Hello from Armenia (Fat Loss, Anxiety)

[tripleg]

Hello all,

I am from Armenia. My interest in GLP-1 meds is fitness/aesthetic related as well as mental health (anxiety) related.

I already do resistance training along with aerobic training and dance. I also have my diet pretty on point. I've been hovering around 1800-1900 kcal per day (I track calories). This amounts to about a 400 kcal deficit per day. Overall my exercise and nutrition habits are pretty solid.

I am currently at ~18% BF and my goals is to get to 15% and ideally 12-13%. To get to this point I already went from 95 kg (209 lbs) to 74 kg (163 lbs) over the course of 2 years (with dieting breaks).

Naturally, the leaner I get the harder it gets. While I am able to maintain a caloric deficit and I think I can get this going for a couple more months until I need another diet break, it is definitely affecting my productivity and quality of life due to feeling hungry for much of the day. So GLP-1s to the rescue.

The second reason is that I have had anxiety my whole life. I've made a lot of progress on this front with exposure therapy and meditation, but here too progress is slow (though steady) and very effortful. And here too I think it's worth experimenting with GLP-1s.

I've read quite a bit about GLP-1s and overall I'm pretty educated about their therapeutic effects and side effects. Here is where I learned about potential positive effects on anxiety/depression/addiction:

The Growing Scientific Case for Using Ozempic and other GLP-1s to Treat Opioid, Alcohol, and Nicotine Addiction

GLP-1s are showing dramatic results in reducing addictive drive while providing holistic mental health benefits to patients.

recursiveadaptation.com

To date, I haven't actually taken any GLP-1s, but looking to change that in the near future 🙂 I haven’t decided yet between semaglutide, tirzepatide, retatrutide as a starting experiment.

Regardless, I value my health and the health of everyone else too. So I am happy to be joining a place that also values safety and Harm Reduction.

 

[Iamnew2this]

Welcome! In my opinion, if you're just starting of with GLP-1s, I would start with either tirz or sema. That's just my opinion. I wish you the best of luck!

 

[GLP1Pharmacist]

Good luck, seemed to have prepared well. If thinking about food/food noise is this biggest issue. IMHO I would suggest starting with Sema, with the high GLP1 receptor binding it seems to be a good match.

 

[tripleg]

I'm kinda leaning toward Retatrutide at the moment, I imagine 2mg or 4mg would be enough for me.

Tirzepatide has is a GLP-1 receptor agonist simialr to Sema, but also adds gastric inhibitory polypeptide (GIP), which not only leads to me weight loss, but also has a stronger effect on anxiety:

"Epic Research published a remarkable patient health data analysis based on their Cosmos system which contains “233 million patient records from 1,325 hospitals and more than 28,900 clinics''. They found dramatically lower depression and anxiety scores for patients treated with GLP-1s. Crucially, the level of improvement was highest for the newest GLP-1 drugs, with tirzepatide performing best of all, consistent with Mounjaro and Zepbound patient reports."

The Growing Scientific Case for Using Ozempic and other GLP-1s to Treat Opioid, Alcohol, and Nicotine Addiction

GLP-1s are showing dramatic results in reducing addictive drive while providing holistic mental health benefits to patients.

recursiveadaptation.com

But Tirzepatide is not as well tolerated as Sema. Enter Retatrutide, which contains a GLP-1 receptor agonist like Sema, GIP like Tirzepatide, and it also adds in glucagon.

As best I can tell Retatrutide is even more effective for weight loss than Tirzepatide. It also seems to be better at sparing lean tissue (higher proportion of the weight lost is fat). In addition it seems to be better tolerated than Tirzepatide, at least anecdotally (but not sure about that).

The effects on anxiety have not been studies as far as I know, but one would expect performance similar to Tirzepatide or better? Since I don't have much weight to lose, a dose of 2mg or 4mg should do the trick, I think. At this dose it's not much more expensive than Sema.

I guess it's a downside that it's not yet FDA approved and hasn't been studies as much as Sema and Tirz.

So at the moment I'm leaning toward Retatrutide. But maybe it's just the perfectionist in me wanting the best. 🙂

 

[Calm Logic]

But Tirzepatide is not as well tolerated as Sema

Not true, generally speaking. And sema seems more likely to cause nausea, sometimes leading to discontinuation.

 

[tripleg]

Not true, generally speaking. And sema seems more likely to cause nausea, sometimes leading to discontinuation.

That's interesting. So Triz is generally as well or better tolerated as Sema? Any good references. I haven't had the chance to read as in depth as I'd like.

 

[Calm Logic]

It may be mostly anecdotal evidence about the nausea:

Head-to-Head Trial Compares Weight Loss Drugs

Tirzepatide (trade name Zepbound) promoted greater weight loss in individuals with obesity than did semaglutide (trade name Wegovy) in a clinical trial led by an investigator at Weill Cornell Medicine and NewYork-Presbyterian that compared the safety and efficacy of the injectable drugs.

news.weill.cornell.edu

The side effects associated with both drugs were very similar. For example, about 44% of individuals in each treatment arm experienced nausea and 25% reported abdominal pain.

While both semaglutide and tirzepatide are associated with similar common gastrointestinal side effects, some clinical data and anecdotal reports suggest that tirzepatide may be slightly better tolerated at higher doses for some individuals.

 

[zpped]

That's interesting. So Triz is generally as well or better tolerated as Sema? Any good references. I haven't had the chance to read as in depth as I'd like.

I would say each newer generation is better for lower side effects. But personal variation can override that for any given person.

 

[tripleg]

The other thing I'm wondering about is that I probably would only want to lose additional 5-7% of total body weight MAX. So that probably means I won't need to the full dose of whichever option I go with.

I won't know until I try, but possibly:
Sema 1 mg
Triz 2.5 mg or 5 mg
Reta 2 mg or 4 mg

And I'd want the dose to also produce anxiety benefit. Theoretically, the dose required for anxiety benefit might be produce too much appetite suppression, but I guess I won't know until I try.

 

[Calm Logic]

For not feeling hungry much of the day, I assume 5 mg of tirz would be the absolute minimum I would need without having a lot of difficulty (since I have gone back down to 5 mg briefly to get a break from side effects). I am on 10 mg now, but I have 40+ pounds to lose still.

I haven't tried sema or reta yet, but I am starting reta in a few weeks. For reta, some people say 4-6 mg is when the appetite suppression is good (or starts to be), but some people do well on less.

Going back to sides, one reason people switch from tirz to reta is so-called tirz fatigue.

 

[zpped]

The other thing I'm wondering about is that I probably would only want to lose additional 5-7% of total body weight MAX. So that probably means I won't need to the full dose of whichever option I go with.

I won't know until I try, but possibly:
Sema 1 mg
Triz 2.5 mg or 5 mg
Reta 2 mg or 4 mg

And I'd want the dose to also produce anxiety benefit. Theoretically, the dose required for anxiety benefit might be produce too much appetite suppression, but I guess I won't know until I try.

The full dose is whatever dose that works for you at the time. it could be 0.5mg or 10mg. The only way to know is start very low and titrate slowly until you get the response you're looking for.