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I had similar issues on Semaglutide, but I've found Tirzepatide much more tolerable. I've lost 165lbs, A1C has gone down to 5, I have more energy at 52 than I did at 32, and I am exercising like a maniac now. Maybe you could try it?
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I have a very similar situation: on it for about a year, 220lbs to 180 at age ~40. Also very active: weight lifting / biking / swimming and - the sport that made me realize I needed to loose weight - rock climbing. I've always been very outdoorsy-adventurous, and climbing/mountaineering is the natural sort of "end game" for this lifestyle. My weight never really got in the way of anything else in my life (maybe my self esteem) but, this might offend some people, but climbing is a sport where you really cannot be even a little bit fat. It makes you painfully aware of your body weight. Most "good" climbers are built like bean-poles. I don't really need to be a "good" climber, just an "okay" and safe climber - I'm mostly interested in alpine trad below ~5.7. I still feel like I need to lose another 10lbs.

I was a fat kid growing up. I've had a BMI of 30±1 since age 12. I also have a family history of heart disease. Literally every male on my father's side for three generations has had a heart attack in their late 50s. We all have roughly the same body type. I already had hypertension in my mid 30s. Semaglutide has made me feel like there's hope.

Unfortunately, I can relate to the lower energy levels. While I'm no longer lugging an extra 40lbs around (a full pack!), I still bonk way faster. My gym sessions are way shorter. Luckily, I haven't lost much muscle mass, so I look great and it's been the "cut" I've never been able to achieve, but I'm sure if I ever wanted to "bulk" I'd have to go off it. I've found if I have a big trip or climb coming up, I have to take a way smaller dose the week, or even weeks, prior. I found this out the hard way when I puked on a climb in North Cascades. I just couldn't eat, and felt like shit the whole time.

The trick has been self managing my dose. I'm on compounded generic, so I can dose myself with my own needles. If I have a big trip coming up, I'll take like 25% of my maintenance dose for a week or two prior. This has been almost a superpower, because I'll get this massive burst of energy from the calorie intake. Im still not really sure if this is healthy, not the "taking 25%" part, but the fact that I feel like superman when I'm off it or on a low dose for a bit. Not sure what this says for someone who is basically taking semaglutide because their weight was holding them back from the activities semaglutide makes them too bonked to do anyways.

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I'm on the pill version, which allows me to adjust the dosage on a more day-to-day level. It also doesn't need a fridge, so it allows me to travel more easily. There's a level that works best for me long-term, and it's quite a bit less than typical.
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I thought the half-life was long enough that skipping a pill or taking a lower dose wouldn't make much of a difference?

Also, do you cut pills? I had looked into this and only found info saying that it ruins the delivery mechanism. I was skeptical of this because it would benefit the pill makers to convince people that these special pills cannot be cut, even though they do not require extended delivery (quite the opposite).

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I guess probably only take the pill n out of 7 days a week? With the long half life you'd probably get the same effect as cutting the pills
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I’m also active and fat. And to me being active is more important than losing weight; I’d rather continue to do those long 2000kcal bike rides on weekends than having a healthier BMI. I’ve heard stories of my own friends bonking during a ride and I decided that I wanted to err on the side of overeating. So semaglutide doesn’t interest me. You aren’t the only one I’ve heard who started to have no energy after being on semaglutide.

That said the dementia benefit mentioned in the article still intrigues me.

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I know people for whom GLP-1s made them lose weight, have a better relationship with food, and reduce their intrusive thoughts, and left them far more able to be active.

I feel like we’ll eventually find out that how well GLPs work is going to depend on the “why” someone has extra weight.

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People bonk because they're not eating enough DURING the ride. I'll eat (actually mostly drink) like 120-200g carbs on longer rides. Record is 700g during a 200km ride. I've seen big guys bonk too. It has very little to do with your BF% (although this is nuanced based on power zones and training 'durability' etc, etc).
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Going back to my endurance days, I think people bonk because they aren't adapted. After a year or so of pushing through the bonk, and growing up with hypoglycemia if I didn't eat frequently, I got to where I could start out at 5am on an empty stomach and not eat until noon or later. If I did bonk, I'd sip V-8(yeah, really) and instantly recover.
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Yeah this was the attitude back in the day and I know some older guys with this mindset but the science on this is pretty clear.

It’s definitely one of, if not the most, currently focused on aspects of endurance sports outside of the actual training.

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I'm on tirzepatide, a competitive athlete, and have no idea what GP is talking about.
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Being a competitive athlete is probably why you have no idea what I'm talking about (and maybe you're not in your 50s). You have a reason to keep your momentum and you are likely more regularly active than I was. Sure I lifted weights, but it was only 2-3 days a week for maybe 6 hours total.
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Maybe start lifting weights again? 50 isn't a death sentence; I know a lot of competitive 50s-year-olds.
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I'm trying but I've got a toddler and now it seems like every joint hurts. No time to get to a gym and no room for a decent home gym. I did start to do back day again at the Y when we go on the weekend for the pool. We'll see...
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A pair of adjustable dumbbells in the corner of the living room is still very doable. Lots of bodyweight exercises too you could look into.
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Back squats and deadlifts are both unreasonably effective, and impossible to load sufficiently with dumbbells.
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Totally understand the young kids thing. Good luck.
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People who eat well below their maintenance calories tend to have lower energy levels. That's the most likely explanation.
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Being active is great but fat is still dangerous. Let's not lie to ourselves.

> decided that I wanted to err on the side of overeating

The reason you bonk is because you've run out of sugar in your muscles not fat

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I figured that the way I adapted out of bonking was that my liver stored more glycogen. It's just a wild guess though.
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True, but sugar can be converted to fat in the body. If you eat too much sugar before/during a ride, the extra sugar becomes fat.
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Yeah but not at rates significant for a large aerobic expenditure. Fat is how the body stores energy and you can burn fat but you cannot convert fat to sugar fast enough at the end of a long run.
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There are so many active overweight or obese guys, whether it's cycling, swimming or hiking .This myth that inactivity = obesity or that activity fixes obesity or being overweight, need to die. It's not that simple. Hunger signals and how the body partitions/uses food is only orthogonal to activity.
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You are a proponent, but your outcomes seem worse?
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Losing 40 pounds where sometimes it feels like this weight is impossible to lose. That's what makes it worth it.
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For a lot of people, the alternative to GLP-1's is dying of a heart attack in their 50s, or taking decades off their lives by developing type 2 diabetes, or any number of complications from weight-related diseases.
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My point is that it's not all roses. Overall I'm glad I took it and will continue to do so. It's not without downsides, despite the endless stream of favorable studies on it.
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I'm younger than you and only loss a about 25 lbs. I've now gone to a maintenance dose and seen my energy recover substantially, I do still think (anecdotally) that when I got off for a week I got even more energy but it's hard to judge.
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I also had low energy but that was really mostly when I was losing weight, which made sense. As I slowed weight loss and reduced dose, energy improved.
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Is it kind of the stuff where the benefits outweigh the side effects? I'm just scared of the unknowns with the drug with such overwhelming positive research. Maybe, I'm a paranoid person but I'm unable to believe that such a powerful drug isn't without any side effect, clinically proven.
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The principal side effect is that you eat less.

Eating less can have positive effects (losing weight), but can also make you feel like shit (in a wide variety of ways), as your body is running on less energy intake than it has been accustomed to.

Depending on your activity level and the makeup of your diet, eating less can also lead to muscle loss and nutrient deficiencies.

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The drug has been in use for 20 years. The only side effect I've had is nausea and it passes after a few minutes.
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Try Tirzepatide or one of the other drugs. They each have their own side effect profile.
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What dose? Have you considered lowering it?
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2.4mg for over 6 months. I'm considering dropping back a level(1.7mg?).
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You’re on too high a dose. The highest dose made me a vegetable, with no energy, and so on. That is not the way.

Lower the dose (with your doctor, of course). For me, the “middle” dose was the sweet spot of positive effects with minimal side effects.

You are likely a “hyper-responder” to GLP-1s.

Also, tirzepatide had far fewer side effects for me, fwiw.

YMMV, of course.

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Yeah I probably should back off a level. I was hoping that moving to a 10-day dose schedule might give me some benefits(and save some money). I recently started doing that, although the decision to do so was mostly driven by having a stomach virus and wanting to more fully recover from the gastric effects before my next dose of semaglutide. After my first 10-day gap between doses I ended up with a strong encounter with the hypoglycemic feeling after going on a walk with my daughter. Sticking to the 1 week schedule but dropping the dosage is probably the right thing to do.
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