Seeking dosage guidance after stalling on Reta

Song1

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About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
 
Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
If you increase your resistance training or start doing it, a lot of people end up retaining extra water. That goes double when you take supplements with the same effect, such as creatine. That said, I've got no personal experience with losing weight at the level you're at (which is impressive).

Even so, as long as you're not dealing with severe side effects, and given that you came from the highest Semaglutide doses before, moving up in dose should be totally fine.

Sadly, at either tail of a bell curve there aren't many others around, so you'll be the one breaking new ground.
 
1. That's some seriously impressive progress, well done!

2. I hit a wall for several months while on a high dose of Tirz. Then I moved over to Reta, and honestly I didn't feel much of anything from it until I reached 8 mg.
 
Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
Also keep in mind that muscle is heavier than fat. So when you're adding muscle, it's very possible—in fact, quite likely—that you're dropping fat while your total weight goes up. If you're seeing good changes in body composition and you feel well, those things matter more than any particular figure the scale shows.
 
yrrdead said:

Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
If you increase your resistance training or start doing it, a lot of people end up retaining extra water. That goes double when you take supplements with the same effect, such as creatine. That said, I've got no personal experience with losing weight at the level you're at (which is impressive).

Even so, as long as you're not dealing with severe side effects, and given that you came from the highest Semaglutide doses before, moving up in dose should be totally fine.

Sadly, at either tail of a bell curve there aren't many others around, so you'll be the one breaking new ground.
That also holds true — what's probably happening is that fat is being swapped out for water and muscle right now, which benefits your health a lot, yet the scale won't reflect it as progress. Plus, since you're not getting side effects, there's still room to push the Reta higher
 
Well done on dropping 135kg — that's an enormous amount.

Once someone has already shed a large amount of weight, these drugs won't behave the way they do when you first begin them while still severely overweight.

The realistic ceiling may be using them to hold onto that huge loss, and even managing that goes well past what the average participant achieved in any of the trials.

Losing a massive amount of weight lowers metabolic rate and raises hunger, which is what makes keeping it off so difficult. What you're describing — no further loss at roughly 1200 kcal/day — is precisely that metabolic adaptation; for virtually anyone else, or under any other metabolic circumstance, that calorie level would produce weight loss.

Coming off 2.4 of semaglutide, you likely could have gone directly to about 5 mg of reta with fewer side effects, and — provided your current dose isn't causing you side effects and you're still hungry — you could probably nudge the dose up faster.

My own situation is fairly similar, except I lost the weight initially without medication and I exercise far less. I'm trying to hold onto a 78kg loss, or 54%, and I take 15mg tirzepatide plus 5mg retatrutide plus, very recently, 0.25mg cagrilintide. Right now I'm losing 100 - 200 grams weekly. But before I started the GLP medications, my loss had stalled at zero for a year with no change in my 1600-1800 kcal/day intake, even though that same intake had produced 6kg per month of loss at the beginning.

The clear move is to keep raising the reta dose as far as you can tolerate, or to 12mg.

Anything past that is up to you and how things are going. If you want to lose more, there are no good options scientifically proven to be safe. But obesity at that severity is genuinely very harmful to health, and my guess is that the risks of higher-dose GLP's or combination therapy are smaller than the risks of regaining weight in that situation. That would point to either going above 12mg retatrutide, adding cagrilintide, or adding semaglutide for extra glp-1 agonism.

It's possible that in your case shedding the last 20 kg isn't achievable, given you aren't losing on 1200 calories daily. It remains a huge achievement, and preserving all of it — or even a lot, or even some — is the key issue for long-term health. In my own case the GLP medications have clearly made that easier to tolerate.

I take it you've had basic bloods, blood pressure and all that checked at some point. Some of the other health risks tied to obesity are far easier to address than the weight itself.
 
@Song1 dropping 135 kg (297 lbs) is an absolutely staggering achievement! I'd really like to know more about your starting point, your reasons for beginning, and the lessons you picked up along the way...

A couple of extra ideas regarding your plateau. The limited clinical research available has shown the strongest outcomes at 12 mg Reta weekly, split across multiple doses. Around here, though, the majority report rapid progress on far smaller amounts. If we take it as given that your sleep, activity and nutrition are all in good shape, then one option would be to test whether a higher dose moves things along. Another route, which some people take, is stacking a second peptide alongside Reta for a synergistic effect while either holding the dose steady or even reducing it. Ultimately this whole thing is extremely, extremely personal and based on anecdote rather than data.

Honestly, what I'd most like to hear about is your age, where you started weight-wise, how many pounds you've been shedding per week on average, what kept you going, the insights you gained, how it shifted your relationships with others, and what your long-term aims are -- why? Because what you've done so far is already remarkable.
 
Not_Your_Dad said:

1. That's some seriously impressive progress, well done!

2. I hit a wall for several months while on a high dose of Tirz. Then I moved over to Reta, and honestly I didn't feel much of anything from it until I reached 8 mg.
Thanks, I may consider increasing it once more; the only downside I've had is trouble sleeping, nothing else bad.
 
onbusiness85 said:

A full body Dexa scan could be useful. It lets you track changes that a scale by itself won't reveal.
Honestly, I had planned to do that. My belt has gone down a couple of notches, but I thought the scale would drop more than any muscle I've added.
 
Song1 said:

onbusiness85 said:

A full body Dexa scan could be useful. It lets you track changes that a scale by itself won't reveal.
Honestly, I had planned to do that. My belt has gone down a couple of notches, but I thought the scale would drop more than any muscle I've added.
Most of the time that happens, but it's possible your fat loss has plateaued while muscle has been added. A scan might reveal that overall you actually dropped 145 kg of fat and gained 10 kg of muscle! Regardless, fantastic work on what you've achieved!
 
Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
You've got to be some kind of peptide deity. 300lbs/135kgs — I had to convert that. Those of us in the USA are clueless about kg. And don't get me going on "stones"...
 
ChicagoFit said:

@Song1 dropping 135 kg (297 lbs) is an absolutely staggering achievement! I'd really like to know more about your starting point, your reasons for beginning, and the lessons you picked up along the way...

A couple of extra ideas regarding your plateau. The limited clinical research available has shown the strongest outcomes at 12 mg Reta weekly, split across multiple doses. Around here, though, the majority report rapid progress on far smaller amounts. If we take it as given that your sleep, activity and nutrition are all in good shape, then one option would be to test whether a higher dose moves things along. Another route, which some people take, is stacking a second peptide alongside Reta for a synergistic effect while either holding the dose steady or even reducing it. Ultimately this whole thing is extremely, extremely personal and based on anecdote rather than data.

Honestly, what I'd most like to hear about is your age, where you started weight-wise, how many pounds you've been shedding per week on average, what kept you going, the insights you gained, how it shifted your relationships with others, and what your long-term aims are -- why? Because what you've done so far is already remarkable.
Hello everyone, lots of good questions here

I'm 47. Over a 2 year stretch I dropped roughly 125kg, and then last year I shed another 10 or so.

As far as how people relate to me, my work career has definitely taken off once more, and I'm treated with more respect now.

On the training side, it's weights plus cardio each morning, mostly boxing / kickboxing / sparring on a near-daily basis, and right now I'm not taking any rest days.

Looking ahead, maybe some masters boxing, but beyond that simply staying alive is enough.

Last year everything had to be paused for a while because my wife was diagnosed with breast cancer, so we had to get her through 3 rounds of surgery (she nearly died from an infection), chemo and radiation therapy, and then the preventative treatments. She's recovered well now and life is back to normal, so it feels good to be at it again.

About 5 days ago I actually bumped my dose up to 7.5 and I've lost another 2kgs, though I also increased my magnesium because I felt like I was holding water. Either way, it's nice to see the scale moving again
 
One thing worth looking into is your thyroid, specifically low T3. At 1200 calories, that's a pretty aggressive cut. Not eating enough left my thyroid suppressed. Before I ever started Reta, I had to raise my intake from under 1500 to 1800 before anything changed.

That being said, I'd put more stock in what you observe and how your clothes feel than in the number on the scale. For me, looser clothing and a midsection that was pulling in pointed to fat loss beyond what the scale showed.
 
With that level of activity, I find it surprising that your weight has stayed largely unchanged at 1200 kcal/day. From my own experience, I know how far metabolic rate can fall after substantial weight loss, but for me it took roughly 1600-1800 kcal/day to hold weight steady, with little exercise beyond walking a few k per day, and I had lost only a little over half as much weight. This really seems like a strong case for using retatrutide at higher doses, since it ought to raise daily calorie expenditure by at least 1-200kcal/day, and sticking to such a low intake over the long term has to be hard. Based on your exercise level and smaller waist, it does seem possible that you have added some muscle mass.
 
skeptick said:

Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
You've got to be some kind of peptide deity. 300lbs/135kgs — I had to convert that. Those of us in the USA are clueless about kg. And don't get me going on "stones"...
So from here on, BTU's (British thermal units) need to be converted into ATU's (American thermal units)
 
DjJoshua said:

skeptick said:

Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
You've got to be some kind of peptide deity. 300lbs/135kgs — I had to convert that. Those of us in the USA are clueless about kg. And don't get me going on "stones"...
So from here on, BTU's (British thermal units) need to be converted into ATU's (American thermal units)
Trump thermal units, seriously???
 
skeptick said:

DjJoshua said:

skeptick said:

Song1 said:

About 5 weeks ago I moved over to Reta from 2.4 mg Wegovy. Right now I'm at 5 mg and the scale won't budge, despite keeping my intake near 1,200 calories per day. I'm thinking about bumping the dose up once more.

All told I've dropped roughly 135 kg, and my goal is another 15–20 kg before I pursue skin removal surgery. That said, the last 12 months have brought almost no meaningful weight loss. Actually, after pushing my training to about 2.5 hours daily and adding weightlifting back in, I'm up around 1 kg. My body composition does appear to be shifting for the better, but the whole process has been pretty frustrating.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
You've got to be some kind of peptide deity. 300lbs/135kgs — I had to convert that. Those of us in the USA are clueless about kg. And don't get me going on "stones"...
So from here on, BTU's (British thermal units) need to be converted into ATU's (American thermal units)
Trump thermal units, seriously???
That one gets my vote !!
 
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