Week 22: First Full Week at 15mg
Two doses into the maximum, the titration noise is gone and the dose is fully steady-state. The pattern from here is consistency — predictable suppression, predictable trend, predictable rhythm.
15mg is the dose ceiling, which changes the framing of every week from here forward. The medication is no longer a moving variable — the only inputs that can change are habits, training, sleep, and stress. For most users, this shift is freeing: the question becomes about consistency rather than optimization.
In SURMOUNT-1, the 15mg arm continued to lose at this stage of the trial, with the slope flatter than the early months but still clearly negative. Mean cumulative loss past month 5 in that arm was around 18 to 19 percent of starting body weight, with month-6 numbers approaching 20 percent.
Appetite Suppression
Stable near-total. Most users at 15mg report eating entirely by schedule rather than by hunger from this point onward.
Typical second-week-at-dose loss. The slope is flatter than the first months but the line continues for most users.
Week 22 Timeline
The Week 22 Timeline
Day 148 (Injection 22)
Second 15mg Dose
Routine injection. With tissue levels already at the maximum-dose plateau, the post-injection window is quiet and the weekly rhythm is familiar.
Days 150-152
Pattern Established
The new appetite baseline is the working baseline. Habits built across the first five months are running automatically — protein, hydration, sleep, training.
Day 154
End-of-Week Read
A clean loss number with no titration noise. This is the truest read on what 15mg is doing for you, and the baseline number for the rest of the half-year mark.
Navigating Symptoms
Constipation and reflux are the most common residual side effects at the maximum dose. Fiber, magnesium, and hydration handle most cases. Persistent severe symptoms are worth a clinician conversation.
A note on intake floors: at 15mg, the genuine risk is undereating rather than overeating. Many prescribers suggest a minimum daily intake — often around 1,200 to 1,500 calories depending on body size and activity — to protect lean mass and metabolic rate. Hitting that floor with protein-dense meals matters more than the exact number.
What Users Report
“Week 22 was the most stable week I have had in months. No symptoms, no thinking about food, scale moved 1.5 pounds. The medication is doing its job and I am doing mine.”
— Lakshmi A.
“Maximum dose feels almost gentle now compared to where I started. Still down a pound this week. Six months in, halfway to my long-term goal, very glad I held this course.”
— Otis F.
Looking ahead
Week 23 is the second-to-last week before the six-month milestone. Continue to the week 23 guide for what to expect as the half-year mark approaches.