fattymckee said:
lessthanhalf said:
What you're hoping to get out of adding reta matters a great deal here. My guess is there's still weight you'd like to shed. Would you be replacing your current regimen with reta, or stacking it on top of 15mg tirz? It would help to know your starting weight, goal weight, current weight, age, and height. Also, how long have you been using tirz? Any side effects from it? And is there a reason you wouldn't simply bump up the tirz dose rather than bringing reta into the mix?
In my own case, I stacked 5mg of reta with 15mg of tirz, and I actually combine both in a single syringe when injecting. That said, my purpose is holding onto a 54% weight reduction, so I figure aggressive dosing and pairing GLP agents makes sense when the goal is controlling serious, long-standing obesity, even though there isn't strong evidence yet on whether that's safe.
For roughly 12 months I have been on 15mg tirz, and my weight keeps going up and down. There is still a great deal I need to shed. Tirz helped me drop 80lbs, though some of it has come back. My next goal is another 50lbs.
My hope was that adding reta could help curb appetite and quiet food noise, since tirz only appears to do that for a few days before fading. I considered splitting tirz into 2 weekly pins, but what I have come across regarding reta sounds encouraging.
Given that your goal is to drop 130 lbs, roughly 60 kilos, it seems you fall into the category of fairly severe obesity, which is also my situation. If tirz at 15mg is still your dose and 80 pounds have already come off, then without percentages it's tough to say for sure, but you're almost certainly near the ceiling of tirz's effectiveness for you, and your weight loss response has been above average. Sadly, current GLP drugs aren't quite potent enough to bring individuals carrying over 30% excess weight back to a normal weight, at least not at standard doses or without stacking additional compounds. The strongest result so far is reta at 29% averaged over a year.
Many suggestions here involve either switching to reta or lowering tirz and adding reta, which is a sensible path, yet I'm skeptical that simply moving from 15mg tirz to 12mg reta would be sufficient to shed the remaining 50 lbs; more plausibly it might account for 10-20 of those pounds.
You didn't bring up side effects, so I'll take it they aren't an issue. My reasoning for adding reta instead of replacing tirz was this: after a year of relentless nausea on low-dose ozempic, tirzepatide at 15mg had very few side effects and kept hunger reasonably in check, so I didn't want to jeopardize that by switching. Instead I simply added a small amount of reta, 5mg, for a bit more glp-1 and gip receptor activity plus some additional benefit from reta's glucagon agonism. That took me from 78kg down to 66kg over 9 months, totaling 54% weight loss. Neither reta nor tirz can be pushed higher because skin sensitivity worsens sharply with even tiny increases of either. More crucially, I had already lost most of the weight without drugs, which helped manage the near-constant hunger from trying to keep so much weight off, and hopefully that will make maintenance easier. Right now I'm also trialing low-dose cagri at 0.25-0.5 mg; I'm unsure whether I like it—slightly less hungry, slightly more nausea, so it's hard to judge.
So my guess is the choices are: switch to reta gradually by raising it while lowering tirz, or just add extra reta, or increase tirz to around 20mg, or introduce low-dose cagri. Each is likely to move things in the right direction, but whether any will be enough to lose another 50 lbs is far less clear. In reality, it will require a long stretch of careful trial and error to find what works best with the fewest side effects. There's basically no science on this yet; my reasoning is that the known and unknown risks of combination therapy are probably smaller than the risks of severe uncontrolled obesity.
The other point is that preserving the current weight loss matters most for future health. Being 50 lbs overweight isn't ideal, but being 130 lbs overweight is truly dangerous, so simply keeping that off dramatically cuts long-term health risks. And over time, maintaining weight loss is much harder than losing it initially, so whatever drug or drugs you choose must be tolerable side-effect-wise to stay on them long term and keep the weight off.
