Dosage advise

Song1

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I’ve been on Reta for about five weeks now, after switching from 2.4 mg Wegovy. I’m currently up to 5 mg but can’t seem to shift any weight at the moment, even though I’m only eating around 1,200 calories a day. I’m considering increasing the dose again.

I’ve lost about 135 kg overall and would like to lose another 15–20 kg before looking into skin removal surgery. However, over the past 12 months I haven’t been able to lose a tangible amount of weight. In fact, since increasing my training to around 2.5 hours a day and reintroducing weightlifting, I’ve gained about 1 kg. My body composition does seem to be improving, but it’s definitely been a frustrating journey.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
 
Song1 said:
I’ve been on Reta for about five weeks now, after switching from 2.4 mg Wegovy. I’m currently up to 5 mg but can’t seem to shift any weight at the moment, even though I’m only eating around 1,200 calories a day. I’m considering increasing the dose again.

I’ve lost about 135 kg overall and would like to lose another 15–20 kg before looking into skin removal surgery. However, over the past 12 months I haven’t been able to lose a tangible amount of weight. In fact, since increasing my training to around 2.5 hours a day and reintroducing weightlifting, I’ve gained about 1 kg. My body composition does seem to be improving, but it’s definitely been a frustrating journey.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
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When you up your resistance training/add resistance training most people start to hold more water. This is especially true if you are using supplements that also have this effect (creatine). Though I don't have any experience with weight loss at your level (which is awesome)

That being said if you aren't having any extreme sides and coming from previous max Semaglutide doses you should be just fine titrating up.

Unfortunately when you are on either end of a bell curve there isn't much company so you are going to be blazing the trail.
 
Song1 said:
I’ve been on Reta for about five weeks now, after switching from 2.4 mg Wegovy. I’m currently up to 5 mg but can’t seem to shift any weight at the moment, even though I’m only eating around 1,200 calories a day. I’m considering increasing the dose again.

I’ve lost about 135 kg overall and would like to lose another 15–20 kg before looking into skin removal surgery. However, over the past 12 months I haven’t been able to lose a tangible amount of weight. In fact, since increasing my training to around 2.5 hours a day and reintroducing weightlifting, I’ve gained about 1 kg. My body composition does seem to be improving, but it’s definitely been a frustrating journey.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
Click to expand...
Remember too that muscle weighs more than fat, so as you build muscle you could be, and almost certainly are, losing fat yet still gain in weight overall. If you are noticing positives in body recomposition and feeling good that is more important than a specific number on the scale.
 
yrrdead said:
When you up your resistance training/add resistance training most people start to hold more water. This is especially true if you are using supplements that also have this effect (creatine). Though I don't have any experience with weight loss at your level (which is awesome)

That being said if you aren't having any extreme sides and coming from previous max Semaglutide doses you should be just fine titrating up.

Unfortunately when you are on either end of a bell curve there isn't much company so you are going to be blazing the trail.
Click to expand...
This is true as well, in effect you are most likely just replacing fat with water and muscle at this point which is great for your health, but won’t show as progress on the scale. And without side effects you still have room to increase the Reta too
 
Congratulations on losing 135kg, that is a lot.
These medications are not going to work the same in that state ( after having lost a lot of weight ) as they do when you start them and are severely overweight.
The best you might have to settle for is to have them help you maintain such massive weight loss, and even that is way beyond the average responses in any of the studies.
Massive weight loss reduces metabolic rate and increases hunger, this makes maintaining weight loss extremely hard. Your description of no further weight loss at about 1200 kcal/day is exactly that metabolic adaptation, in just about any other person or metabolic condition that number of calories will cause weight loss.
Going from 2.4 of semaglutide you could probably have jumped straight to 5 mg or so of reta, with less side effects, and you could possibly , assuming you have no side effects from your current dose and are still hungry, push the dose a bit quicker.
I am in a somewhat similar position, though I initially lost the weight without medication and am doing much less exercise. I am attempting to maintain a 78kg weight loss or 54% , and am taking 15mg of tirzepatide plus 5mg retatrutide plus very recently 0.25mg of cagrilintide. With current weight loss of 100 -200 grams per week. But prior to starting the GLP medications my weight loss slowed to zero for a year with no change in intake of 1600-1800 kcal/day , despite this intake causing 6kg per month weight loss at the start.
The obvious thing is to keep pushing up the dose of reta to as high as you can tolerate it or 12mg.
Any options beyond that depend on you and how it is going, if you are wanting to still lose more weight then there are no good scientifically proven to be safe options. But obesity of that severity is really very bad for your health , and I would guess the risks of higher dose GLP's or combined therapy is less than the risks of weight regain in that situation. Which would mean either higher than 12mg retatrutide, adding in cagrilintide, or adding in semaglutide for extra glp-1 agonism.
It may be that in your situation getting rid of the last 20 kg is not possible, given you are not losing weight on 1200 calories a day. It is still a massive achievement and maintaining all or even a lot or even some of that loss is the most important issue in terms of long term health. In my case the GLP medications have definitely made that easier to tolerate.
I assume you have had basic bloods, blood pressure and all that checked out at some point. Some of the other associated health risks that come with obesity are a lot easier to fix than the weight side of things.
 
Amazing progress well done! Are you tracking your Kcal?
 
@Song1 a weight loss of 135 kg (297 lbs) is monstrously fantastic! I would love to hear more about when/why you started and what you discovered...

A few more thoughts about your weight loss stall. The very few clinical studies have had best results at 12 mg Reta per week in divided doses. Most here are seeing fast results with much lower doses. Assuming you are sleeping and moving sufficiently and getting adequate nutrients, the first step might be seeing if increasing the dose helps. Alternatively, like others, you might get a synergistic benefit by adding a different type of peptide to Reta and keeping the same dose or even lowering it. In the end, it is all very, very, individualized and antidotal.

Frankly, Im more interested in your age, starting weight, lost pounds per week average, why you stayed motivated, what you learned, how it affected relationships with people, and your long term goals --why? Because you have already been incredible.
 
Not_Your_Dad said:
1. Congrats on the amazing progress!

2. I stalled out on high dose Tirz for a few months. Switched to Reta, didn't get anything really noticeable on Reta til I hit 8 mg.
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TY I might try upping it again, no negative side effects other than a lack of sleep
 
Song1 said:
I was going to do that in fairness I've lost a couple of notches on the belt but expected weigh loss to exceed muscle gain
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It usually does, but your fat burning may have stalled, and you've put on muscle mass. A scan could show you that your net weightloss is actually 145 kg of fat and 10 kg of muscle GAIN! Either way, great job on the progress!
 
Song1 said:
I’ve been on Reta for about five weeks now, after switching from 2.4 mg Wegovy. I’m currently up to 5 mg but can’t seem to shift any weight at the moment, even though I’m only eating around 1,200 calories a day. I’m considering increasing the dose again.

I’ve lost about 135 kg overall and would like to lose another 15–20 kg before looking into skin removal surgery. However, over the past 12 months I haven’t been able to lose a tangible amount of weight. In fact, since increasing my training to around 2.5 hours a day and reintroducing weightlifting, I’ve gained about 1 kg. My body composition does seem to be improving, but it’s definitely been a frustrating journey.

Protein intakes good, diets clean and I don't drink,

Any advise from anyone thats gone through similar?
Click to expand...
You must be a peptide GOD. 300lbs/135kgs Had to look that up. Us USA ers are kg ignorant. Don't even get me started on "stones"...
 
ChicagoFit said:
@Song1 a weight loss of 135 kg (297 lbs) is monstrously fantastic! I would love to hear more about when/why you started and what you discovered...

A few more thoughts about your weight loss stall. The very few clinical studies have had best results at 12 mg Reta per week in divided doses. Most here are seeing fast results with much lower doses. Assuming you are sleeping and moving sufficiently and getting adequate nutrients, the first step might be seeing if increasing the dose helps. Alternatively, like others, you might get a synergistic benefit by adding a different type of peptide to Reta and keeping the same dose or even lowering it. In the end, it is all very, very, individualized and antidotal.

Frankly, Im more interested in your age, starting weight, lost pounds per week average, why you stayed motivated, what you learned, how it affected relationships with people, and your long term goals --why? Because you have already been incredible.
Click to expand...
Hey All Great Questions

47, I lost about 125kg over 2 years, then about 10 Last year

In regards to relationships with people my work career certainly has taken off again and people certainly treat me better,

In regards to training its weights and Cardio every morning boxing / kickboxing / sparing mainly daily, No rest days ATM

Long term goals maybe some masters boxing, other than that just staying alive is good,

last year I had to put everything on hold for a bit as my wife had breast cancer so we had to get her over three rounds of surgery (almost dying of infection) Chemo and Radiation therapy, then the preventative treatments, but she's come good now and life's normalized again, so its good to be back at it.

I actually up'd my dosage to 7.5 about 5 days ago and Im down another 2kgs but also boosted my magnesium as I felt like I was retaining water, either way nice to see the scales move again
 
Something to consider is checking your thyroid (low T3). 1200 calories is a steep caloric restriction. My thyroid was low from not eating enough. My caloric intake went up to 1800 from les than 1500 before I saw results (this was before getting on Reta).

That said, I would trust what you see and how your clothes fit more than the scale. I found that the results I saw from loose clothes and my stomach pulling back suggested more fat loss than the scale reported.
 
I am amazed that your weight is even mostly stable on 1200 kcal/day with that amount of exercise. I know first hand how much the metabolic rate drop from massive weight loss can be but in me at least it was more like 1600-1800 kcal/day to keep weight stable, with not a lot of exercise or just walking a few k per day, and I only lost a bit more than half as much weight. Really a good use case for retatrutide at higher doses as it should increase daily calorie use by at least 1-200kcal/day, as maintaining a dietary intake that low long term must be difficult. It does sound like you might have increased muscle mass a bit going on your amount of exercise and reduced waist size.
 
skeptick said:
You must be a peptide GOD. 300lbs/135kgs Had to look that up. Us USA ers are kg ignorant. Don't even get me started on "stones"...
Click to expand...
Now we have to change BTU's (British thermal units )to ATU's (American thermal units)
 
First off, congratulations on your progress! 135kg lost is amazing and it sounds you're doing everything you can to support your new healthy lifestyle. That being said, 1200 calories is extremely low and with 2.5 hrs of weightliting/training per day, your body has likely shifted into conservation mode. It will adjust to the "new normal" and hold on to fat stores as long as possible. You need to up your calories, especially protein, but good fats and carbs too. You didn't mention your current weight, but getting to at least 1800-2000 calories would be a good start. You could likely be shifting your body composition from fat to muscle, so the scale number may not move down like you have seen in the past, however, your overall ratios will be much more healthy and sustainable. Good luck and again, great job on your progress!!
 
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