woundcarping said:
randompersonrandom said:
For the majority of folks, I'd say tirz is the stronger option at this point; reta suits those with a mild collecting habit.
Tirz comes with longer-term safety and efficacy information, and we've got a solid grasp on titration, adverse effects, dosing — makers have had ample time to refine production, it's been available long enough that the price isn't sky-high, and all in all it's an excellent medication whose mechanism clicks for people who struggle to stop overeating too frequently.
With reta, our current knowledge falls short of what we'd truly need to confirm we're getting product that performs reliably, won't unpredictably break down or develop potency issues after X amount of time, or trigger the sort of severe outcomes we'd catch if it were widely used. It's extremely fresh, and complications and surprises are likely for several years.
It makes complete sense for anyone who's discovered tirz doesn't work for them, yet tirz should genuinely be the first thing most people try, and for many it's the one that fits perfectly.
Another thing worth doing is comparing what you're aiming for against the trial results, then deciding where that leaves you. Say, for instance, your target is dropping 30+% of the weight you started at — then when you set 48-week Reta trial data beside 72-week Tirz data, Reta at least doubles the odds. *At 48 weeks Reta was still climbing, whereas Tirz had already flattened out by 72 weeks.
One concept I'm currently turning over, which came from @Grogu, is that what our bodies grow accustomed to is the peptide over a stretch of time rather than a set dose.... the different dose curves look alike and level off around the same points in time. That runs counter to "low and slow"... though as far as I know, no studies have looked at what happens when you raise the dose past the plateau — tracking weight changes and setting that against simply having been on a larger dose prior to plateauing.
Exactly — there's a gap in the research when it comes to continuing to raise doses during the window where we'd expect these drugs to plateau, and there's nothing at all on switching mechanisms within that same window (say, bringing in an amylin receptor agonist, or phentermine/topiramate, or metformin for that matter).
A while back I saw an interview with Dr. Jastreboff — she led most of the tirzepatide clinical trials — where the question came up about what to do when tirzepatide doesn't get someone to their target weightloss. Her answer was along the lines of: it may depend on how severe a person's obesity is, and if the goal isn't met, more than one medication could be needed. Should one stop working, she'd move that patient onto a different medication.