lessthanhalf said:
ToeMittens said:
I’d like to jump into this thread too, because I’m after similar guidance.
My details:
47/F
Beginning weight: 235 lbs
Now holding steady near 145 lbs
I began Tirz in December ‘23, and by June ‘24 I had increased step by step to 15 mg each week.
In March ‘26 I went up to 20 mg weekly.
My weight loss had already flattened roughly 12 months ago. Given my starting point, I mostly accepted that, but more recently the food noise has started returning and I’ve noticed myself choosing poorer options. If possible, I’d like to lose another 10-15 lbs. I recently raised my dose to 20 mg per week, which gave me some improvement. Last week I began dividing the dose into 10 mg twice weekly (Tuesday PM and Saturday AM), and that has helped further. Still, I worry that this peptide may be close to the limit of what it can do for me, so I’m exploring other options.
A few months back I came across the whole Grey market world. At first I only went that route to cut costs (thinking about how much I’ve wasted at Mochi across the last 30 months… /cry), but reading all this research has shown me possibilities I hadn’t considered.
One idea is possibly changing to a Reta/Cagri stack. My thinking is that I’d want to gradually replace Tirz with Reta and finish that change before attempting to add Cagri, but I can’t decide what amount to begin with. Nearly every post I’ve seen comes from people using 10/mg or less of Tirz weekly. At my current Tirz dose, would a Reta dose of 2 mg/week even register for me? Should I test that for several weeks while keeping my Tirz dose unchanged? Should I reduce my Tirz dose once I begin Reta?
Has anyone else transitioned away from such a high Tirz dose as it stops working as well? Any ideas, suggestions, or guidance? Am I over- or under-thinking this? Are there other peps you’d suggest for someone like me who is in the early stages of Peri?
If you got through all of that, thanks for reading! I’m so grateful for this community!
You mention that tirzepatide has stopped working as well, but you're sitting at roughly 145 lbs after beginning at 235 lbs — that's 90 lbs gone. That's a real, significant accomplishment, and the medication is doing its job, not failing. (Unless the scale is creeping up.) What it can't do beyond that point is produce further loss; it can only keep the weight from returning. To me, that maintenance effect is the single most valuable thing these drugs offer. From a long-term health and quality-of-life standpoint, holding onto the loss is both the toughest and the most crucial piece.
Usually, when weight comes off — with or without GLPs — energy use falls because there's less fat, organ, and muscle mass to metabolize, and the body then tries to save energy by lowering it further. On top of that, hunger runs higher than normal. So a lower calorie need plus extra appetite almost always leads people to regain, whereas GLP drugs suppress that appetite rise and improve metabolic function, and have consistently shown weight loss maintained, at the weight-loss dose, for as long as 4 years so far. There's no solid evidence of tolerance to the weight-loss effect over the long term.
Maintenance is the stage where nearly every diet-and-exercise approach collapses. With GLP drugs it isn't as hard, but it isn't necessarily easy either. At this point, I'd say staying on tirz or another agent to hold the lost weight is essential — but you're asking it, even at a higher dose, to do more than it managed in trials, where the maximum average loss was closer to 25%, while you're asking it to hold back 38% (90/245).
Switching to reta is one option, though I doubt it would do much better than 20mg of tirz at standard doses, and you clearly already handle that fine. (My own choice, at 15mg of tirz while still hungry and trying to keep off about a 50% loss, was to add 5mg of reta, and later 0.5 of cagri.) Switching to reta does come with more side-effect risk than staying on tirz, but it's a legitimate route. Alternatively, adding cagri very gradually at 0.25mg and ramping slowly is the least disruptive approach, or adding reta alongside tirz at not huge doses since you're already at 20mg of tirz. Or simply push tirz up to 25mg, though there's a fair chance you're entering diminishing-returns territory as doses climb. In theory, reta plus cagri should be the strongest combination currently available, but it likely brings more side effects than tirz.
My view is that using these drugs above standard doses or in combinations probably does add risk of known or unknown adverse effects, but in situations where it seems necessary — severe obesity with very high long-term health risks — the drugs are probably safer than regaining the weight.
