Gastric Sleeve and Reta

alphaamigo

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Had a sleeve procedure 10 years back. It brought me to a point I'm fine with, though I'm hoping Reta can assist me in getting my BMI below 30. To me, it looks like a pretty clear beneficial combo. Does anyone have firsthand experience with this?
 
If the stomach has stretched out by now and gone back to normal, then I don't think there would be a problem. Any side effects you might get are usually minimal and don't involve the stomach. Plenty of people go on Mounjaro soon after surgery, and Reta would work the same way 🙂
 
Beardboost said:

If the stomach has stretched out by now and gone back to normal, then I don't think there would be a problem. Any side effects you might get are usually minimal and don't involve the stomach. Plenty of people go on Mounjaro soon after surgery, and Reta would work the same way 🙂
The pouch has expanded over time, yet sticking to the high protein, low carb plan my doctor prescribed still leaves me feeling limited, and weight loss is possible. The real problem comes when I fall off track after several months and then go on a carb binge. A relative gave me Tirz to try, and even on a very small test dose, the drop in food noise let me ease straight into better routines. Once I moved up to the standard starting dose, eating felt impossible, so I quit. After learning that Reta cuts food noise while suppressing appetite less strongly, I figured it would be an ideal fit.
 
A lot of folks think the only reason bariatric procedures cause weight loss is that the stomach gets smaller. That factor matters, yes, but there is more going on. Typically the operation also cuts through at least some of the vagus nerve, and that nerve is what carries satiety hormone signals — GLP-1 being 1 example — from the digestive tract up to the brain, a process known as afferent signaling. When that afferent signaling is reduced or wiped out, it contributes heavily to the weight loss. Rodent studies back this up: when researchers operated so that the stomach was untouched and only the nerve was cut, the animals still dropped a substantial amount of weight.

Another member here reported that, in their own case at least, this made the effects of bariatric surgery and a GLP additive, and they went on to lose a great deal more weight with a GLP after their surgery-related loss had plateaued. I would not count on your experience mirroring theirs, but it is certainly something we can hope for on your behalf.
 
Tirz or Reta would both work. There's no need to push Tirz until food aversion kicks in. If you won't be able to get your Reta dose high enough for the BMR boost, then Tirz is likely just as effective.

What amount of weight are you aiming to drop?

As Tubby mentioned, I'd anticipate a somewhat distinct reaction given the shifts in ghrelin and GLP production.
 
woundcarping said:

Tirz or Reta would both work. There's no need to push Tirz until food aversion kicks in. If you won't be able to get your Reta dose high enough for the BMR boost, then Tirz is likely just as effective.

What amount of weight are you aiming to drop?

As Tubby mentioned, I'd anticipate a somewhat distinct reaction given the shifts in ghrelin and GLP production.
My peak weight was 370. Surgery happened when I was 340. After the procedure I dropped to 260, and for roughly the past 5 years I've been bouncing back and forth between 280 and 305. During a 3-week stretch on tirz, I shed 14 lbs. My height is 6'3". Getting below 240 is what I'm aiming for, which would move me out of morbid obesity. That makes 235 a solid target for me. I carry a lot of muscle, so I'll be putting in serious effort to preserve as much of it as I can.
 
Beardboost said:

If the stomach has stretched out by now and gone back to normal, then I don't think there would be a problem. Any side effects you might get are usually minimal and don't involve the stomach. Plenty of people go on Mounjaro soon after surgery, and Reta would work the same way 🙂
No—the stomach won't expand simply from the passage of time. What causes it to stretch is repeatedly eating past fullness. My own sleeve was performed more than 10 years ago, and to this day I'm unable to consume a large amount of food.
 
alphaamigo said:

woundcarping said:

Tirz or Reta would both work. There's no need to push Tirz until food aversion kicks in. If you won't be able to get your Reta dose high enough for the BMR boost, then Tirz is likely just as effective.

What amount of weight are you aiming to drop?

As Tubby mentioned, I'd anticipate a somewhat distinct reaction given the shifts in ghrelin and GLP production.
My peak weight was 370. Surgery happened when I was 340. After the procedure I dropped to 260, and for roughly the past 5 years I've been bouncing back and forth between 280 and 305. During a 3-week stretch on tirz, I shed 14 lbs. My height is 6'3". Getting below 240 is what I'm aiming for, which would move me out of morbid obesity. That makes 235 a solid target for me. I carry a lot of muscle, so I'll be putting in serious effort to preserve as much of it as I can.
It seems like you have a decent amount of weight to shed. I'm 1 or 2 inches shorter than you, and when I began Tirz 16.5 weeks ago I weighed 282lb; this morning the scale read 238lb. A few factors pushed me to switch over to Reta, and one of them was the idea that it helps spare lean mass.

My suggestion would be to get a DEXA scan at the outset, then repeat it every so often, so you can track whether your efforts to hold onto muscle are working.

My current stack is Reta, trt, and hmb-fa, aiming to cut down catabolic losses. Across my last two scans I dropped 18.7lb, and only around half a pound of that came from lean mass.
 
alphaamigo said:

Had a sleeve procedure 10 years back. It brought me to a point I'm fine with, though I'm hoping Reta can assist me in getting my BMI below 30. To me, it looks like a pretty clear beneficial combo. Does anyone have firsthand experience with this?
Absolutely — Reta got me to my goal in the end. I say go for it.
 
alphaamigo said:

Had a sleeve procedure 10 years back. It brought me to a point I'm fine with, though I'm hoping Reta can assist me in getting my BMI below 30. To me, it looks like a pretty clear beneficial combo. Does anyone have firsthand experience with this?
My VSG was done 17 years ago. At my peak I weighed close to 600lbs. Similar to your situation, it brought me down to roughly 250lbs, and I held there for 7-8 years. After that, carbs took over, I shot back up to around 400lbs, and my knees had to be replaced. I had one done once I'd gotten to 300lbs, and that was through my own efforts. Then, following 3 months off work, I climbed to 325. That's when I began Compounded Tirz: 125lbs came off over 16 months, and 3 Dexa scans showed I put on 4lbs of lean mass during that stretch. The final 23lbs came off with Reta, achieved in a single month at 4mg. All told I've lost about 400lbs. For maintenance I alternate 1mg of Tirz and 1mg of Reta shots every 84 hours, and my BMI went from 84 to 27. Keep in mind, I didn't exercise during this period, though I did do a great deal of Physical Therapy. My diet stayed on point, and I also used some Lipo C & NAD+ back then.

Reta works well. Locate a reliable source, begin at a low dose and go slowly, easing your way up. It can raise your resting heart rate; if that happens, add Taurine. It definitely lacks the food suppression that Tirz provides, so keep your protein and electrolytes in check.
 
One week in, so here's a small update. For week 1, I chose to split it into two 1mg doses; week 2 begins tomorrow with one 2mg dose. My intention is to stay at 2mg for 4 weeks, then very likely move to 4mg, and after that not raise it further unless there's a need. (Plenty of good guidance has come my way about saving titration upward for last rather than reaching for it first.)

Even so — wow. This is something I really like. Food aversion has been 0%, and that was the absolute worst part of tirz. So far I can think about food and eat without issue, yet the satisfaction I get while eating is fantastic. Maybe it's in my head, but there's a warmth inside me, somewhat like being in ketosis — except I'm not eating low carb, just high protein. By my own sense, I've eaten a lot, but the scale is already moving: 3lbs gone in week 1.

Being able to eat matters a lot to me. With tirz, feeling disgusted by food was something I truly disliked. Meanwhile, food noise has basically vanished, I'm eating an amount I consider healthy, and the satisfaction sticks with me.

Does anyone else recognize this?

BTW, in case you're wondering why I already intend to increase at 4 weeks: it's to reach what research indicates is an effective dose for the 3rd glucagon receptor. Should that prove too strong, I will definitely lower it. My hope is that 4mg becomes my long-term dose.
 
alphaamigo said:

One week in, so here's a small update. For week 1, I chose to split it into two 1mg doses; week 2 begins tomorrow with one 2mg dose. My intention is to stay at 2mg for 4 weeks, then very likely move to 4mg, and after that not raise it further unless there's a need. (Plenty of good guidance has come my way about saving titration upward for last rather than reaching for it first.)

Even so — wow. This is something I really like. Food aversion has been 0%, and that was the absolute worst part of tirz. So far I can think about food and eat without issue, yet the satisfaction I get while eating is fantastic. Maybe it's in my head, but there's a warmth inside me, somewhat like being in ketosis — except I'm not eating low carb, just high protein. By my own sense, I've eaten a lot, but the scale is already moving: 3lbs gone in week 1.

Being able to eat matters a lot to me. With tirz, feeling disgusted by food was something I truly disliked. Meanwhile, food noise has basically vanished, I'm eating an amount I consider healthy, and the satisfaction sticks with me.

Does anyone else recognize this?

BTW, in case you're wondering why I already intend to increase at 4 weeks: it's to reach what research indicates is an effective dose for the 3rd glucagon receptor. Should that prove too strong, I will definitely lower it. My hope is that 4mg becomes my long-term dose.
Reta left me pretty ravenous right up until I reached 6.0. Because of that, I brought tirz into the mix to deal with the appetite. Protocol was never something I stuck to. I still take both, and my Reta dose is 8 now.
 
My doctor's target for me while I lose weight is roughly 2000 calories per day along with 130g of protein. Right now I'm in week 2 of 2mg, and getting past 1500 calories is tough since I feel so full. Hitting the protein target only happens some of the time. Back when I was on tirz, there were stretches of days when I couldn't even get 600 calories down. That really wasn't healthy. My thinking is that once my system adjusts, eating more will get easier, and moving up to 4mg should be doable.
 
2mg should be maintained for a 4-week period

once 1 month has passed, Reta will have reached 100% effectiveness

moving up to 4mg is unnecessary provided you are unable to consume a minimum of 2000 cal per day
 
alphaamigo said:

Had a sleeve procedure 10 years back. It brought me to a point I'm fine with, though I'm hoping Reta can assist me in getting my BMI below 30. To me, it looks like a pretty clear beneficial combo. Does anyone have firsthand experience with this?
My procedure wasn't a sleeve—it was a duodenal switch with biliopancreatic diversion, which combines a sleeve with a bypass. While Tirz has delivered better results, using it by itself brings me side effects (severe tiredness, altered taste in food, and hard stools), so I combine it with Reta.
 
alphaamigo said:

My doctor's target for me while I lose weight is roughly 2000 calories per day along with 130g of protein. Right now I'm in week 2 of 2mg, and getting past 1500 calories is tough since I feel so full. Hitting the protein target only happens some of the time. Back when I was on tirz, there were stretches of days when I couldn't even get 600 calories down. That really wasn't healthy. My thinking is that once my system adjusts, eating more will get easier, and moving up to 4mg should be doable.
For me, hitting protein targets without hassle only worked when I started stirring plain protein powder into coffee. The trick is to blend it with something cool or cold first, then pour the hot coffee in gradually—otherwise you get lumps. My usual mix: 2-3 scoops, 1 cup of Darigold Fit milk, 1 packet of high-protein Carnation Instant Breakfast, and 2 cups of coffee. That lands somewhere between 107 and 120 grams of protein in a single shake. Since I'm not someone who eats breakfast, this approach feels necessary for me.
 
I underwent RNY 22 years back. Eating large amounts has never been possible for me. My restriction lasts forever. Even so, my weight loss halted once the first year after surgery passed. I even regained a few pounds. GLPs turned things around for me, at last I shed the last 40 pounds and dropped under my target weight. The results were amazing. My journey went sema, then tirz, then Reta.
 
Wecandothis said:

alphaamigo said:

One week in, so here's a small update. For week 1, I chose to split it into two 1mg doses; week 2 begins tomorrow with one 2mg dose. My intention is to stay at 2mg for 4 weeks, then very likely move to 4mg, and after that not raise it further unless there's a need. (Plenty of good guidance has come my way about saving titration upward for last rather than reaching for it first.)

Even so — wow. This is something I really like. Food aversion has been 0%, and that was the absolute worst part of tirz. So far I can think about food and eat without issue, yet the satisfaction I get while eating is fantastic. Maybe it's in my head, but there's a warmth inside me, somewhat like being in ketosis — except I'm not eating low carb, just high protein. By my own sense, I've eaten a lot, but the scale is already moving: 3lbs gone in week 1.

Being able to eat matters a lot to me. With tirz, feeling disgusted by food was something I truly disliked. Meanwhile, food noise has basically vanished, I'm eating an amount I consider healthy, and the satisfaction sticks with me.

Does anyone else recognize this?

BTW, in case you're wondering why I already intend to increase at 4 weeks: it's to reach what research indicates is an effective dose for the 3rd glucagon receptor. Should that prove too strong, I will definitely lower it. My hope is that 4mg becomes my long-term dose.
Reta left me pretty ravenous right up until I reached 6.0. Because of that, I brought tirz into the mix to deal with the appetite. Protocol was never something I stuck to. I still take both, and my Reta dose is 8 now.
If you don't mind me asking, what's your tirz dosage, and how do you plan out your pins?
 
alphaamigo said:

Had a sleeve procedure 10 years back. It brought me to a point I'm fine with, though I'm hoping Reta can assist me in getting my BMI below 30. To me, it looks like a pretty clear beneficial combo. Does anyone have firsthand experience with this?
June marks 5 years since my surgery. Maintenance has gone quite well for me, and I've managed a solid body recomposition too. That said, just like you -- the food noise was LOUD, and combined with perimenopause/menopause it left me battling roughly 10lbs of ...regain or inflammation, I honestly can't tell which. Last January I began on a very low Tirz dose, which let me drop all of that regain and stay stable, though more recently the food aversions have crept in a bit more. In February I had an open shoulder procedure that turned out far hairier than expected, so I've been out of the gym for 2 months, and until recently only light cardio was possible; I've now started ramping that back toward my pre-shoulder levels. Since I couldn't move much yet was still eating to protect my pouch from the meds for my shoulder, those damn 10lbs are back! Right now I'm on a split dose of about 8mg of tirz per week, and soon I'll add a low dose of Reta to see whether I can get things under control again. A vial has been sitting waiting for reconstitution for about a month -- I kept putting off mixing it because it seemed like a waste while I wasn't exercising much! Hopefully I'll get it going this coming week.
 
domin8brix said:

Wecandothis said:

alphaamigo said:

One week in, so here's a small update. For week 1, I chose to split it into two 1mg doses; week 2 begins tomorrow with one 2mg dose. My intention is to stay at 2mg for 4 weeks, then very likely move to 4mg, and after that not raise it further unless there's a need. (Plenty of good guidance has come my way about saving titration upward for last rather than reaching for it first.)

Even so — wow. This is something I really like. Food aversion has been 0%, and that was the absolute worst part of tirz. So far I can think about food and eat without issue, yet the satisfaction I get while eating is fantastic. Maybe it's in my head, but there's a warmth inside me, somewhat like being in ketosis — except I'm not eating low carb, just high protein. By my own sense, I've eaten a lot, but the scale is already moving: 3lbs gone in week 1.

Being able to eat matters a lot to me. With tirz, feeling disgusted by food was something I truly disliked. Meanwhile, food noise has basically vanished, I'm eating an amount I consider healthy, and the satisfaction sticks with me.

Does anyone else recognize this?

BTW, in case you're wondering why I already intend to increase at 4 weeks: it's to reach what research indicates is an effective dose for the 3rd glucagon receptor. Should that prove too strong, I will definitely lower it. My hope is that 4mg becomes my long-term dose.
Reta left me pretty ravenous right up until I reached 6.0. Because of that, I brought tirz into the mix to deal with the appetite. Protocol was never something I stuck to. I still take both, and my Reta dose is 8 now.
If you don't mind me asking, what's your tirz dosage, and how do you plan out your pins?
I follow a somewhat unusual dosing pattern. I take 1 mg tirz, then 2 days afterward 3 mg Reta, then 2 days afterward 1 mg tirz, then 2 days afterward 3 mg Reta.
 
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