Is my patience the real problem?

[eternalyouth2]

Glps have been part of my life since 2022, starting on sema under a dr's prescription, and I took off 50lbs across the first 1.5 years. Then insurance cut me off and I went grey. After reading up on the benefits I switched to tirz, hoping to shift another 10lbs. That switch took roughly another year to deliver, given I was already at the low end of the range — 135 down to 125, at 5'4 F. I pushed all the way to the top dose of 15mg, but the side effects were wearing me down. I dropped back to 10mg and began putting weight on. That was back in April and I climbed to 130; it sounds trivial, but 5lbs shows on a small frame. I figured maybe my body wanted a rest and made my peace with the extra 5lbs. Except it kept creeping, and between what life was throwing at me and simply being hungrier, I was back at 135. So 7 weeks ago I moved to Reta — 2mg for two weeks, then 4mg for 3 weeks, then 6mg for some weeks, and this week up to 7mg. Zero weight loss... I do exercise (walking, weights, large, yoga and versa climber) and while Reta actually seems to make me hungrier in some ways, my diet is dialed, following the 80/20 rule. Am I being impatient?? lolI

I've got Cag on the way and I'm wondering whether to add it or just raise my reta dose? Any feedback would be appreciated.

 

[spanky2026]

At 135 your BMI sits around 23, which is a perfectly "good" level. Maybe your body simply has no interest in going lower — a set point genuinely is a thing, and while GLPs can pull you down to a lower set point when yours is very high, there's a limit to how far they can take that.

 

[jpru2001]

Agreeing with what's already been said, and I'd add this: as a rule, someone who was on a max dose GLP, stops for a while and then restarts is going to need a high dose once more.

 

[eternalyouth2]

spanky2026 said:

At 135 your BMI sits around 23, which is a perfectly "good" level. Maybe your body simply has no interest in going lower — a set point genuinely is a thing, and while GLPs can pull you down to a lower set point when yours is very high, there's a limit to how far they can take that.

Ugh... that's really not what I was hoping to hear

 

[eternalyouth2]

jpru2001 said:

Agreeing with what's already been said, and I'd add this: as a rule, someone who was on a max dose GLP, stops for a while and then restarts is going to need a high dose once more.

Big reta doses scare me a bit, given the raised heart rate I've already got — it kicked in the moment I hit 2mg, and it has stayed at that higher HR since.

 

[Seasonal1]

Assuming the meds are working and you're training, what remains is diet. Are you logging what you eat? Weighing it? Accounting for every bite? CICO has not gone anywhere. And can you honestly say you're running a steady deficit?

 

[skaylife]

eternalyouth2 said:

Glps have been part of my life since 2022, starting on sema under a dr's prescription, and I took off 50lbs across the first 1.5 years. Then insurance cut me off and I went grey. After reading up on the benefits I switched to tirz, hoping to shift another 10lbs. That switch took roughly another year to deliver, given I was already at the low end of the range — 135 down to 125, at 5'4 F. I pushed all the way to the top dose of 15mg, but the side effects were wearing me down. I dropped back to 10mg and began putting weight on. That was back in April and I climbed to 130; it sounds trivial, but 5lbs shows on a small frame. I figured maybe my body wanted a rest and made my peace with the extra 5lbs. Except it kept creeping, and between what life was throwing at me and simply being hungrier, I was back at 135. So 7 weeks ago I moved to Reta — 2mg for two weeks, then 4mg for 3 weeks, then 6mg for some weeks, and this week up to 7mg. Zero weight loss... I do exercise (walking, weights, large, yoga and versa climber) and while Reta actually seems to make me hungrier in some ways, my diet is dialed, following the 80/20 rule. Am I being impatient?? lolI

I've got Cag on the way and I'm wondering whether to add it or just raise my reta dose? Any feedback would be appreciated.

Why not go back to tirz, given it treated you better? The fact that Reta works for a lot of people doesn't mean it will work for you.

I was doing well on Tirz myself, and then switched to Reta out of curiosity, and I suppose a quiet wish for quicker results, and got nothing out of it. After 2 weeks with no movement on the scale, the food noise returning and 3 days of brutal diarrhea, I called it. Back on Tirz and everything settled within a few days. I'm not claiming reta is bad or useless. It just wasn't good for me.

Everybody responds differently. For hunger noise and appetite suppression, Tirz is clearly the stronger of the two. That much is certain. On the other hand it strips muscle unless you're training actively and eating enough protein.

 

[ladyj779]

Your weight is already perfectly healthy. To go lower, you have to burn more than your body needs to hold steady. That can be done the easy way, by eating less, or the hard way, by moving more. Whichever route you pick, what settles it is calories, not medication

 

[eternalyouth2]

Seasonal1 said:

Assuming the meds are working and you're training, what remains is diet. Are you logging what you eat? Weighing it? Accounting for every bite? CICO has not gone anywhere. And can you honestly say you're running a steady deficit?

Funnily enough, counting calories and weighing food is a first for me on this glp 'journey'. That started when I moved to Reta 7 weeks ago. Depending on how much I'm moving, I average 1400-1700 cals a day. The food scale has come out of retirement, having sat unused since before glp. Odds are I was eating less back then simply because I had no appetite.

 

[eternalyouth2]

skaylife said:

eternalyouth2 said:

Glps have been part of my life since 2022, starting on sema under a dr's prescription, and I took off 50lbs across the first 1.5 years. Then insurance cut me off and I went grey. After reading up on the benefits I switched to tirz, hoping to shift another 10lbs. That switch took roughly another year to deliver, given I was already at the low end of the range — 135 down to 125, at 5'4 F. I pushed all the way to the top dose of 15mg, but the side effects were wearing me down. I dropped back to 10mg and began putting weight on. That was back in April and I climbed to 130; it sounds trivial, but 5lbs shows on a small frame. I figured maybe my body wanted a rest and made my peace with the extra 5lbs. Except it kept creeping, and between what life was throwing at me and simply being hungrier, I was back at 135. So 7 weeks ago I moved to Reta — 2mg for two weeks, then 4mg for 3 weeks, then 6mg for some weeks, and this week up to 7mg. Zero weight loss... I do exercise (walking, weights, large, yoga and versa climber) and while Reta actually seems to make me hungrier in some ways, my diet is dialed, following the 80/20 rule. Am I being impatient?? lolI

I've got Cag on the way and I'm wondering whether to add it or just raise my reta dose? Any feedback would be appreciated.

Why not go back to tirz, given it treated you better? The fact that Reta works for a lot of people doesn't mean it will work for you.

I was doing well on Tirz myself, and then switched to Reta out of curiosity, and I suppose a quiet wish for quicker results, and got nothing out of it. After 2 weeks with no movement on the scale, the food noise returning and 3 days of brutal diarrhea, I called it. Back on Tirz and everything settled within a few days. I'm not claiming reta is bad or useless. It just wasn't good for me.

Everybody responds differently. For hunger noise and appetite suppression, Tirz is clearly the stronger of the two. That much is certain. On the other hand it strips muscle unless you're training actively and eating enough protein.

That could well be it...I'll stick with it for another few weeks.

 

[ladyj779]

eternalyouth2 said:

Seasonal1 said:

Assuming the meds are working and you're training, what remains is diet. Are you logging what you eat? Weighing it? Accounting for every bite? CICO has not gone anywhere. And can you honestly say you're running a steady deficit?

Funnily enough, counting calories and weighing food is a first for me on this glp 'journey'. That started when I moved to Reta 7 weeks ago. Depending on how much I'm moving, I average 1400-1700 cals a day. The food scale has come out of retirement, having sat unused since before glp. Odds are I was eating less back then simply because I had no appetite.

Grab the lose it app, put it on sedentary, and don't eat back what you burn exercising.

At 46 and perimenopausal, at 5 ft 6, my tdee works out around 1600. I've no idea of your age, but you're both shorter and lighter than me. Yours could easily come in under 1700. That's not to say 1700 calories would make you gain, only that if the aim is loss rather than maintenance you'll likely need to work out your tdee and stay under it day after day until the scale reaches where you want to be. And where you want to be really shouldn't be much below where you are now

 

[eternalyouth2]

ladyj779 said:

Your weight is already perfectly healthy. To go lower, you have to burn more than your body needs to hold steady. That can be done the easy way, by eating less, or the hard way, by moving more. Whichever route you pick, what settles it is calories, not medication

That isn't something I'd argue with, but as I said, my diet is dialed in. Here's the big thing though — on 15mg I simply wasn't hungry, I was plainly eating less, and I wasn't tracking anything. That effect faded, and I moved to Reta, which is only mid as far as suppression goes. What I'm really asking is whether to keep pushing the dose, given I'm only on 7mg reta, and/or bring Cagrilintide in. After 4 years on these meds I'd guess my tolerance is fairly high.

 

[eternalyouth2]

ladyj779 said:

eternalyouth2 said:

Seasonal1 said:

Assuming the meds are working and you're training, what remains is diet. Are you logging what you eat? Weighing it? Accounting for every bite? CICO has not gone anywhere. And can you honestly say you're running a steady deficit?

Funnily enough, counting calories and weighing food is a first for me on this glp 'journey'. That started when I moved to Reta 7 weeks ago. Depending on how much I'm moving, I average 1400-1700 cals a day. The food scale has come out of retirement, having sat unused since before glp. Odds are I was eating less back then simply because I had no appetite.

Grab the lose it app, put it on sedentary, and don't eat back what you burn exercising.

At 46 and perimenopausal, at 5 ft 6, my tdee works out around 1600. I've no idea of your age, but you're both shorter and lighter than me. Yours could easily come in under 1700. That's not to say 1700 calories would make you gain, only that if the aim is loss rather than maintenance you'll likely need to work out your tdee and stay under it day after day until the scale reaches where you want to be. And where you want to be really shouldn't be much below where you are now

I'm 36. I ran the TDEE cal and it puts me at 1595 for sedentary — and I'm a long way from sedentary. I did it over again just now and it wants me down at 1295. On this 7mg reta there's no way I wouldn't be hungry lol.... Upping my dose should help with the hunger side of it, I'd think.

 

[ladyj779]

eternalyouth2 said:

ladyj779 said:

Your weight is already perfectly healthy. To go lower, you have to burn more than your body needs to hold steady. That can be done the easy way, by eating less, or the hard way, by moving more. Whichever route you pick, what settles it is calories, not medication

That isn't something I'd argue with, but as I said, my diet is dialed in. Here's the big thing though — on 15mg I simply wasn't hungry, I was plainly eating less, and I wasn't tracking anything. That effect faded, and I moved to Reta, which is only mid as far as suppression goes. What I'm really asking is whether to keep pushing the dose, given I'm only on 7mg reta, and/or bring Cagrilintide in. After 4 years on these meds I'd guess my tolerance is fairly high.

Dialed in to hold at 130. Great stuff!

Er — 135. My mistake.

 

[moodymama76]

ladyj779 said:

eternalyouth2 said:

Seasonal1 said:

Assuming the meds are working and you're training, what remains is diet. Are you logging what you eat? Weighing it? Accounting for every bite? CICO has not gone anywhere. And can you honestly say you're running a steady deficit?

Funnily enough, counting calories and weighing food is a first for me on this glp 'journey'. That started when I moved to Reta 7 weeks ago. Depending on how much I'm moving, I average 1400-1700 cals a day. The food scale has come out of retirement, having sat unused since before glp. Odds are I was eating less back then simply because I had no appetite.

Grab the lose it app, put it on sedentary, and don't eat back what you burn exercising.

At 46 and perimenopausal, at 5 ft 6, my tdee works out around 1600. I've no idea of your age, but you're both shorter and lighter than me. Yours could easily come in under 1700. That's not to say 1700 calories would make you gain, only that if the aim is loss rather than maintenance you'll likely need to work out your tdee and stay under it day after day until the scale reaches where you want to be. And where you want to be really shouldn't be much below where you are now

That's roughly my method too. The difference is mine is set at 1500, and I ignore whatever extra activity burns off. Some days I come in under 1500, other days over. Never by much either way. Activity varies day to day as well. Over the long run it evens out.

 

[eternalyouth2]

ladyj779 said:

eternalyouth2 said:

ladyj779 said:

Your weight is already perfectly healthy. To go lower, you have to burn more than your body needs to hold steady. That can be done the easy way, by eating less, or the hard way, by moving more. Whichever route you pick, what settles it is calories, not medication

That isn't something I'd argue with, but as I said, my diet is dialed in. Here's the big thing though — on 15mg I simply wasn't hungry, I was plainly eating less, and I wasn't tracking anything. That effect faded, and I moved to Reta, which is only mid as far as suppression goes. What I'm really asking is whether to keep pushing the dose, given I'm only on 7mg reta, and/or bring Cagrilintide in. After 4 years on these meds I'd guess my tolerance is fairly high.

Dialed in to hold at 130. Great stuff!

Er — 135. My mistake.

Lol great... well my thinking is that Cag will make sticking to the lower cals easier.

 

[gusterbuster]

Some details would help. Female, 36, around 130 lbs. What's your height? At 5'2'' losing a bit is reasonable, whereas at 5'9'' you'd be drifting into eating disorder territory, short of a bikini competitor prep.

Having helped plenty of people in real life, most simply don't track their food, or don't track it accurately. They eyeball it and underestimate, that sort of thing. I've asked people to photograph their meals so I can set it against their myfitness pal log, and the gap between the picture and what got entered can be stark.

If the calories you're on are on the low side, the better move is probably to raise them by a couple hundred and spend the next 3ish months getting stronger in the gym, allowing the weight to creep up a couple lbs. You'll be stronger, some lost lean mass will likely have been rebuilt, and your metabolism will be primed to shed fat. From the sound of it you've been in a deficit for 4ish years?

Have you had hormones checked — thyroid, estrogen, testosterone, IGF-1?

Also, 7mg Reta coming off 10-15mg tirz and you're not starving? That surprises me. On a mg for mg basis Tirz is usually the more potent.

 

[Stace_wow]

When someone is obese the weight drops off 'more easily', and I heard this said yesterday…no idea who by, but the point wasn't that weight loss is easy, only that small changes produce bigger, faster visible results in obese people. At a lower body weight, and the nearer you are to goal, the more meticulous everything has to be.

At 135 you may just have to be patient, and accept that progress will come slowly. Cag might help…but you're only 7 weeks into Reta with a fast dose escalation…it could still be building in your system…I'd give it time.

 

[eternalyouth2]

gusterbuster said:

Some details would help. Female, 36, around 130 lbs. What's your height? At 5'2'' losing a bit is reasonable, whereas at 5'9'' you'd be drifting into eating disorder territory, short of a bikini competitor prep.

Having helped plenty of people in real life, most simply don't track their food, or don't track it accurately. They eyeball it and underestimate, that sort of thing. I've asked people to photograph their meals so I can set it against their myfitness pal log, and the gap between the picture and what got entered can be stark.

If the calories you're on are on the low side, the better move is probably to raise them by a couple hundred and spend the next 3ish months getting stronger in the gym, allowing the weight to creep up a couple lbs. You'll be stronger, some lost lean mass will likely have been rebuilt, and your metabolism will be primed to shed fat. From the sound of it you've been in a deficit for 4ish years?

Have you had hormones checked — thyroid, estrogen, testosterone, IGF-1?

Also, 7mg Reta coming off 10-15mg tirz and you're not starving? That surprises me. On a mg for mg basis Tirz is usually the more potent.

Function health testing happens twice a year for me, and I add hormone testing on top. So everything sits in range — though whether that range is the right one for me, who knows.

The last few months I'd say I've been eating more, and as I told another commenter, I've in fact been logging my calories for the past 9ish weeks, starting just before I decided to move from T to Reta. September had me at 125, and 10lbs or so has crept on since — with my menstrual cycle it's a solid 135 the rest of the month, otherwise 132/133. It doesn't sound like much, but at 5'4 it's not enjoyable. (I know it's trivial… wahhhh wahh)

What I was actually after advice on is this: given I was on 15mg tirz, should I stay with Reta and raise the dose? Or bring cag into the mix? Holding to this calorie drop on 7mg Reta is a struggle. I get that cals matter, but isn't the whole point of the meds to be a tool that lets you stick to the deficit.

 

[eternalyouth2]

Stace_wow said:

When someone is obese the weight drops off 'more easily', and I heard this said yesterday…no idea who by, but the point wasn't that weight loss is easy, only that small changes produce bigger, faster visible results in obese people. At a lower body weight, and the nearer you are to goal, the more meticulous everything has to be.

At 135 you may just have to be patient, and accept that progress will come slowly. Cag might help…but you're only 7 weeks into Reta with a fast dose escalation…it could still be building in your system…I'd give it time.

The reality check is appreciated, particularly that last paragraph. I'll stay the course and ease off a bit. A few more weeks on Reta, then I'll decide on the cag. We'll see how it goes.