fattymckee said:
I've been using 15mg tirz for about a year and have been fluctuating weight up and down. I still have a lot to lose. With tirz I was able to lose 80lbs, but have gained back a bit. I am wanting to lose 50 more.
I was hoping that reta would assist with appetite suppression and food noise, which the tirz seems to help with for a few days then falls off. I thought about pinned tirz twice a week instead but with what I've read about reta it seems promising.
It sounds like you are in the group of people ( like me ) with fairly severe obesity given you want to lose a total of 130 lbs or about 60 kilos. If you are still on tirz at 15mg and have already lost 80 pounds, without percentages it is a bit hard to be certain but almost certainly you are at the limit of what tirz can do for you, and you have had a better than average weight loss response to it. Unfortunately GLP drugs are not yet quite good enough to get people with over 30% extra weight back down to normal weight , at least at normal doses or without adding extra drugs. The best so far being reta at 29% over a year on average.
A lot of the recommendations on here are for swapping over or dropping the dose of tirz and adding reta, which is a reasonable option, but I doubt just swapping to 12mg reta from 15mg tirz is going to be enough to lose the last 50 lbs, more likely might help with 10-20 of it .
You do not mention side effects , so I assume they are not a problem. My logic in adding in reta rather than swapping to it , was that after having intractable nausea from low dose ozempic for a year, tirzepatide at 15mg was really low in side effects and controlled hunger fairly well, so I did not want to risk mucking that up by swapping, so I just added in a bit of reta 5mg for a bit extra on glp-1 and gip receptors plus some extra effect from reta's glucagon agonism, and that got me to 66kg from 78kg over 9 months to a total of 54% weight loss. Doses of either reta or tirz cannot be increased as skin sensitivity gets much worse with tiny dose increases of either drug. But more importantly as I had lost most of the weight without drugs, helped control the more or less constant hunger from trying to keep that much weight off. Which hopefully will make keeping the weight off easier. Currently trying low dose cagri as well 0.25-0.5 mg , not sure if I like it , bit less hungry , bit more nausea, so hard to say.
So I would guess the options are to try switching to reta slowly by increasing it and decreasing tirz, or just adding extra reta, or increased doses of tirz to 20mg or so, or adding in cagri at low doses. Any of them are likely to have some effect in the right direction, whether it will be enough to lose a further 50 lbs is much harder to say. Realistically it is going to take a long period of gradual experimentation to find what works best with minimal side effects. There is essentially no science on this yet at all, my logic is the risks of combined therapies, known and unknown are likely to be lower than the risks of severe uncontrolled obesity.
The other issue is that maintaining the current weight loss is the most important factor for future health, being 50 lbs overweight is not great for health, but being 130 lbs overweight is really very bad, so just keeping that off reduces long term health risks drastically. And over the longer term keeping the weight off is a lot harder than losing it in the first place, so what ever drug or drugs you use need to be tolerable in terms of side effects to stay on them long term to keep the weight off.
