4 ms·

Do we know what the reason is for the limits of around 10-20%?

hsuduebc2 9mo ago
As you lose weight, your body needs fewer calories to run. That “needed amount” keeps dropping with your size, until it eventually equals what you’re eating on the medication. At that point you’re no longer in a deficit, so weight loss slows or stops.
- doubleunplussed 9mo ago
  That is true but requires some extra assumptions to explain why people don't keep losing weight - because the strongest influence on most people's appetite in the short run is how much of a deficit or surplus they're currently in. Thus as TDEE drops, so does hunger. In "setpoint theory" there's an additional hunger drive based on whether you are below or above a given level of adiposity - your "setpoint". This is often given as an explanation for why people can't keep weight off, and is the sort of thing you'd need to posit to explain why people on GLP-1 inhibitors can't as easily get to lower levels of adiposity.
rootusrootus 9mo ago
I don't know that there's a consensus on what the limit really is. Semaglutide is good for about 15%, tirzepatide about 20%, and retatrutide about 25%. Some people don't get that much, some people get a lot more. Personally, tirzepatide got me just over 35%. I never got anywhere near max dose, either, I am what is colloquially referred to as a super responder.
- vladgur 9mo ago
  Sorry for personal questions please answer any OR none as you feel comfortable 1) How is your energy/stamina following the 35% loss 2) Have you done any dexascans/bodyspecs to measure your lean mass percentage before and after your loss 3) Did you take any steps to reduce the muscle loss? 4) with 35% loss, what BMI are you at?
  - jaggederest 9mo ago
    Not the original guy, but down 32%, for a point of comparison: 1) Amazing, like being a decade and a half younger 2) Not before, planning one in the next couple months, but I use skinfold and impedance and they say I've dropped from about 48% to ~20% as I've dropped from 272 to 186, lean mass seems maybe 5kg lower than I started with? Less lean mass loss than I expected. 3) Weight bearing exercise and medium-high protein intake (>80g/d) 4) Per above, starting BMI 37.9 -> ending BMI 25.9
    - vladgur 9mo ago
      these are amazing numbers -- how long did this loss take?
      - jaggederest 9mo ago
        Just over 2 years from end to end, the majority towards the end when I finally got onto the right GLP-1 medication.
      - rootusrootus 9mo ago
        To add my own anecdata, it took me a bit over a year (September 2024 to December 2025) to lose the weight. I averaged about 1.5 pounds a week consistently.
    - rootusrootus 9mo ago
      Your stats are very similar. I started at something like 274 (though my overall highest point ever was 284 a couple years ago) and now I'm down to 181. It's a huge difference, as you say it's like being 15-20 years younger. Life changing.
  - wincy 9mo ago
    I also lost 35% body mass, from 318-208 today. It took from September 2024 to beginning of January 2026. 1) amazing, I can actually do things now. I didn’t realize how much I was resting and just not doing anything around the house. I managed to do my work with stimulants but that’s about it. 2) I did a scan and am currently around 110% for with 100% being the baseline for the average male my age, for my muscle mass. I did lose more muscle mass in the 230-210 loss than most of the previous, but I think that’s because I couldn’t ride my bike everywhere as it’s winter time. I had to chug protein shakes while losing weight and do physical therapy for a few body parts, especially my hip and my shoulders as they were easy to hurt. Going to the gym regularly solved this long term. 3) I guess I answered question 2 4) I’m now 27.1 BMI, although my percent body fat is only 18.9%, so I’m not concerned about the number since I have access to a body scanner and can see I’m fine. My visceral fat levels have dropped below concerning levels, which is great. I also sleep way better, and the heartburn I thought was just a part of life went from “literally every day” to “once or twice a year, and only if I do something I shouldn’t have”. I was also way more aggressive about just going to the dose and hit 15mg in April of 2025, and have stayed there. I might go for another 10 pounds mostly out of vanity.
- jaggederest 9mo ago
  Super responders unite, I'm down 32% and shooting for 36% before I hit maintenance. I only made it about half way up the dosage chart before I had to back off due to losing too rapidly (!!). I took a 3 month maintenance and am back to losing again, it's been life changing. The other wild thing is general health improvement - all of my bloodwork has gone from questionable to better than standard - closer to ideal values than I would ever expect. Liver values, cholesterol, lipids, blood pressure, everything. I expected them to improve but not to the degree that they have, my LDL has gone down by 60%. Actuarial tables say it's given me another ~10 years of probable lifespan, and even more if you think in healthspan.
  - rootusrootus 9mo ago
    Congratulations! It feels great, doesn't it? I was not quite pre-diabetic, but trending in that direction. Blood pressure elevated (but not quite 'high'), cholesterol and stuff in the sketchy zone. But now ... everything is really good! A1C was 4.9 at my most recent test. Cholesterol great, blood pressure ~115/70 every day now, etc. I went from what felt like a slow but steady decline through middle age and now I feel 20 years younger, the future looks not like decrepitude but way more active and exciting.

As you lose weight, your body needs fewer calories to run. That “needed amount” keeps dropping with your size, until it eventually equals what you’re eating on the medication. At that point you’re no longer in a deficit, so weight loss slows or stops.

doubleunplussed 9mo ago
That is true but requires some extra assumptions to explain why people don't keep losing weight - because the strongest influence on most people's appetite in the short run is how much of a deficit or surplus they're currently in. Thus as TDEE drops, so does hunger. In "setpoint theory" there's an additional hunger drive based on whether you are below or above a given level of adiposity - your "setpoint". This is often given as an explanation for why people can't keep weight off, and is the sort of thing you'd need to posit to explain why people on GLP-1 inhibitors can't as easily get to lower levels of adiposity.

rootusrootus 9mo ago

I don't know that there's a consensus on what the limit really is. Semaglutide is good for about 15%, tirzepatide about 20%, and retatrutide about 25%. Some people don't get that much, some people get a lot more. Personally, tirzepatide got me just over 35%. I never got anywhere near max dose, either, I am what is colloquially referred to as a super responder.

vladgur 9mo ago
Sorry for personal questions please answer any OR none as you feel comfortable 1) How is your energy/stamina following the 35% loss 2) Have you done any dexascans/bodyspecs to measure your lean mass percentage before and after your loss 3) Did you take any steps to reduce the muscle loss? 4) with 35% loss, what BMI are you at?
- jaggederest 9mo ago
  Not the original guy, but down 32%, for a point of comparison: 1) Amazing, like being a decade and a half younger 2) Not before, planning one in the next couple months, but I use skinfold and impedance and they say I've dropped from about 48% to ~20% as I've dropped from 272 to 186, lean mass seems maybe 5kg lower than I started with? Less lean mass loss than I expected. 3) Weight bearing exercise and medium-high protein intake (>80g/d) 4) Per above, starting BMI 37.9 -> ending BMI 25.9
  - vladgur 9mo ago
    these are amazing numbers -- how long did this loss take?
    - jaggederest 9mo ago
      Just over 2 years from end to end, the majority towards the end when I finally got onto the right GLP-1 medication.
    - rootusrootus 9mo ago
      To add my own anecdata, it took me a bit over a year (September 2024 to December 2025) to lose the weight. I averaged about 1.5 pounds a week consistently.
  - rootusrootus 9mo ago
    Your stats are very similar. I started at something like 274 (though my overall highest point ever was 284 a couple years ago) and now I'm down to 181. It's a huge difference, as you say it's like being 15-20 years younger. Life changing.
- wincy 9mo ago
  I also lost 35% body mass, from 318-208 today. It took from September 2024 to beginning of January 2026. 1) amazing, I can actually do things now. I didn’t realize how much I was resting and just not doing anything around the house. I managed to do my work with stimulants but that’s about it. 2) I did a scan and am currently around 110% for with 100% being the baseline for the average male my age, for my muscle mass. I did lose more muscle mass in the 230-210 loss than most of the previous, but I think that’s because I couldn’t ride my bike everywhere as it’s winter time. I had to chug protein shakes while losing weight and do physical therapy for a few body parts, especially my hip and my shoulders as they were easy to hurt. Going to the gym regularly solved this long term. 3) I guess I answered question 2 4) I’m now 27.1 BMI, although my percent body fat is only 18.9%, so I’m not concerned about the number since I have access to a body scanner and can see I’m fine. My visceral fat levels have dropped below concerning levels, which is great. I also sleep way better, and the heartburn I thought was just a part of life went from “literally every day” to “once or twice a year, and only if I do something I shouldn’t have”. I was also way more aggressive about just going to the dose and hit 15mg in April of 2025, and have stayed there. I might go for another 10 pounds mostly out of vanity.
jaggederest 9mo ago
Super responders unite, I'm down 32% and shooting for 36% before I hit maintenance. I only made it about half way up the dosage chart before I had to back off due to losing too rapidly (!!). I took a 3 month maintenance and am back to losing again, it's been life changing. The other wild thing is general health improvement - all of my bloodwork has gone from questionable to better than standard - closer to ideal values than I would ever expect. Liver values, cholesterol, lipids, blood pressure, everything. I expected them to improve but not to the degree that they have, my LDL has gone down by 60%. Actuarial tables say it's given me another ~10 years of probable lifespan, and even more if you think in healthspan.
- rootusrootus 9mo ago
  Congratulations! It feels great, doesn't it? I was not quite pre-diabetic, but trending in that direction. Blood pressure elevated (but not quite 'high'), cholesterol and stuff in the sketchy zone. But now ... everything is really good! A1C was 4.9 at my most recent test. Cholesterol great, blood pressure ~115/70 every day now, etc. I went from what felt like a slow but steady decline through middle age and now I feel 20 years younger, the future looks not like decrepitude but way more active and exciting.