Weight gain after GLP use

[JFinHK]

While obviously how you do things is up to you, I disagree with a lot of the underlying logic involved.

I do not know anything about JFinHK but for the sake of interpreting the situation say started at 100kg , lost 16 wants to lose 10 more. I cannot work out BMI without height, but it is going to be low 30's to mid to high 30's.

So on a low dose of reta at 2.5mg you have lost 16% body weight which is better than average, but you want to lose 26%, and are stalled at that low dose, there is no sensible alternative to increasing the dose so it can do its job.

It almost sounds like some sort of self torture for no good reason to try to do it without the drug helping you as well as it can. You have said nothing about side effects limiting the doses, so I assume you are limiting the dose from advice I would regard as bad advice from the naturopath , and trying to do it by self control with just a little help from reta.

There is no doubt that people can lose weight short term by self control, but hardly anyone ever succeeds in keeping weight off long term that way.

On the other hand drugs like retatrutide can solve the problem long term by simply taking them and staying on them once the weight is lost. Given your response so far you are likely to do well on a higher dose and have a very good chance of getting to your target. Now is basically the first and only time ever there has been a treatment option for obesity that actually works and works well, and while it is at it improves blood sugar , blood pressure, lipids and most likely reduces the risks of many serious long term health issues caused by overweight and obesity.

While you do not suffer from severe obesity ( I am guessing without the right numbers ) the degree of overweight is definitely enough to increase long term health risks of both serious illness and in some ways more importantly reduced quality of life either from health consequences or the social disadvantages of being overweight or obese.

I think a lot of societies' uninformed opinions, biases and bigotry about obesity gets internalised, so a lot of people with obesity feel it is their fault and they should be able to control it as that is what they have been told most of their life.

My way of thinking is choose the options that work, even better if there is solid scientific evidence to support what treatment options work.

Trying to achieve long term weight loss and maintenance from diet exercise and willpower is unlikely to succeed, maybe 5%.

Doing it with retatrutide is going to have vastly higher success rates, not 100% as some people will not tolerate the side effects and some will respond less well than average . But going on the studies with an average weight loss of 29% in a year or so, the odds of losing 26% of your weight and keeping it off long term are better than 50/50, and given your response to low doses probably a lot better than that.

It is not bad for you , addictive or immoral, and it is hard to see many downsides , it cannot be cost as the legit version is not even out yet. It makes a lot more sense to increase the dose to the dose that causes the weight loss you want to achieve .

I should add, I started mid-April last year. So it’s averaging 0.4kg per week only.

 

[lessthanhalf]

Starting at 54yo, a BMI of 34 , high blood pressure, NAFLD, high cholesterol, it is fairly safe to say that you are at fairly high risk of long term health issues given you have already clear signs of metabolic syndrome. While I do not have a problem with raising doses slowly to minimise side effects, there is good hard evidence that full standard doses of tirzepatide or semaglutide ( but not yet for retatrutide ) are more effective than lower doses at preventing diabetes and cardiovascular disease in those at high risk. And I would think you would definitely be in the category of people who would especially benefit from the metabolic effects of GLP's. So you would be much safer taking them than not taking them, and safer again at full doses than lower doses. You have to take some of this on faith for reta as none of this is proven for it yet, but reta is quite possibly more effective than the others for fatty liver disease so it has that advantage even if the research is at an earlier stage..

I was not trying to give you a hard time, i just thought it sounded like you were being very reluctant to increase doses from a very low dose given you said weight loss had been stalled for 2 months. A lot of people on forums like this who are using low doses of reta have less severe obesity and are younger so may not need higher doses. I doubt very much that the speed of weight loss makes much or any difference to loose skin, I think if the underlying connective tissue in the subcutaneous fat is stretched and under tension it will recover but if the connective tissue fibers have got longer over time then the skin will end up loose, and there is not a lot you can do about it other than cosmetic surgery afterwards. Personally after losing nearly 80 kilos I am very happy to have a lot of loose skin , it is so much better and more comfortable than the same amount of skin stretched out over all that extra weight.

Given that so much of the discussion on this forum emphasises low doses and slow increases , I think it is useful to say that higher doses are often a better option if the science agrees.

 

[Grogu]

Given that so much of the discussion on this forum emphasises low doses and slow increases , I think it is useful to say that higher doses are often a better option if the science agrees.

I think some of the hesitation of titrating up for some people is part of the societal stigma that using glp-1 medications to treat obesity is somehow “cheating”. Therefore, using less medication is less “cheating”…

The science has evolved with millions of people using glp-1s in clinical settings and I think that titrating up to the highest dose isn’t necessary for everyone. I think that the current conventional wisdom is to titrate up if sides are being tolerated and if the benefits (i.e., weight loss, lack of food noise, etc.) are not being realized. I have a family member on 1.5mg of tirzepatide for 4 months having fantastic results and that’s great. I’m on 16mg and doing great. Both can coexist. BUT, when people are not getting the results they want and are on low doses and can tolerate higher doses, I don’t get it. This is especially true for those severely metabolically challenged.

 

[JFinHK]

I think some of the hesitation of titrating up for some people is part of the societal stigma that using glp-1 medications to treat obesity is somehow “cheating”. Therefore, using less medication is less “cheating”…

The science has evolved with millions of people using glp-1s in clinical settings and I think that titrating up to the highest dose isn’t necessary for everyone. I think that the current conventional wisdom is to titrate up if sides are being tolerated and if the benefits (i.e., weight loss, lack of food noise, etc.) are not being realized. I have a family member on 1.5mg of tirzepatide for 4 months having fantastic results and that’s great. I’m on 16mg and doing great. Both can coexist. BUT, when people are not getting the results they want and are on low doses and can tolerate higher doses, I don’t get it. This is especially true for those severely metabolically challenged.

The stigma/cheating dilemma could be valid when you're deciding whether to get on GLPs, probably not so much when deciding whether to titrate up.

In my case, from my doc's point of view, we have cholesterol and the liver under control, but for weight loss, she wanted to see me exercising more consistently first. Hoping maybe that will get things moving before we get to higher doses. That goes back to the original topic - weight gain after coming off the GLPs. I do need more muscle to avoid that.

 

[Grogu]

The stigma/cheating dilemma could be valid when you're deciding whether to get on GLPs, probably not so much when deciding whether to titrate up.

In my case, from my doc's point of view, we have cholesterol and the liver under control, but for weight loss, she wanted to see me exercising more consistently first. Hoping maybe that will get things moving before we get to higher doses. That goes back to the original topic - weight gain after coming off the GLPs. I do need more muscle to avoid that.

Sounds like your doc is managing, or at least guiding, your titration, so unlike many using compound or grey, you’re receiving medical advice. Most people are largely on their own. Making sure you show more consistent exercise is her withholding treatment. Her stigma proffered as medical treatment. As if you exercise more you’ll lose weight. If her focus is weight loss, then that’s 95% calorie deficit and 5% exercise. You’re never going to lose weight if your diet is bad no matter how much exercise you do. No amount of muscle will prevent weight regain after stopping glp-1 for most people. Getting back to the original topic.

 

[Mr.Tired]

Some new and relevant research coming out on this.

Quitting GLP-1 drugs triggers rapid regain, but 25% of weight loss may last

https://medicalxpress.com/news/2026-03-glp-drugs-triggers-rapid-regain.html

 

[Grogu]

Some new and relevant research coming out on this.

Quitting GLP-1 drugs triggers rapid regain, but 25% of weight loss may last

https://medicalxpress.com/news/2026-03-glp-drugs-triggers-rapid-regain.html

Thanks for posting. I guess keeping off 25% of weight lost is better than gaining everything back and more….

The underlying research that this article is based was published recently in a sub-journal of The Lancet.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(26)00043-X/fulltext

This study is a meta-analysis.

 

[lessthanhalf]

The standard old medical paradigm of diet and exercise to manage obesity is a failure as a therapy, while it will sometimes work short term it has appallingly low long term success rates. Any drug with a success rate of 5% or so would never be approved or be allowed to continue being used , so why should advice with similarly low success rates be used, when there are better options. Old habits die hard I guess.

So a doctor refusing to use GLP medication or increase doses unless you exercise more first is actually completely the incorrect approach. Just from personal experience exercising is so much easier while carrying less weight. I did not even try till i had lost 30 kilos and even then walking fairly short distances was pretty painful on my knees and especially feet, another 30 kilos lighter and there was no pain at all. Many forms of exercise while overweight carry very high risks of injury as well.

 

[Grogu]

The standard old medical paradigm of diet and exercise to manage obesity is a failure as a therapy, while it will sometimes work short term it has appallingly low long term success rates. Any drug with a success rate of 5% or so would never be approved or be allowed to continue being used , so why should advice with similarly low success rates be used, when there are better options. Old habits die hard I guess.

So a doctor refusing to use GLP medication or increase doses unless you exercise more first is actually completely the incorrect approach. Just from personal experience exercising is so much easier while carrying less weight. I did not even try till i had lost 30 kilos and even then walking fairly short distances was pretty painful on my knees and especially feet, another 30 kilos lighter and there was no pain at all. Many forms of exercise while overweight carry very high risks of injury as well.

Exactly, a doctor requiring a certain amount of exercise to increase dose is not science based and definitely not a good approach. No part of the titration regime in the clinical studies included to titrate up only if you’re doing “enough” exercise. Even current clinical guidance considers side effects tolerance and loss of efficacy in determining dose, not exercise.

Don’t want to give the wrong impression that I think that exercise is not needed or not helpful. Dr. Now on My 600lb life even wants his 600+lb patients doing some type of physical activity. Even if that’s rolling their neck around and moving their legs.

 

[randompersonrandom]

The problem with "You should use your time on the drugs to learn better eating habits so you can discontinue them." is that it assumes I didn't understand good eating habits and that this was somehow due to ignorance on my part.

I knew EXACTLY how to weigh food, assess calories, exercise, and be in a deficit, which I think is demonstrated fairly easily by the fact that once I had meds to fix the "I just couldn't stick with it because I was hungry and miserable and the urge to eat was intrusive" part, I stopped being fat.

 

[deluge]

Exactly, a doctor requiring a certain amount of exercise to increase dose is not science based and definitely not a good approach.

There is a valid point to at least some exercise. I read that the average weight loss is 60% fat and 40% muscle.

I made working out a requirement of my Tirz journey due to those numbers. Some kind of cardio every day, and some strength training every other day. I already had enough health issues (OSA, Fatty liver, uncontrolled hypertension), I didn't want to go down in muscle mass, especially heart muscle!

I do agree that a Dr shouldn't be withholding doses or increases is a flawed plan, though.

 

[lessthanhalf]

While exercise is definitely a good idea and any exercise is better than none, Some people are starting from an extremely inactive baseline, and exercising whilst severely obese is genuinely difficult both physically and socially. I do not think it was realistic for me to try to start at 145 kilos, given that when I did start at 115kg walking for 5 minutes caused pretty severe pain. And had I been living in a more populated area I would have felt very self conscious at that weight. I think there is a case for waiting a bit if starting BMI is very high, and you are very unfit, just to minimise injuries and pain. I was lucky to do this in the country where carrying a large stick did not look too ridiculous, and it certainly saved me from several sprained ankles. Starting exercise with severe obesity does need to be done carefully due to the high risk of injury.

 

[drzoid614]

Don't be sad! Please, be happy that modern science has found a pharmalogical solution to a metabolic condition that society had made you believe is a character flaw. Glp-1s correct an imbalance in the mind/gut signaling system that you've been suffering. No different then any other medicine people take for a chronic condition.

I had gastric bypass in 2003, so 23 years ago. At the time, even though it was great, I knew it wasn't the solution. I knew at the time that eventually there would be a pharma solution that would actually address the underlying disease.

And there it is in a nutshell. Is obesity a disease? For some, yes. Society is slow to recognize. Just like alcohol use disorder. Don't be sad! Be happy that you live in a beautiful world where scientists would find this for us and relish in the treatment and never look back.

well put!

Some new and relevant research coming out on this.

Quitting GLP-1 drugs triggers rapid regain, but 25% of weight loss may last

https://medicalxpress.com/news/2026-03-glp-drugs-triggers-rapid-regain.html

And this is a great read! Thank you for sharing

 

[CNCCurrency]

well put!

And this is a great read! Thank you for sharing

damn 60% after 1 year, I will never not take a maintenance dose as long as I'm breathing. Which I comfortable with

 

[SpiralJetty]

I experience weight gain when I reduce my dose of Tirz or don't take it for like a month or so.