Looking for weight loss brakes!!

[FarmgirlRebel]

I'm losing too much weight and it's not slowing down.

Yeah, it may seem like a good problem to have, but at my age, "skinny" isn't a good look and I'm approaching it....fast

I'm 5'6 and 134lbs, but I am carrying about 8-10lbs of excess skin around my abdomen area...so as my doc put it, I'm sitting in the 120s of real weight.

I went from a size 24 to a 4 and now eyeballing and fitting into some 2s. Not a lot of 4s and even less 2s on the clothing racks...and I am going to start looking like a wraith if I can't slow this down. 10 more pounds and I'm below healthy BMI.

I'm freaked out about stopping GLPs all together, I've titrated down to 2.5mg of Tirz....but still keep losing. Tirz crushes my appetite.

But what is really hosing me up is my biliopancreatic duodenal switch (extreme bariatric surgery) I had in 2021. It left me with a permanent malabsorption component and while it helped me lose the weight, it is now causing some issues with slowing the train down.

To put into perspective, if I consume 1500 calories, with high protein I'll only absorb anywhere from 950-1200 of those calories I'm struggling to get in 1200 calories, which makes my calorie absorption rate far lower than it should be.

Having basically lost 200lbs, I have a real fear of regain so I'm playing with dosing to find a sweet spot that I can up my calorie intake. I'm thinking of switching to Reta for maintenance with the hopes I'll have more appetite on it than the Tirz, but still have some suppression.

I do have an appointment with my endo doc, but that isn't until September, meanwhile, I'm open to any tips or tricks. I am leading a very active lifestyle, which also contributes to the calorie burn.

 

[lessthanhalf]

The calorie intake you mention is interesting as most people on here would claim it is not really possible to stay weight neutral or close to it on such a low intake, but in the context of very large weight losses over years, maintenance calories really do seem to get pretty low. How to fix the current issue depends on whether eating more is going to help or not, if eating more is not going to change how many calories you can absorb then the solution is going to be different and probably based on changing what you eat to be more easily absorbed.

If eating more is going to help, then simplest is just keep on dropping the dose of tirz until you feel like you are eating more or weight stabilises, even if the dose ends up at 1mg a week. In some ways it is a better problem to have than getting to a plateau at high doses and at a weight miles above your target, and obviously has a lot to do with the previous surgery. There must be a dose that works if you were previously 200 lbs heavier ( assuming that was after the surgery and before the tirz )

If you have to you can just stop the tirz for a while until your weight stabilises or starts going up , and only then restart it at very low doses.

I do not know much about the surgery you have had or how exactly it affects digestion, but some types of food must be more easily or quickly absorbed than others, if the limitation is absorption rather than intake? As a short term solution there are food replacement systems ( simplified or elemental diets ) for people with short gut / malabsorption problems, do not know much about them and probably expensive but there should be options to stabilise things if stopping the tirz alone does not work. After that I suspect you might need an expert like your endocrinologist, or weight loss surgeon.

 

[Grogu]

I'm freaked out about stopping GLPs all together, I've titrated down to 2.5mg of Tirz....but still keep losing. Tirz crushes my appetite.

How about spreading of out your dose rather than stopping? The idea of ever stopping tirz freaks me out too. You could also consider titrating down even more. Nothing says that 2.5mg is the minimum dose.

 

[FartfulCodger]

I prescribe lowering the dose and taking 1 quart of ice cream per day.

 

[RubbaDubba1]

If you're using a factory lilly 2.5mg pen? Get a sterilized 10ml vial and inject the pen into that. Then take out half of the 2.5mg and try that for the week and see how it works out for you. I did this with some Semaglutide pens and tried to dose it that way. Didn't work for me, Sema too strong. Or try some Cagrilintide, I just started a week ago so far nothing though.

 

[woundcarping]

Like others have said, keep lowering your dose in terms of decreased amount and/or increased time between doses.

A problem is a problem for sure, but on the surface your solution seems easier than the inverse.

 

[FarmgirlRebel]

If you have to you can just stop the tirz for a while until your weight stabilises or starts going up , and only then restart it at very low doses.

I am thinking this might be a very good approach and something that just might work.

How about spreading of out your dose rather than stopping? The idea of ever stopping tirz freaks me out too. You could also consider titrating down even more. Nothing says that 2.5mg is the minimum dose.

I'm going to have to do this...was prescribed the stupid single use pens so I'll just get some sterile vials and empty them into that

A problem is a problem for sure, but on the surface your solution seems easier than the inverse.

I would rather have this issue (as long as I can stabalize) than the reverse tbh, but it's a head bender for sure that I'm even dealing with it. Not on my bingo card.

 

[BNLFL]

I’m in the same situation, but not as drastic. Hit my second goal and then some. I’m on Reta and was on a 9mg dose. I’m never going off this stuff, and just dropped to 6mg on Friday. I need to see what the scale says this Friday and go from there. I have the belly skin crap too. I’d do what they all said above and lower the dose. Surprised I have the belly skin losing 2lbs/week.

 

[Seasonal1]

You could also spread out your shots. Some people leave the dose but move to a shot every 10 days or every other week.

 

[SeaGypsy]

I'm in the same boat! I'm at 2.5 Tirz, still losing. Next shot I will drop it to 2mg. If I'm still losing I will start spacing out the dosage. I cannot lose anymore! I have some Reta on hand but I didn't do well with my heart rate on that one. Besides that I have years of Tirz stocked up so I really want to find my happy place using Tirz. Getting off the tirz is not an option for me, I cannot go back to the food noise.

 

[kenadams]

Have you tried a Carnivore Diet?

Meat, eggs, and fat are the most nutrient dense and wont spike insulin.

Weight is good so long as it comes from muscle and bone density.

You want to lose "fat" and not "weight" per se

 

[Builderman]

Honestly if 2.5 mg is crushing your appetite, I don’t see an issue with dropping down to 2 and the slowly down to even 1mg and seeing how your body reacts.

If you’re getting too skinny and can’t eat more calories due to the triz, lowering the dose just to eat more calories seems like the answer.

Maybe even time to consider switching to reta, can still help with weight loss and body composition, however, more people, like myself, do not experience intense hunger suppression on it.

But with 2.5mg crushing your appetite I wouldnt personally be too concerned with going even lower than that just so I could eat a bit more.

 

[Stace_wow]

I like the idea of dose spacing, or lengthening your doses out, 10-12-14 days between. You can try this while you wait for supplies to lower your dose?

I would also mention that you can look at things that have become habit in the grocery store. If you lean towards nonfat, low fat options on things, try the full fat options. IDK if you have ever had full fat yogurts, but wow, they are delicious. Chicken thighs instead of breasts, and rib eyes instead of strips!!!!! Yummm! Butter on your veggies, extra cheese in your salads, nuts for snacking...This kind of thing.

Good luck to you! I know you will figure out what works, and wont have to deal with that food noise. <3

 

[FarmgirlRebel]

Have you tried a Carnivore Diet?

Meat, eggs, and fat are the most nutrient dense and wont spike insulin.

Weight is good so long as it comes from muscle and bone density.

You want to lose "fat" and not "weight" per se

I tried carnivore a while back, it just isn't something I can stick to well. I have to force myself to eat protein as I have never been a huge meat eater...I lasted 2 weeks on carnivore before saying f-this

 

[FarmgirlRebel]

I like the idea of dose spacing, or lengthening your doses out, 10-12-14 days between. You can try this while you wait for supplies to lower your dose?

I would also mention that you can look at things that have become habit in the grocery store. If you lean towards nonfat, low fat options on things, try the full fat options. IDK if you have ever had full fat yogurts, but wow, they are delicious. Chicken thighs instead of breasts, and rib eyes instead of strips!!!!! Yummm! Butter on your veggies, extra cheese in your salads, nuts for snacking...This kind of thing.

Good luck to you! I know you will figure out what works, and wont have to deal with that food noise. (you DO NOT want to know). But good idea on those thighs and drums over white meat.

 

[Stace_wow]

Thanks, I full fat everything as I don't absorb hardly any fats through my intestines...it's a tricky balance though, because too much fat can lead to....uhhhh, interesting outcomes (you DO NOT want to know). But good idea on those thighs and drums over white meat.

I fear I may know of the outcomes you speak

Hope you find the brake pedal

 

[Nopenada]

I loved being on Rey’s because I just felt better in my body on it (minus the anhedonia, which was a big problem) and I had way less blood sugar symptoms. But I will tell you, I overshot my goal as well… on 1mg twice a week. I stopped for awhile because I was running out of fat and didn’t want to lose more muscle. Tried going down to a microdose and tried going to just once a week but I still kept losing and it was getting out of hand.

Now trying to keep weight off with cagri and going to be trying Elora as soon as I get it. But I do miss the good effects. There just doesn’t appear to be a small enough dose in the world for me. I hope you find yours!

 

[HouseCat]

No advice other than what others have said. I’ve heard of people doing itty bitty micro doses of tirz, like 0.25-0.5mg. Personally I Ike the spacing out suggestion people gave, and then you can always drop dosing from there.

On a side note…girl it is giving me LIFE & hope that you lost 200lbs and are now in size 4s! I can’t even imagine fitting into such a small size. And not to negate your problem at all, but I’m happy that you have this problem instead of having it the other way around!

 

[laansasa]

I agree with everyone about dropping your dose. I am at 1mg week split (0.5mg Tues & Fri). It can eat normally and control the weight.

 

[bamagirl26]

I hope to have such struggle, well not really because it sounds stressful, but I agree with others to drop dose to 1.5 mg or spread dose out farther apart. And lots and lots and lots of protein. Congrats on losing a tremondous amount.. and thanks also for sharing your Orange cap research. It helped give me peace of mind