lessthanhalf said:
So that adds up to 21 lbs over 3 months? Call 5-10 of it water, which leaves 11-16 as genuine fat loss, so somewhere between 3.7 to 5.3 lbs each month. At 5.3 lbs you are shedding over half a kilo weekly, which is not bad at all.
Slow-ish, fair enough. Somebody sitting at that starting weight has almost certainly tried shedding pounds before - how did that attempt go, also sluggish?
How each person reacts, both in appetite suppression and in side effects, varies enormously. In trials 12mg of reta produced roughly 29% loss on average over a little more than a year, yet around 5 - 10% shed barely anything and a comparable slice dropped 40%+. The good news is that the group who lose nothing, that 5-10%, does not include you, and how things behave at low doses probably says little about the long game, though you may well end up below the average loser.
Is that calorie figure even trustworthy? Almost nobody counts accurately, and without weighing and logging every single item for a full seven days the number is guesswork - then you feed the lot into chatgpt so it can break down calories, protein, carbs, fat and so on, which is straightforward apart from all the weighing and recording. Considering how much you are trying to shift, a couple of dietician appointments could be worth the money, though on glps I would ignore what they say.
Honestly the exact number of calories barely matters. What these drugs do is blunt appetite, so eating to hunger already leaves you in a deficit. Willpower-driven restriction, in my view, does not really work - maybe for a few months, rarely for years - so the goal is simply to reach a dose that does something. Swapping the kinds of food you eat, rather than the quantity, is probably the better tactic: target 1.5g/kg/day of protein against lean body mass to limit muscle loss, favour low calorific density and high protein, keep fat low, and cut out entirely the rewarding, calorie-dense, high glycemic index carbs. That approach took me from 145kg down to 75 kg before I touched the glp drugs. ( hungry most of the time, mind you )
Titrating slowly exists to keep the sudden, nasty side effects away, the kind that leave you vomiting for a week. Move quicker than 2mg per 4 weeks and those odds climb, so you are weighing the upside of arriving sooner against the risk. Age and other conditions matter too: being older, unwell or diabetic means more caution and a slower ramp.
So the choice is either patience plus a slow ramp, ( and rapid weight loss is rarely a good thing , you tend to feel dreadful ) , or more speed with the extra side effects that come with it. If you pick speed, check glp plotter before changing anything. Splitting into smaller, more frequent shots is the only fairly low risk shortcut, whether that means every 2nd or 3rd day or twice weekly. Sitting at 6mg a week, for instance, you could bolt on a midweek 1mg and watch what happens, then add 2mg the following week if all is well. Or shave part of the 6mg off and move it to the other injection. Smaller amounts mean side effects, when they arrive, tend to settle faster. What you do need is a feel for the drug's behaviour over time: blood levels keep climbing for as long as 4 weeks after any increase, which is exactly why increases get spaced 4 weeks apart. The moment side effects or heavy appetite suppression appear, ease right off the ramp - sitting on 6mg and feeling mildly nauseous, jumping to 8mg will almost certainly make it worse. Let that guide each future step. And once you land on your final dose, simply raise one shot while lowering the other gradually so you can get back to a weekly schedule if that suits you better.
Once you are at 12mg, or at whatever ceiling you can hold without unpleasant side effects, the longer term picture gets clearer - though with your starting weight it will take time. My honest guess: aiming to lose over 50% of body weight means extras will probably be needed somewhere along the line. There is unfortunately no research at all yet on how to stack them properly. What I would do is climb to 12mg of reta, or as near as tolerable, and if progress has stalled consider very low doses of eloralintide or cagri, ramped extremely slowly. Should things already be moving and weight still coming off, waiting until reta stops working in a year or so is just as sensible. How much extra loss elora or cagri actually adds is unknown at this point. Were the effect genuinely additive, reta plus elora might carry you most of the way to that 50% down, which is surgery-grade results with no surgery. Working out your own best combination may take some trial and error.
Higher doses and stacked glp therapy almost certainly carry more known risk, plus some nobody has mapped yet. Set against severe obesity, though, which brings enormous long term health danger, the drug side of the ledger is very unlikely to look as frightening as leaving the condition untreated.
One more thing: do not quit the drugs out of frustration at not reaching a normal weight. Before glps existed, dieticians and endocrinologists treated 5 or 10% kept off long term as a genuine success, and even that much slashed long term health risk considerably. Holding onto whatever loss you achieve matters more than almost anything else.
These days I hold steady on tirz15mg /reta 5mg/cagri0.5mg weekly, sitting at 64 kg, which is 55% down from the 145 kg I started at. The glps only came in after most of the weight was already gone, purely to blunt the near permanent hunger that came with keeping it off during that first year, and they have done the job well - it is coming up on 3 years now since I hit 75kg.
