FlexNP

Sensing a pattern here, another retatrutide trial patient.

127lbs lost. 38% body weight reduction.

Cholesterol down 32%

Went from 3 HTN meds to none.

A1c from 6.4% to 5.3%

Bariatric surgery in a shot y'all.

I need more caffeine to even begin to make sense of this.

Yeah I've seen it put ulcerative colitis in remission. Just seeing if other providers had similar experiences as me.

Another day, another trial patient with a 36% loss on retatrutide over the last 16 months with a 41% drop in LDL cholesterol and a 15% increase in GFR.

Ho hum.

One thing I will note is that because GLP-1RA modules the immune system so much in terms of tamping down inflammation and switching macrophages over to M2 mode, it could hypothetically help reduce rejection. I'm just spitballing but the MOA is plausible. Just need data.

Fun hypothetical question for y'all: if you had a patient would irritable bowel syndrome w/diarrhea and they were obese, would you consider starting them on a GLP 1 med to help symptoms and manage weight?

It is! He's got a long way to go, but this is an encouraging start. It was this or consider bariatric surgery. His starting BMI was 43.5 and everything metabolic was starting to go sideways as you can imagine.

Shock GIF ALT: Shock GIF

My cousin has been in the Triumph-6 trial for retatrutide for 42 days and has already lost 21 pounds 🤯🥵

He's eating 1800 cals a day and still only on the second lowest dose(4mg)

My reaction when he texted me earlier:

Or you could....hear me out...end tariffs and raise taxes on the richest 1%?

Freshly picked garden tomatoes, grilled hot dogs and Mac n cheese for dinner tonight. Screams summer to my brain and taste buds!

Retatrutide. Triple agonist, GLP1 GIP and Glucagon agonist. It'll be bariatric surgery in a once a week shot. Probably FDA approved in late 2026

Truly the equivalent of waiting to the last minute when the patient is bradycardic, unconscious with a BP of 70/40 and then deciding maybe we should start an IV?

Ugh. I just keep thinking about the nearly 1000 unmatched spots for family medicine and peds combined 😞

As a prescriber, my goals when this is FDA approved are to get people to lose the weight, whatever that max dose looks like and then back them down to a maintenance dose where they're not losing and not gaining to try and avoid this issue (this is the trial design Lilly is doing for Triumph-6 trial)

I know I am. Its biggest fan here, but it genuinely scares me a little bit because it's so powerful, and because if someone was on a high dose and not eating enough protein it could lead to a problem.

Anecdotally, when I finished the trial I managed to put on about 8 lb of muscle in 2 months just by switching to Tirz. So I think the 12 mg dose I was on was definitely suppressing muscle gain despite me lifting and eating 150g of protein daily.

Biggest challenge is that glucagon is catabolic to amino acids. The bodybuilders aren't hitting doses high enough and they eat so much protein to counteract it. But Phase 2 data shows its somewhat dose-dependent and amino acid dependent. Could hurt muscle gain w/o enough protein

Here's my final stats from back in May when I finished up.

I was in one of the trials for it. I finished a few months back.

I went from 34.7 to 23.2 in ~9 months. Actually made it to normal BMI in 6 months then trickled down from there. Still 24.6 BMI now just w/ added muscle.

Reta will get pretty much almost anyone back to a normal BMI with a high enough dose...

That was me during my clinical trial for sure 🤣

Yup yup.

Probably. 4mg dose looks like it'll match tirzepatide 15mg for weight loss. That's only one dose escalation from the starter dose. So yeah way fewer sides if most folks only need lower doses

The 12mg dose(max trial dose) on the other hand is like Thanos with all infinity stones level powerful.

Everyone loses on Reta. Everyone.

If he's a strong responder on Tirz he'd probably be at 60lbs lost if it was reta.

Haven't found one person in any of the trials who hasn't lost at least 15%

Reminds of my neighbors down the block, have a giant front patio that they literally never use. You know that man will absolutely never use this and if they do it'll be for some dumb stunt

And it's why drugs with glucagon agonism fascinate me so much. Glucagon is part of that starvation chain, producing energy from other substrates(proteins, fats) and now we're harnessing it to help with weight loss. Scientific advancements are awesome

Yeah consider that our body's don't want to lose weight simply because that's banging on the figurative "you're starving" signal.

Given the excess of food available it's no wonder obesity is problematic. Some of it is literally just our body's way of protecting itself

That's fantastic news! Fingers crossed

A lot of that's gonna be happening when retatrutide hits the market...

Side bar it's why I'm excited to see the data on orforglipron for weight loss. Popping a pill once a day to maintain weight loss would be a real easy sell for a big chunk of folks I think

Yeah the regain rate is unfortunately high. Best approach if using for weight is to figure out a maintenance dose. Usually a lower dose every 10ish days keeps the weight stable and minimizes side effects for most patients in my experience(personal and professional)

Also, I'd love to see how your cholesterol, triglycerides and other lab values have changed given the amount of weight you lost so far