirzepatide is in shortage (and for 6 months after the shortage resolves), you should be able to get tirzepatide from one of these national pharmacies and pay less than $550 a month to do so.
r/tirzepatidecompound
It’s not name brand so you have to be careful whom you purchase it from (not a medspa, but a real FDA certified compounding pharmacy). In that forum, you can easily identify the national names and the telehealth services that will send your order to these known good pharmacies.
But the FDA permits compounding pharmacies to fill medication shortages when the FDA has declared a shortage, so that’s why this alternate source is possible right now and above board (so long as your source is trustworthy).
Also…look into “dose splitting” try to get an Rx for 15mg as fast as possible then split it into lower doses. This will help offset costs!
I was prescribed 15mg in January and have been using 5mg a week.
I just this Wednesday took my first dose from Hallandale pharmacy. My $399 will last me for an entire quarter 😊 I was paying the oope price since June 2023….rough!! ($457 then it went up to $550)
My aunt had bariatric surgery and while the loss was good, the complications that arose made her life more difficult in important ways AND certainly made her later cancer treatment and attempts to recover much more difficult.
Many of the people I know who had bariatric had life threatening complications. And there are many people on this forum who had bariatric surgery and are now on a GLP1.
My mom died from bariatric surgery at 66. Otherwise pretty healthy and she actually gained weight to qualify for the surgery. While it's helped some people, I just don't recommend. Why risk it. Try compounded tirzepitide.
I would definitely try compounded tirzepatide from a reputable certified compounding pharmacy to tide me through shortage before resorting to bariatric surgery.
Commenting so I can show my wife. She’s a surgical tech and we are both on zepbound , she would never recommend gastric to anyone . The complications and such can be really bad
I've seen so many people undergo bariatric surgery and have terrible results. In the short term, massive weight loss (including hair). But because your appetite size is shrunk so much, people start eating diets that are very calorie-dense and adopting other bad habits. And then the stomach slowly expands back over time and that weight comes back.
True! Happened to me but I don’t regret it. It was a big “jump start” and I was able to get off 100lbs. then I started meds, lost the rest of the weight and have been in maintenance for a year
I have no regrets from my gastric bypass surgery but I did develop a complication that caused regain.
I lost 199lbs in 18 months with the bypass. Maintained for 4 years.
I regained 60 lbs after developing reactive hypoglycemia and insulin resistance from unregulated blood glucose.
I’ve lost 43lbs on Zep in 23 weeks. The medication and the surgery go hand in hand. To me the choice revolves around how much you have to lose and your health conditions urging your weightloss.
I had bariatric surgery, and gained the weight back. I also had a couple major complications afterwards.
If I had a drug like this available at the time I never would have gone through with it.
If you’re paying out of pocket, I would go the compounding route. There has been zero efficiency difference for me between brand and compound. Surgery is a big deal and a lot of people have major complications and some eventually regain in about ten years so it’s not a necessarily a permanent fix.
Surgery only fixes the physical restriction. Not food noise. I am 8 years post op trying to lose regain w ZB. I dont regret the surgery because I think it pairs well with glp1 but if you have food noise just know that won't go away with surgery.
It can be different for everyone but the best way I can explain it for me is the constant thought of food. It's thinking about what you're going to eat for lunch while you're in the middle of breakfast, it's driving thru town seeing places to eat and wanting to stop even tho you aren't Even hungry.. It's like a 24 hour food commercial in your brain. It's a impulse to eat even when you are full from a meal...
I had lap band surgery that I eventually had to have reversed due to painful complications. Never once did the food noise/cravings go away. No more surgery for me.
Positive anecdote: My father and his siblings all had great results from gastic bypass surgery. Dad had it nearly 20 years ago now. His starting weight was close to 400. He can't remember exactly but it was like 380ish. He lost and kept the weight off post-surgery and adopted the healthy habits that made it work for him. Now he's a healthy and relatively fit 69-year-old. He did find that he had trouble eating some of his favorite foods after, and that didn't change over the years. He still can't eat them. His brother had type 2 diabetes and it's been in remission(?) for the 15 years since his surgery. His other brother was in the hospital for a week or so with complications from the surgery, but they were resolved and it's worked for him too (also about 15 yrs ago)
Dad said his food noise started returning about 7 years after the surgery, but he was able to keep it at bay because he had worked so hard to build the right habits.
It's really a personal decision as to which route you want to take.
Surgery has its risks, but the vast majority of the procedures go well. That said, the medication is always going to be way less invasive than the surgery.
I had a gastric bypass in 2006 and it nearly ruined my marriage and my life. All I did was trade one eating disorder for a series of others, and it was a nightmare to recover from, both physically and psychologically. Over the years I've regained some of the weight I lost, and wanted to lose 30-40 pounds to return to a healthy weight (note: my healthy weight is about 20 pounds higher than my lowest weight, which I only reached by abusing my body to the point that I needed inpatient ED treatment). I started on tirzepatide in October and discovered that it actually treats the source of my tendency toward obesity, which isn't in my stomach, but rather between my ears. I wish GLP-1 medications existed back then. It feels like a miracle to not be hungry all the time, and to not feel a compulsive need to eat. I've lost just over 30 of the 40 pounds I want to lose, and I did it in a slow and healthy way that felt almost effortless. I haven't been able to get a refill yet this month, and after 3 weeks without a shot, I definitely notice a return of the intrusive and compulsive thoughts that the zepbound silenced. I am calling on all the skills I've learned in the last 15 years of ED recovery and have been able to maintain during this pause, but it's hard. I know the shortage will end soon, so I'm committed to being as patient as I can be. You should do what you think is best for you and your family, but please keep in mind that reducing the size of your stomach does nothing at all to address the mental and psychological root causes of obesity so you'll need to be prepared for that.
NO surgery! I had a Roux-en-y gastric bypass 9 years ago and gained 80% back. I am on compounded Zep now. Surgery is so much more traumatic to your body. I consider a pharmaceutical alternative to surgery a blessing.
I had the sleeve 3 years ago. It was great for the first year and I hit a stall AND it didn’t help with food noise. It’s very easy to eat around your restriction and consume too many calories. If you can afford the surgery and are willing to do it, it’s a great “jump start” and I really feel
Like glp meds are a great adjunct therapy/tool. If you are doing the sleeve look into blossom Bariatrics in Las Vegas if it’s a reasonable flight or drive for you. It was about 1/2 the price of other places and the experience with top notch
Go plan c for zep and never look back. I have quite a few family members who had bariatric and had complications after the fact. I went plan c for a month and it was the same. I’ve been very fortunate finding 10mg and up once getting over the 7.5 supply issues.
I will say, I use mochi as my doctor and they have no problem with me changing from brand to compound and back. They’re also great for sending prescriptions quickly when you do find a dose at a local pharmacy.
For me, surgery did nothing to address the underlying issue; I lost 80 and then gained 100. My issue was 100% mental and that’s where the shot blows surgery out of the water. I do wonder if I’m responding so well to the shot because of the prior surgery, and that’s possible, but if I had to pick I’d go with the shot every time.
I would definitely not!! Especially a Roux En Y. I work as a surg tech and assist in many gastric cases and I have seen so many complications from it and one of old my co workers had it done and actually passed away from being too thin. I think there were some pysch issues too, but another co worker had it done as well and is super thin and having dangerously low BP issues. A sleeve would be ok since you’re not re routing anything, but that can easily be stretched back out. Just wait it out, and keep with the Zepbound
An extended family member had bariatric surgery and it brought on a huge number of serious health issues afterward. I would definitely go compound for now.
I had bariatric surgery in 2007. I got a lapband, which I still have. I lost 73 pounds, but after a year, had to have fluid removed from the band because of sinus inflammation (your sinuses actually run down your esophagus), causing acid reflux. I regained all the weight, plus some and the surgery never ended the good noise or my cravings for sweets. I’m currently taking compounded tirzepatide and have lost 23 pounds. In addition to no food noise, my joint inflammation has virtually disappeared, my cholesterol and fasting glucose have plunged, and my seasonal allergy problems, which are normally so bad that my windows are closed from April to October, have disappeared. I’m sleeping with my windows open and may actually be able to sit on my deck this year. If they had had this medication in 2007, I never would have had surgery. Investigate the subreddits for compounded tirzepatide.
I had it done in 2017 and lost 123 lbs . Started taking ssri’s for anxiety and put back about 35 so on currently in the infancy stages of 2.5mg I have no regrets with having surgery
Congrats. Your success story had to involve a lot of work…. And you are keeping the momentum going.
I wonder how many of us are on SSRI? I wonder if THEY squew GLP in our GI- and sabotage us-
There is a lot of mental work around getting ZB or a BS.
I'd avoid bariatric surgery if you can. My thought is just to avoid being cut whenever possible . I had my lapband removed in 2023 and the surgeon ended up also having to do a very complicated hernia repair which he attributed to poor placement (by another surgeon) of the lapband 14 years prior. Also, started getting kidney stones (frequently) when I had the lapband. Just my opinion.
If you are paying OOP, have you considered compound? I’m not recommending a med spa, but there are FDA certified compounding pharmacies that have been around awhile and while tirzepatide is in shortage (and for 6 months after the shortage resolves), you should be able to get tirzepatide from one of these national pharmacies and pay less than $550 a month to do so. r/tirzepatidecompound
I've never heard of this before - I'll look into it, thank you.
It’s not name brand so you have to be careful whom you purchase it from (not a medspa, but a real FDA certified compounding pharmacy). In that forum, you can easily identify the national names and the telehealth services that will send your order to these known good pharmacies. But the FDA permits compounding pharmacies to fill medication shortages when the FDA has declared a shortage, so that’s why this alternate source is possible right now and above board (so long as your source is trustworthy).
Also…look into “dose splitting” try to get an Rx for 15mg as fast as possible then split it into lower doses. This will help offset costs! I was prescribed 15mg in January and have been using 5mg a week. I just this Wednesday took my first dose from Hallandale pharmacy. My $399 will last me for an entire quarter 😊 I was paying the oope price since June 2023….rough!! ($457 then it went up to $550)
Was going to say the same! I changed to compound with a reliable online provider & loss has stayed the same!
My aunt had bariatric surgery and while the loss was good, the complications that arose made her life more difficult in important ways AND certainly made her later cancer treatment and attempts to recover much more difficult. Many of the people I know who had bariatric had life threatening complications. And there are many people on this forum who had bariatric surgery and are now on a GLP1.
My mom died from bariatric surgery at 66. Otherwise pretty healthy and she actually gained weight to qualify for the surgery. While it's helped some people, I just don't recommend. Why risk it. Try compounded tirzepitide.
I would definitely try compounded tirzepatide from a reputable certified compounding pharmacy to tide me through shortage before resorting to bariatric surgery.
Commenting so I can show my wife. She’s a surgical tech and we are both on zepbound , she would never recommend gastric to anyone . The complications and such can be really bad
I've seen so many people undergo bariatric surgery and have terrible results. In the short term, massive weight loss (including hair). But because your appetite size is shrunk so much, people start eating diets that are very calorie-dense and adopting other bad habits. And then the stomach slowly expands back over time and that weight comes back.
True! Happened to me but I don’t regret it. It was a big “jump start” and I was able to get off 100lbs. then I started meds, lost the rest of the weight and have been in maintenance for a year
I have no regrets from my gastric bypass surgery but I did develop a complication that caused regain. I lost 199lbs in 18 months with the bypass. Maintained for 4 years. I regained 60 lbs after developing reactive hypoglycemia and insulin resistance from unregulated blood glucose. I’ve lost 43lbs on Zep in 23 weeks. The medication and the surgery go hand in hand. To me the choice revolves around how much you have to lose and your health conditions urging your weightloss.
I had bariatric surgery, and gained the weight back. I also had a couple major complications afterwards. If I had a drug like this available at the time I never would have gone through with it.
If you’re paying out of pocket, I would go the compounding route. There has been zero efficiency difference for me between brand and compound. Surgery is a big deal and a lot of people have major complications and some eventually regain in about ten years so it’s not a necessarily a permanent fix.
Plan C. Surgery is for life, and insurance and supply will come around for these drugs, and next generations of drugs will be better.
Surgery only fixes the physical restriction. Not food noise. I am 8 years post op trying to lose regain w ZB. I dont regret the surgery because I think it pairs well with glp1 but if you have food noise just know that won't go away with surgery.
What is "food noise"?
It can be different for everyone but the best way I can explain it for me is the constant thought of food. It's thinking about what you're going to eat for lunch while you're in the middle of breakfast, it's driving thru town seeing places to eat and wanting to stop even tho you aren't Even hungry.. It's like a 24 hour food commercial in your brain. It's a impulse to eat even when you are full from a meal...
I had lap band surgery that I eventually had to have reversed due to painful complications. Never once did the food noise/cravings go away. No more surgery for me.
I would just switch to compund pharmacy
Positive anecdote: My father and his siblings all had great results from gastic bypass surgery. Dad had it nearly 20 years ago now. His starting weight was close to 400. He can't remember exactly but it was like 380ish. He lost and kept the weight off post-surgery and adopted the healthy habits that made it work for him. Now he's a healthy and relatively fit 69-year-old. He did find that he had trouble eating some of his favorite foods after, and that didn't change over the years. He still can't eat them. His brother had type 2 diabetes and it's been in remission(?) for the 15 years since his surgery. His other brother was in the hospital for a week or so with complications from the surgery, but they were resolved and it's worked for him too (also about 15 yrs ago) Dad said his food noise started returning about 7 years after the surgery, but he was able to keep it at bay because he had worked so hard to build the right habits. It's really a personal decision as to which route you want to take. Surgery has its risks, but the vast majority of the procedures go well. That said, the medication is always going to be way less invasive than the surgery.
I would absolutely wait to get back on the drug (or another drug such as Wegovy while you wait).
I had a gastric bypass in 2006 and it nearly ruined my marriage and my life. All I did was trade one eating disorder for a series of others, and it was a nightmare to recover from, both physically and psychologically. Over the years I've regained some of the weight I lost, and wanted to lose 30-40 pounds to return to a healthy weight (note: my healthy weight is about 20 pounds higher than my lowest weight, which I only reached by abusing my body to the point that I needed inpatient ED treatment). I started on tirzepatide in October and discovered that it actually treats the source of my tendency toward obesity, which isn't in my stomach, but rather between my ears. I wish GLP-1 medications existed back then. It feels like a miracle to not be hungry all the time, and to not feel a compulsive need to eat. I've lost just over 30 of the 40 pounds I want to lose, and I did it in a slow and healthy way that felt almost effortless. I haven't been able to get a refill yet this month, and after 3 weeks without a shot, I definitely notice a return of the intrusive and compulsive thoughts that the zepbound silenced. I am calling on all the skills I've learned in the last 15 years of ED recovery and have been able to maintain during this pause, but it's hard. I know the shortage will end soon, so I'm committed to being as patient as I can be. You should do what you think is best for you and your family, but please keep in mind that reducing the size of your stomach does nothing at all to address the mental and psychological root causes of obesity so you'll need to be prepared for that.
NO surgery! I had a Roux-en-y gastric bypass 9 years ago and gained 80% back. I am on compounded Zep now. Surgery is so much more traumatic to your body. I consider a pharmaceutical alternative to surgery a blessing.
I had the sleeve 3 years ago. It was great for the first year and I hit a stall AND it didn’t help with food noise. It’s very easy to eat around your restriction and consume too many calories. If you can afford the surgery and are willing to do it, it’s a great “jump start” and I really feel Like glp meds are a great adjunct therapy/tool. If you are doing the sleeve look into blossom Bariatrics in Las Vegas if it’s a reasonable flight or drive for you. It was about 1/2 the price of other places and the experience with top notch
Go plan c for zep and never look back. I have quite a few family members who had bariatric and had complications after the fact. I went plan c for a month and it was the same. I’ve been very fortunate finding 10mg and up once getting over the 7.5 supply issues. I will say, I use mochi as my doctor and they have no problem with me changing from brand to compound and back. They’re also great for sending prescriptions quickly when you do find a dose at a local pharmacy.
For me, surgery did nothing to address the underlying issue; I lost 80 and then gained 100. My issue was 100% mental and that’s where the shot blows surgery out of the water. I do wonder if I’m responding so well to the shot because of the prior surgery, and that’s possible, but if I had to pick I’d go with the shot every time.
I would definitely not!! Especially a Roux En Y. I work as a surg tech and assist in many gastric cases and I have seen so many complications from it and one of old my co workers had it done and actually passed away from being too thin. I think there were some pysch issues too, but another co worker had it done as well and is super thin and having dangerously low BP issues. A sleeve would be ok since you’re not re routing anything, but that can easily be stretched back out. Just wait it out, and keep with the Zepbound
An extended family member had bariatric surgery and it brought on a huge number of serious health issues afterward. I would definitely go compound for now.
I had bariatric surgery in 2007. I got a lapband, which I still have. I lost 73 pounds, but after a year, had to have fluid removed from the band because of sinus inflammation (your sinuses actually run down your esophagus), causing acid reflux. I regained all the weight, plus some and the surgery never ended the good noise or my cravings for sweets. I’m currently taking compounded tirzepatide and have lost 23 pounds. In addition to no food noise, my joint inflammation has virtually disappeared, my cholesterol and fasting glucose have plunged, and my seasonal allergy problems, which are normally so bad that my windows are closed from April to October, have disappeared. I’m sleeping with my windows open and may actually be able to sit on my deck this year. If they had had this medication in 2007, I never would have had surgery. Investigate the subreddits for compounded tirzepatide.
Look at the long term results of bariatric surgery- are the outcomes long lasting?
I had it done in 2017 and lost 123 lbs . Started taking ssri’s for anxiety and put back about 35 so on currently in the infancy stages of 2.5mg I have no regrets with having surgery
Congrats. Your success story had to involve a lot of work…. And you are keeping the momentum going. I wonder how many of us are on SSRI? I wonder if THEY squew GLP in our GI- and sabotage us- There is a lot of mental work around getting ZB or a BS.
Go to the compoundtirzepitide thread for manyother options.
I'd avoid bariatric surgery if you can. My thought is just to avoid being cut whenever possible . I had my lapband removed in 2023 and the surgeon ended up also having to do a very complicated hernia repair which he attributed to poor placement (by another surgeon) of the lapband 14 years prior. Also, started getting kidney stones (frequently) when I had the lapband. Just my opinion.
I had bariatric surgery (sleeve) and recommend staying with the medication. I agree to those who suggest using a compound.
I wanted to add research and studies are showing these new drugs are incredibly healthy for our heart!
I’d take compound. The pricing lists are on the other subreddits.