替拉帕肽和减肥手术

[nurseratchit]

Up front I'll tell you, I know now that my main obesity and diabetes problem is food noise. Tirz revealed that to me when I woke up on Nov 7 2023, after having taken the first shot the night before, and my food noise was gone. I had gotten control of my life back.

I had gastric bypass in 2017. At almost 300 lbs (M, 5' 6"), my surgeon made me go on ultra low carb diet to lose as much as possible before the surgery. It was 8 months of Hell thanks to the food noise. Absolutely brutal and I know there was some clinical depression in there (maybe PTSD lol???) along the way due to it. Got down to 220 and had the surgery, which got me to about 180. Then I started slowly gaining over the years. Last year was back to 240 when I started Mounjaro after I got a new diabetes Dr and he put me on it.

On Nov 8 2023 I completely changed my eating habits for the better, and have had a fairly consistent 2lb/week loss. I'm at maintenance now, bouncing around 150-153.

There have been a few dosage modifications along the way. I'm currently on 5mg every 4 days.

Tirz gave me my life back and got me where I wanted to be with my weight. Surgery couldn't do that because surgery can't touch the food noise.

I plan to be on tirz or something like it for life.

That really is a mind blowing experience isn't it. I remember reading about this before I tried it but one can't fully appreciate it until they experience it. I didn't even know I had it until it was gone which was within 24 hours of first injection.

 

[dogmom]

I had VSG in 2011 at about 330lbs. lost about 150lbs by 2013 but never got to goal weight (155lbs). I did get to 175lbs . Slowly year by year after reaching 175lbs I gained weight , like 5lbs+ a year and after 8 to 9 years I had gained about 55lbs back.

So in October 2022 I heard about GLP meds and mounjaro specifically. I've been on various GLP meds since then, off and on, Tirz, sema, reta, and also had long periods of stalls, but was able to get to 155lbs just recently.

I'm still happy I had VSG. It helped me from gaining all my weight back. Kept me at a "normal fat" weight rather than super morbidly obese weight.

I also think because I stopped binging (haven't binged since fall 2022), my stomach has shrunk back to my 2011 VSG stomach size.

 

[touringsedan]

I had a RNY in 2007, lost 150 (420->270) and held that for 5 years and starting gaining and would bounce around 290-310 always dieting and at war with my body and losing.

Enter GLP-1 agonists. Food noise suppression alone is a game changer for me as I feel that my lifetime battle with obesity already trained me to be a master dieter, but now I can follow any diet and focus on other things not food and lose weight.

Lost 55 lbs since July and it's working great.

I don't have the delayed gastric emptying effects or the fullness as I don't use my normal stomach, so for me I do rely mostly on the food noise suppression to keep me on track.

 

[clayd]

I wish you the best of luck combating two addictions instead of just one. I don't think that transference addiction is discussed enough before people undergo bariatric surgery, unfortunately. One of my friends is on tirz, and it has curbed her drinking immensely. (I believe she's at 10mg), so hopefully, you'll get that same effect soon. I feel for you. Keep doing what you gotta do to get to where you wanna go!

It's not stressed enough that 15-20% of bypass patients will end up dependent on alcohol. That's a huge number. I'm always torn about whether I'm glad I did the surgery because I'm still down 90 pounds but I have this other struggle now. In some ways if these meds continue to evolve, hopefully these surgeries will become more of a last resort/ a thing of the past

 

[fyrepep 3034]

Surgery did zilch for my food noise and appetite. Other than physically restricting the amount of food I could eat (literally only a couple of tablespoons in the beginning), the constant screaming in my brain for consuming more food never went away. Just needing to taste it even. It's been over 24 years since I had my surgery but I still remember when I physically could not eat the food due to the pain it would cause with the small pouch, but I would chew food just to feel like I was eating, and then spit out. Gross, I know, but that's what I did.

With tirz that voice in my head has been silenced. I get hungry, but it's normal hunger and I eat a normal amount of food, and then I'm done and don't think about it again until I'm actually hungry again. I have been battling my weight since I was 8 years old (doctor told my mom I needed to lose 20 lbs) and it has never stopped. Now here I am on the cusp of 46 in a couple of weeks and I am still not sure this is real. I have tried everything you can imagine over the last 38 years to lose weight, and none of it ever came even remotely close to what this medication has done for me.

Side note: my mom (age 74) has been morbidly obese my entire life. She was 410 lbs at here highest and has had two bariatric surgeries in her life. She lost weight with both, but not permanently. She started Mounjaro (diabetic) also in Dec 2023 at 292 lbs. She is has now lost 77 lbs and says the same thing about the food noise. It's just gone and she feels normal regarding hunger and satiety for the first time in her life.

These are life-changing meds and I'm so sad and also angry that many people who desperately need them cannot get them due to their high cost. I really do hope

I agree with you that it sucks bad that people who desperately need the medication don't have access to them. It seems extremely unfair. I have had to administer ridiculous amounts of Suboxone and methadone to addicts, but we don't provide the same level of care and access to food addicts. I am not sure why the topic of food addiction is not taken seriously or a dress like it is with other addictions.

I'm glad to hear that both you and your mother are doing so well, and I really look forward to the food noises disappearing.

 

[fyrepep 3034]

I had a RNY in 2007, lost 150 (420->270) and held that for 5 years and starting gaining and would bounce around 290-310 always dieting and at war with my body and losing.

Enter GLP-1 agonists. Food noise suppression alone is a game changer for me as I feel that my lifetime battle with obesity already trained me to be a master dieter, but now I can follow any diet and focus on other things not food and lose weight.

Lost 55 lbs since July and it's working great.

I don't have the delayed gastric emptying effects or the fullness as I don't use my normal stomach, so for me I do rely mostly on the food noise suppression to keep me on track.

Wow! I'm glad to hear that you had such good results in such a short period of time! It's also interesting to hear about the different ways it works for different people. I do wonder how it's going to work for me, as I kept my duodenum, but I lost most of my stomach and a lot of my small intestines. Of course, it doesn't bother me to be full or not. I'll just eat anyway. The only exception that is when I took Phentermine, and I had to stop it because I couldn't even manage to drink a protein shake because the act of swallowing it made me want a vomit, and my life depends on my ability to consume vitamins and protein.

I feel like I am praying for a miracle with this stuff, and y'all are telling me it's possible. I think one of my biggest fears is I've had the granddaddy of all bariatric surgeries, and while I've maintained my goal weight for years, I have put back on over 30 lb. And it makes me feel like a failure and hopeless that even though I had the most restrictive bariatric surgery possible, I was still able to gain weight through it.

 

[fyrepep 3034]

It's not stressed enough that 15-20% of bypass patients will end up dependent on alcohol. That's a huge number. I'm always torn about whether I'm glad I did the surgery because I'm still down 90 pounds but I have this other struggle now. In some ways if these meds continue to evolve, hopefully these surgeries will become more of a last resort/ a thing of the past

I hear you. I have the same debate with myself, because I have seriously complicated my future by having bariatric surgery. Like I don't have normal poops. And I am so reliant on protein and vitamins to make sure that I can keep myself alive. If we had an apocalypse, I would probably die because I wouldn't have access to calcium, magnesium, vitamin d, vitamin a, vitamin k, etc. But then also the surgery is what gave me my life back. So yes, it's definitely a double-edged sword. I was wondering the same thing if this stuff will put bariatric surgery on the back of burner. Obviously, it's a choice of last resort to begin with, and if there was any other choice when I had it, I would have made it. Here's to hoping!

 

[touringsedan]

Wow! I'm glad to hear that you had such good results in such a short period of time! It's also interesting to hear about the different ways it works for different people. I do wonder how it's going to work for me, as I kept my duodenum, but I lost most of my stomach and a lot of my small intestines. Of course, it doesn't bother me to be full or not. I'll just eat anyway. The only exception that is when I took Phentermine, and I had to stop it because I couldn't even manage to drink a protein shake because the act of swallowing it made me want a vomit, and my life depends on my ability to consume vitamins and protein.

I feel like I am praying for a miracle with this stuff, and y'all are telling me it's possible. I think one of my biggest fears is I've had the granddaddy of all bariatric surgeries, and while I've maintained my goal weight for years, I have put back on over 30 lb. And it makes me feel like a failure and hopeless that even though I had the most restrictive bariatric surgery possible, I was still able to gain weight through it.

You are in no way a failure. This is a chronic disease that turns our brain/body against us in ways non-suffers really cannot understand.

I hope you have the experience that I did when I was like why do I feel so calm and things just seem quiet.. It was the suppression of the food noise.

I have also had to find hobbies and things to keep me busy as I freed some much time being on this medication.

 

[fyrepep 3034]

你绝不是失败者。这是一种慢性疾病，它会以非患者难以理解的方式让我们的大脑/身体与我们对抗。

我希望你能体验到我曾经有过的感受：为什么我感觉如此平静，周围一片寂静……那是因为食物的噪音被抑制了。

服用这种药物后，我有很多空闲时间，所以也需要寻找一些爱好和事情来充实自己。

谢谢你提醒我，在这个过程中要善待自己，耐心等待。我今天早上打了第一针，对未来充满期待！

 

[mduckett99]

我于2019年6月接受了袖状胃切除术（VSG），术前体重为350磅。到2020年3月，我的体重降到了225磅。然后新冠疫情爆发，我的体重反弹，到今年1月又回到了341磅。1月份我开始服用处方减肥药，到7月份减掉了大约40磅。从7月份开始，我一直在服用睾酮（最初是通过配药药房配制），然后在10月初开始服用阿莫普特（Amopute）。截至今天早上，我的体重已经降到了241.8磅。这种药物彻底改变了我的生活。它教会了我如何像“正常人”一样饮食，这比手术本身有效得多。

 

[clayd]

我于2019年6月接受了袖状胃切除术（VSG），术前体重为350磅。到2020年3月，我的体重降到了225磅。然后新冠疫情爆发，我的体重反弹，到今年1月又回到了341磅。1月份我开始服用处方减肥药，到7月份减掉了大约40磅。从7月份开始，我一直在服用睾酮（最初是通过配药药房配制），然后在10月初开始服用阿莫普特（Amopute）。截至今天早上，我的体重已经降到了241.8磅。这种药物彻底改变了我的生活。它教会了我如何像“正常人”一样饮食，这比手术本身有效得多。

在几个网络论坛上，我惊讶地发现很多人都是在七月份左右开始接触复合减肥药的。很多人之前都用的是复方药房，现在有些人开始改用粉剂了。我自己的情况也差不多。我

记得当时新闻报道说Hims/Hers公司要开始提供复合减肥药，他们的股价也跟着飙升，我就是那时候开始研究各种方案的。我很好奇六七月份是不是还发生了什么其他事情，让这么多人加入了这股潮流。

 

[clevesand]

在几个网络论坛上，我惊讶地发现很多人都是在七月份左右开始接触复合减肥药的。很多人之前都用的是复方药房，现在有些人开始改用粉剂了。我自己的情况也差不多。我

记得当时新闻报道说Hims/Hers公司要开始提供复合减肥药，他们的股价也跟着飙升，我就是那时候开始研究各种方案的。我很好奇六七月份是不是还发生了什么其他事情，让这么多人加入了这股潮流。

六七月份，早期采用复利减肥法的人开始大量减重，并在社交媒体上发布了相关内容，这产生了滚雪球效应。

 

[clayd]

六七月份，早期采用复利减肥法的人开始大量减重，并在社交媒体上发布了相关内容，这产生了滚雪球效应。

我猜主要是在TikTok上吧？（我没有TikTok账号）

 

[fyrepep 3034]

我于2019年6月接受了袖状胃切除术（VSG），术前体重为350磅。到2020年3月，我的体重降到了225磅。然后新冠疫情爆发，我的体重反弹，到今年1月又回到了341磅。1月份我开始服用处方减肥药，到7月份减掉了大约40磅。从7月份开始，我一直在服用睾酮（最初是通过配药药房配制），然后在10月初开始服用阿莫普特（Amopute）。截至今天早上，我的体重已经降到了241.8磅。这种药物彻底改变了我的生活。它教会了我如何像“正常人”一样饮食，这比手术本身有效得多。

I hate it for all of us when we have regain. It's so frustrating and discouraging, but I am really enjoying reading about the success everyone has had on tirz. I am grateful and thankful we have an opportunity to utilize it. Congratulations on the loss so far!

I totally understand what you mean about not learning to eat like a normal person, although, I will never experience that due to malabsorption. But it was eating almost nothing to eating everything in sight with me only stopping because if I didn't, I'd vomit. I want to be able to stop when I am no longer hungry and feel "normal".

 

[mduckett99]

on several forums around the internet, i am shocked at how many people started around the july timeframe. many with a compounded pharmacy, now some of those switching to powder. i'm on exactly the same path.

i remember that it hit the news around that time that hims/hers would start offering compounded weight loss and their stock popped, that's when i started researching my options. i wonder if there was something else in june/july that made a bunch of people get on the bandwagon

I didn’t even know that compounding was a thing for this medication until my PCP mentioned it. I have an awesome PCP who said he had other patients doing really well on it. He sent a script directly to Empower Pharmacy in Texas. Less than a week later, I had my meds and started.

 

[lrossetto0722]

Surgery doesn't really do anything for appetite, which is why most people "eat their way around a sleeve" and gain weight eventually. You are physically restricted from eating a lot of food. They say your stomach produces less Ghrelin so you're not as hungry, but I'm not sure if that's real or voodoo science.

I was always able to use the surgery as a great tool and I just didn't keep garbage food in the house. When I started T, I was still only a 31.5 bmi, so I have done well in the last 14 years since surgery. But VSG and Tirz are a one-two punch. You are physically restricted, and you're not hungry anymore. If these meds had been around I would not have had the surgery. So much of life revolves around food. I find myself coming up with excuses to decline lunch and dinner invites because it creates a lot of anxiety and embarrassment for me hoping to not have to explain to people why I cannot hardly eat any food. I would love to be able to really enjoy a nice persian or Italian restaurant again--my favorites.

If anyone is interested, I highly recommend the surgeon in Mexico, Dr Alvarez. It was $7500 back then.

那也是我的主刀医生！刚做完袖状胃切除手术的时候效果很好，但后来体重又反弹了40-60磅。感觉自从开始做Tirz治疗后，我的胃囊又恢复了原状……有点奇怪……以前我能吃下一整个三明治或者一整片披萨，现在却吃不下了。而且，袖状胃切除手术后我的最低体重是123磅，现在做了Tirz治疗后达到了119磅。

 

[anniesolion]

你们当中有人做过减肥手术，后来体重反弹，之后用过替泽帕肽吗？

通常来说，减肥手术后的患者会被排除在研究之外，但听说替泽帕肽在减肥手术后使用也取得了成功。不过，相关数据非常有限……

我是VSG俱乐部成员。我通过VSG手术减掉了90磅，但距离我的预期目标还有40-50磅的时候就停止了。我设定了两个目标体重：一个是统计学上实际可行的目标（我已经达到了），另一个是我的梦想目标，我现在正借助Tirz努力实现它。

我对VSG手术的效果非常满意，减掉的超重百分比属于平均水平。我保持了一段时间……然后又反弹了20多磅，最高达到了201磅。

我一直在考虑尝试GLP-1，而这正是我需要的动力。4个月前我开始服用Tirz，现在除了几磅之外，所有反弹的体重都减掉了，我对实现梦想目标体重充满希望。服用Tirz的感觉很像VSG手术后的前12-18个月，但在饮食限制方面更加可预测。我的饮食限制从未完全消失，但随着时间的推移，限制程度有所减轻，变得难以预测。有些日子我可以（也确实）吃东西，而且在限制饮食的情况下“绕过”限制饮食也是完全可能的。袖状胃切除术（VSG）确实有所帮助，但与服用Tirz相比，我仍然难以忍受“食物噪音”和对食物的渴望。服用Tirz后，我的“食物噪音”明显降低，同时限制饮食又能延长饱腹感（我猜是因为胃排空减慢），而这种饱腹感在我袖状胃切除术康复并恢复正常饮食后并没有完全体验到。

总的来说，对我而言，我觉得袖状胃切除术和Tirz是一个绝佳的组合。我预见到未来可能会有针对部分患者的联合治疗方案。