Weight Loss, by Nevin Pratt

Disclaimer: Everything here is my opinion only. I am not a medical doctor, and this is not medical advise.  Please consult with your doctor.

Please read the Overview page before reading this page.  It sets the context for everything else.

Tracking:

People are generally too fat, and that stresses their hips and knees.  Lose weight to save your joints, and your quality of life.  Either that or be miserable as you age.  Your choice.

The most important thing you can do for weight loss is to track all of your food.  I recommend and use the phone app "Lose It!".  It is comprehensive, fast, and in my opinion the best tracker on the market.  If you track it, and limit your calories to what the app suggests (based on the goals you tell it), you will naturally adjust your diet to be more healthy because you will find it impossible to stay within your calorie budget otherwise. 

I recently met with Dr. Jeffrey Gross who looked over my latest blood tests, turned to me and said, "you don't each much sugar, do you".  I replied, "no", whereupon he responded "I can tell from your blood tests."

I am not off sugar, but I found it impossible to meet my targets, as tracked by "Lose It!", without more careful and healthier selection of foods.  And once you begin making those adjustments, it will become easy.  But you must start with tracking.

GLP Peptides:

There is a weight loss class of peptides generally referred to as GLP peptides.  Those peptides stimulate the stomach and gut into releasing certain hormones that your brain reads and causes the food noise in your brain to turn off.  You eat less. 

There are a number of downsides of GLP peptides, depending on the peptide, but one downside in common them is about 35-40% of the weight you lose is typically lean body mass.  There are things you can do to mitigate the lean body loss, but losing lean body is a common attribute of GLP peptides.

To minimize muscle loss while using GLP peptide(s), resistance training is not an option.  It is mandatory.  Otherwise you will lose a lot of muscle!

Another mandatory item is sufficient protein intake.  You should target 1 gram of protein per pound of your target weight.  This is hard to do when you are on a calorie restrictive diet, and you will not be successful without tracking (I recommend the "Lose It!" tracker app) .

Semaglutide:

This is the most common GLP peptide.  It is known under the brand names Ozempic and Wegovy, but is also commonly sold as just semaglutide.  It stimulates just one stomache hormone, GLP-1, and is therefore known as a single-agonist peptide.

Tirzepatide:

Tirzepatide is a dual-agonist peptide, stimulating both GLP-1 as well as GIP stomach hormones.  It is sold under the brand name Mounjaro.  It has fewer reported side-effects, and greater weight loss, than semaglutide.  Some trials have shown an average weight reduction of 20.2% in the tirzepatide group compared to 13.7% in a semaglutide group. 

Retatrutide:

Retatrutide is a triple agonist peptide, stimulating GLP-1, GIP, and also glucagon.  It is currently in phase 3 "Lilly" trials for weight loss.  In a 48-week trial, it resulted in an average weight loss of 24.2%.  There are rumors that Cagrilintide (also in trials) will beat it to the commercial market.

Cagrilintide:

Cagrilintide works with a different mechanism that the other GLP peptides.  It acts as an amylin analogue, mimicking the effects of the natural hormone amylin. Novo Nordisk is in clinical trials with cagrilintide.  So far, it is showing significantly higher weight loss in all treatment groups as compared to a single-agonist peptide (liraglutide, which is like Ozempic), but stacking them together is even better than either alone.

AOD-9604:

Instead of supressing appetite, this peptide works as a weight loss by boosting metabolism.  It isn't as effective at weight loss as the before-named peptides, but it has the added benefit of aiding in the prevention and possible treatment of osteoporosis, through direct action on osteoblasts, the cells which build new bone.   Also, many clinics combine it with hyaluronic acid injections, because studies show AOD-9604 aids in cartilage regeneration.

GHRP Peptides:

There is another class of peptides, known as GHRP peptides (Grown Hormone Releasing Peptide) designed to increase growth hormone.  This can also aid in weight management by helping you to "recomp" your body with less fat and more muscle.  This peptide class uses a different mechanism than the GLP peptides, but isn't as effective if your goal is weight loss rather than muscle gain.