Experience with 20mg/wk reta?

If anything the results have shown the opposite. Eat less, move more, and weight comes down.

I didn't realize the FDA had issued any guidance on reta since it's still in trials.

I've lost the same amount of weight before using only diet and exercise, but the medications feel much better and safer. The first time around I also lost my gallbladder. At this weight, after losing through diet and exercise alone, I end up in a really bad mental place, constantly thinking about food, running lots of miles daily, and sticking to a strict eating schedule where any small slip can derail everything. I've been through that cycle multiple times. On the naive point, yes, I think it's a bit naive to assume 3 milligrams weekly feels the same for you as it does for everyone else. Phase 2 trials at 12 milligrams showed a large portion of people are non-responders. Some also have bigger weight issues than others. What's your current and highest BMI? Mine are 26 and 49. Max tirzepatide did nothing for my weight loss, though I had plenty of side effects. I don't think that's accurate at all. These drugs work through a specific mechanism.

That's why I said to a degree. Some people deal with metabolic adaptation and resistance. You can try fixing that without a GLP-1 but it's much easier with one. There are also insulin sensitivity problems that these drugs help with. Anyone can lose weight in a calorie deficit, sure, but it's definitely harder for some than others.

Sorry, I didn't mean to suggest 3 milligrams should work for you. I understand some people need to go higher. I was just explaining where my comment came from. The first time I lost weight I went from BMI 31 to 23 without any medication and it took two years. This time I started at 28 but I'm mostly using reta for body recomposition, which is why my dose is lower than yours. Your reply actually supports my point. It sounds like you've lost the weight naturally before but the medication makes it easier and better for your mental state. Insulin sensitization, quieting the reward pathways, and possible leptin effects aren't just from the weight loss itself. There's evidence of direct receptor activity. Receptor distribution points to central nervous system effects too. It's also well known that metabolic slowdown happens with calorie deficit weight loss, and GLP-1s help counter that. I didn't intend to sound aggressive, just that I'd hesitate to raise my own dose further without checking every other part of my plan first.

My mistake, I meant Lilly's clinical trials.

Your reply comes across more like griefing and shaming than actually helping. That said, I also lost a gallbladder and had severe pancreatitis leading to two long hospital stays from keto diets that went wrong. No other diets worked after leaving the army and then spending decades at a desk job. Compound tirzepatide plus diet has gotten me down to my target BMI. With the weight off, exercise became much easier despite four autoimmune conditions that aren't in remission. These GLP-1 drugs have been life-changing for me. My brother who weighs 400 pounds hasn't responded to them at all. Setting aside the willpower debate, some people just draw a bad hand genetically. Good luck on your journey. You might also want to check out some of the good posts on microdosing here. That approach has helped quite a few people.

Whoa there. Be careful calling them tools. There are people on this forum with thousands of posts who will jump in to say you're wrong and just raise the dose because they're cheap. I learned that the hard way.

Well said. It's worth noting that figuring out what other metabolic issues someone has is important. You'll want a good doctor or at least one willing to order plenty of blood work, especially specific markers you request, because most general practitioners don't know much about these things. Luckily we have more tools available now. I'm helping someone right now who was extremely obese with triple bypass and heart failure. He's down from 400 pounds to 350 in three months. I want him at 220 in the next 64 weeks. His fasting glucose has improved a lot and insulin sensitivity is much better. I'm not telling him exactly what to take, just guiding him and providing a meal plan and exercise routine at no cost because I care about the guy. I care about everyone, maybe too much sometimes. My wife once told me I can't save all the whales. No pun intended on her part but kind of funny.

Love it. Another option would be adding a testosterone boost along with the tesa. For the Meso crowd that might appeal.

GB?

Yeah I'm learning that too. I guess I've spent too much time on Meso. Didn't think asking about diet and exercise would be taken so badly. Lift weights, do steady cardio, track protein and macros and most of the time weight comes off. Add reta and you'll definitely lose. Relying on the drug as the main driver doesn't make sense to me. Can you get more sleep? Can you add a few thousand steps a day? Can you tweak your diet a bit? Those are the questions I think should come before going past the highest tested dose of a drug, especially when it's still working.

Probably because you don't have much of a GLP deficiency, if any. In that case these drugs act more like a tool since you didn't really need them to begin with.

If you even suggest on reddit that someone move a little more you're close to getting banned. Probably leftover effects from the body positivity movement that shifted into just using the shots without any lifestyle changes.

I'm fine skipping moral arguments about weight loss, but for the most part a GLP deficiency is a made-up idea. Humans didn't suddenly develop one in two generations. It is documented that statins reduce GLP production, so if you're on one that's a real deficiency and probably explains why statin use links to higher diabetes risk. Other drugs likely do the same and modern processed food probably contributes too, along with many other factors. Let's just agree some people will rely mainly on GLPs for weight control while others will use them as an add-on to lifestyle work. Both beat doing nothing. I think our own insecurities make us defensive when someone points out that lifestyle still matters for results.

Is it reasonable to assume reaching a healthier BMI will correct those deficiencies or do they persist? In this case the person is already at BMI 26. I'm not saying higher doses don't make sense for people with higher BMIs, but once you're near goal shouldn't the focus shift toward lowering the dose and building lasting habits?

I'm sure that works for some people. Overall the data doesn't look great though. The SURMOUNT-4 results showed people regained a good amount of weight after stopping tirz even while continuing lifestyle changes, and kept gaining. On the other hand, quite a few people here including myself prefer staying on GLPs long term for the health benefits and reduced food noise. I'm surrounded by food all day so I really value not being tempted while on these drugs. The typical American kitchen environment is terrible unless you live alone or have family on board too.

My own theory is that because GLPs have worked so well, people fixate on that one hormone's role in hunger. Then companies market products claiming to naturally raise GLP to profit from the attention. In five years after reta is out longer, researchers will probably start framing obesity as inadequate glucagon signaling instead. The problem with that view is that for most people it's not mainly a hunger issue even though that's how it feels. It's more of a broader metabolic problem where obesity is just one possible result. Suppressing hunger through very high GLP signaling does help with weight loss. If the issue was just GLP being 10 to 15 percent too low then the deficiency idea might hold, but we're not raising it by that small amount. We're pushing it orders of magnitude higher than anything that occurs naturally. It's a clever workaround for a problem elsewhere in the system.

I'm all for micro-dosing once goals are reached and bloodwork and health look good. I know several very fit people, especially women, who micro-dose tirz and it works well for them. I imagine I'll keep using reta off and on in the future because it's making this cut much easier.

I share the same views as you do in this discussion and others. You come across as more neutral and aware of the situation described. What puzzles me is the way certain individuals react strongly whenever opinions differ slightly from their own, suggesting others leave for different communities because of unresolved personal issues affecting their behavior here, despite everyone aiming to assist similarly. Having joined recently, I can predict when that repeated thread about whether something counts as cheating or assistance will appear. My goal is simply to offer alternative viewpoints based on personal stories to aid with issues, yet it feels restricted by one person's tendency to undermine and subtly criticize any comment not focused on increasing amounts. The original poster mentioned starting at a high body mass index and reaching a much lower one, yet still thinking about further increases beyond recommended levels. We both recognize the progress made, but the focus remains on weekly numerical drops instead of fat percentage shifts. Highlighting this draws similar negative responses. Their current index is close to mine, differing by less than one point. Responding becomes harder with multiple revisions to their messages, now totaling six updates.

I've always backed taking the entire amount. My intent was simply that basics like rest patterns, training habits, and meal choices need sorting first before any big dose increases. That stands out here since the poster has neared a healthy weight range yet keeps dropping pounds. They described logging lots of miles while shedding weight initially. Jogging counts as one of the least useful activities for trimming fat because it spikes hunger levels and few people adjust their effort across different heart-rate ranges. Mixing strength sessions with steady low-intensity cardio tends to deliver better results for fat reduction. This led me to wonder about their overall eating and movement setup. I've encountered plenty of users on these meds who skip consistent nutrition and activity then express surprise at limited progress.

Great points.

Absolutely! Tapping their username inside any discussion brings the option up right away. This won't block access to those heated exchanges since replies from others stay visible, although the actual messages stay hidden until selecting the reveal option.

Appreciate it. There's already a thread like this on another board I moderate. Hadn't checked here until now. The request was for someone besides me.

I was interested in the 20 milligrams weekly number because I saw it mentioned in another thread and I'd like any data on symptoms or results. The 12 milligram limit comes from phase 2 studies that showed diminishing returns for most people at that level, but there are probably individual exceptions. Since it sounds like some people have personal data I'd like to hear from them. I do expect I'll go somewhat higher than 12 milligrams if my weight loss slows and I find I'm responsive to the higher dose. In fact I measure body fat percentage daily by proxy with a waist measurement. My waist shows a linear decrease of 0.03 inches per day, which is about 0.04 percent per day using the Navy equation. I've had dexa scans periodically that confirm the method is roughly accurate. However I've been very muscular at high body weights and could do pull-ups at 270 pounds, so I'm skeptical of the simple idea that muscle is always good and fat is always bad. For many later-life health issues I suspect your body systems only have so much

You raise a good observation here yet a few aspects of that study seem worth looking into more closely. The duration may not have captured steady state effects for the higher amounts tested. Extending it could have let the outcomes for those two higher groups separate even more before leveling off. Matching the groups that started from the same lower amount shows their paths pulling apart. The overlap only appears when placing the faster ramp up group against the slower one and that overlap might stem from how quickly the amounts increased at the beginning rather than the final amounts reached. Those numbers reflect group averages while the spread among participants was wide. It would be interesting to track how one person responds across several different amounts since some react strongly even to small weekly increments while others show little change until amounts rise further. The group averages point toward that pattern being possible. For any single person a plot of total change against amount taken might follow a similar shape though the range of amounts needed would differ between individuals.