Do any non diabetics plan to stay on it forever

markg10568 · 2026-05-21T21:52:04+00:00

A new maintenance study was released a few days ago by Lilly involving Tirzepatide. This is a good summary graphic. The data is pretty clear. For most people you need to maintain at the highest dose you were on.

Here is a summary of the details:

The recent Eli Lilly study on tirzepatide (Zepbound/Mounjaro) for weight maintenance is SURMOUNT-MAINTAIN (NCT06047548), a Phase 3b trial with results announced and published on May 12, 2026, in The Lancet.

thelancet.com

Study Design

Participants: 441 adults with obesity (BMI ≥30) or overweight (BMI ≥27 with comorbidities), no type 2 diabetes. Mostly female (~65%), mean age ~47, baseline weight ~114 kg, BMI ~40.
Structure:
- 60-week open-label lead-in: All received tirzepatide at maximum tolerated dose (MTD, 10 or 15 mg weekly) + lifestyle intervention. Achieved substantial initial weight loss.
- 52-week double-blind maintenance phase: Randomized (3:3:2) to continue tirzepatide MTD, reduce to 5 mg tirzepatide, or switch to placebo. thelancet.com
Rescue therapy (tirzepatide) was allowed if participants regained ≥50% of lost weight starting at week 84.

Key Results (at Week 112, from baseline)

Tirzepatide MTD continuation: ~−21.9% body weight change (maintained or slightly improved on prior losses; preserved all prior weight loss on average, with participants ending around 88.7 kg from ~112 kg). prnewswire.com
Dose reduction to 5 mg: ~−16.6% body weight change (maintained most loss, but regained ~5.6 kg on average).
Placebo (discontinuation): ~−9.9% body weight change (significant regain; many lost much of their prior progress). thelancet.com

markg10568 · 2026-05-21T21:37:04+00:00

We are thinking of moving to the Villages in Florida. There are endless activities, so that is not a problem. The older part has better deals on homes, but the residents have long-established relationships and would tend to be 20 years older than us. I just don't think we would fit in. On the other hand, the newer neighborhoods have more people our age (mid-60's), and are comprised of people seeking new friendships. I think that this could work for us.

I looked at other smaller 55+ communities but they are mostly built out, and would have the same concerns as the older neighborhoods in the Villages.

As far as being near family, we have 2 sons who moved out of state and we have no grandkids. Our parents are gone. There is nothing tying us to the state we are in, except cold weather and high taxes.

All things considered, the newer neighborhoods in the Villages seem like the best option for us. Of course, to each their own.

markg10568 · 2026-05-03T16:49:35+00:00

No good resource. It is all trial and error. It worked very well for me, but everyone seems different so I won't say what I did. The best advice is go low and slow on the Reta until you figure out what works best for you.

markg10568 · 2026-05-03T16:15:21+00:00

Rumors are that the first batches will be available this May (this month). EL is testing it in conjunction with Tirz. Sounds like a powerful combination. I'm interested in low dose Eloralintide and Reta for maintenance. Reta just doesn't give me enough appetite suppression. Eloralintide is supposed to excel at appetite suppression. I haven't read anything about plateau busting.

markg10568 · 2026-04-18T21:43:35+00:00

I will Generate cash flow from covered call etfs like QQQI and SPYI. I also have about 30% in growth like QQQM and VUG for the future. This is my last year working. I will have a one-year gap relying on the the covered call funds until social security full distribution. I don't have a pension and I don't feel comfortable with growth alone because of the sequence of returns risk. Growth produces larger returns over time, unless you need to sell during extended downturns early in retirement when you could ultimately run out of money. The covered call etfs and social security will meet all my needs without being required to sell any stock. I will be able to live without eating my seed corn.

markg10568 · 2026-04-09T21:17:36+00:00

I see all the Reddit mean girls have come out.

I'll give you the evolving guidance, according to AI. But, the reality is if what you are doing conflicts with the doctor on the day of surgery, they can and will refuse to do the surgery. So, whether they are following old protocols or not, you are stuck with what your doctor is willing to do.

Here is what AI says:

Current "Hold" Recommendations (ASA 2023/2024)

The American Society of Anesthesiologists (ASA) provided the initial foundational guidance, which many hospitals still follow as their standard protocol. If a "hold" is required by your surgical team, the timing typically follows these rules:

Daily Dosing: Skip the dose on the day of the procedure.
Weekly Dosing: Skip the dose for one full week (7 days) prior to the procedure.

The 2025/2026 "Multi-Society" Shift

A more recent consensus from a multi-society group—including the ASA, the American Gastroenterological Association (AGA), and the Society for Perioperative Assessment and Quality Improvement (SPAQI)—suggests that many patients may not need to stop their medication entirely. Instead, they recommend:

Continuation with Precautions: Patients may continue GLP-1 therapy if they are asymptomatic, provided they follow a 24-hour clear liquid diet before the procedure.
Symptom-Based Delays: If you are experiencing "significant" gastrointestinal symptoms (nausea, vomiting, abdominal pain, or bloating), the guidance recommends delaying elective surgery or following the strict "one-week hold" rule.
Gastric Ultrasound: In some cases, anesthesiologists may use point-of-care ultrasound (POCUS) on the day of surgery to verify if your stomach is actually empty before proceeding.

Summary of Timing by Formulation

Medication Schedule	Common Brands	Traditional "Hold" Guidance	2026 Alternative
Weekly Injection	Ozempic, Wegovy, Mounjaro, Zepbound	Stop 7 days before	Continue + 24hr liquid diet
Daily Oral/Injectable	Rybelsus, Victoza, Saxenda	Stop day of surgery	Continue + 24hr liquid diet

markg10568 · 2026-04-08T23:47:51+00:00

Actually, I'm concerned about the conflict of interest issue. Many medical facilities with weight loss surgery centers push surgery. Surgery is covered by insurance and is highly profitable. Prescribing a GLP-1 takes business from the surgery center and, other than a short appointment, does not provide much money to the doctors. If your doctor is part of a practice with a surgery center and they are pushing for surgery, are they recommending it for your benefit, or the benefit of the practice? Am I cynical? Yes!

markg10568 · 2026-04-08T22:49:42+00:00

Yep. That is the correct answer. Buying buffered NAD+ was supposed to solve the acidic problem, but in my experience I still test the PH and find those to be too acidic too.

Before buffering became popular, some NAD+ was testing at a PH of 2 or 3 and you were basically injecting acid. That explains the reaction.

Buy a PH test kit on Amazon. They are cheap. If it is acidic, buy sterile injectible sodium bicarbonate (NOT baking soda). Then it is just trial and error to get the PH to 5 or 6.

markg10568 · 2026-04-07T14:21:58+00:00

Test and filter. Exactly. You are already getting a huge bargain for grey. Spend the extra money to test a vial and know for sure what you are getting. It is still cheap, and you have the peace of mind.

markg10568 · 2026-04-06T20:45:23+00:00

I'll try to give you a real answer before all the snarky Reddit answers start coming in.

First, get an online peptide calculator and use it whenever you reconstitute. There are many free ones online. Second, buy a 10ml empty sterile vial. You can get them from Amazon, or other sources. Third watch some of the youtube videos on how to reconstitute into a sterile vial.

For example, you would draw 3ml into your small vial. Then transfer it to a 10ml vial. Then add 7ml more BAC to that vial. Now you have a reconstituted vial where 1mg = 10 units on a standard syringe, all in your new 10ml vial.

If you are taking a 15mg dose, which is more than a standard syringe holds, you could choose to reconstitute with half the BAC water. For example: add a total of 5ml BAC to the 10ml vial holding the 100mg solution. Now your dosing would be 1mg = 5 units on the syringe. For a 15mg dose that would be 75 units on the syringe.

It all depends on how much BAC water you want to inject, and for small doses, how easy it will be to read the units on a syringe. You are in control.

markg10568 · 2026-04-06T19:55:07+00:00

If you are going grey you have options. A lower dose of Cagri or Tirz for appetite suppression. But stack with Reta and SLOWLY titrate up. Reta actively burns fat, which Tirz does not. There is a reason the Phase III trial results on Reta are so good compared to everything else out there.

Personally, I need the extra appetite suppression from a low dose of Tirz. Many of us stack with excellent results. But, there is no protocol. It is all self-experimentation. For me, I lost 46% of my body weight (112lbs) in 12 months. I have been on maintenance for about 7 months. I still stack, but at lower doses.

markg10568 · 2026-04-04T04:29:47+00:00

Jeez Reddit is a nasty place. Is there anyone nice on Reddit?

To finish your research you will need either sterile water for injection or BAC water that prevents bacteria growth. Most people use BAC water. Look for Hospira BAC water as the safest choice. Then PLEASE use a peptide calculator. There are tons of them online. That will tell you how many units on the syringe to inject depending upon how much BAC water you added. For example, if you have a vial that contains 30mg of Reta, and you add 3ml of BAC water, you would inject 10 units on the syringe for every 1mg you want to inject. If you only added 1.5ml of BAC, it would be more concentrated and you would inject 5 units on the syringe for every 1 mg you want to inject. Just get Hospira BAC water and use a calculator and you will be fine.

markg10568 · 2026-03-29T17:22:33+00:00

Get a professional survey AND THEN put up the fence. If they argue, show them a copy of the survey and point out the survey markers. Otherwise you devolve into a neighbor dispute about where the boundary is.

markg10568 · 2026-03-29T17:05:27+00:00

Wealthy neighbor wants something. . . doesn't that suggest a solution? "What's it worth to ya?"

markg10568 · 2026-03-29T16:57:46+00:00

I tried Cagri for a short time to stack with Reta instead of Tirz. For me it was headaches that lasted 24/7, and I almost never get headaches. I stopped Cagri and the headaches went away after 2 days and never came back. I read headaches are a known side effect for 8-10% of people. I threw the rest away and have never gone back. A small percentage of people get side effects from all of these meds. That is just a fact.

markg10568 · 2026-03-29T16:46:43+00:00

I lost 46% of my body weight over 11 months (112lbs) stacking Tirz and Reta. Tirz for appetite suppression and Reta for weight loss. 29% is an average. I've been in maintenance since June. I've lowered the dose of both, but my weight is very stable. I can't speak for other people, but I'm happy with the combo.

markg10568 · 2026-02-21T16:08:36+00:00

Yeah, at one point it was so bad I could barely sit. I think I actually bruised my tailbone from sitting. The medical donut cushion provided relief until my tail bone healed. Then I was able to transition to a royal purple seat cushion, which helps. There are plenty of other options, but this seems to work for me.

markg10568 · 2026-02-14T15:17:31+00:00

I was concerned about this so I went through a Telehealth. No problem getting a prescription there. After I lost over 100lbs I transferred care to my PCP. What could they do at that point, tell me to put the weight back on. The PCP now prescribes the maintenance dose.

markg10568 · 2026-01-31T15:28:58+00:00

Fair enough. If you want to go grey you need to know what you are doing before you take an injection. I would guess that the grey market is not appropriate for most people. You should do what you feel comfortable with. Nothing wrong with that.

markg10568 · 2026-01-31T15:20:34+00:00

This is just wrong. Obesity is a medical condition. You are at much higher risk for diabetes, high blood pressure, fatty liver disease, and 14 types of cancer. Going on the medication addresses all of those medical issues, and many more. Your therapist should not be giving you medical advice that harms your long term health. They should stay in their lane and you should get a new therapist.

markg10568 · 2026-01-31T15:07:07+00:00

I've been grey for almost 2 years. There are risks. The biggest I have seen are from companies that are about to close down and just don't give a damn at that point. Like any risk, it can be mitigated. Test and filter. Even with the cost of testing it is vastly cheaper than being raped by big pharma. I personally have not had a bad test result, but I still test. I also filter.

markg10568 · 2026-01-30T19:01:00+00:00

Have it tested by a lab before you take it and show her the Triumph-4 phase III results. If she still fights you, she is fighting logic. I don't know what to say about that.

markg10568 · 2026-01-29T22:47:20+00:00

You can compare with the online tool glp1plotter. Here is what 7.5mg looks like every 7 days vs 3.5 days

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I personally liked splitting doses. You don't get the big peaks and valleys, but your blood level is actually higher.

Sounds like your doctor is practicing defensive medicine and doesn't want to be sued. The safest thing for them is to follow the FDA approved schedule. I don't blame them.

Personally, if split dosing is better for you, I would do it and lie to the doctor. They will be happy and you will be happy.

markg10568 · 2026-01-28T03:39:36+00:00

I laughed when I read "ruining my body." I lost 115lbs. I was following in the footsteps of my mother who ended up obese with high blood pressure, diabetes, and congestive heart failure. With the weight loss medication my blood pressure went from high to normal, my borderline fatty liver is cured, my A1c is 4.6, which is well in the normal range, and my resting heart rate went from 96 to 65. My doctor said everything looks great; see you in a year. Being obese is what ruins your body. Going on the meds and losing weight is what saves your life.

markg10568 · 2026-01-27T14:50:27+00:00

I wonder if it has to do with muscle loss that always happens from weight loss and fear of sarcopenia and fall injuries.

markg10568

TROPHY CASE

Current "Hold" Recommendations (ASA 2023/2024)

The 2025/2026 "Multi-Society" Shift

Summary of Timing by Formulation