Bariatric surgery, malabsorption and GLPs

You had surgery right when guidelines were shifting toward SADI-S for very heavy patients instead of the more aggressive BPD/DS, which is rarely done now, only about two percent of cases. My own bypass was years earlier and my starting BMI was probably higher. I have not seen the same rapid drop on tirzepatide that you describe. Finding someone with the exact same surgery may be unnecessary; what matters more is how others have managed fast loss on tirzepatide by adjusting doses and adding retatrutide.

I had a sleeve instead, done before these medications existed. I take reta because of type 1 diabetes and ongoing weight gain. It does not quiet food thoughts as strongly as tirz but both help with loss. Many switch from tirz to reta without a set plan and simply adjust until they find a workable level. Once switched, most need a moderate dose rather than a very low one. Walking and daily activity help, though I worry about muscle loss too.

I understand completely. I had a sleeve years ago and my mother had the DS, so I know the procedure. She tried Tirz for a while and lost some weight, but side effects increased at higher doses and she stopped when coverage ended. She has kept the loss so far and may try an oral option later. For myself I have been testing low doses of both medications together and found small amounts sufficient for holding weight. After recent surgery I am slowly returning to strength work while watching the scale creep back up during stressful weeks.

Why move to Reta at all?

I had a vertical sleeve years ago. Be careful because results can fade if habits slip. Keep up with vitamins, focus on protein, and eat cleanly to avoid regaining a lot of weight.

My surgery only comes to mind when planning meals to hit protein and other needs. I prefer regular food over processed high-protein items. A standard multivitamin works better for me than the specialized bariatric versions, which caused nausea.

I had a sleeve several years ago. The quieting effect on tirz is welcome, but for maintenance I would probably just lower the tirz dose rather than switch medications, since the new one may drive further loss instead of holding steady.

The iron in many formulas can be the troublesome part. I take mine with food and have settled on a bariatric brand that includes a probiotic. I also like their calcium options.

I used another medication first and did well until coverage stopped. After a period of lower dosing I switched and began Tirz. Early progress was modest until I added a small amount of another agent. A study later supported higher doses of that agent, but I had already committed to Tirz. I have accumulated extra supply and a relative is doing something similar before retirement.

I also had a sleeve some years ago. After life changes the weight returned and I recently started tirz to reduce food thoughts while adding exercise to protect muscle. I am earlier in the process so I do not have much personal data yet, but I am interested in what works for others in our situation. For daily supplements I use a multivitamin plus fish oil combination that is easy to take and reasonably priced.