每周服用 20 毫克雷他定的经验？

[BNLFL]

Love it. Another option would be a testosterone boost along with the tesa:

View attachment 18579

For marketing to the Meso crowd:

View attachment 18584

GB?

 

[soapysnake]

whoa whoa whoa there mister. be carful talking about them as tools. there are some people on this forum with several thousand posts that wont hesitate to tell you how you are wrong and to just up the dose because they are so affordable...i learned that first hand

lol learning this too now. I guess I’ve spent too much time on Meso? Didn’t think asking a question about diet and exercise would be so offensive. Lift weights, do LISS cardio, track your protein/macros and most of the time you’ll lose weight. Throw in Reta and you’ll for sure lose the weight. Relying on a drug as the primary contributor to losing weight doesn’t make sense to me. Can you get more sleep? Can you increase your steps by 3k a day? Can you adjust your diet a little bit? I feel like these are the questions to ask before going past the max tested dose of a drug, especially when it’s still working.

 

[Calm Logic]

Relying on a drug as the primary contributor to losing weight doesn’t make sense to me.

Probably because you don't have a GLP deficiency, or much of one anyway. In which case GLPs are more like a tool, because you never needed them in the first place.

Related threads:

A hard truth about GLP-1s and Body Transformations

GLP-1s can help with weight loss, but it won't give you the dream body or lasting results you're actually looking for. So let me drop some value that might save you from future disappointment. Weight Loss ≠ Muscle Building GLP-1s suppresses appetite and slows gastric emptying. You might get...

glp1forum.com

GLP-1s 'cheating' OR a TOOL

Hi all! I am having an interesting spiral of thoughts right now.. I see so many people online saying GLP1s are 'cheating'. But lets be real. How is it cheating if it isn't a game? This is life. This is my health and my journey in taking back my body and being able to live the healthy life I...

glp1forum.com

 

[Estarossa19]

lol learning this too now. I guess I’ve spent too much time on Meso? Didn’t think asking a question about diet and exercise would be so offensive. Lift weights, do LISS cardio, track your protein/macros and most of the time you’ll lose weight. Throw in Reta and you’ll for sure lose the weight. Relying on a drug as the primary contributor to losing weight doesn’t make sense to me. Can you get more sleep? Can you increase your steps by 3k a day? Can you adjust your diet a little bit? I feel like these are the questions to ask before going past the max tested dose of a drug, especially when it’s still working.

If you dare mention to anyone on reddit to move a little bit more you're on the verge of getting banned.

Think it's remnants of the body positivity movement that moved over to just jabbing themselves and not making any lifestyle changes at all.

 

[tubby]

Probably because you don't have a GLP deficiency, or much of one anyway. In which case GLPs are more like a tool , because you never needed them in the first place .

I'm all for skipping "moralizing" arguments about weight loss, but for the most part "GLP deficiency" is a fictitious concept. Humans didn't suddenly evolve a GLP deficiency over two generations.

Now it is documented that statins reduce GLP production, so if you're taking one, that's legitimately a GLP deficiency (and likely why statin use is associated with an increased risk of diabetes). I'm sure other drugs do the same and modern processed food is surely contributing as well (not to mention dozens of other inputs that impact us in subtle ways).

Let's just agree that some people are going to rely primarily on GLPs as the weight control measure, while others are going to utilize them more as a boost on top of lifestyle improvements. Both approaches beat doing nothing. I think it's our own insecurities that cause us to take offense when others note that lifestyle still plays into overall results.

 

[Calm Logic]

One theory: "Glucagon-like peptide-1 (GLP-1) deficiency occurs in obesity-related pathologies due to defects in the intestinal lumen. And expanding the L-cell population has emerged as a promising avenue to elevate GLP-1 secretion to tackle metabolic disorders."

Regardless of "GLP deficiency" vs. "functional impairment," L-Cells look interesting (as does DPP-4):

Lactobacillus rhamnosus GG Supernatant Improves GLP-1 Secretion Through Attenuating L Cell Lipotoxicity and Modulating Gut Microbiota in Obesity - Probiotics and Antimicrobial Proteins

Obesity is associated with decreased secretion of glucagon-like peptide-1 (GLP-1), which may result from lipotoxic damage to L cells caused by elevated levels of free fatty acids (FFAs). Although the probiotic Lactobacillus rhamnosus GG (LGG) exhibits anti-apoptotic properties, its potential to...

link.springer.com

The functional capacity of L cells and overall intestinal GLP-1 production depend critically on L cell survival. Therapeutic strategies aimed at enhancing L cell viability and preserving their population could represent a novel approach for addressing obesity-related disorders [ 27 ].

Anti-Inflammatory Effects of GLP-1-Based Therapies beyond Glucose Control

Glucagon-like peptide-1 (GLP-1) is an incretin hormone mainly secreted from intestinal L cells in response to nutrient ingestion.

What Is an L-Cell and How Do We Study the Secretory Mechanisms of the L-Cell?

L-cells in non-human primate colon (Cynomolgus macaque). L-cells were identified based on proglucagon immunoreactivity (green). In upper panel two L-cells are shown. Lower panels shows a close-up of the L-cell in the upper panel (indicated by arrow). At the highest magnification, the individual GLP-1 granules are visible. Cell outlines are labelled by e-cadherin (red) and nuclei are stained with DAPI (grey).

 

[soapysnake]

Probably because you don't have a GLP deficiency, or much of one anyway. In which case GLPs are more like a tool , because you never needed them in the first place .

Is it fair to assume that getting down to a healthier BMI level will fix those deficiencies? Or do they stay with someone forever? In this case the user said they’re at a 26 BMI currently. I’m not saying I don’t understand higher doses in higher BMI individuals, but once you start getting to your goal weight shouldn’t you be wanting to transition towards titrating down and forming habitual lifestyle changes?

 

[Calm Logic]

Is it fair to assume that getting down to a healthier BMI level will fix those deficiencies?

I'm sure for some people. Not looking good though in general, based on the SURMOUNT results, where people gained a good amount of weight after stopping tirz (and kept gaining weight):

SURMOUNT-4: Weight regain despite continuing lifestyle and diet modifications

I'm not sure if this study was posted here yet, but the long and short of it is... Obese adults did 36 weeks of tirzepatide + lifestyle modification (500 kcal/day deficit + ≥150 min/wk activity). After 36 weeks, the group was randomized and split into a tirzepatide group and a placebo group...

glp1forum.com

OTOH:

That's the exact result I'd expect, if I'm being honest.

Had the "lifestyle" intervention been sufficient to converge at a BMI of 25 (or whatever target one chose) then there would have been no need for the drug in the first place. The problem is that the primary lifestyle driver chosen was simple calorie-restriction. That's obviously going to break down when you take away the drug that enables easy calorie-restriction.

In any case, a number of people here (including myself) would prefer to stay on GLPs for life for the health benefits, less food noise, etc:

I like that graph a lot , very clear signal about what happens when it is stopped, and a strong argument for staying on glp-1 agonists for maintenance. But even for those who stopped there are still significant benefits in terms of weight and long term risks. Before these medications were available research would talk about the metabolic and risk benefits of 5-10% weight loss, and that those benefits were still significant.

I am surrounded by calories all day long, so I really appreciate not being tempted on GLPs. And the food environment in the average American kitchen is horrible, unless you decide to live alone or have a family that is on board.

 

[tubby]

One theory : "Glucagon-like peptide-1 (GLP-1) deficiency occurs in obesity-related pathologies due to defects in the intestinal lumen. And expanding the L-cell population has emerged as a promising avenue to elevate GLP-1 secretion to tackle metabolic disorders."

Regardless of "GLP deficiency" vs. "functional impairment," L-Cells look interesting (as does DPP-4 ):

Lactobacillus rhamnosus GG Supernatant Improves GLP-1 Secretion Through Attenuating L Cell Lipotoxicity and Modulating Gut Microbiota in Obesity - Probiotics and Antimicrobial Proteins

Obesity is associated with decreased secretion of glucagon-like peptide-1 (GLP-1), which may result from lipotoxic damage to L cells caused by elevated levels of free fatty acids (FFAs). Although the probiotic Lactobacillus rhamnosus GG (LGG) exhibits anti-apoptotic properties, its potential to...

link.springer.com

Anti-Inflammatory Effects of GLP-1-Based Therapies beyond Glucose Control

What Is an L-Cell and How Do We Study the Secretory Mechanisms of the L-Cell?

我个人的理论是，由于GLP-1受体激动剂（GLP-1受体激动剂）已被证明如此有效，导致人们过度关注这种特定激素在饥饿信号传导中的作用。然后，一些公司为了牟利，兜售“自然提升GLP-1受体水平”之类的无稽之谈。就像五年后（等Reta上市一段时间后），我确信其他研究人员会将肥胖归咎于“胰高血糖素信号传导不足”。

这种理论的问题在于，对大多数人来说，肥胖并非饥饿问题（尽管我们确实感觉如此），而更多的是一种代谢问题，肥胖只是代谢紊乱的表现形式之一。抑制饥饿感（通过极高的GLP-1受体激动剂水平）确实有助于减肥。如果GLP-1受体激动剂水平低10%到15%，我或许会接受GLP-1受体激动剂缺乏的说法，但我们服用这些药物并不能将其提升10%到15%。我们将其提升了几个数量级，达到了自然界永远无法达到的水平。这是一种巧妙的权宜之计，旨在解决系统中其他地方的问题。

 

[Calm Logic]

用类固醇来打比方，我认为这就像是从临床低睾酮水平到超生理睾酮水平的转变：

类别 GLP-1 状态/活动 关键研究/证据 精瘦个体 100%（基线） 餐后分泌旺盛；是健康代谢信号的基础。 肥胖个体 减少约20%至25%。 与瘦型对照组相比，餐后 GLP-1 和 GLP-2 水平显著降低。 5毫克替泽帕肽 超生理饱和度 5 毫克剂量可持续激活受体，从而导致体重减轻约 12-15% (SURPASS-1)。 药理 GIP/GLP-1 协同作用 替拉帕肽是一种“偏向性”双重激动剂；GIP 成分增强了整体代谢“活力”。 机制 半衰期延长 天然 GLP-1 持续时间约为 2 分钟；替拉帕肽持续时间约为 5 天，持续不断地向大脑发出“呐喊”。

但与那些服用管制药物的合成代谢类固醇（AAS）使用者不同，我们无需担心因健康原因而停止使用GLP类药物。事实恰恰相反。

 

[BNLFL]

我听到第一个三个音节的词“carry on”就出局了。

 

[soapysnake]

我相信对某些人来说确实如此。但总体情况并不乐观，根据SURMOUNT的研究结果来看，人们在停止服用Tirz后体重显著增加（并且持续增加）：

我个人非常支持在达到目标、血液检查和健康状况都正常之后进行微剂量服用。我认识很多身材非常好的人，特别是女性，她们都在微剂量服用Tirz，效果非常好。我想我以后也会断断续续地服用Reta，因为它让减脂变得非常容易。

 

[bbbilly]

i would just like to ask @Calm Logic, you always seem to come in and try to defend the OP from something i guess you see as an attack on them and always site the same couple of threads to prove a point while also backhandedly demeaning anyone that is into the fitness scene by telling us we would be better off going to some other forum or calling us some sort of "bro" in a demeaning way but i never see you stop to ask the OP of these types of threads why they want to up the dose even though they are losing 1.26lbs/week and are "approaching normal bmi"

we all have an opinion on the subject, thats why we give our two cents, but whenever someone seems to even suggest maybe stepping back and reevaluating what they are doing you always swoop in and completely derail the entire thread with your double sided comments about us "AAS bros".. i don't even know what AAS is. but why always attack us instead of suggesting that op maybe evaluate their mindset on losing 1.26lbs/week not being enough for them before that line of thinking leads to anything worse. all we know is what they put in the opening line. if they are completely sedentary and just pinning more and more reta why not suggest to maybe start getting some steps in? that would be an easy thing to do to add to their lifestyle to help keep them back where they want to be heading but god forbid we mention it or you will share a thread from this very forum on how moving more doesn't lead to increased weightless or something.

lets just let the OP get a bunch of personal opinions and info and let them decide what they want to do instead of you spearheading every thread to "its cheap, just up the dose" they asked about upping their dose past the clinical trial dose right? where are all the threads of other people talking about that? or the new studies of them upping the max dose? you didnt even help with the original discussion...

 

[lessthanhalf]

This is in response to bbbilly and soapysnake mostly. Your approach is not necessarily wrong in the right context, people trying to optimise body composition, or with mild obesity or overweight, where low doses and extra exercise are good options.

Where it is wrong is trying to apply that experience to people with severe obesity , like the OP here with a starting BMI of 49, or me starting at 52. In that context those people have almost always tried for many years unsuccessfully to manage their weight with diet and exercise and may succeed temporarily but in the long term have not.

The success rate of diet and exercise to manage severe obesity is extremely poor long term, and it is not just a cosmetic or lifestyle problem, it is a very serious health problem with very high risks of diabetes, heart disease, stroke and cancer.

Using GLP drugs at full therapeutic doses is the correct strategy in this context, assuming side effects do not limit doses, as it maximises chances of large weight losses and as a pure drug effect independently of effects on weight reduces chances of heart disease stroke diabetes and probably cancers, as well as reducing risks of those diseases via weight loss.

In that context only , BMI's above 40 or so, if weight is still high at full doses, higher than standard doses or combinations are probably safer than not using them. The risks are unknown, but the risks of severe obesity are so high that it is unlikely the risks of GLP therapy at high doses is worse. It gets much more complicated as to whether those unknown risks outweigh the benefits in trying to optimise body weight below BMI's of 25-30 in those who have already lost quite a bit of weight, or those with less severe obesity at the start.

Using GLP therapy without obesity to optimise body composition has completely unknown risk to benefit conditions, it is not studied and might never be. It may reduce long term health risks but it will be very hard to ever answer that question, as the low chances of serious problems would require enormous populations over many years to see any trends, which makes it just too expensive. In this situation using the lowest possible dose is absolutely a good idea, to reduce risks of rare but serious adverse effects from GLP therapy. Gallstones, pancreatitis or blindness are high prices to pay for getting body fat to 12%, but not in the context of 40 x increased risks of common serious diseases from severe obesity.

 

[bbbilly]

whether those unknown risks outweigh the benefits in trying to optimise body weight below BMI's of 25-30 in those who have already lost quite a bit of weight, or those with less severe obesity at the start.

i dont disagree with anything that you've said, here or in other threads. you seem alot more objective and understanding of the context given in the threads. im simply wondering why we always get blasted by calm anytime we have any perspective that doesn't perfectly align with theirs, and get told to go back to some other forum because they have some deep seeded issues from some trauma in their personal life and take it out on us here, when we are just trying to help, just like everyone els. ive only been on the forum for like a month but i already know when they will come in and copy paste that "is it cheating or as tool" thread they spam all the time.

i am just trying to help give other perspectives on things to maybe help someone with their problem with my own anecdotal experience but it seems more and more like i am not allowed to just because one person wants to discredit, belittle and backhandedly insult me everytime i post something that isnt to just up the dose.

also the op did say that they were at 49bmi and is down to 26. and is still considering upping the dose past those upper doses. thats where we agree, they have done a great job so far but are still in the mindset of seeing a certain number loss every week rather than a bodyfat percent change. but i cant point that out either without being accosted for it either. i mean hell they are only like 0.9 bmi higher than me so we are atleast at the same ballpark.

and i find it even more difficult to respond to them when they edit their posts like 5 times and keep changing things

EDIT: they have updated their last post 6 times now

 

[bbbilly]

I edited more than usual, because it's not easy making sense of what you are saying, especially given what the OP has said himself:

you allready edited this twice. it might be better if you thought about what you have to say first. then maybe re read it a couple of times and revise it before you post so everyone is on the same page when you post. i think every post on this thread from you is edited, not just your response to me. or is that how try to win these discussions? by waiting untill someone responds then edit your post with additional info and comments?

ope. literally updated as i was re reading this response to you.

let me just ask what your input to the op was about his situation? what was your advice? as of right now with your current edits i dont see where you gave any bit of info to op rather you came here to target another person...

ope updated again dang i cant even keep up without you changing what im responding to.

and btw i like how you went and showed were i said i lost weight with the help from zepbound. what you dont know is i lost over 100lbs before naturally. got lazy and got fat again. lost 60lbs of it before i decided to take (to me, for my mindset and situation) the easy way out and hop on the glp train. got back off it to bulk, then lost 25lbs naturally again before getting back on them for anti inflammatory benefits. ill try to find you some pictures soon.

 

[bbbilly]

allready edited the post...

i was warning someone to be carful so they wouldnt be attacked for their mindsetlol. i didnt mention you, and you are not the only one that does it so you must be self conscious about it

edited it again...

and again...

edit.. the comments i have been responding to have removed for some reason...

 

[soapysnake]

Using GLP drugs at full therapeutic doses is the correct strategy in this context

I’ve never argued against using the full dose though. The only point I was trying to make here is someone should look to make sure they have dialed in their sleep, exercise and diet before making any extreme titration jumps. Especially in this case where OP has gotten close to normal BMI and is still losing weight.

OP mentioned they were running a lot the first time they lost weight. Running is one of the WORST forms of exercise for losing fat. It sends your appetite through the roof and most runners aren’t properly targeting different HR zones in their training. Weight lifting + LISS cardio is one of the most effective forms of exercise for fat loss. Hence the reason for me questioning OP’s diet and exercise plans. I just know too many people that are on a GLP that don’t diet or exercise and then complain when it doesn’t work.

 

[lessthanhalf]

Behavior modification as a strategy for weight loss can work, creating durable long term sustainable patterns of eating and exercise is possible, but I would argue that the odds of success with this approach are inversely proportional to weight. So while it may have OK chances starting at a BMI of 30 or so, the chances of it working at a BMI of 40+ are really pretty bad. Part of it is that people in general are not very good at making long term changes in well established patterns of behavior, and I do not think it is unreasonable to assume that those with severe obesity are a selected group that is less good at this long term than average, and this is part of why their obesity got so bad. I absolutely do not see this as a moral failure or willpower issue. Any diet and exercise plan or program that requires constant mental effort to sustain is likely to fail, for the simple reason that mental effort is a finite resource that runs out eventually. A lot of people may not agree with this, but it has been shown over and over again in lots of different contexts including maintaining weight loss.

The advantage of GLP therapy for weight loss is that it takes mental effort and all of the emotional baggage about weight and eating control out of the equation, and if you stay on them long term weight loss is sustained, even if you get depressed or stressed or it is holiday time or any of the usual normal life issues that cause people to go back to old patterns of behavior, and start putting weight back on. Removing the guilt and shame part of being overweight , losing and regaining weight is one of its biggest advantages, and I think with time, now that there are more effective treatments for obesity medical attitudes to it will continue to improve and maybe eventually everyone else. Seeing evidence that a medication can fix it is good evidence it is not just lazyness and gluttony. ( which is what most people think )

I do not think diet or exercise need to be optimised while on GLP drugs, while it is obviously better for health if they are, it is not required, and weight loss will happen anyway. Being realistic a larger percentage of obese people have worse diet and exercise habits than average, and mostly people are not great at changing this long term. I have no objection to people wanting to focus on this part of the problem, so long as it is not to criticise those who for many reasons are not able to change their lifestyle behaviors successfully. A lot of the benefits of these drugs on long term health risks will still happen if weight loss occurs without improvements in food choices or increased exercise.

There are significant reasons why GLP therapy needs to be continued to maintain weight loss, one is that due to metabolic adaptation energy expenditure is likely to be substantially below average for someone of their age, weight and activity level after large weight losses. So that maintenance requires a lower than usual calorie input long term , at least years. And large weight losses make you more hungry. So to keep the weight off you need to eat less than normal amounts of food while being more hungry than normal. This is nearly impossible to maintain without some restraint on the hunger side of things, which is mostly where GLP drugs work.

 

[Calm Logic]

Even if obesity is dramatically improved, damage could have already been done, and considering cardiovascular risk or assessing if existing damage is present is worth considering. I found out I had very early heart failure and significant coronary artery disease, despite not having symptoms after I lost the weight, even if these cannot be reversed progression can be dramatically slowed by the correct treatment. Anyone with that degree of obesity should be assessed to see if statins and low dose aspirin are needed, and at least an ECG and urine protein checked.

Great points.