What am I doing wrong?

[HereKittyKitty]

I made the change from Sema to Tz on Jan 2nd. About 20 pounds remained for me to lose. Over 3 weeks, 5 lbs came off. Rushing to shed this final amount isn't something I care about.

On Feb 20, I went up in dose. The same 0.75 lbs has been lost and regained for 7 weeks now.

Hunger has been completely absent. There is no food noise at all! Getting my protein and fiber in takes real effort. Each day I take in 72+ ozs of water. Cardio plus resistance work happens 4-5 days/week.

Whether Tz simply doesn't suit me and Sema is where I should return, dosing above what's approved (though tested!) there, or whether I should raise my Tz dose, stack, or try something else... I just don't know.

Comparing my own experience to the gushing weight loss stories I see from others here and elsewhere is something I'm fighting hard not to do in my head. Some days go better than others. This morning the scale informed me that fecking 0.75 lbs had come back. Screaming or crying feels right. Or both.

Despite what feels like endless reading, conversations with the few people I know IRL who grey, and videos I've watched, I still wonder whether I'm doing something incorrectly.

 

[Vash]

Do you count your calories?

 

[tubby]

Let's say sema had you stuck — you didn't say so outright, but that's my hunch for why you'd make the switch to tirz. Under that assumption, tirz is doing its job in one respect: combined with whatever else you've changed, it's stopped the scale from climbing back up. What it apparently isn't doing is packing enough punch to push you down any further.

Something I feel gets overlooked with GLPs: yes, they cut calories, but that alone doesn't capture why weight comes off. A blog post I came across does a nice job unpacking a GLP study in rodents that speaks to exactly this:

Loading…

uncertaintyprinciples.suspicious-link-removed.com

Ignore the fat partitioning and respiratory quotient material (I suspect Gary draws some shaky conclusions there) and focus on what the study actually found: the calorie-matched control arm shed fewer pounds than the GLP arm, even though both ate the same amount.

What's happening biochemically in your particular body, I couldn't begin to say. One observation though: if you only titrated up on tirz a few weeks ago, then because of how sema and tirz clear from the system, the ratio of GLP-1 to GIP agonism you're carrying right now hasn't reached typical tirz proportions — leftover sema is still tilting it toward GLP-1. Whether that helps or hurts, I can't say. What I can say with confidence is that you are not yet at the steady-state GLP-1 to GIP ratio you'll have 1 month from now (if you stay on tirz).

On the practical side, a number of people in your position stack in maz or survo (what's sometimes called the "ghetto reta" approach). That does cut both ways: it may push things further toward stronger GLP-1 agonism, and it also triggers whatever metabolic lever glucagon agonism pulls. Is that better than reta by itself? No clue — except that folks, particularly those with a sema history, tend to prefer the flavor of appetite suppression that comes from more GLP-1 input than reta alone provides. Which one wins on outcomes? I honestly don't know!

 

[Arkend]

HereKittyKitty said:

I made the change from Sema to Tz on Jan 2nd. About 20 pounds remained for me to lose. Over 3 weeks, 5 lbs came off. Rushing to shed this final amount isn't something I care about.

On Feb 20, I went up in dose. The same 0.75 lbs has been lost and regained for 7 weeks now.

Hunger has been completely absent. There is no food noise at all! Getting my protein and fiber in takes real effort. Each day I take in 72+ ozs of water. Cardio plus resistance work happens 4-5 days/week.

Whether Tz simply doesn't suit me and Sema is where I should return, dosing above what's approved (though tested!) there, or whether I should raise my Tz dose, stack, or try something else... I just don't know.

Comparing my own experience to the gushing weight loss stories I see from others here and elsewhere is something I'm fighting hard not to do in my head. Some days go better than others. This morning the scale informed me that fecking 0.75 lbs had come back. Screaming or crying feels right. Or both.

Despite what feels like endless reading, conversations with the few people I know IRL who grey, and videos I've watched, I still wonder whether I'm doing something incorrectly.

Our bodies can behave in unpredictable ways. One thing I keep telling myself is that even the smallest detail can shift things. About 7 pounds is what 1 gallon of water weighs. So if you consumed that much in a single day and didn’t fully flush it out, the scale would reflect it. Throw sodium into the mix, and you’ll retain even more water.

My suggestion would be to log your food intake and workouts for 2 weeks, then check whether the number on the scale moves. If it doesn’t, cut 100 calories per day, stick with that for 2 weeks, and watch for any difference. It’s really just about adjusting various levers to figure out what does the trick.

 

[HereKittyKitty]

Vash_ said:

Do you count your calories?

Yep! Every food and drink item gets logged. My macros are monitored too, so I know I'm meeting my protein and fiber targets. Right now I'm at 900-1,000 kcal/day. There's simply no room for more food.

@tubby thanks for sharing that article. I'll go through it tonight. Once sema became unavailable to me, I spent a few (3?) months with no glp at all. Then in Sept I returned to sema after discovering grey plus doing a month of research. To reach my last rx dose, I shortened each titration step to 2 weeks. Between Sept and Jan 1, my loss was minimal. Barely anything. Then on Jan 2, Tz.

Yes, I'll read the article once work is done. Thanks again!

 

[GrandmaJ]

HereKittyKitty said:

Vash_ said:

Do you count your calories?

Yep! Every food and drink item gets logged. My macros are monitored too, so I know I'm meeting my protein and fiber targets. Right now I'm at 900-1,000 kcal/day. There's simply no room for more food.

@tubby thanks for sharing that article. I'll go through it tonight. Once sema became unavailable to me, I spent a few (3?) months with no glp at all. Then in Sept I returned to sema after discovering grey plus doing a month of research. To reach my last rx dose, I shortened each titration step to 2 weeks. Between Sept and Jan 1, my loss was minimal. Barely anything. Then on Jan 2, Tz.

Yes, I'll read the article once work is done. Thanks again!

Strange as it sounds, your intake may be too low. My nutrition counselor advised me to raise mine from about 900 calories to 1250-1300 per day, based on my height and age (58, 5'2). Once I began eating more, the weight started coming off again. It wasn't easy, but I mixed black beans and sweet potatoes into my salads, or ate a few corn tortillas to get the calories up. Since food doesn't appeal to me at all, the struggle is real!

 

[Jfrick11]

tubby said:

Let's say sema had you stuck — you didn't say so outright, but that's my hunch for why you'd make the switch to tirz. Under that assumption, tirz is doing its job in one respect: combined with whatever else you've changed, it's stopped the scale from climbing back up. What it apparently isn't doing is packing enough punch to push you down any further.

Something I feel gets overlooked with GLPs: yes, they cut calories, but that alone doesn't capture why weight comes off. A blog post I came across does a nice job unpacking a GLP study in rodents that speaks to exactly this:

Loading…

uncertaintyprinciples.suspicious-link-removed.com

Ignore the fat partitioning and respiratory quotient material (I suspect Gary draws some shaky conclusions there) and focus on what the study actually found: the calorie-matched control arm shed fewer pounds than the GLP arm, even though both ate the same amount.

What's happening biochemically in your particular body, I couldn't begin to say. One observation though: if you only titrated up on tirz a few weeks ago, then because of how sema and tirz clear from the system, the ratio of GLP-1 to GIP agonism you're carrying right now hasn't reached typical tirz proportions — leftover sema is still tilting it toward GLP-1. Whether that helps or hurts, I can't say. What I can say with confidence is that you are not yet at the steady-state GLP-1 to GIP ratio you'll have 1 month from now (if you stay on tirz).

On the practical side, a number of people in your position stack in maz or survo (what's sometimes called the "ghetto reta" approach). That does cut both ways: it may push things further toward stronger GLP-1 agonism, and it also triggers whatever metabolic lever glucagon agonism pulls. Is that better than reta by itself? No clue — except that folks, particularly those with a sema history, tend to prefer the flavor of appetite suppression that comes from more GLP-1 input than reta alone provides. Which one wins on outcomes? I honestly don't know!

Your frustration comes through loud and clear.... . You're ticking every box: calories and macros are logged, water intake is on point, and you never skip a workout. That takes serious dedication, and hitting a wall like this can knock the wind out of you, particularly when you've put in that much effort.

The piece that jumps out at me most is how little you're eating. With the cardio and resistance training you're doing, 900–1,000 kcal/day is far too low. Your system has probably shifted into "survival mode," clinging to whatever energy it can find, and that alone can bring fat loss to a standstill. It's literally trying to survive starvation.

There are times when the smarter play isn't grinding even harder, but instead feeding your body what it's asking for so your metabolism can reset. That might look like a temporary dose reduction or dialing back the intensity, giving your body room to "wake back up" and start responding AGAIN. If you cmat fuel your body, especially after this much time on these peptides.... It's time to lower. And if you're truly in that mode... This reset won't happen in a single night, but once you take your foot off the gas and give your body proper fuel, especially alongside the good habits you already have , it will happen.

Keep in mind, moving slowly is still moving forward. Seven weeks of ±0.75 lbs isn't a failure, your body is adjusting and looking out for itself. Go easy on yourself; the final stretch is always the hardest part.

 

[AcadiaPeptides]

It genuinely seems like nothing in your routine is off, and I can see why hitting this wall is so maddening. Shedding those final pounds is famously sluggish, and that doesn't mean a mistake has been made on your end. Hunger is under control, training is happening, protein is coming in, water is going down — the tough pieces are all handled.

Measuring yourself against others stings, since what gets shared is usually the big drops, not the stretch where 1 pound keeps flip-flopping. What you're going through counts, even when it isn't dramatic.

If the medication has you second-guessing, that's a conversation for your prescriber, (all we can do is listen) but none of this adds up to failure on your part. It's simply your body digging in its heels, not delivering a verdict on how hard you're trying.

Others are in the same spot, and you haven't done anything incorrectly. This is just the portion that moves slowly.

 

[tubby]

The way GLPs and what people call "starvation mode" (whatever that effect actually amounts to) influence one another is, as far as I can tell, not something anyone has figured out. Still, my sense is that if someone's body had slowed down enough for that to explain the whole picture, OP would have picked up on it — things like feeling cold all the time and being noticeably sluggish.

Body recomposition could also just be what's happening here. When GIP agonism gets added in, and at a pretty high dose at that, while GLP-1 agonism is reduced, it's plausible that this offsets part of the muscle loss that may have come with sema, since a larger share of your protein intake would be going toward building muscle and lean tissue instead.

My honest impression is that OP isn't fully accounting for just how big a shift sema to tirz represents when it comes to hormonal effects.

 

[WLBLD]

HereKittyKitty said:

I made the change from Sema to Tz on Jan 2nd. About 20 pounds remained for me to lose. Over 3 weeks, 5 lbs came off. Rushing to shed this final amount isn't something I care about.

On Feb 20, I went up in dose. The same 0.75 lbs has been lost and regained for 7 weeks now.

Hunger has been completely absent. There is no food noise at all! Getting my protein and fiber in takes real effort. Each day I take in 72+ ozs of water. Cardio plus resistance work happens 4-5 days/week.

Whether Tz simply doesn't suit me and Sema is where I should return, dosing above what's approved (though tested!) there, or whether I should raise my Tz dose, stack, or try something else... I just don't know.

Comparing my own experience to the gushing weight loss stories I see from others here and elsewhere is something I'm fighting hard not to do in my head. Some days go better than others. This morning the scale informed me that fecking 0.75 lbs had come back. Screaming or crying feels right. Or both.

Despite what feels like endless reading, conversations with the few people I know IRL who grey, and videos I've watched, I still wonder whether I'm doing something incorrectly.

This could have been written by me. I only began GLPs on Feb 1st, and it's my first time. Weeks 1 and 2 brought a 2lb drop, then another 1lb for a total of 3lbs, after which it fluctuates, though I'm still very much a beginner. I make sure to drink plenty of water and keep a close eye on my food intake.

What's your current dose? My start was 1mg T, and the following week I moved to 1.65mg (aiming for a gradual ramp), but about 4 days after that I went along with what everyone was saying and gave Reta a try at .5mg, followed by 1mg the next week, and now I'm stuck bouncing up and down. It's wild because previously, no matter what I did, I couldn't drop weight despite trying everything for yearssss, yet I had no appetite so eating well was easy. These days I'm hungry (though I stay in control and don't eat extra to make up for it, keeping to 1,000-1,200cal). Everyone else has lost their appetite while mine has only just shown up. I have 50lbs to lose

 

[indolent]

Beyond what others have already suggested, I would concentrate on

1. cutting back on carbs (and choosing wisely when it comes to carbs that offer something useful, such as the protein and fiber found in a small amount of black beans eaten without rice)
   
2. keeping an eye on how much salt you take in from day to day (= holding onto water). Keep in mind, though, that a certain amount of salt is necessary.

 

[Vash]

HereKittyKitty said:

Vash_ said:

Do you count your calories?

Yep! Every food and drink item gets logged. My macros are monitored too, so I know I'm meeting my protein and fiber targets. Right now I'm at 900-1,000 kcal/day. There's simply no room for more food.

@tubby thanks for sharing that article. I'll go through it tonight. Once sema became unavailable to me, I spent a few (3?) months with no glp at all. Then in Sept I returned to sema after discovering grey plus doing a month of research. To reach my last rx dose, I shortened each titration step to 2 weeks. Between Sept and Jan 1, my loss was minimal. Barely anything. Then on Jan 2, Tz.

Yes, I'll read the article once work is done. Thanks again!

How are your macros split? You may have to tweak the ratios.

 

[HereKittyKitty]

indolent said:

Beyond what others have already suggested, I would concentrate on

1. cutting back on carbs (and choosing wisely when it comes to carbs that offer something useful, such as the protein and fiber found in a small amount of black beans eaten without rice)
   
2. keeping an eye on how much salt you take in from day to day (= holding onto water). Keep in mind, though, that a certain amount of salt is necessary.

I appreciate it.

My carb intake is under control. I have T2 diabetes in remission, and I make sure to keep it that way.

As for salt, I'll certainly check into that!

 

[HereKittyKitty]

Vash_ said:

HereKittyKitty said:

Vash_ said:

Do you count your calories?

Yep! Every food and drink item gets logged. My macros are monitored too, so I know I'm meeting my protein and fiber targets. Right now I'm at 900-1,000 kcal/day. There's simply no room for more food.

@tubby thanks for sharing that article. I'll go through it tonight. Once sema became unavailable to me, I spent a few (3?) months with no glp at all. Then in Sept I returned to sema after discovering grey plus doing a month of research. To reach my last rx dose, I shortened each titration step to 2 weeks. Between Sept and Jan 1, my loss was minimal. Barely anything. Then on Jan 2, Tz.

Yes, I'll read the article once work is done. Thanks again!

How are your macros split? You may have to tweak the ratios.

Here's the issue... for 7 years now, my carb intake has stayed under the macros from the calculator.

My protein sits a bit below what you'd typically anticipate. I aim for 100g each day. Reaching that amount daily is tough. There's only so much I can consume. I avoid empty calories. All my choices center on protein and fiber. Nothing I eat has less than 15g per serving. I use protein powder as a supplement since eating enough solid food isn't possible. This is hands down my hardest part.

 

[mtomm]

My guess is that it comes down to water weight. Your calorie tracking makes it clear that you're eating below maintenance. That said, anything that stresses the body—restricting calories and changing peptides included—can easily cause you to retain fluid. I'd wait another few weeks before drawing conclusions. A sudden drop on the scale wouldn't shock me at all.

 

[HereKittyKitty]

tubby said:

Let's say sema had you stuck — you didn't say so outright, but that's my hunch for why you'd make the switch to tirz. Under that assumption, tirz is doing its job in one respect: combined with whatever else you've changed, it's stopped the scale from climbing back up. What it apparently isn't doing is packing enough punch to push you down any further.

Something I feel gets overlooked with GLPs: yes, they cut calories, but that alone doesn't capture why weight comes off. A blog post I came across does a nice job unpacking a GLP study in rodents that speaks to exactly this:

Loading…

uncertaintyprinciples.suspicious-link-removed.com

Ignore the fat partitioning and respiratory quotient material (I suspect Gary draws some shaky conclusions there) and focus on what the study actually found: the calorie-matched control arm shed fewer pounds than the GLP arm, even though both ate the same amount.

What's happening biochemically in your particular body, I couldn't begin to say. One observation though: if you only titrated up on tirz a few weeks ago, then because of how sema and tirz clear from the system, the ratio of GLP-1 to GIP agonism you're carrying right now hasn't reached typical tirz proportions — leftover sema is still tilting it toward GLP-1. Whether that helps or hurts, I can't say. What I can say with confidence is that you are not yet at the steady-state GLP-1 to GIP ratio you'll have 1 month from now (if you stay on tirz).

On the practical side, a number of people in your position stack in maz or survo (what's sometimes called the "ghetto reta" approach). That does cut both ways: it may push things further toward stronger GLP-1 agonism, and it also triggers whatever metabolic lever glucagon agonism pulls. Is that better than reta by itself? No clue — except that folks, particularly those with a sema history, tend to prefer the flavor of appetite suppression that comes from more GLP-1 input than reta alone provides. Which one wins on outcomes? I honestly don't know!

I really appreciate your input, @tubby. Reading that article taught me a lot and opened my eyes. The CICO explanation doesn't convince me. Years back I followed keto, and honestly the past month or so has felt a lot like that period, with several of the same side effects showing up, though less intense.

All the people who read about what I'm going through and took the time to respond have handed me plenty to chew on and work through, including your reminder to take things slower and your advice to cut myself some slack.

Tonight I'm going back through a full year of food logging records, looking for anything in there that could help me right now. The kcal I take in each day sits well below what the marcos calculators say I should have. I'm not sure how I could possibly eat more than I already do, but this deserves a close, careful look.

Thanks. I'll stick with it and go through the ideas people gave me today. I'm grateful that each of you spent time passing along what you know and what you've noticed. A lot of the time, I'm blind to things in myself that other people pick up on without effort.

 

[WLBLD]

One more idea that came to mind: are you taking in electrolytes? Certain ones contain a high amount of sodium.

 

[HereKittyKitty]

I haven't done that. Picking up sodium there would be a sneaky possibility.

 

[lessthanhalf]

To give a proper answer, I would need to know your starting weight, age, height, how much you dropped on Sema and at which dose, your current tirz dose, and your present weight.

For someone to stop burning any fat while eating 900 kcal/day, metabolic adaptation would have to be extraordinarily severe. That scenario would only be plausible for a short woman who had already shed a massive amount of weight — and even then, 900 kcal/day is among the lowest maintenance intakes I have ever come across. In my own case, daily energy expenditure fell by 1500 kcal over the course of a year, landing at 1600 kcal/day at a stable weight, roughly a 50% reduction. So the phenomenon is definitely real, but 900 is remarkably low, particularly when exercise is factored in.

Could your calorie tracking be off? It might be worth going back, weighing everything again, and redoing the calculations. Research shows that people's self-reported calorie intake is wildly imprecise. I do not mean this as a dig at all — it is just that this could account for why no weight is coming off at that intake.

Some folks here have suggested eating more calories. I have never encountered any scientific evidence supporting that idea. If anybody has actual journal citations, I would genuinely like to read them.

CICO is real — the second law of thermodynamics cannot be sidestepped. In practice it is far from straightforward, since nobody truly knows their measured energy expenditure, and it shifts enormously with activity level and with weight loss. Still, I doubt 900 kcal/day is sufficient to hold weight steady over the long run.

If I had to guess, I would say you are probably still losing fat, just very slowly, and the stall is mostly fluid balance fluctuations, based purely on the calorie intake.

Since you only recently began tirz, I am assuming you are not at 15mg. Is there any reason not to raise the dose? Even with the same calorie intake, it has metabolic effects that promote fat loss. Switching to reta is an option, as it does increase metabolic rate, especially at higher doses, by 1-200 kcal/day — but I am not sure it is necessary if you have not yet tried a higher tirz dose. And making the switch takes time and involves hassle.

It might be worth getting thyroid hormone levels checked?

 

[tubby]

lessthanhalf said:

To give a proper answer, I would need to know your starting weight, age, height, how much you dropped on Sema and at which dose, your current tirz dose, and your present weight.

For someone to stop burning any fat while eating 900 kcal/day, metabolic adaptation would have to be extraordinarily severe. That scenario would only be plausible for a short woman who had already shed a massive amount of weight — and even then, 900 kcal/day is among the lowest maintenance intakes I have ever come across. In my own case, daily energy expenditure fell by 1500 kcal over the course of a year, landing at 1600 kcal/day at a stable weight, roughly a 50% reduction. So the phenomenon is definitely real, but 900 is remarkably low, particularly when exercise is factored in.

Could your calorie tracking be off? It might be worth going back, weighing everything again, and redoing the calculations. Research shows that people's self-reported calorie intake is wildly imprecise. I do not mean this as a dig at all — it is just that this could account for why no weight is coming off at that intake.

Some folks here have suggested eating more calories. I have never encountered any scientific evidence supporting that idea. If anybody has actual journal citations, I would genuinely like to read them.

CICO is real — the second law of thermodynamics cannot be sidestepped. In practice it is far from straightforward, since nobody truly knows their measured energy expenditure, and it shifts enormously with activity level and with weight loss. Still, I doubt 900 kcal/day is sufficient to hold weight steady over the long run.

If I had to guess, I would say you are probably still losing fat, just very slowly, and the stall is mostly fluid balance fluctuations, based purely on the calorie intake.

Since you only recently began tirz, I am assuming you are not at 15mg. Is there any reason not to raise the dose? Even with the same calorie intake, it has metabolic effects that promote fat loss. Switching to reta is an option, as it does increase metabolic rate, especially at higher doses, by 1-200 kcal/day — but I am not sure it is necessary if you have not yet tried a higher tirz dose. And making the switch takes time and involves hassle.

It might be worth getting thyroid hormone levels checked?

There's no peer review behind it, but here's a post from someone who posts regularly on GLPForums that lays out how, by way of illustration, the calories from "protein" might be claimed to yield less metabolic energy than the calories tied to other macros.




Does Titrating up help weight loss?



RS has been on Tira 7.5mg with only 15 pounds to go to goal weight. Loss 80 pounds total. They hit a stall now. Will titrating up actually help with the weight loss or just control appetite better? RS doesn't generally have hunger issues at this dose running keto in calorie deficit . Also...

GLP1Chat.com

Yet folks grow far too fixated on calorie tracking, to their own detriment. Bomb calorimetry data is the sole objective calorie measurement available to us (and it is the origin of the figure printed on the label), and that involves a thermodynamic pathway that is quite distinct. Inside a calorimeter, all that is being captured is the heat released when the substance is oxidized down to carbon dioxide and water. That differs greatly from the usable work that can be produced by moving, breaking down, and finally metabolizing those very same substances within a human body.

You could compare it to measuring the heat released by burning a gallon of gasoline, then attempting to use that figure to estimate how much useful work the engine in your Toyota Camry can extract from burning that same gallon of gasoline (which would be considerably less). Granted, thermodynamics tells us that in the engine, work plus heat released ought to sum to the same total as the heat measured from plain combustion, but with the Camry, some of that work energy must additionally be squandered managing the surplus heat, and how much depends on the outdoor temperature.

In much the same way, within the human body, numerous complicating variables govern how much of that food energy (calories) becomes productive biological processes, how much is lost to overhead, and that is before even considering how hormonal signaling can override those processes. People bundle and blur all of it together under the label TDEE, but only because they are trapped inside that framework and their sole way of coping is to act as though it can all be averaged and blurred, given that confronting those real intricacies would expose their model as junk.