Week 20: Steady at Target
The fourth injection at 2.4mg closes out the first full month at the target dose. The titration is firmly in the rear-view, the body has adjusted, and the picture of life at the maintenance level is now clearly visible.
Week 20 is the fourth and final injection of the first full month at 2.4mg. After 17 weeks of stepping up and three weeks of settling, this is the first moment where you can look at a full block of steady-state data at the target dose. Four weeks of consistent dose, consistent appetite, and a weight trend that is no longer being distorted by titration shocks.
That makes it a useful checkpoint. The trend over these four weeks tends to be a reasonable signal of what the next few months will look like — barring lifestyle disruptions or dose changes. Plenty of people see a slower but steady decline through this stretch and decide, with their prescriber, that this is the right place to stay.
Appetite Suppression
Reliable, deep suppression. Most users describe meals as planned events rather than hunger responses.
Loss tends to continue at a slower but steady pace through the maintenance phase. Single-pound weeks are normal at this stage.
The Week 20 Timeline
The Week 20 Timeline
Day 134 (Injection 20)
Fourth 2.4mg Dose
The injection feels routine by now. Side effects are typically minimal — most users barely notice the dose around the injection day itself.
Days 136-138
First Month Review
Pull together the four-week data at 2.4mg. Weight trend, side effect notes, energy log, habit observations — the full picture of life at the target dose.
Day 140
Sustainability Check
Is the current setup something you can do for another six months? If yes, protect it. If not, this is a useful moment to raise it with your prescriber.
Navigating Symptoms
By the end of the first month at 2.4mg, most users have a clear sense of which side effects are persistent and which are gone. A short list of mild, manageable issues is the typical picture.
What to focus on this week is the durability question. The medication is doing its job consistently; the habits around it are starting to feel like a routine rather than an effort; the trend on the scale is meaningful even if slower. The question is whether this whole setup is something you can sustain for the next six months and longer. Most people, by week 20, have a real answer.
It is also a good moment to revisit nutrition. Maintenance at 2.4mg is the stretch where chronic under-eating quietly becomes a risk — appetite stays low, decisions stay easy, and protein intake silently drifts down. Even one short check-in with a food log can highlight gaps that are easy to close before they become problems.
What Users Report
“First full month at 2.4mg done. Side effects almost nothing, appetite very low, lost about eight pounds in the month. I'm calling that a win and staying the course.”
— Linda V.
“I'm a slower responder, but the trend over the last month is clearly down. My doctor and I agreed to stay at 2.4mg and reassess after another six weeks.”
— Karim S.
Looking ahead
Week 21 puts you at five months on the medication. The picture stays mostly steady, but small shifts — habits deepening, plateaus appearing, life events intervening — start to shape the journey more than the dose itself. The maintenance phase has its own work.