For those on Reta, what’s your exit strategy?

[oldrunnerguy]

Hit goal and micro dose to maintain.

Exactly what I plan on doing, except I'll switch back and forth between Reta and Tirz whenever I feel like it.

Lessthanhalf said, "there are 2 main categories of people on this forum, some, often older, with long term severe obesity and another group that is typically younger, fitter and less obese..."

There's more groups, but waaaay less people in them. I'm in the "old people who are not obese but see low-dose GLP1 usage as a way to lower A1C levels and blood pressure, improve lipid profile and other metabolic markers etc., all in the hopes of spending as much time as possible on this planet" group.

 

[Obi Pep Kenobi]

Get ripped then clean bulk and repeat

 

[CMA Pooky]

If a person reaches goal weight and just wants to maintain, is switching from Reta to Tirz or Sema a possibility? Wondering if this may be possible due to wanting to lower the resting heart rate without the Glucagon agonist from Reta. Thoughts?

 

[Cannonball72]

Exactly what I plan on doing, except I'll switch back and forth between Reta and Tirz whenever I feel like it.

Lessthanhalf said, "there are 2 main categories of people on this forum, some, often older, with long term severe obesity and another group that is typically younger, fitter and less obese..."

There's more groups, but waaaay less people in them. I'm in the "old people who are not obese but see low-dose GLP1 usage as a way to lower A1C levels and blood pressure, improve lipid profile and other metabolic markers etc., all in the hopes of spending as much time as possible on this planet" group.

I have battled with weight for as long as I can remember, 53 now.

Started with diet center and weight watchers clinics when I was in the 2nd grade.

Around 15 yrs old, I had always loved bicycles, but at around 14-15 I “found cycling”. Combo of increased activity and hormones enabled me to drop around 50lbs sophomore year of HS to college. I was always the fat kid.

In college, fresh start. No one knew me as the fat kid.

Over the years, pure exercise was not enough. I learned solid nutrition and have always maintained insane levels of exercise. And then I hit about 47/48. It started slipping away. Went from 180 to 200, 220, etc. yo-yo’d 200-220 since then. Older, work demands, stress, boredom, exhaustion and etc.

Fast forward, was reading a lot about GLPs, and stumbled across Reta. A miracle to me.

I had always thought I had ADD or ADHD etc, but am high functioning via all the discipline I built through nutrion and exercise management.

Tried Reta, for the first time in my life, my head felt clear of noise and need for constant stimulation.

Stress/boredom/emotional eating has completely gone away. I am now always thinking - “this is what “normal” people must feel like”.

No more binge eating or drinking. I can feel satisfied with normal portion sizes. I don’t need to eat or drink to satisfy my need for stimulation.

For the first time ever, I don’t feel like weight gain is one slip away.

As a bonus, I have maintained fitness hygiene and weight has melted off. From Feb to April, down 20lbs, 20 more to go.

For me, it’s more than weight, it’s mental/emotional peace and I feel very confident that I can maintain without the struggle and fear of having it all slip away.

Hit that goal, maintain. For both the weight and my head.

The biggest surprise, and I will repeat because it is worth repeating, my head is clear. This is worth as much if not more to me than the weight. I don’t see a reason to go back to the noise and distraction.

Microdosing will be equal parts weight management and mental/emotional peace/freedom.

 

[Theneedle]

I have cycled reta 6 weeks on 6 weeks off, end the 6 weeks with max dose, and try to maintain the habits and lifestyle for the 6 weeks off. Once I reached my goal weight, I pushed it a bit more, expecting a bit of bounce-back weight. This protocol has seemed to adapt my body and lifestyle pretty well to the new weight and physique. My weight doesn't fluctuate massively when dosing on and off, and habits are easier to maintain.

Also, Retas half life is 6 days, so it will be completely out of the body 3-4 weeks after the last dose, so during 3-4 off the 6 weeks off, you will still reap some of the benefits.

 

[MountainsoftheMoon]

Does there need to be an exit strategy? The biggest advantage GLP medications offer is weight loss maintenance. Not as well researched yet, other than the studies that just kept people on them after the initial trial ended, but in those cases weight loss was very consistently maintained for up to 5 years. Nearly everyone with weight issues has lost weight with diet, exercise and self discipline at some point and nearly every one of those has put the weight back on again. GLP drugs offer an escape from this endless cycle of trying to control something that feels uncontrollable.

Part of the reason for differences in opinion on taking GLP's long term, is there are 2 main categories of people on this forum, some, often older, with long term severe obesity and another group that is typically younger, fitter and less obese. The second group is far less likely to see themselves needing GLP medications long term, which may well be true but it will take another decade to find out for sure, and the first group that is much more likely to stay on them long term, and see them as helping to fix a serious life long problem.

I wish you success in your endeavor to keep the weight of without them, but the question I would ask is why? Being overweight or obese long term has serious adverse health consequences, weight cycling, despite its bad reputation, does actually reduce some of those consequences, but has other disadvantages as well. How many years of going through the weight cycling will it take to convince you that that strategy is not working? ( not a criticism , I got to 65 kg in 2012 and back up to 145 by 2022 ). Staying on GLP's not only reduces health problems due to obesity by reducing weight but also, independently of effects on weight reduces many long term health problems, including diabetes development, heart disease and cancers. So staying on them is not bad for your health , it is beneficial. They are definitely not addictive. So the real issue with staying on them is the sense of being dependent on a medication to help control weight. Which I guess feels like not being in control of it yourself? Trying to reduce doses once weight loss has got to where you want is fine, or even stopping it, although I think this is a genuinely bad idea if the obesity was severe, but the most reasonable and realistic way to do it is with careful monitoring of weight and a willingness to restart or increase doses if weight starts to go up rather than let it get out of control first.

The whole obesity epidemic is a fairly recent phenomena, at least in terms of a large percentage of the population being affected, and there are lots of causes, but ultimately the biggest one is the cheap availability of high calorie, low effort food, at the same time as a decline in everyday physical effort at home or at work. And this was enough to make half the population obese. Better habits do not fix this, they are an attempt to control your own behavior to minimise the damage from a generally obesogenic environment. Parts of this can be controlled, by only buying certain types of food and minimising your exposure to those foods on a daily basis. But probably not enough to solve the problem.

I see GLP medications as an escape from the cycle of weight loss, weight gain and the self loathing that comes with it. This alone is enough to improve quality of life, even if weight loss is not to ideal levels. I may be a bit biased in my thinking that diet and exercise really do not work as a strategy for long term weight loss, it is true that it can, but it really is not common. And I am not suggesting that GLP medications make poor dietary and lifestyle choices a good idea, but there is evidence that dietary choices improve on GLP treatment and from personal experience exercising is much easier, safer and more pleasant without lugging around a lot of extra kilos. And even if someone continues to be sedentary and eat an unhealthy diet, which realistically , given the population is obese to start with is fairly likely, the health benefits from weight loss and the drugs themselves will still happen, maybe not as well as if it was combined with a healthy diet and exercise , but a lot better than nothing.

I don’t have that answer. I agree that each case is different, and your assessment of the two camps seems to be fairly accurate. I myself fall outside of those two groups, (as a mid-late 30’s non obese, non fitness lifestyle person), but share parallels with each. My issues are primarily phycological/ addiction related, and not metabolic. I am overweight, significantly so when out of shape. However I am not categorized as obese by my doctor, but “at risk for longterm health complications if I don’t start building better habits and get my weight in check”. This has been the same assessment from any doctor for the last 10+ years. Up until my mid 20s, I had no issues with weight gain.

I have struggled with alcohol and drug addiction in my past, and at times, it seemed like there was no way out. But I have been able to shift out of that and maintain sobriety for years. Likewise I was smoker for most of my adult life, and have been tobacco free for 5 years, despite feeling like there was no hope after many attempts at quitting. I hope to build similar pathways in my life around food/ binge eating, which is the last frontier for me.

My intention to eventually be non reliant on peptides is a personal mission. For my own reasons, I want to be in control of my life and my actions. Being able to prove to myself that I can do it without medical intervention is a key goal.

That being said, here I am after many attempts without, and you could argue that even if I can get off and sustain without peptides longterm, that it was still medical intervention as a catalyst. I am totally fine with that. I think GLPs are a miracle, and a game changer. I do not have any issue with the idea of taking them for life, and I realize for many, that may be non optional. I do not see getting off of them as a higher ground than staying on them. Again this is a highly personal goal.

Ultimately, to your point, being healthy and keeping the weight off is the most important health consideration. With or without the help of peptides. If I am unable to achieve the goal described, I take no issue with staying on them longterm and won’t hesitate to do so. But not until I’ve tried getting off after reaching my targets first!

That’s my story and I’m sticking to it. To each their own

 

[UpDownLeftRightAS*]

Hit goal and micro dose to maintain.

Definitely, until something more subtle comes along (which, pipeline is packed!). Probably a .5mg- 1mg weekly low/ slow/ therapeutic if possible for a long run

 

[BNLFL]

Started reta 2/1. 17 pounds down first month. Only 9 in March. Im having to convince myself losing 9 or 10 pounds a month is a good thing. Diet and gym are perfect. 225 start weight. 198 today. Body recomp happening. Once hitting goal weight and numbers id like to titrate down then see if I can go off. Realistically I see myself just going low dose once a week. Cureent dose is 3mg on Sunday am. I have to force myself to eat Sunday night to Wednesday night. Thursday Friday and Saturday the appetite suppression is not there but I know not to get crazy with the food.

First month is usually a bunch of water weight, especially if you're watching what you eat. I lost 5lbs the first week at 2mg. Currently on 6mg. I average 2-2.5/lbs a month.

 

[Zydeceltico]

I don’t have that answer. I agree that each case is different, and your assessment of the two camps seems to be fairly accurate. I myself fall outside of those two groups, (as a mid-late 30’s non obese, non fitness lifestyle person), but share parallels with each. My issues are primarily phycological/ addiction related, and not metabolic. I am overweight, significantly so when out of shape. However I am not categorized as obese by my doctor, but “at risk for longterm health complications if I don’t start building better habits and get my weight in check”. This has been the same assessment from any doctor for the last 10+ years. Up until my mid 20s, I had no issues with weight gain.

I have struggled with alcohol and drug addiction in my past, and at times, it seemed like there was no way out. But I have been able to shift out of that and maintain sobriety for years. Likewise I was smoker for most of my adult life, and have been tobacco free for 5 years, despite feeling like there was no hope after many attempts at quitting. I hope to build similar pathways in my life around food/ binge eating, which is the last frontier for me.

My intention to eventually be non reliant on peptides is a personal mission. For my own reasons, I want to be in control of my life and my actions. Being able to prove to myself that I can do it without medical intervention is a key goal.

That being said, here I am after many attempts without, and you could argue that even if I can get off and sustain without peptides longterm, that it was still medical intervention as a catalyst. I am totally fine with that. I think GLPs are a miracle, and a game changer. I do not have any issue with the idea of taking them for life, and I realize for many, that may be non optional. I do not see getting off of them as a higher ground than staying on them. Again this is a highly personal goal.

Ultimately, to your point, being healthy and keeping the weight off is the most important health consideration. With or without the help of peptides. If I am unable to achieve the goal described, I take no issue with staying on them longterm and won’t hesitate to do so. But not until I’ve tried getting off after reaching my targets first!

That’s my story and I’m sticking to it. To each their own

I am also a former smoker and sober from drugs and alcohol and ALSO had to get my weight in check due to cardiovascular concerns and I was not obese but fell into the severely overweight category according to doctors and BMI. I understand your perspective.

That said, what I have discovered - for myself - is that the smoking, drugs, and alcohol (and poor eating habits for that matter) were very poor and definitely learned coping/management skills for the negative behavioral consequences of what I only recently discovered to be ADHD and also major insulin resistance which left me in huge blood sugar swing states which - for me over my 62 years - was devastating emotionally.

My point in sharing all of that is - again - I get it with the drugs, alcohol, and smoking. Intention continues to be huge.

ADHD and chronic pre-diabetes?

All the intention in the world will not result in these conditions being anything other than an ongoing vicious internal civil war. They're not mental/psychological.

They are metabolic, physical, hard-wired and I am not going to meditate or pray or self-determine or 12-Step myself out of them.

Both conditions are incredibly and gratefully mitigated since I began glp1s last year.

My two cents. ymmv

 

[JoonyO]

I have only been on reta since 1/5. I am going to see what happens when I get to my goal weight and how things go as far as side effects long term.

I can't see dealing with this sulfur stomach and narcolepsy-like exhaustion for the rest of my life.

I've read of the sulfer burps and such and IMO it's what or how much was eaten that causes it. Speculative as I've never had 'em, yet, but I eat pretty bland and don't eat too much at a time.

I've also never had the "I'm too full" and can't eat anymore or "the thought of food gags me" symptom. So there's that. I started sema last July after ( and before I learned about cal deficits ) about an 8 month "stall". I was mostly eating a couple of rib eyes, pork rinds and macadamia nuts every day and was frustrated with the stall. Of course now I know I was eating too many calories but at the time I said the hell with it and spent too much on a 90 day Sema treatment from an online "clinic". It did break the stall and I also learned about macros and cal deficits so I intermittent fast every day now for 16+ hours and keep calories down to 1500 or so. I suppose since I'm at 155 I should probably start to consider trying to eliminate the glps entirely and just rely on diet and exercise. I'll mull it over. Reta has a lot of good anecdotal experiences spoken about it and it definitely doesn't inhibit my ability to eat as much as I want.

So there's that.

 

[Grogu]

I have to be honest, every couple of weeks this question comes up about continued use of glp-1 medications and I'm always surprised how much people want off these medications. Trust me, I'm generally not a fan of medications and I'm on a couple of maintenance medications that I'd actually prefer not to be on, but I take them because I know that the medications are good for me and will likely lead to a longer life. That being said, glp-1s have been like a warm fuzzy blanket to me. The mind-gut altering effects are amazing and I've benefited so much from these medications that I don't want to ever stop taking them, ever.

 

[Retazempic]

My sentiments EXACTLY!!!!

 

[Cannonball72]

My wife has always said I am like a light switch, either on or off, no dimmer, specifically with respect to food, drink and exercise.

Light switch on - long periods of straight and rigid disciple - forcefully exerted control.

Light switch off - a night out where I drank and ate in a reckless, hedonistic, gluttonous way. Potentially a longer period where I was functional, but definitely not healthy.

On Reta, I have a dimmer. i can go out, put the drink down, put the food down, etc. truth be told, I don’t even want the drink and food is easy to moderate.

IME a miracle substance that I have no intention of fully stopping. Will find a minimum effective dose that makes current existence maintainable/sustainable.

 

[woundcarping]

I do plan on titrating down, if and as tolerated. If that developed to the point I practically wasn’t taking it and stopped, that’s fine with me. None of that is a goal or metric of success for me.

Not dealing with food noise, weight rebound, etc is my maintence goal.

Being open to changes based on new information is a goal.

The lifetime monetary cost of the peptides at current levels is entirely irrelevant to me. Unless there’s an unknown biological cost that hasn’t been revealed yet, I don’t care if I pin forever.

I don’t care if any of this makes me less of a man; I’m already 16% less man that I was 4 months ago.

 

[Grogu]

I do plan on titrating down, if and as tolerated. If that developed to the point I practically wasn’t taking it and stopped, that’s fine with me. None of that is a goal or metric of success for me.

Not dealing with food noise, weight rebound, etc is my maintence goal.

Being open to changes based on new information is a goal.

The lifetime monetary cost of the peptides at current levels is entirely irrelevant to me. Unless there’s an unknown biological cost that hasn’t been revealed yet, I don’t care if I pin forever.

I don’t care if any of this makes me less of a man; I’m already 16% less man that I was 4 months ago.

Really great advice and frame to think about long-term maintenance. The goal shouldn't be just focused on getting off the medication as if that's the goal. The goal is losing the excess weight, but also preventing weight rebound and food noise return.

Unfortunately, this is not my first rodeo losing 100+lbs. But hopefully this is my last time losing 100+ lbs. Once at goal, I'm definitely open to the concept of titrating down and seeing what happens and if my body will tolerate it. But the goal is long-term weight stability. None of this rollercoaster anymore!

 

[tubby]

I don’t care if any of this makes me less of a man

In theory it could even make you more of a man, as carrying excess body fat can increase the rate at which your body converts testosterone to estrogen.

 

[gimmeshelter]

achieve goal weight. Titrate off. Monitor if goal weight w no reta is realistic. Keep improving fitness and nutrition, may end up on a maintenance amount I've seen nothing that indicates reta is dangerous long-term .

 

[suppressed]

My original plan was to titrate off Tirz once hitting goal weight. I effortlessly quit nicotine in the last weeks, having tried countless times before with no success before taking tirz. My emotional state does seem slightly blunted but thats an easy trade off to make. Many facets of my life have improved simultaneously. It has made me consider titrating down to a micro dose schedule. All very interesting and unexpected

 

[m100568]

IME a miracle substance that I have no intention of fully stopping. Will find a minimum effective dose that makes current existence maintainable/sustainable.

I agree with this sentiment. However, after decades of fighting my weight I will be more succinct -- 'til death!

 

[Dogmandu]

I'll happily take a dose I can tolerate - for life. It's not even a close call.

Chronic conditions require chronic treatments and that means long term.

It's essentially replaced Metformin & statin, which I would have had to take for life, and was quite OK with that. This is no different.

I don't look at Reta as a quick weight loss trick. Reta is a metabolic Swiss Army knife. It has fixed chronic conditions that strict diet and exercise could not. As long as I want those conditions under check, Reta will remain a weekly thing. Until something better comes along in a decade or two.