Aggression in GLP-Fueled Weight Loss

kartikeya

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I've come across multiple accounts of individuals pursuing a highly aggressive weight loss strategy, and from what I gather, that route carries a greater likelihood of serious adverse effects along with a stronger possibility of putting the weight back on. I'm not going to pin down what "aggressive" means here because doing so might feel a bit exclusionary, but I'd really like to hear from folks who dropped a substantial amount of weight (50+ lbs) while avoiding rapid dose escalation or harsh dieting.
 
I dropped roughly 75lbs. At the start, shedding the weight was a breeze. I was injecting 15mg of tirz and the pounds practically disappeared. As a responder, I did really well. That said, I also followed intermittent fasting, which in my case meant waiting until after 4PM to eat, and stopping at midnight if hunger hit.

Jump ahead 1 year: I'd taken off the bulk of what I aimed for, around 65lbs, but I really wanted my abs visible again! That left roughly 15lbs more to lose. To get there, I had to push my tirz dose higher. I went up to 30mg, which I realize is a lot, and I did shed those last 10lbs. This happened just recently, so my plan is to drop back to 15mg for maintenance.

Overall, the weight I've lost comes to about 30% of what I weighed at the beginning. Thankfully, I don't have loose skin or anything like that. Past a plateau, I needed to raise my tirz to 30mg to keep the scale moving down, but we'll see how maintenance goes.

If anything's unclear, feel free to ask.
 
According to my clinic provider, the "sweet spot" is 1-2 lbs per week. I'd treat that with some caution, but I've noticed it mentioned a few times.
 
Looking back, I'd probably take things at a gentler pace. Skin requires time to contract, and going too fast places extra strain on the entire body. Still, reaching my target weight sooner has been a plus. Patience isn't exactly my strong suit — I simply don't have it.
 
I never needed to follow an "extreme diet." On multiple days each week, I find it nearly impossible to consume food, and occasionally whatever I manage to take in sits poorly and is expelled from my system.
 
Rs is closing in on a total of 98 pounds down? By now my rs has such solid stamina and strength that I'd basically need to deliberately pull something recklessly dumb to make my rs's body shed more weight than it already does each week. Rs puts in a routine 20 to 50 miles on an exercise bike plus an upper body workout 7 days a week while running an 800 calorie deficit. No soreness at all. No dip in energy. No appetite. It's good and bad at the same time. Weirdly, whenever i start a fresh vial, the weight plunges sharply all over again.
 
Devilseye said:

I dropped roughly 75lbs. At the start, shedding the weight was a breeze. I was injecting 15mg of tirz and the pounds practically disappeared. As a responder, I did really well. That said, I also followed intermittent fasting, which in my case meant waiting until after 4PM to eat, and stopping at midnight if hunger hit.

Jump ahead 1 year: I'd taken off the bulk of what I aimed for, around 65lbs, but I really wanted my abs visible again! That left roughly 15lbs more to lose. To get there, I had to push my tirz dose higher. I went up to 30mg, which I realize is a lot, and I did shed those last 10lbs. This happened just recently, so my plan is to drop back to 15mg for maintenance.

Overall, the weight I've lost comes to about 30% of what I weighed at the beginning. Thankfully, I don't have loose skin or anything like that. Past a plateau, I needed to raise my tirz to 30mg to keep the scale moving down, but we'll see how maintenance goes.

If anything's unclear, feel free to ask.
What made you choose 30mg of Tirz rather than stacking cagri or Elora, or moving over to Reta? Up to now, I’ve only come across people going as high as 20-25.
 
Since the start of October 25, I've dropped over 60lbs, hitting that mark this week. There's likely another 10-15lbs I want gone, though right now the belly fat is being stubborn and refusing to budge. My regimen is 4.5mg taken twice weekly. The only time I bump the dose up is when hunger becomes impossible to ignore and I keep catching myself mindlessly staring into the fridge. At first, the scale went down 4-5lbs across the first 2 weeks, then it leveled off at 2lbs for a stretch, and after that it crept down to 1lb per week. Recently it's been nearly flat, though this week I got a 1lb drop again. My guess is that as I get closer to a 'normal' BMI, my body is pushing back somewhat. I'm resisting the temptation to just inject more, and instead letting things settle so I can hold steady on a lower dose long-term. Depending on if I run, jog, or shuffle (😂) that day, I take in somewhere around 1400-1600 calories. 5 days a week I do dumbbell work and resistance bands. Going ultra low on calories is tempting, but I don't want to shed more muscle than I have to, so I eat chicken and eggs repeatedly alongside veggies or salad, plus some carbs to fight off fatigue when running. I also drink plenty of water. There's some mild loose skin on my inner thighs and a bit of turkey neck, which creams and potions are helping with. I'm hoping that resolves on its own over the next year or so with time. At 54 and married, I figured this was preferable to a cardiac event. My only frustration is not having begun a few years earlier. I'm glad to help however I can, though I don't have much to say about side effects since the twice-weekly schedule has eliminated even a trace of them 🤞.
 
Down 81lbs right now, having begun roughly around this period 1 year ago. Initially it was natural, after that some pharmacy tirz, and gray from about Nov 2025 onward. Since November, most of it (roughly 70lbs) has dropped off, which works out to about 2.3lbs weekly. I'd call that fairly typical, maybe leaning aggressive. My suggestion would be to take it slower, because the side effects (loose skin, nausea, fatigue) have been rough.
 
Over the course of a year, I dropped roughly 70 lbs. My days were packed with house renovation projects and yardwork, so there was no room for the gym, and honestly I carried a lot of guilt about that. When I average out my weekly loss, it comes to 1.38 lb. The early months were where most of the weight came off, though; these days I'm thrilled if I manage 3 lb in a whole month. Tirz was my starting point, then I brought reta into the mix and slowly reduced tirz as I raised reta. Things like tesa, cag, and similar options? Never touched them. And none of the really scary side effects that get discussed have happened to me.

Goal weight is still ahead of me, which occasionally makes me wonder whether I played it too safe. That doubt, I suspect, comes largely from social media warping how I see my body now, which is honestly in a much better place. Being in my 50s means there's some loose skin, specifically around where my pregnancy stretch marks are.

Every so often the thought crosses my mind, [[Q2]] but I'm not sure how much good that does. No 2 bodies react the same way, so the only real option is to pay attention to what works in our own case.
 
kartikeya said:

I've come across multiple accounts of individuals pursuing a highly aggressive weight loss strategy, and from what I gather, that route carries a greater likelihood of serious adverse effects along with a stronger possibility of putting the weight back on. I'm not going to pin down what "aggressive" means here because doing so might feel a bit exclusionary, but I'd really like to hear from folks who dropped a substantial amount of weight (50+ lbs) while avoiding rapid dose escalation or harsh dieting.
While it goes against what you were looking for, I can back this up. On reta, I dropped 33lbs over 4 months (2.33mg weekly for the first month, then 4.66mg weekly after that), and it led to gallbladder problems I'm now managing without surgery. Lowering the dose since then has made a difference.
 
Over 200 days I've dropped 70lb, which works out to about 1% each week, while keeping an average deficit near ~1100 calories.

Vomiting has never happened for me. The only rough patch was a couple of days of feeling bleh right after my first .25mg Sema dose. Splitting it into .125mg 2x/week took care of that.

Sleep could be better, though it's acceptable. Once I quit paying attention to the sleep debt metric on my Oura Ring, my feelings about my sleep improved a lot. The tracking continues, and I can export the data to analyze myself.

My Reta intake is substantial, yet adverse sides are practically absent, and I can do whatever and eat whatever… nearly “living my best life” so I don't consider that to be exceptionally aggressive.

kartikeya said:

I've come across multiple accounts of individuals pursuing a highly aggressive weight loss strategy, and from what I gather, that route carries a greater likelihood of serious adverse effects along with a stronger possibility of putting the weight back on. I'm not going to pin down what "aggressive" means here because doing so might feel a bit exclusionary, but I'd really like to hear from folks who dropped a substantial amount of weight (50+ lbs) while avoiding rapid dose escalation or harsh dieting.

Higher chance of sides, sure. People nuke their gallbladders, drop excessive lean mass, lose hair and bone density…. A higher chance of regain doesn't make sense unless the person stops doing what caused them to lose the weight to start with.
 
On glps, my rate of loss isn't quicker than when I previously just used the loseit app plus walking.

Typically I've managed about 10lbs each month--though for me, during most of that stretch, it usually stayed around 1% of my body weight weekly or less. Some weeks I drop 1lb, other weeks 3 or 4, but overall it averages near 1% a week, even now that I weigh less.

So it's not "losing faster," but I'd say I'm far, far LESS aggressive about weight loss while on glps compared to off them. Off glps, shedding pounds takes a total single-mindedness (read: obsession), covering both cutting calories and hitting movement targets. With glps, both just fold into my normal routine, barely needing any thought or effort. Still, I do think about it, only it's more like WOW! this is life changing! Wow! I can't believe I lost more weight without being miserable!

Eta: 56lbs down since Feb 15, currently 7.5 tirz, 2 reta. Would like to lose ~25lbs more, and it feels possible
 
FartfulCodger said:

Looking back, I'd probably take things at a gentler pace. Skin requires time to contract, and going too fast places extra strain on the entire body. Still, reaching my target weight sooner has been a plus. Patience isn't exactly my strong suit — I simply don't have it.

Going at a slower pace is absolutely an option if that's what you prefer. Less muscle mass would likely be lost that way. That said, there is 0 evidence showing that a slow rate of loss changes the way your skin adjusts to your body. In my view, that comes down mostly to genetics and age. Ive seen 20 year olds with loose skin after loosing 100lbs and here I am at 75lbs weight loss with no loose skin visible at 48. Its genetics mostly from my experience.
 
anotherusername said:

Devilseye said:

I dropped roughly 75lbs. At the start, shedding the weight was a breeze. I was injecting 15mg of tirz and the pounds practically disappeared. As a responder, I did really well. That said, I also followed intermittent fasting, which in my case meant waiting until after 4PM to eat, and stopping at midnight if hunger hit.

Jump ahead 1 year: I'd taken off the bulk of what I aimed for, around 65lbs, but I really wanted my abs visible again! That left roughly 15lbs more to lose. To get there, I had to push my tirz dose higher. I went up to 30mg, which I realize is a lot, and I did shed those last 10lbs. This happened just recently, so my plan is to drop back to 15mg for maintenance.

Overall, the weight I've lost comes to about 30% of what I weighed at the beginning. Thankfully, I don't have loose skin or anything like that. Past a plateau, I needed to raise my tirz to 30mg to keep the scale moving down, but we'll see how maintenance goes.

If anything's unclear, feel free to ask.
What made you choose 30mg of Tirz rather than stacking cagri or Elora, or moving over to Reta? Up to now, I’ve only come across people going as high as 20-25.

For me, tirzepatide delivered good results. Lilly has been looking into larger doses. I gave cagrilintide a shot, but its benefit was only temporary. I log all of my data, and after roughly 2 months of use, the effect dropped off a lot. Once I stopped it, I saw 0 change. On top of that, it leaves you more fatigued than tirzepatide does. Not worth it. I would have given Elora a try, but it wasn't obtainable at that point. I experimented with small doses of retatrutide, yet for some reason my hunger went up a lot. Because intermittent fasting had already worked for me, I chose to stay on tirzepatide. I've come across folks here who go as high as 60mg for major weight loss. At 30mg I lost 30% of my bodyweight, which sits at the higher end. I'll be dropping to 15mg shortly and will find out how I do.
 
Devilseye said:

FartfulCodger said:

Looking back, I'd probably take things at a gentler pace. Skin requires time to contract, and going too fast places extra strain on the entire body. Still, reaching my target weight sooner has been a plus. Patience isn't exactly my strong suit — I simply don't have it.

Going at a slower pace is absolutely an option if that's what you prefer. Less muscle mass would likely be lost that way. That said, there is 0 evidence showing that a slow rate of loss changes the way your skin adjusts to your body. In my view, that comes down mostly to genetics and age. Ive seen 20 year olds with loose skin after loosing 100lbs and here I am at 75lbs weight loss with no loose skin visible at 48. Its genetics mostly from my experience.
I held that same view at one point.

WebMD lists several possible causes of loose skin:

  • The speed at which weight comes off
  • What share of your total body weight was shed
  • The length of time you spent at your starting weight
  • Genetics
  • Age
 
FartfulCodger said:

Looking back, I'd probably take things at a gentler pace. Skin requires time to contract, and going too fast places extra strain on the entire body. Still, reaching my target weight sooner has been a plus. Patience isn't exactly my strong suit — I simply don't have it.
For a while there, I had absolutely no patience and honestly saw myself as failing — 90 lbs took me a year and a half to drop. Now that I look back on it, going slow was the right call. Had I shed the weight faster, I'm convinced my skin would be far looser and saggier than it is today. Dropping only 1-2lbs per week (and some weeks the scale didn't budge at all) is, I believe, what spared me from hair loss, from burning through more muscle than fat, from gallbladder trouble, and from the rest of the fallout that comes with rapid weight loss. I simply repeated to myself, "slow and steady wins the race," and I suppose that approach ended up working in my favor.
 
FartfulCodger said:

Devilseye said:

FartfulCodger said:

Looking back, I'd probably take things at a gentler pace. Skin requires time to contract, and going too fast places extra strain on the entire body. Still, reaching my target weight sooner has been a plus. Patience isn't exactly my strong suit — I simply don't have it.

Going at a slower pace is absolutely an option if that's what you prefer. Less muscle mass would likely be lost that way. That said, there is 0 evidence showing that a slow rate of loss changes the way your skin adjusts to your body. In my view, that comes down mostly to genetics and age. Ive seen 20 year olds with loose skin after loosing 100lbs and here I am at 75lbs weight loss with no loose skin visible at 48. Its genetics mostly from my experience.
I held that same view at one point.

WebMD lists several possible causes of loose skin:

  • The speed at which weight comes off
  • What share of your total body weight was shed
  • The length of time you spent at your starting weight
  • Genetics
  • Age

You're likely correct, but I'm not sure how much each of those elements actually matters. Based on what I've seen myself, I'd still say genetics and how long someone has carried extra weight are the biggest influences.
 
Six months in, I've dropped 41 pounds — that's 15.5% of where I started — and I'm sitting at 10mg of tirz right now. As far as titration goes, my strategy has been to hold at the smallest dose that still does the job, instead of following the fixed step-up timeline used in the studies. So my overall rate landed inside what most people would call the "safe and sustainable" window, though toward the slower side (roughly 0.6% of body weight per week when averaged out).

At certain points the slowness got to me and I felt like pushing harder, but looking back I'm glad I stuck with the slower route. My max bench did take a hit, which is a minor irritation even if it's not a big deal in the grand scheme. On the plus side: no loose skin, labs look fine, nothing serious in terms of side effects, and I suspect a much bigger chunk of muscle would have vanished had I forced a faster pace.
 
kartikeya said:

I've come across multiple accounts of individuals pursuing a highly aggressive weight loss strategy, and from what I gather, that route carries a greater likelihood of serious adverse effects along with a stronger possibility of putting the weight back on. I'm not going to pin down what "aggressive" means here because doing so might feel a bit exclusionary, but I'd really like to hear from folks who dropped a substantial amount of weight (50+ lbs) while avoiding rapid dose escalation or harsh dieting.
How any given person will react to GLP drugs — both in terms of unwanted effects and in terms of the benefits like hunger suppression and weight reduction — simply cannot be forecast. The doses that ultimately get you to lose weight are mostly a function of your own response as the dose is stepped upward. One path is to push doses up fast, accepting a greater chance of nastier side effects; another is to treat it like an ordinary diet and cut calories hard no matter what your appetite is doing. Either way, if the goal is meaningful weight loss, what matters in the end is whether the whole process stays sustainable and tolerable enough that you continue it over the long haul — and after that, the biggest and most difficult piece is maintenance, which only functions long term if it remains tolerable. With GLP's, the upside is that hopefully you only have to take the weight off one final time, provided you keep using them to hold the weight down.

The easiest and relatively low-risk route is to begin with the standard drug company dosing schedule. Should the pounds be coming off too quickly, you can dial it back to lower the chance of gallstones, though side effects are the main thing that governs this; essentially the rule is that if hunger is still present or the scale is not moving and no side effects have appeared, keep raising the dose until it starts working or side effects turn into a problem. From there, let that experience inform later increases or decreases. And with luck, you reach your goal weight before hitting the maximum dose and before weight loss stalls out, which tends to happen around a year or so in.

As far as I know, nothing shows that how fast you lose weight changes your risk of regaining it. Rapid loss sharply raises gallstone risk and can leave you feeling terrible, but it does give a feeling of fast progress. Still, when there is a great deal of weight to shed, choosing the easier path over the harder one makes more sense, because if it is easy you will stay with it for however long it takes and reach your target. Ideally, you land on a glp dose that holds appetite in check, so that maintaining a healthy weight amounts to nothing more than taking the correct dose each week. Better eating and exercise clearly matter too, but likely more for your health overall than for the weight loss itself.
 
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