Am I being impatient with weight loss on Reta after switching from Tirz?

Noooo that is not the answer I wanted to hear.

The higher doses of reta worry me because my heart rate jumped right away at 2 mg and has stayed elevated since.

This is actually the first time I have tracked and weighed my food since starting these meds. Since switching to reta I average 1400-1700 calories depending on activity level. Before that I was probably eating less because the hunger was lower.

That could be true. I will give it a few more weeks.

Try the Lose It app set to sedentary and do not eat back exercise calories. At my height weight and age my TDEE is only about 1600 so yours is likely similar or lower. To lose you probably need to stay below that number consistently.

I agree calories matter but my intake is now tracked. The bigger issue is that 15 mg tirzepatide kept hunger very low and now on reta the suppression is only moderate. I am mainly asking whether I should keep increasing since I am only at 7 mg or add another medication. After four years on these drugs my tolerance is probably high.

I am 36. My calculated TDEE at sedentary is 1595 but I am active so to lose I would need to drop to around 1295 which feels hard on only 7 mg reta because hunger returns. Raising the dose might help control that.

Your current intake is set to maintain 135 pounds.

I set a flat 1500 calories and ignore exercise calories. Some days I am under and some over but it averages out over time.

Adding the other medication might make it easier to stick to the lower calorie target.

I do regular bloodwork including hormones and everything is in range though that may not be optimal for me. I have been tracking calories for the past nine weeks and eating more lately. From 125 in September I have slowly gained about 10 pounds with my cycle pushing it to 135 most of the month. At 5'4" that feels noticeable even if others see it as minor. What I really wanted advice on is whether to keep raising reta after coming from 15 mg tirzepatide or add the other medication because staying at the lower calorie level is tough on 7 mg. The meds are supposed to make the deficit easier to follow.

Thanks for the honest feedback especially the last part. I will stay the course for a few more weeks on reta before deciding about adding anything else.

Thanks!

Wishing you the best of luck.

This is really about consistent tracking and patience rather than the medication. You also moved from 2 mg to 7 mg in only seven weeks which is much faster than the trial schedule of increases every four weeks. That pace can raise side effects and limit future options. At your height and weight you are already light. Healthy eating and exercise do not automatically equal a deficit unless portions are weighed and logged every time. If you are not doing that you do not yet know whether calories are truly the issue.

I have not had side effects on reta except the higher heart rate which is expected. I came from 15 mg tirzepatide after four and a half years on these medications. The main problem now is weaker appetite control so I was looking for next-step suggestions. I also stopped drinking when I started the first medication in 2022.

Combining the two medications is the approach that works for me.

The reduced hunger control is mainly because the current reta dose is lower relative to the previous 15 mg tirzepatide and because so much weight has already been lost. The medication is now mostly fighting the body's drive to regain rather than any true tolerance developing. Finding the right long-term maintenance doses with the fewest side effects can take experimentation.

I see your stack and that is the direction I am leaning toward.

Hope you find what works. So far reta feels only average for me.

That response was very helpful thank you.

I recall from the trial data that the resting heart rate increase peaked around 24 weeks and then started to come back down though it had not fully returned to baseline by the end of the study.

I wish I could pin that response.

Good to know. The extra few beats are noticeable especially during the luteal phase but nothing extreme.

You have got this.

I like measurements too. Last summer at 125 my waist was 24 inches hips 35 and upper thighs 20. Now at 135 those are 25 36 and 21.5. I am leaning toward the right side of the comparison photos but preferred my numbers from last year. The thread had some useful suggestions so I will keep trying.