Wife is gaining weight on Reta. Anyone know why?

She is 46, five foot six, started Reta at 129 pounds and is now 137. Seven months ago on Tirz she weighed 148. The goal was to flatten remaining stomach and waist fat after getting lean, so we switched because Reta is said to target fat. We dropped from 7.5 mg Tirz to 5 mg for four weeks then 2.5 mg for three weeks, overlapped one week with 1 mg Reta, and have been on Reta alone at 1 mg for three weeks. We kept the Reta dose low because her target is only 125 pounds and we thought only the last fatty areas needed work.

That makes sense. We will raise the Reta dose to 2 mg.

Spot reduction through diet alone does not work. Exercise can change shape while weight stays the same or drops. Pilates movements that lower and raise straight legs from 90 degrees can strengthen the lower core and help trim the belly area. Twisting moves can also tighten the waist. Those exercises might be useful while returning to whatever Tirz dose previously produced steady loss. One milligram of any GLP-1 is not enough to drive further fat loss on her current intake.

That hunger comes from the glucagon action.

In short she still had fat to lose. Waist fat is just fat, and Tirz was removing it. Switching away from a working medication because of an incorrect idea about how Reta targets fat was unnecessary. If muscle was being lost instead, that is a training and protein issue, not a Tirz problem. Stopping an effective drug for no clear benefit explains the reversal.

Reta seems to make otherwise reasonable people ignore what was already working and chase the newest option instead.

Exactly. Cutting Tirz almost to nothing and replacing it with almost nothing of Reta just brings the appetite back and then some.

I am in the same boat. Cardiac side effects are real and Tirz is cheaper and stores more reliably. Reta worked for me but the main draw was novelty and hype. Looking back I probably should have started with Tirz. A family member switched from compounded sema to compounded Reta and sees no effect, likely for the same dosing-drop reason as the original post. Chasing trends is not ideal, though I am part of the trend myself.

Reta as the latest passing fad? I was more drawn to the gray-market aspect than the trend. I use Reta when I want to drop pounds and Tirz when I want the quiet mind and no food noise. Food noise has stayed gone since I began Tirz, and I keep a little Reta on hand for occasional help with weight.

The same thing is happening to me. Barely any scale movement after ten weeks. I started at 1 mg for three weeks, went to 2 mg for five weeks, and just took 4 mg. The five or six kilos lost are visible but modest given that I eat only 1800 to 1900 calories, lift heavy three or four times a week, and still feel hunger is controlled. Maybe calories are too high after all, yet the glucagon effect should be adding more fat loss and I am not sure what is missing.

After ten weeks the problem is not insufficient food. Calories are high enough to block loss. Muscle gain from lifting could be masking fat loss on the scale, but to actually drop weight intake must fall below maintenance needs, either by eating less or moving more.

Four milligrams is still the point where observable loss usually begins, and therapeutic levels are higher once approved. Appetite suppression is not the main action of Reta anyway. If hunger is low and results are absent, it is worth checking whether the product is actually Reta or something else.

Glucagon effects are said to be dose-dependent and minimal at 4 mg. I have lost forty pounds using no more than 4 mg total per week split twice. I eat modestly and focus on protein. Suggest trying 1 mg twice a week, then leaving the dose alone for a couple of months while ignoring the scale and staying active.