Week 48: weight down 19 kg, labs flat—anyone else?

Lipid lag is real. LDL basically sits flat for months, then drops about 20 points around month 9. Weight moves way faster the whole time, on a totally different clock.

Month 9? Mine was opposite—LDL early, CRP stuck.

Did you check lean mass? I lost 22 lb but DEXA showed 4 lb lean. Changed how I read the scale.

DEXA is the part I wish I'd done at week 0. My scale says 18 kg down but I have no clue on composition.

NCT04184622 is my rabbit hole too. 2539 people, 72 weeks, 5/10/15 mg. But I can't find granular lab trajectories.

That's why I stopped expecting linear labs. Weight is the headline; markers probably have their own curve.

My hs-CRP dropped 4.1 to 1.9 by week 20, before much weight came off. Lipids took almost a year.

CRP timing seems all over the place—early for some, late for others. Sleep changes?

Sleep tracking worth knowing about: the first 10 weeks tend to be rough, then it evens out. Whether that's the tirzepatide or just finally not snoring — nobody can really say.

Your waist unmber is the one I'd trust more than BMI. Mine went 42 to 36 inches before labs moved much.

I've kept a spreadsheet since week 0. Weight dropped fast weeks 4–16, then plateaued for a month. Fasting glucose came down 99 to 88, LDL actually rose slightly at week 12, then fell by week 40. Your lipid lag and the lean mass question both ring true. I added lifting twice a week; my rate slowed but clothes fit better and my waist kept shrinking. I wish the 72-week trial had monthly labs, because endpoints hide that non-linear pattern. Also, the 2539-person enrollment still feels small when you try to slice by response type.

The non-linear lab thing tracks with what I see in my own numbers. Weight down 20 kg, LDL didn't budge until month 10. Monthly labs would be gold.

My labs lagged six months, but my jeans confessed at week 12. Waist tape beats LDL for me.

Sleep is my weird lab: bad weeks, CRP climbs before weight does; good sleep, waist drops first.

Honestly 11 points off LDL in 48 weeks is a win. Lipid panels can be stubborn like that — mine barely budged until month 9.

Weekends wreck me. Friday pizza, Monday scale up 3 lb, labs never notice. I track sodium now.

Mine went the opposite order on liver stuff, weirdly. ALT dropped 38 to 24 by about week 14 and my ferritin slid too, while LDL sat at 138 for six months before it budged at all. Non-HDL ended up more useful to watch than LDL alone. Are you getting a full panel each draw or just the basics? I only get the good one twice a year so my timeline looks choppy even when things are moving.

The part people forget is the labs can move first while the scale sulks. A1c going 5.9 to 5.5 by week 20 of tracking, while the scale gives up maybe 6 lb that whole stretch, is a real pattern. Then weeks 24 through 40 it catches up, about 22 lb down, and the labs go flat. One fasting draw can also read flat if you were low on fluids that morning, so it’s worth not over-reading single sets.

Not a lab thing, but my tape measure moved long before my scale did. Weeks 30 to 38 the scale was honestly flat, same 182 to 183 every morning, but my waist went 40 to 36.5 and I dropped a shirt size. What changed was lifting 3x a week and pushing protein from around 110g to 135g, plus walking went 8k to 11k steps. The first month I ate back every calorie I burned and netted zero, so that was a real fail on my part. Where do you measure, navel or natural waist? Mine reads two inches different depending on the spot.

Nineteen kilos down and you're stressing over eleven LDL points? Go get the new belt, you earned it.

My LDL sat at 138 for nine months, then fell 24 points in one eight-week gap. Labs are lumpy, not linear.

About 40 weeks in and my lipids track my sleep harder than my weight. Two months of 5.5-hour nights, LDL 136; same scale number, back to 7 hours and cut the late-night grazing, next draw 118. If your draws landed after a rough stretch, that's worth knowing before you read too much into the 11 points.

What finally moved my numbers wasn't the deficit, it was food quality at the same calories. Same 1,700 a day, but swapped the afternoon vending machine run for Greek yogurt and berries and added about 25g fiber, and triglycerides went 148 to 96 across roughly ten weeks. My rate of loss didn't budge. Your labs may just be on a slower clock than the scale.

The number that gets quoted is nineteen kilos in 48 weeks — that's the headline. What people tend to gloss over: the lipid panel is a supporting character, not the plot.

48 weeks and waist down 5 inches is the real recomp signal. My labs lagged my waist by months, and hs-CRP was stupidly sensitive to timing: a heavy squat session 48h before the draw had it higher than a 10-lb weight change did. I now log training/sleep/hydration for the 3 days before labs just to read them honestly. Did your panel include ApoB, or just standard LDL? If LDL is barely moving while your waist drops, that’s the follow-up I’d want, not just the raw trial trajectory.

LDL and hs-CRP can be late adapters. During active fat loss, cholesterol traffics through the liver and can stay stubborn even while glucose/waist improve. Did you get ApoB, Lp(a), or an NMR particle count? My n=1: ApoB tracked ALT/GGT and fasting insulin better than scale weight; hs-CRP didn’t drop until I’d been weight-stable about 8 weeks. At week 48, are you still losing or plateaued? That context makes the labs read very differently.

Hi, brand-new here—first week, so I’m mostly lurking and taking notes. Did your triglycerides or HDL move at all, even if LDL stayed stubborn? And were both lab draws under the same fasting/hydration conditions and same lab? I’m only tracking waist, resting pulse, and how stairs feel right now, because the scale is already weirding me out. Sorry if that’s a basic question—just curious whether the supporting numbers lag differently than the main one.

Your LDL lagging the scale is so familiar. Mine was the last to move; triglycerides and HDL shifted first, and the trig/HDL ratio was the number that finally showed progress. hs-CRP didn’t budge until my resting HR trend came down, so I added that to my tracker next to waist and labs. Did your panel break down that way? I’m curious if your triglycerides dropped more than LDL. With two kids, I only trust 7-day averages—one pizza night otherwise sends me spiraling.

weight is a fast variable; labs are slow variables with different time constants. Mine went the other way: scale flat for ~10 weeks while trigs and ALT finally moved, then LDL followed later. I track non-HDL/ApoB alongside trigs and ALT on a 12-week rolling chart because single draws are mostly noise. What did your trigs and ALT do over the 48 weeks?

Curious whether you’ve got ApoB/non-HDL or trig/HDL from the same draws? My standard LDL looked stubborn too, but non-HDL and triglycerides moved well before it did. Also, my ALT/GGT normalized around month 10, while CRP took longer—visceral fat/inflammation seemed to lag the scale by several months. Did your panel include liver enzymes or ApoB? I’m trying to figure out if it’s a timing thing or if standard lipids just aren’t sensitive enough at this stage.

Similar timeline here: -18.6 kg over 47 weeks, and my ApoB was flat at 97→94 until I held weight steady for ~6 weeks; then it slid to 81. ALT went 33→21 only afer the loss rate slowed. My trendline says my liver/inflammation markers track rate of loss, not total loss—weekly deficit spikes made everything look worse. Did you pull fasting insulin/HOMA-IR? That shifted earlier than lipids for me. Also worth checking if your draws landed after a brutal training or low-sleep week; mine did, and it skewed the panel.

Not in that trial, but I keep a nerdy spreadsheet with ApoB, ALT, and fasting insulin against weekly waist/height. My ApoB didn’t move until ~6 weeks after the scale plateaued, and ALT tracked waist way better than pounds. So labs looked “flat” during the fast-loss phase even though the tape was changing. Did yours keep drifting after weight stabilized, or did everything just freeze? Also curious: if you’ve got ApoB or LDL-P, did those move more than plain LDL? I’d love granular trial data too—spaghetti plots by BMI stratum would be gold.

Systems view: scale is daily signal, standard labs are a noisy quarterly sample. I log hs-CRP against sleep debt and training load because one rough week can bury a real trend. Comparing 4-week rolling averages instead of single draws made my “flat” labs look less flat. Waist:height and resting HR moved first for me. Did

Road warrior here too. The thing that finally made my numbers make sense was adding a “travel week” note to my lab log: airport pretzels, hotel breakfast, three time zones, zero fiber. My weight drops fast on the road because I walk terminals, but my lipid panel looks worse if I draw within five days of a heavy travel stretch. Now I book labs after about two weeks of normal-ish routine and it’s less noisy. Did you happen to get your draw right after a trip? Also, how’s your sleep and daily steps been? That’s the only other thing that shifted my hs-CRP, not the scale.

I cook for six — three teenagers and my mother-in-law — so the spoon-licking thing is very real. What finally let me compare apples to apples was tracking waist monthly and ApoB instead of just LDL. The scale kept dropping, but ApoB and ALT sat still until I stopped grazing while I cleaned the kitchen and started sleeping. Curious whether anyone's labs include ApoB or liver enzymes, and whether sleep moved. My hs-CRP tracked sleep much more closely than weight did.

I teach middle school band, so most meals happen in my car between rehearsals. ALT was the only lab that budged fast—38 down to 24 around week 20 of actually logging everything—while LDL acted like the kid who won't practice. Cheap protein was 2 eggs, nonfat Greek yogurt, bagged lentils; waist dropped before labs caught up. Did y'all check ALT/GGT or ApoB? And were both draws same time and fasted? My 8am fasted draw vs a 2pm "oops, I ate" draw looked like different people. Google Sheet with weight/waist = full spreadsheet goblin mode.

Did your panel include fasting insulin or ALT? My weight/waist moved way before some labs, but ALT went 38→24 and HOMA-IR 3.1→1.8 around month 7. Also hs-CRP has been noisy for me—2.9, 3.4, 2.1—and it tracks my sleep debt and hard workouts more than fat loss. I now log draw time, sleep, and last workout next to each lab. Were your draws all at the same time of day/fasted state? That alone changed my “trend” once.

I drive a school bus, pre-trip at 5:40 a.m., so sleep debt and draw timing wreck my labs way more than the scale does. I log draw time, hours since last meal, sleep, hydration, and any hard lifting in the prior 48h. CRP and lipids seemed stuck until I matched those variables. Were all your draws

Systems take: LDL is a lagging composite. I switched to tracking ApoB; mine sat flat during active loss and only moved ~15% after ~10 weeks at stable weight. If you’re still in deficit, that panel is a mid-flight reading. Also, raw data from that trial still won’t have DEXA/visceral fat, so the scale-vs-labs mismatch stays. Are you still losing or holding?

Nineteen kilos and 5 inches off your waist is huge—congrats. Since LDL can be stubborn while glucose and inflammation improve, I’m curious: did your panel include triglycerides or A1c? In my own tracking, those two moved more with my waist and consistency than the scale did. Also, do you log anything like steps or protein anchors for the weeks your labs were drawn? I’m nosy because I’m trying to find my own lag pattern.

One thing I’d check: was that LDL calculated or direct? If trigs dropped, Friedewald can make LDL-C look flatter than ApoB/particle number. My n=1: trigs went 180→110, calculated LDL barely moved, ApoB fell ~15%. Also, 48 weeks is early for plaque stuff; CRP and glucose moving is real. What’s your trig/HDL ratio doing? That often shifts before LDL-C in the data I’ve seen.

Fellow maintainer here. Do you have baseline DEXA or even smart-scale lean mass? At 48 weeks my weight fell 22 kg, but lean mass dipped until I added two resistance sessions and prioritized protein. My LDL stayed boringly high; triglycerides/HDL ratio and fasting insulin moved first. If you’re digging into NCT04184622, I’m more curious about the body-composition and inflammation sub-analyses than weight alone. What’s your waist-to-height ratio now? Mine went 0.61 → 0.52, and that tracked CRP better than the scale ever did.