Might be a stupid question

[Cypress]

I started tirz a few months ago, and have titrated up very slowly. I have lost weight and am about half way to goal. Part of the reason I want to lose slowly is so I don't get questions like "what are you on". I'm keeping my medicine to my self. The other reason I wanted slow is loose skin, although I did just start klow. So for the question; every one seems to try to loose as fast as possible what's the advantage? Should I change my protocol? I look at this as a marathon not a sprint since I believe I'll be on this med for life.

 

[byefatlicia]

That's a great question.
I ask myself sometimes if I should've pushed harder in the beginning when the Tirz was working full force. I had it in my mind that I could take my time and I'd eventually get "there".
But as time goes on, and things slow down at the scale, I wonder if I missed my best chance at big loss.
I don't have the answer to what is best. For me, this was the route I chose and sometimes I question if it was right.

 

[Zydeceltico]

I started tirz a few months ago, and have titrated up very slowly. I have lost weight and am about half way to goal. Part of the reason I want to lose slowly is so I don't get questions like "what are you on". I'm keeping my medicine to my self. The other reason I wanted slow is loose skin, although I did just start klow. So for the question; every one seems to try to loose as fast as possible what's the advantage? Should I change my protocol? I look at this as a marathon not a sprint since I believe I'll be on this med for life.

Personally - I believe that your thinking is the sane, manageable, and healthy approach. I wouldn't change a thing.

 

[Cypress]

Thank you. I just wonder if I'm missing something. Maybe overall my loss will be less, but I think my goal will be reachable.

 

[Chili777]

The lowest possible effective dose is a very valid strategy, and used by many people. As long as you're losing weight steadily, keep it up. And that's a smart question to ask, not a dumb one.

 

[rixsternaz]

Only a few months and you're halfway to your goal is a milestone. Shedding the pounds off slowly is a healthy way preserving your muscle and minimizing sagging skin. I would not change your protocol at this time. Keep up the great work!!

 

[deleted.user.16]

every one seems to try to loose as fast as possible what's the advantage?

For me the reason are
1) I'm impatient
2) I'm a woman and don't super care about preserving muscle (and my body seems to build muscle with very little effort anyways)
3) My personality type makes me enjoy doing extreme things for fun.
4) I see a lot of people here and on Reddit saying they developed a tolerance really quick and need higher and higher doses to work, so I'm trying to lose more weight earlier on in case that happens to me.

The other reason I wanted slow is loose skin

I keep hearing this repeated over and over EVERYWHERE but have never once seen evidence that losing slow is better for your skin. If anyone can provide it I would love to see and it would actually change the way I am approaching this. But I've been following various weight-loss subreddits for years (while procrastinating starting my own weight loss) and I've seen people in the fasting subreddit lose 50 lbs in 40 days with no loose skin and other people say they painstakingly counted every calorie to eat just 200 kcal under their TDEE for years and their pictures have rolls and rolls of loose skin. (This is not to say that I think losing faster is better for loose skin, it's just to say that I don't think I've seen any correlation).

Should I change my protocol?

Not if it fits your personal goals and it's working for you.

I look at this as a marathon not a sprint since I believe I'll be on this med for life.

Great, keep doing what you're doing and don't let what other people are doing influence you if you have different goals than them.

 

[Ragu1]

I started tirz a few months ago, and have titrated up very slowly. I have lost weight and am about half way to goal. Part of the reason I want to lose slowly is so I don't get questions like "what are you on". I'm keeping my medicine to my self. The other reason I wanted slow is loose skin, although I did just start klow. So for the question; every one seems to try to loose as fast as possible what's the advantage? Should I change my protocol? I look at this as a marathon not a sprint since I believe I'll be on this med for life.

When I started on tirz 2 plus years ago, the prevailing opinion was low and slow, loose skin was a concern as were side effects. You titrate up when your dose no longer worked. Not sure what the impetus was to change how losing is now a sprint and how many glass you can stack. I would stay on your current path and do what works for you.

 

[AcadiaPeptides]

I’m right there with you on the “marathon, not a sprint” mindset. I’ve been on Tirz for about four months now, and I actually started stacking Reta because I’ve really been enjoying the journey and how steady it’s felt. Since Christmas I’m down 27 lbs, which still blows my mind a little.
I also have some KLOW and TESA arriving this week that I’m excited to try. The KLOW is mainly because I’m in my 50s and dealing with pain and old injuries that have been hanging around for decades—not to mention the loose skin that’s starting to show up. And the TESA is for tackling that last bit of belly and organ fat that just doesn’t want to budge.
For me, the pace hasn’t been about going as fast as possible, just going at a pace that feels sustainable and keeps me motivated. Everyone’s protocol ends up looking a little different, and that’s okay. What matters is that it works for your body and your long‑term goals.

 

[miss-sanne]

I started tirz a few months ago, and have titrated up very slowly. I have lost weight and am about half way to goal. Part of the reason I want to lose slowly is so I don't get questions like "what are you on". I'm keeping my medicine to my self. The other reason I wanted slow is loose skin, although I did just start klow. So for the question; every one seems to try to loose as fast as possible what's the advantage? Should I change my protocol? I look at this as a marathon not a sprint since I believe I'll be on this med for life.

I didn't. I'm at my almost goal weight, and I aimed for average 0,5-1 kg per week. It ended up being 0,5 mg per week. I did loose 23 kg's, about 25 % of my starting weight over 10 months.
If it works for you, don't change it.
People are different, some people want fast results, just do you.

 

[Cypress]

I'

I also have some KLOW and TESA arriving this week that I’m excited to try. The KLOW is mainly because I’m in my 50s and dealing with pain and old injuries that have been hanging around for decades—

I also am in my 50s, I don't want to look older. My Mum is a little heavier and doesn't look her age but my grandma was tiny and looked well beyond her years. I am trying to have grandma's size and Mum's looks.

 

[Grogu]

I started tirz a few months ago, and have titrated up very slowly. I have lost weight and am about half way to goal. Part of the reason I want to lose slowly is so I don't get questions like "what are you on". I'm keeping my medicine to my self. The other reason I wanted slow is loose skin, although I did just start klow. So for the question; every one seems to try to loose as fast as possible what's the advantage? Should I change my protocol? I look at this as a marathon not a sprint since I believe I'll be on this med for life.

If after a few months you are already 1/2 way to your goal, then you probably didn't have a lot of weight to lose, so I think that it's important to put that into context, especially since others may read this thread who have substantially more weight to lose and are just starting out.

To provide the counterpoint to low and slow, which I believe you are asking about, if people have significant amounts of weight to lose (which doesn't necessarily seem to apply to you), there appears to be a "window of opportunity" after which weight loss on glp-1 medications tends to slow and plateau (12 to 16 months). Switching to another medication or stacking might break that stall, but that's an entire separate conversation.

So, for morbidly obese individuals, low and slow might not be the most effective strategy given the aforementioned window of opportunity. I think that the medical community has revised it's guidance on dose titration since the tirzepatide clinical studies to recongize that if a patient is losing weight consistently and having good hunger suppression that there is no need to titrate up. But, if a patient is not losing weight or is suffering from food noise, and is tolerating the current dose, that dose escalation makes sense.

My fear for people who have a lot of weight to lose, is that they somehow perceive that low and slow is "better" and "less cheating" and forego the full benefits of treatment and then don't reach the weight loss goals they could have if they had taken a more aggressive (if they can tolerate it) dose escalation regime.

 

[staffn1]

If after a few months you are already 1/2 way to your goal, then you probably didn't have a lot of weight to lose, so I think that it's important to put that into context, especially since others may read this thread who have substantially more weight to lose and are just starting out.

To provide the counterpoint to low and slow, which I believe you are asking about, if people have significant amounts of weight to lose (which doesn't necessarily seem to apply to you), there appears to be a "window of opportunity" after which weight loss on glp-1 medications tends to slow and plateau (12 to 16 months). Switching to another medication or stacking might break that stall, but that's an entire separate conversation.

So, for morbidly obese individuals, low and slow might not be the most effective strategy given the aforementioned window of opportunity. I think that the medical community has revised it's guidance on dose titration since the tirzepatide clinical studies to recongize that if a patient is losing weight consistently and having good hunger suppression that there is no need to titrate up. But, if a patient is not losing weight or is suffering from food noise, and is tolerating the current dose, that dose escalation makes sense.

My fear for people who have a lot of weight to lose, is that they somehow perceive that low and slow is "better" and "less cheating" and forego the full benefits of treatment and then don't reach the weight loss goals they could have if they had taken a more aggressive (if they can tolerate it) dose escalation regime.

I agree with this. This was also my fear. Lose too slow and you hit the 12-16 month plateau too early.

 

[Cypress]

If after a few months you are already 1/2 way to your goal, then you probably didn't have a lot of weight to lose, so I think that it's important to put that into context, especially since others may read this thread who have substantially more weight to lose and are just starting out.

To provide the counterpoint to low and slow, which I believe you are asking about, if people have significant amounts of weight to lose (which doesn't necessarily seem to apply to you), there appears to be a "window of opportunity" after which weight loss on glp-1 medications tends to slow and plateau (12 to 16 months). Switching to another medication or stacking might break that stall, but that's an entire separate conversation.

So, for morbidly obese individuals, low and slow might not be the most effective strategy given the aforementioned window of opportunity. I think that the medical community has revised it's guidance on dose titration since the tirzepatide clinical studies to recongize that if a patient is losing weight consistently and having good hunger suppression that there is no need to titrate up. But, if a patient is not losing weight or is suffering from food noise, and is tolerating the current dose, that dose escalation makes sense.

My fear for people who have a lot of weight to lose, is that they somehow perceive that low and slow is "better" and "less cheating" and forego the full benefits of treatment and then don't reach the weight loss goals they could have if they had taken a more aggressive (if they can tolerate it) dose escalation regime.

That finally makes sense in head I have a total of about 50 pounds to loose total. I'm loosing about 1/2 pound a week now. Everyone talking about greater losses had me wondering and a little jealous wondering if I had the wrong approch. Thanks

 

[Chili777]

That finally makes sense in head I have a total of about 50 pounds to loose total. I'm loosing about 1/2 pound a week now. Everyone talking about greater losses had me wondering and a little jealous wondering if I had the wrong approch. Thanks

It depends on your goals. I followed the trial protocol because my blood panel sucked. I mean really sucked. I work remotely, so I don't have people asking me a bunch of questions. I lost an average of 2 lbs a week for 6 months. Doesn't mean everyone has to follow the trial, because we have the option of losing at a comfortable rate. I'm also a great responder, with little to no sides, and that's a factor. My last blood work done in January was the best of my life, so Reta is like made for me. Everyone is different.

 

[LabRatts]

I started tirz a few months ago, and have titrated up very slowly. I have lost weight and am about half way to goal. Part of the reason I want to lose slowly is so I don't get questions like "what are you on". I'm keeping my medicine to my self. The other reason I wanted slow is loose skin, although I did just start klow. So for the question; every one seems to try to loose as fast as possible what's the advantage? Should I change my protocol? I look at this as a marathon not a sprint since I believe I'll be on this med for life.

Development of HEALTHY habits is worth taking time to do right.
Everyone needs to determine what that means for them individually as no two people are exactly the same.
Just remember that “comfort is a slow death” and live accordingly. 🙏🫡

 

[latviantower]

I titrated up as fast as possible - I was so excited to finally find something that worked. So I lost that 100 pounds in about 9 months. Should I have gone more slowly? Yes. I was on 4 different BP agents, I weaned myself off of those and had to check my BP several times a day. I developed orthostatic hypotension - I’d stand up and go right down if I didn’t hang on to something. My PCP (who was in on my compounded journey) said that she was quite certain if the weight loss had been slower, my body would have adjusted better. All is well now, but there were a couple of scary months!

 

[Labcat]

Great question, I don’t think that has been studied for glps.

Rapid weight loss seems to clinically make faces look gaunter initially, which then seems to settle down, I saw that in a lot of people, in the times before glps. But I’m not aware of actual studies showing an ultimate difference in skin laxity as a result of rapidity of weight loss.

Also before glps, there were some large multi year studies that showed fast weight loss was no less likely to be still retained at the 3 year point, and possibly due to the excitement along with the resulting motivation to stay in a strict calorie limited diet, people with rapid weight loss seemed to lose more weight.

If something is working for you, your only data point is that that method works for you. I think we can all examine ourselves a bit to understand whether we have internal or externally motivated reasons for our actions.

The only thing I think about is that the longer we are at an unheathy weight, the longer that unhealthy weight’s related issues like inflammation are affecting our health in possibly an irreversible way. I don’t see any data that rapid weight loss is unhealthy, unless one gets malnutrition.

The reduction in mortality due to glps (12%) seems to hold across all cause death, and across various and no underlying medical conditions so it’s likely that glps will not only help us keep weight off but will improve our health independent of that. (Comparatively, tirz vs glp1s in type 2 diabetics showed a 42% better mortality rate)

I’m not sure we understand how the body adapts and accomodates to glp1 meds. We know they trigger antibodies, but they don’t seem to generally be neutralizing. We know that the body adapts in some ways at least, which is why paced dosage escalation is recommended. Whether people stop responding and regain weight while on these meds would seem to be a very worthwhile study to have… from studies, we seem to know that it works for 4 years at least.
But overall, I don’t think anyone is going to be able to advise you for sure. And what you’re doing is very health positive, so if having the control over your health is important to you, that’s a good thing also.

 

[lessthanhalf]

I think you are looking at it exactly right , as a very long term / permanent issue. In that case how long it takes to get there does not make a huge difference. The biggest reason for aiming for full doses long term is more severe obesity, where higher doses are probably better at reducing long term health problems, than lower doses. At a total of 50 lbs overweight I am guessing you are probably not in that category. But if you have things like high blood pressure high lipids or high sugars and or are older higher doses are worth considering, but getting there slowly is still not an issue. Losing weight fast has definitely got some extra risks, like gallstones and fainting and fatigue, but can be good to provide motivation as results happen faster.

 

[HereKittyKitty]

Thank you. I just wonder if I'm missing something. Maybe overall my loss will be less, but I think my goal will be reachable.

You're not missing anything. You keep doing what's working for you. 💜

 

[FartfulCodger]

The only thing I think about is that the longer we are at an unheathy weight, the longer that unhealthy weight’s related issues like inflammation are affecting our health in possibly an irreversible way.

My BP has dropped dramatically in the past 5 during over my 50-pound loss. Even without the weight loss, I'm glad that I'm getting to a healthy BP faster.

 

[sheilarae74]

I have stuck with only losing 1-2 lbs a week for the past year and a half. At 52, I am convinced this method has kept my skin from sagging worse than it has been.

 

[Devilseye]

I think that the window of opportunity is a very real thing. You do get used to the drugs and they do become less efficacious. Max out your weight loss while appetite control is high is as calid a strategy as any. Theres also evidence of the setpoint theory that your body will loose weight until it gets to its new “equilibrium”. In either case, the only thing that the take it slow approach can probably give you is more fat mass loss vs lean body mass if you train and eat properly.

Also regarding skin laxity i dont think there is any correlation. If your skin has stretched out beyond your elasticle capacity you will have loose skin. Period. Its genetic to some extent and depends on your fat gain %.

 

[Cypress]

I am working out almost every night, I don't want to be skinny fat. I just started klow to prevent the skin laxity (hopefully). Maybe I'll look like I'm 20 again (and maybe pigs will fly).

 

[Grogu]

I think that the window of opportunity is a very real thing. You do get used to the drugs and they do become less efficacious. Max out your weight loss while appetite control is high is as calid a strategy as any. Theres also evidence of the setpoint theory that your body will loose weight until it gets to its new “equilibrium”. In either case, the only thing that the take it slow approach can probably give you is more fat mass loss vs lean body mass if you train and eat properly.

Also regarding skin laxity i dont think there is any correlation. If your skin has stretched out beyond your elasticle capacity you will have loose skin. Period. Its genetic to some extent and depends on your fat gain %.

I would agree with all of this, the only thing I would add is that we don't know the role of using multiple glp-1s or other treatments after the window of opportunity to encourage more weight loss.

What is clear, at least for tirzepatide, is that weight loss plateaus at about 12-15 months and patients stay at the lower weight as long as treatment is continued and that there is no significant additional weight loss after the 12-15 months.

What we don't know is what happens after the window if the patient switches to reta or adds phentermine, phentermine/topiramate, or naltrexone/bupropion to tirzepatide in combination. Will that carry the patient to "goal". I'm not sure that there is any evidence or current clincial guidlines for what to do when folks don't reach their weightloss goal on their first glp-1.

 

[HereKittyKitty]

I think that the window of opportunity is a very real thing. You do get used to the drugs and they do become less efficacious. Max out your weight loss while appetite control is high is as calid a strategy as any. Theres also evidence of the setpoint theory that your body will loose weight until it gets to its new “equilibrium”. In either case, the only thing that the take it slow approach can probably give you is more fat mass loss vs lean body mass if you train and eat properly.

Also regarding skin laxity i dont think there is any correlation. If your skin has stretched out beyond your elasticle capacity you will have loose skin. Period. Its genetic to some extent and depends on your fat gain %.

And age. Laxity also depends on age.

 

[CariocaLeftSeoul]

And age. Laxity also depends on age.

I think age is a huge factor. My skin was never stretched out beyond capacity since I don't have stretch marks and didn't have lose skin after my pregnancies, even though my total weight at the end of those was considerably more than my total weight before starting GLP-1, and I did lose weight after my pregnancies. But that was also 11 years ago, and now my weight loss wasn't superfast, but my skin is loose and feels thin.

 

[spanky2026]

My fear for people who have a lot of weight to lose, is that they somehow perceive that low and slow is "better" and "less cheating" and forego the full benefits of treatment and then don't reach the weight loss goals they could have if they had taken a more aggressive (if they can tolerate it) dose escalation regime.

This! On a lot of the subs in Reddit and FB and such there is a near cult of Low and Slow, and while that works for some, as you noted the studies showed that if you have a lot to lose, you'll see best results on the higher doses, there's no advantage to hanging low. But my God, there are groups where I could point that out and get my head take off.

 

[Grogu]

This! On a lot of the subs in Reddit and FB and such there is a near cult of Low and Slow, and while that works for some, as you noted the studies showed that if you have a lot to lose, you'll see best results on the higher doses, there's no advantage to hanging low. But my God, there are groups where I could point that out and get my head take off.

And for those of us who partake in TV, we're bombarded daily by Rebel Wilson espousing the benefits and virtues of microdosing. "Micro changes, big results". 😂 She's not fat Amy anymore, she's the microdosing spokeswoman.

I have to be honest, when I first looked into Zepbound and read online, I too thought that low and slow was best. Then I read the clincial trials and a bunch of scientific materials, and yeah no. That's not right for most people.