lessthanhalf said:
Sadly, no scientific studies exist on this topic as of now. My advice would be to jump straight to reta, because if someone responds poorly to glp-1 agonists, that poor response may not carry over to a drug that also acts on gip and glucagon, or to cagri or eloralintide, since those work through a completely different system, amylin. Poor response to GLP drugs can stem from genetic variants in the GLP-1 receptor itself or in downstream signalling pathways, and that is likely why 5-10% of people shed little or no weight while taking them. Down the road there will be research into how to handle this situation, but right now there is none. In my view the chances of a poor response to tirz or reta are quite high, certainly above average, yet there is no solid data to rely on. Still, for most people these are incredible drugs, so it is worth devoting a month or 2 or 3 to trying reta and seeing whether it appears to work. If it does not, then move on to cagri or eloralintide.
On ozempic I cannot claim to have lost any weight, since I spent a year at low doses; the whole time it left me tired, somewhat ill and somewhat nauseated, though it did cut appetite a little, which made it slightly easier to hold onto a 70 kg weight loss. Fortunately 15mg of tirz plus 5mg of reta plus 0.5mg of cagri gave far better appetite suppression and less nausea than 0.8mg/week of ozempic, and over the following year I dropped another 14 kg or so on that combination