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doi: 10.1055/s-2007-978671 14 DiamondFJEichlerDC

I think some people assume that Im the optimization guy or the massive amounts of protein intake guy

Okudaira H, Shikano N, Nishii R, Miyagi T, Yoshimoto M, Kobayashi M, et al

You should contact your healthcare provider if: Persistent, severe hunger continues despite being on the 2.4 mg maintenance dose for at least 812 weeks, particularly if accompanied by inadequate weight loss (less than 5% of initial body weight) Sudden increase in appetite after previously experiencing good appetite control, which may indicate treatment tolerance or an underlying medical issue Symptoms suggesting hypoglycaemia (shakiness, sweating, confusion, intense hunger) occur, especially if you have type 2 diabetes or are taking other glucose-lowering medications