Low carb vs. GLP-1: which approach wins?

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tendency

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I've been wondering about this. Across YouTube and similar platforms, there's no shortage of channels, dietitians, and doctors insisting—often quite forcefully—that going low carb is basically the only route to treat, reverse, or manage metabolic syndrome and pre-diabetes. Now that GLP-1 medications exist, what do you all make of that argument? Especially since a lot of people simply can't stick to that kind of diet no matter how much effort they put in.

With these drugs available, does the low carb message still hold up as a requirement? I haven't really seen anyone tackle this question—at least not yet—so I'd like to hear your thoughts.
 
When my wife and I began taking Reta, we cut back on carbs. That strategy has paid off for the two of us.
 
That's how it appears from where I stand. I began keto roughly 4 years back. At 177cm and 120kg, I was heavily overweight, perhaps obese. Over 16 months, I dropped 42kg, landing at 78kg. That gave me an ideal BMI and matched the weight I had back in secondary school (I'm 49 now). As I mentioned, keto was the starting point, but a few months in, I shifted to low carb and added intermittent fasting (2 meals a day). Other than keto, my sole exercise was walking about 25k steps daily. Occasionally I'd swim, but rarely. Then I switched jobs, and my activity vanished. From 25k steps, I went down to 3-4k daily. I stayed on low carb and IF, yet the weight crept back. In the end, I put on 17kg, reaching 95kg by the start of this year. I chose to bring activity back and joined a gym after several years off. I trained intensely: 5 days weekly, 30mins cardio, and weightlifting with a PPL routine. The scale barely moved...then I found GLP-1. I looked into getting ozempic legally, but once I saw the cost, I searched online and came across grey...and this amazing forum and community. In April, I made my first order - R10 and Glow - and it snowballed. I've now been on Reta for 2 months (plus a few other peps 😆) at 3mg/week. Since starting Reta, I've lost 10kg and 7% body fat. Currently, I'm 82kg with 22% BF. My aim is 12% BF and a clear six pack by my 50th birthday this coming January...my eating plan has moved from low carb to high protein/low carb/low fat. I still eat 2 meals daily.
 
At one point I followed a carnivore way of eating. Weight came off only in tiny amounts, yet my overall condition improved — inflammation went down, joint discomfort eased, and so on. Still, speaking just for myself, I couldn't keep that up long term.

With that said, tirz has pretty much pushed me toward eating fewer carbs because I'm concentrating on getting enough protein. I don't count macros in any strict way, but my carb intake is certainly on the low side. 70lbs has come off, and I'm just 10lbs away from my target, so clearly I'm someone who backs GLP-1s.
 
When I began reta, I just tracked calories and that was it. It didn’t matter how many carbs, fat, or protein I had that day—if I stayed below a set calorie number, I was fine. Now I’ve reduced carbs a lot and aim for more protein, but I still count calories. This change has made a huge difference for weight loss.
 
I've been doing keto for years and really like it, but I wouldn't call it mandatory. Since starting reta, I've actually paused keto for a while—it's simpler to keep calories down without going full keto. My approach now: prioritize protein, then round out meals with vegetables plus rice or potatoes, and avoid added sugars.

Compared to the typical American diet—which is basically garbage—I figure I'm still on the lower-carb side.

Keto carries its own set of habits and identity. What I've appreciated recently is being able to eat non-keto while out with friends and not spend days feeling awful as my body flips in and out of ketosis.
 
My preference leans toward fewer carbs, since they leave me feeling stuffed—and when the GLP is already curbing my appetite, piling on carbs can push my stomach past its limit.

Carbs still show up in my daily eating, just not at every sitting, and the bulk of them come from produce. That's the pattern that suits me, though each person's body responds differently 🙂
 
If Keto is something you're able to maintain, that's the route I'd take. I'd be willing to go all the way to carnivore. The problem is that it's genuinely difficult, and when someone is severely obese and/or carries a great deal of visceral fat, choosing a GLP-1 is preferable to losing your life.
 
I stuck with keto for close to 10 years. Nothing else I tried could keep me from eating past the point of physical discomfort. My weight dropped from 240lbs down to 180, I felt great about how it turned out, and for me the sacrifices involved were justified.

Sadly, my activity level can't match what it once was, so pounds began returning and following the plan grew harder to maintain.

With Tirz and Reta, I've been able to eat the way a “normal” person does and take back control of my body, without having to follow any particular diet rigidly. As others above have said, eating sensibly still matters, but now I don't feel guilty about enjoying some ice cream. Part of that is being able to take 1 scoop, feel satisfied, and stop rather than going back for more. It's kind of magical.

That said, I'm no doctor. I don't portray 1 on YouTube either. Honestly, I'm not even a disgraced chiropractor pretending to be a doctor on YouTube.
 
I set targets for calories and protein each day. Those targets shift based on whether I'm cutting or maintaining. Once my protein is met and I still have calories remaining, I'll add carbs if I feel like it.

When cutting, I keep carbs fairly low.
 
tendency said:

I've been wondering about this. Across YouTube and similar platforms, there's no shortage of channels, dietitians, and doctors insisting—often quite forcefully—that going low carb is basically the only route to treat, reverse, or manage metabolic syndrome and pre-diabetes. Now that GLP-1 medications exist, what do you all make of that argument? Especially since a lot of people simply can't stick to that kind of diet no matter how much effort they put in.

With these drugs available, does the low carb message still hold up as a requirement? I haven't really seen anyone tackle this question—at least not yet—so I'd like to hear your thoughts.
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Just my 2 cents, but the other poster is right: the calorie target is what matters most. Burning the carbs you take in, on a low-carb plan, works well when you're cutting. Keto can work well too, but far more often it backfires unless you run it exactly right. Converting protein into carbohydrate is rough on the body (easy to do when keto isn't dialed in), and with too few ketones to burn, or when you keep slipping in and out of ketosis (again, keto not dialed in), it's miserable. For nearly everyone, the simple approach you can stick with wins.
 
Reta's purpose is to correct what you eat. Keto, honestly, I'm not clear on what that even means. Then there are folks doing carnivore or whatever—that's just crazy. The real answer is nutritious meals with fewer calories. That always comes down to lean proteins, vegetables, a bit of fruit, and cutting back on starchy carbs such as rice.

For most people, the result is fewer carbs than they'd eat without reta. If that matches how you define keto or low-carb, then fine. I simply refer to it as eating healthy.
 
62M, used to compete in sports. At 33, after a bad EB virus infection, Hashimoto's wrecked my thyroid, and I went from 182 to 239 in 6 months. Nothing changed in what I ate or in my cycling training routine. The difference was that a pill now ran my metabolism instead of a working body system.

Because I was stubborn, I landed on an eating plan that did the job. 800 calories: 1 salad with fish each day, no breakfast, no dinner, no dressing, no carbs. That got me back to my competitive weight. But it is far from sufficient to support ordinary functioning, let alone any kind of sport.

So I raised the calories, my weight climbed, then I cut back again, and this loop repeated.

Lately, the lowest I could reach on my own was 220Lbs doing OMAD, carnivore. (one meal a day)

What I am getting at: yes, a target weight can be reached through sheer starvation, sorry, I mean dedication. Yet for a lot of us, the price is poor nutrition and too few calories to do athletic things of any kind.

December 2025 is when I began Reta, at 262 on the scale, after rebounding from that starvation-level 220 pounds once I started eating more like a normal person. I have since reached my goal weight. And none of the malnutrition problems that come with 800 calorie diets.

Honestly, it feels good to eat like a normal person. Today at lunch I even had a double Filet o Fish, and I did not have to fear putting on 5 pounds by the next morning the way I used to.

Conclusion: my metabolism is genuinely broken. Retatrutide is the antidote.
 
tendency said:

I've been wondering about this. Across YouTube and similar platforms, there's no shortage of channels, dietitians, and doctors insisting—often quite forcefully—that going low carb is basically the only route to treat, reverse, or manage metabolic syndrome and pre-diabetes. Now that GLP-1 medications exist, what do you all make of that argument? Especially since a lot of people simply can't stick to that kind of diet no matter how much effort they put in.

With these drugs available, does the low carb message still hold up as a requirement? I haven't really seen anyone tackle this question—at least not yet—so I'd like to hear your thoughts.
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On YouTube, Dr. Jones strongly advocates for keto alongside GLP-1 medications.
 
tendency said:

I've been wondering about this. Across YouTube and similar platforms, there's no shortage of channels, dietitians, and doctors insisting—often quite forcefully—that going low carb is basically the only route to treat, reverse, or manage metabolic syndrome and pre-diabetes. Now that GLP-1 medications exist, what do you all make of that argument? Especially since a lot of people simply can't stick to that kind of diet no matter how much effort they put in.

With these drugs available, does the low carb message still hold up as a requirement? I haven't really seen anyone tackle this question—at least not yet—so I'd like to hear your thoughts.
Click to expand...
My take is that the right choice hinges on what you're actually trying to fix. For someone carrying a little extra weight, plenty of routes can work. But when obesity is severe, I'd say GLP medications are the answer right now, and what you eat becomes a much smaller piece of the puzzle.

Even with all the keto success stories people share above, a 2013 meta analysis found " Individuals assigned to a VLCKD showed decreased body weight (weighted mean difference − 0·91 (95 % CI − 1·65, − 0·17) kg, 1415 patients)" So that works out to 0.91kg lost across 12 months on a very low carb ketogenic diet.

That lines up with what I generally believe: consciously restricting calories through diet isn't a great long term obesity treatment. Keto can certainly cut hunger, but whether it holds up over the long haul is more open to question.

Glp drugs bring appetite down, producing a calorie deficit, and in many respects pairing them with an ordinary healthy way of eating, like mediterranean with added protein, is more logical. . Still, if keto helps you keep hunger in check, that's fine, though it's tougher to fit in enough fibre, fruit and veges while staying in ketosis .
 
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