lessthanhalf said:
Sarsippius said:
Roughly 12 months is what you have before tolerance develops and hunger comes back. Keep that in mind when planning.
Once you've dropped 125 lbs, this scenario is a textbook illustration of what people often interpret as the drug losing potency or tolerance setting in.
Sure, at that level of weight loss, appetite goes up, but that's your body reacting to the weight loss itself, not the drug becoming less effective. Additionally, energy use falls because there's less lean and fat mass burning calories, plus a significant amount of metabolic adaptation from eating fewer calories over the long haul. Together, these factors halt further weight loss even while you remain on the GLP. The key point, though, is that continuing the medication prevents weight regain, so it's effectively maintaining a new, lower set point and will continue doing so as long as you stick with it.
In an ideal world, you'd hit your target weight right as this kicks in. Take someone 6ft4in aiming for a BMI of 25—that's 90kg or 198 lbs, meaning 27lbs below where you are now. Naturally, this varies with body composition and muscle. If you began at 350 and are at 225 now, you've shed 35.7% of your initial weight. That beats any result from GLP trials, though reta and cagri haven't been tested in combination.
Since you're already at the max for both reta and cagri, there's no clear-cut path to additional weight loss. One approach is to accept and celebrate what you've accomplished, as it rivals bariatric surgery minus the operation, and it's typically enough to eliminate obesity-related health issues. Over the long run, preserving that loss matters far more than shedding extra pounds when it comes to outcomes. The reta/cagri pairing is theoretically among the best available. At this stage, choices include upping reta or cagri, or bringing in tirz for added GIP activity. Switching entirely to tirz probably won't do much, and what you try next likely hinges on your current side effects. Sadly, escalating doses from here edges into diminishing returns, where more reta or adding tirz could ramp up side effects with minimal additional weight loss.