What happens if I miss a dose?

These medications have a relatively long half life, meaning they stay in your system for a while. Skipping one dose will not see an immediate return to how things were before. But within a few days, as the drug levels drop, you will likely notice the familiar food noise creeping back: the cravings getting louder, the portion sizes harder to control, the mental preoccupation with food returning. Your reward pathways, which have been given a period of calm, start firing up again. For some people, this can feel quite dramatic after weeks or months of relative peace around food.