Options to break a tirz stall- reta? more cardio? radical acceptance?

I am on 15 mg tirz plus 5 mg reta and finally moved past a two-month stall. I raised the reta very slowly over four months. I keep reminding myself the weight did not come off overnight so I should not expect it to come off that fast now. I stay in a calorie deficit most days, though the effect weakens the farther I get from shot day. My body seems to need time to adjust to the new lower weight and the losses arrive in waves. I have shifted my goals away from the scale and toward cardio improvements instead.

You listed the main choices. Switching to different tirz seems least useful, and simply accepting the weight is next. Raising the tirz dose is worth trying if side effects allow. Adding or switching to reta is another route if sides permit. Cagri or elora could be considered for the amylin effect. Diet and extra exercise are unlikely to be sustainable for most people.

I would add elora. The maker would probably recommend adding it or switching fully to reta. In the short term, simply increasing the tirz dose is the simplest step. Do you inject weekly or split the dose every five days or some other schedule?

I would personally add two fasting days each week, but only if appetite suppression is still strong enough to make it comfortable. I would walk for an hour on those fasting days and drink plenty of tea, electrolyte water, and coffee. That approach can lower insulin and free up fat stores. On the regular eating days I would raise calories to around 1600 to reassure the body that food is available. Reaching 150 lbs at 5 ft 3 is certainly possible.

Try changing eating patterns for a while: raise calories for a week, switch to strict keto, try carnivore while still eating enough calories, eat sardines daily for a week, do a three-day fast, or switch to OMAD. The goal is to keep the body from adapting. Start with a short break from the deficit even if that means lowering the tirz dose temporarily. Just avoid sugar and sweets.

You will get there. The thread already has several good ideas. Adding a small amount of sema is another option worth considering if hunger returns. The suggestions below are also solid.

Before adding reta I would try cagri or sema first because they cost less. I inject tirz on Thursday and the other two on Monday. I keep a vial of reta in the freezer as a last resort.

If hunger is not an issue I would focus on tracking intake more precisely with a scale so I know exact calories, including hidden ones from sauces, dressings, butter, and oil. Once the number is clear I would drop intake by 50 calories a day and check progress after a week, repeating as needed. Fasted zone-2 cardio is also useful because it burns fat without increasing hunger and supports long-term health.

A single fasting day usually works for me. Because I already follow keto, carnivore, and OMAD it is easy to skip or delay one meal. Any fast needs to be done carefully if other health conditions or medications are involved.

I ended a months-long stall by adding elora.

Congratulations on the progress so far. Insulin is the main fat-storage hormone, so look at your current macros. If it were me I would add 1.5 mg sema and 3 mg elora, splitting the elora into three doses per week. This is still a long process.

The older slower approach is to keep food intake steady, add a short workout before meals while still in a fasted window, and simply wait four to eight weeks. That combination often restarts loss. You might actually be in a body-recomposition phase that looks like a stall on the scale.

Whatever route you choose, remember that keeping the new lower weight is the real challenge, so any tactic must be something you can continue indefinitely. That is why I avoid recommending extra dieting or exercise that cannot be sustained. If you have no side effects on tirz, a higher dose is reasonable. Other peptides are also options, and elora in particular seems promising once tirz has done all it can. It is currently the priciest and hardest to find, but availability is improving.

Are you still dieting hard? You could take a short break and let yourself gain a couple of pounds, then see whether the medication starts working again after a few weeks. Adding a little reta while keeping tirz the same is another possibility, but start low. You do not have to accept the current weight if you want to lose more. The body may simply be holding onto calories because it senses rapid loss. Also consider trying the vial you already have on hand, since responses can vary between batches.

I prefer buying single vials rather than full kits. I have kept my cagri vial separate in the fridge to avoid accidental overdose and have never used an entire vial at once, only adding it occasionally to break a stall. I titrated too quickly once and reached 600 mcg, which produced GI sides that may have helped with weight. For elora I would probably wait because I am not in a rush for the final pounds. Studies on combining it with tirz look strong, and the theory that it can help reset set point is appealing. Reta is also worth having on hand even if some people stop it due to sides; a lower dose is always possible.

Increase to 20 mg. The maker has tested safety up to 25 mg and holds patents on the 20 mg and 25 mg doses.

Tesofensine for 90 days.

I will sit down tomorrow with a clear head and write down all the suggestions. So there really is still a chance. I had started to feel like the medication had taken me only two-thirds of the way and then stopped. Elora, cagri, or more tirz are options, or perhaps a short fast. Sardines are not for me and longer fasts make me queasy, but there are still things worth trying instead of just feeling stuck.

Exactly. Since hunger and food noise are not major problems right now, focus on improving what you already eat before adding another peptide that would simply suppress appetite further. Make small swaps such as plain nonfat Greek yogurt instead of sour cream or drink a protein shake and eat a big bag of steamed vegetables before a higher-calorie meal. Those changes can easily remove several hundred calories a day, which may be enough to restart progress when weight is holding steady.

Goodness, is that going to be added to the direct plan anytime soon? With your sense of humor you could land a job anywhere in this country working sanitation.

Your ideas all seem sensible enough and since this process stretches out over months there is room to test a few approaches. The progress you have already made stands out, dropping from 245 to 180 pounds works out to roughly a quarter of starting body weight and counts as a solid result on that dose, yet expecting another big drop from the same medication alone feels unlikely though it should help hold the line against regain. From a medical standpoint the pounds already gone matter far more than any further reduction, because the biggest drop in future problems comes early on. Once these medications appeared and made sustained loss feel achievable many people including myself noticed their goals kept shifting upward. I started out aiming for enough change so daily movement would stop leaving me drained and soaked, but that number grew much larger over time. Serious excess weight carries well known dangers that outweigh the added uncertainties of higher amounts or mixing agents, even if those uncertainties remain untested over long periods. When the current dose left me still wanting food I tried layering in another compound mainly to quiet appetite rather than chase more scale movement since most of my change happened beforehand. You mention few unwanted reactions and decent appetite control already, so my next step would have been a small addition of the other agent for its distinct metabolic action instead of simply raising the first one. The newer option would now come before that for anyone hoping to push further. It works a bit better than the similar older compound and tends to bother people less, though it costs more. When trying either on top of what you already take begin with tiny amounts and go up gradually because unwanted effects show up more readily in combination than when either is used alone. Early data on pairing the newer one with your current medication pointed to noticeable extra loss over half a year while the older pairing with a related drug produced weaker results and more complaints. Holding the lower weight steady ends up being the real goal since that is what avoids the long term issues tied to obesity. Once weight stops moving on the highest amount of the first medication that amount is probably what will keep things stable going forward. Reaching beyond the usual range of loss therefore requires either mixing agents or going higher than standard levels. I have little faith that changes in eating patterns or activity alone produce lasting results with this condition, though choosing foods that are less energy dense can certainly make a lower intake feel more manageable.

Another possibility involves overeating wildly yet sticking mainly to fiber and protein across two days while doubling cardio sessions then resuming normal meals but holding onto the higher exercise volume. That pattern has often worked out for me. I once hit twenty five miles daily on a stationary cycle though results differ for everyone.

My approach might involve bringing in extra compounds while making some daily habit adjustments, though deciding the value of those remaining thirty pounds falls to you. Should they matter above all else then sorting out digital currencies becomes key for reaching the widest selection of compounds worldwide. Help shows up if you look around. Could the hair thinning come from too little fat intake instead of just cutting calories? That falls outside what I know well. From discussions I've seen dropping roughly a quarter of total body mass counts as the usual result with this medication. Certain people fall short while others surpass it but trials point to that figure as typical.

Losing that much weight represents major success. Even after a month without the scale moving it doesn't prove you've reached your endpoint. I didn't rush to add another medication right away. My calorie needs dropped along with my body weight so the original gap between what I burned and what I ate had likely shrunk. An online estimate gave me a rough idea but I compared it against my actual logs of food consumption movement patterns and how the numbers changed over time. I started by noting a typical seven days of meals how I recorded everything my step count and workout sessions including all extras like condiments beverages and weekend variations. That created a reliable overview without automatically requiring smaller portions. Increased training can lead to more stored glycogen and its accompanying water while muscle repair fluid shifts cycle timing or digestive slowdowns can also mask changes on the scale. Checking weekly average weights plus waist tape readings showed whether real progress continued underneath. With intake already low and hair thinning I avoided further reductions and instead examined protein levels plus overall nutrient balance. Persistent low hunger indicated the current medication remained effective. I gathered solid details on habits first before considering changes. I tracked my meals activity levels and the actual weekly trends plus measurements to begin with.

Nice job dropping the extra pounds, looks like real headway there. Still the hair thinning part has me worried though. I checked my own labs not long ago when something similar popped up. Figuring out what the system actually requires gets tricky without those numbers. Shifts in hormones or nutrients might be behind the problem. Logging meals, training sessions, and stats such as lean tissue levels helped me spot what needed changing. Flying blind turns into too much trial and error without clear numbers. Paying attention to that stuff made the difference for me.

Whenever a stall happens I go for a two-week period eating at maintenance. Fluid retention can add a little weight at the beginning so there's no need to worry and slash calories hard. Following those weeks back in deficit usually gets the loss going again. I schedule this every three to four months during extended cuts. It runs counter to intuition but delivers.