THe Complexity of Weightloss

[When_Pigs_Fly]

You have heard this from me before. I have tried everything from RNY to WW to Jenny Craig (remember her???) to fasting. Yeah, sometimes it worked and sometimes it didn’t. Nothing stuck. No logical science about it - no calorie reduction and pure CICO did NOT do it. No rigorous workout routine. Nothing. I’ve been on this earth for 65 years. Thanks to tirz I’m at almost the lowest weight ever - but I started HRT (pellets) and I think that’s caused some gain. My butt has now returned but so have some minor live handles. Regardless, I hate it and it scares the sh*t out of me - I do not want to go back to weighing 240. That fear is real. Some of you get it, some of you don’t.

Thanks for supporting me on this journey. Thanks for all the peptide info y’all have given and shared from your experience. I’m still on 15 mg tirz weekly and just started adding reta. Will also consider elora. Getting more comfortable w reconstituting and it’s helped me not spend thousands on these drugs every month.

If I can help anyone, I’m here to pay it forward. I so value this forum.

 

[thatkatmat]

I would stop taking HRT if it was making me fat again...and find another way. But that's me

 

[HereKittyKitty]

Congrats on your success!

 

[Skidude]

You have heard this from me before. I have tried everything from RNY to WW to Jenny Veaig (remember her???) to fasting. Yeah, sometimes it worked and sometimes it didn’t. Nothing stuck. No logical science about it - no calorie reduction and pure CICO did NOT do it. No rigorous workout routine. Nothing. I’ve been on this earth for 65 years. Thanks to tirz I’m at almost the lowest weight ever - but I started HRT (pellets) and I think that’s caused some gain. My butt has now returned but so have some minor live handles. Regardless, I hate it and it scares the sh*t out of me - I do not want to go back to weighing 240. That fear is real. Some of you get it, some of you don’t.

Thanks for supporting me on this journey. Thanks for all the peptide info y’all have given and shared from your experience. I’m still on 15 mg tirz weekly and just started adding reta. Will also consider elora. Getting more comfortable w reconstituting and it’s helped me not spend thousands on these drugs every month.

If I can help anyone, I’m here to pay it forward. I so value this forum.

I was gaining on TRT, but once it got balanced the gain stopped.

over a year on it now and weight is fairly static.

 

[lastresort]

You have heard this from me before. I have tried everything from RNY to WW to Jenny Veaig (remember her???) to fasting. Yeah, sometimes it worked and sometimes it didn’t. Nothing stuck. No logical science about it - no calorie reduction and pure CICO did NOT do it. No rigorous workout routine. Nothing. I’ve been on this earth for 65 years. Thanks to tirz I’m at almost the lowest weight ever - but I started HRT (pellets) and I think that’s caused some gain. My butt has now returned but so have some minor live handles. Regardless, I hate it and it scares the sh*t out of me - I do not want to go back to weighing 240. That fear is real. Some of you get it, some of you don’t.

Thanks for supporting me on this journey. Thanks for all the peptide info y’all have given and shared from your experience. I’m still on 15 mg tirz weekly and just started adding reta. Will also consider elora. Getting more comfortable w reconstituting and it’s helped me not spend thousands on these drugs every month.

If I can help anyone, I’m here to pay it forward. I so value this forum.

Its not that CICO doesnt work. Its that we DONT know the exact "calorie out" part.

Most online estimates grossly overestimates basal metabolic rates. Just because one is 30lb doesnt mean your basal metabolism is like, 4000kcal per day.

I m glad you found your solution.

 

[ladyj779]

Its not that CICO doesnt work. Its that we DONT know the exact "calorie out" part.

Most online estimates grossly overestimates basal metabolic rates. Just because one is 30lb doesnt mean your basal metabolism is like, 4000kcal per day.

I m glad you found your solution.

This is precisely my issue with those who argue against cico.

It doesn't matter what any estimator tells you: if you personally are consistently eating x calories and over a couple weeks are either gaining or not losing, you personally need fewer calories. Again, regardless of what you believe that you need.

The meds can absolutely help either by curbing your appetite so that eating fewer calories doesn't suck, or sucks less, or by augmenting your burn (it's not that much right now, guys, sorry), but if you aren't losing over time, your body needs fewer calories.

 

[lastresort]

This is precisely my issue with those who argue against cico.

It doesn't matter what any estimator tells you: if you personally are consistently eating x calories and over a couple weeks are either gaining or not losing, you personally need fewer calories. Again, regardless of what you believe that you need.

The meds can absolutely help either by curbing your appetite so that eating fewer calories doesn't suck, or sucks less, or by augmenting your burn (it's not that much right now, guys, sorry), but if you aren't losing over time, your body needs fewer calories.

Except, I am not entirely arguing in favor of CICO.

You cannot forever cut calorie intake. Lets say you have an unusually low metabolism of 1400kcal for whatever reason. You cannot realistically eat 900kcal every day to lose weight. It's a miserable and unsustainable way of living. Even if you do, our basal metabolism will reduce as one loses weight, and there is a good chance it will rebound.

The problem with CICO is not the math. I t is the real life constraint that we cannot forever eat less and less until we eat like literal ants.

 

[ladyj779]

Except, I am not entirely arguing in favor of CICO.

You cannot forever cut calorie intake. Lets say you have an unusually low metabolism of 1400kcal for whatever reason. You cannot realistically eat 900kcal every day to lose weight. It's a miserable and unsustainable way of living. Even if you do, our basal metabolism will reduce as one loses weight, and there is a good chance it will rebound.

The problem with CICO is not the math. I t is the real life constraint that we cannot forever eat less and less until we eat like literal ants.

I'm not like oh it's awesome that I need to eat 1200 calories to lose weight, it's just reality.

You don't have to like or dislike reality for it to simply be reality.

The great thing is better meds are being tested that will further help slower metabolic rates (and myriad other things that make weight loss so hard), but we still have to work within the confines of present reality and therapies to reach out goals, OR appreciate that our ultimate goals might not be totally attainable with current therapeutics.

The issue is people who honestly reject that they must eat less to lose weight, not those who say I cannot or will not eat less than x, and I accept that that might make my current goals unattainable

 

[HereKittyKitty]

CICO is not a sustainable remedy to obesity.

The body has a setpoint to which it will always work to return. The only way to change that setpoint is through surgical intervention.

CICO will help a person lose weight, yes. It will not keep the weight off in the long term.

This is not my opinion. I am not a trained medical professional. This is communicated by obesity specialists.

 

[ladyj779]

CICO is not a sustainable remedy to obesity.

The body has a setpoint to which it will always work to return. The only way to change that setpoint is through surgical intervention.

CICO will help a person lose weight, yes. It will not keep the weight off in the long term.

This is not my opinion. I am not a trained medical professional. This is communicated by obesity specialists.

Among other mechanisms, weight loss causes hormonal changes in many of us that drives us to consume more calories. Meds can help control how we react to these metabolic siren songs, this does not mean cico is not reality. It does mean that we are (hopefully) less susceptible to our own particular biologies and able to keep our caloric intake in check.

 

[Skidude]

Except, I am not entirely arguing in favor of CICO.

CICO is not a sustainable remedy to obesity.

Although I agree with both of these statements, at least in my case I needed drug intervention.

Would either of you disagree with the following?

Calorie Target: The explicit protocol aimed for an energy deficit of about 500 kcal per day and at least 150 minutes of physical activity per week

SURMOUNT 1-4 clinical trials formally required lifestyle counseling that targeted a daily calorie reduction of approximately 500 kilocalories alongside increased physical activity. [ 1 , 2 ]

Trial Dietary Protocols

Lifestyle Counseling: Participants in the trials received regular lifestyle counseling from health professionals or dietitians to help them adhere to a balanced diet. [ 1 ]

Calorie Target: The explicit protocol aimed for an energy deficit of about 500 kcal per day and at least 150 minutes of physical activity per week. [ 1 ]

Intensive Variations: SURMOUNT-3 included an initial 12-week intensive lifestyle intervention phase before randomization, which recommended specific low-calorie targets (1,200 kcal/day for women and 1,500 kcal/day for men). [ 1 ]

How the Medication Interacted with Diet

Appetite Suppression: While the dietary deficit was a required part of the study design, tirzepatide itself heavily suppressed appetite and reduced spontaneous food intake, making it easier for participants to achieve that caloric deficit. [ 1 , 2 ]

Calorie reduction: Eating fewer calories is the main driver of weight loss

How GLP-1s Work

Appetite control: They target the brain's hunger centers to lower appetite and reduce food cravings.

Delayed digestion: They slow down how fast the stomach empties, helping people feel full much faster and longer after eating.

Blood sugar regulation: They help the pancreas release insulin, which stabilizes blood sugar levels. [ 1 , 2 , 3 , 4 , 5 , 6 ]

Important Health Factors

Calorie reduction: Eating fewer calories is the main driver of weight loss on these drugs, but overall nutrition still matters.

Nutrient intake: Eating less food can lead to a lack of essential vitamins and protein if meals are not nutrient-dense.

Muscle mass: Combining the medication with regular exercise and enough protein helps ensure the body loses fat instead of healthy muscle

 

[lastresort]

I'm not like oh it's awesome that I need to eat 1200 calories to lose weight, it's just reality.

You don't have to like or dislike reality for it to simply be reality.

The great thing is better meds are being tested that will further help slower metabolic rates (and myriad other things that make weight loss so hard), but we still have to work within the confines of present reality and therapies to reach out goals, OR appreciate that our ultimate goals might not be totally attainable with current therapeutics.

The issue is people who honestly reject that they must eat less to lose weight, not those who say I cannot or will not eat less than x, and I accept that that might make my current goals unattainable

I am not really disagreeing with anything you said so IDK why you are turning this into a debate.

"You have to be disciplined at eating" and "you can't forever cut calories" aren't mutually exclusive.

 

[HereKittyKitty]

Calorie Reduction (CI) is mandatory for weight loss.

CICO is not a sustainable approach to maintaining weight loss.

Obesity is not a failure of character. Obesity is a metabolic and hormonal disorder.

These peptides we so eagerly and appreciatively consume do more than delay stomach emptying, quiet food noise, and suppress appetite.

They are not "better phentermine". They are systemic operators.

 

[AllCourtTENNIS 27687]

I started estrogen and got an IUD with progesterone before starting tirz. I have been able to lose a lot of weight, but I also had to stack with reta to get close to goal. On tirz alone, I got so very stuck and feared I was cursed. I broke the stall but I'm still 10-20 lb from goal, even after 13 months.

I absolutely would not stop HRT. I watched both my grandmothers suffer horribly and eventually die on dialysis because of complications of vaginal atrophy. First, UTI after UTI, then bladder infections, then kidney infections, then kidney failure, dialysis, and death. It was all so very preventable but the taboos about vaginas were apparently important to some people with louder voices than me.

DO NOT STOP THE ESTROGEN. (link to a study)

 

[hotsauceboss]

Among other mechanisms, weight loss causes hormonal changes in many of us that drives us to consume more calories. Meds can help control how we react to these metabolic siren songs, this does not mean cico is not reality. It does mean that we are (hopefully) less susceptible to our own particular biologies and able to keep our caloric intake in check.

I've felt hormonal hunger changes personally when I added Tesa to Reta. Before that, hunger was basically something that didn't happen. After Tesa and the hormone changes it produced, I did get a return of the hunger feelings, but not enough to affect my goals. I can understand how HRT (or TRT) would cause something similar. When it comes to biology, we humans like to pretend that we know everything because it makes problems and solutions simple. But while we might all agree on some general principles, the reality is that the details we don't know for certain make a more significant impact than we want to admit.

 

[When_Pigs_Fly]

I was gaining on TRT, but once it got balanced the gain stopped.

over a year on it now and weight is fairly static.

What’s TRT?

 

[Skidude]

What’s TRT?

Testosterone replacement therapy, designed to bring levels normal.

 

[ladyj779]

But while we might all agree on some general principles, the reality is that the details we don't know for certain make a more significant impact than we want to admit.

And also that our biologies are unique, be it in minute ways or massive ways. Hence my comment on another thread that individual researchers combining therapies based on their own specific feels is probably the best we can do to optimize our own personal responses at least until AI health is so far along that it analyzes and provides custom regimens for each individual patient.

 

[ladyj779]

I am not really disagreeing with anything you said so IDK why you are turning this into a debate.

"You have to be disciplined at eating" and "you can't forever cut calories" aren't mutually exclusive.

I think you are reading "you" as you, specifically, rather than the general you.

 

[Grogu]

The body has a setpoint to which it will always work to return. The only way to change that setpoint is through surgical intervention.

I’ve struggled with set point theory for a long time. My issue is that nothing seems to “reset” the setpoint downwards, but each new high weight seems to create a new set point. Even bariatric surgery doesn’t appear provide a new setpoint at the weightloss nadir, but at some higher weight. And even then, some regain all the excess weight lost.

I totally get that CO is tough to measure and that TDEE might be a bad estimate, but I honestly believe that most people have no idea how many calories they really eat and how many they potentially need. Just had a conversation last night with a family member and said that there are 3,500 calories in a pound of fat. She had no idea that pounds could be quantified in calories. She also didn’t realize her TDEE is 1,400 calories while mine is 2,600. When we eat lunch together we’re eating the same amount of food …