Weight Loss: Tirz or Reta for my case of NALFD

[ii337]

27M, 170 cm, 70 kg, recently diagnosed with NAFLD.


Been on ~1,800 kcal/day and walking 20k+ steps daily for 2 months with minimal fat loss before I got diagnosed. Never used peptides before. I did some research to just boost this process up. (Goal is 7-8KG loss)

I’m considering a short-term protocol (around 12 weeks) with the goal of kickstarting fat loss and liver recovery, then maintaining the results through lifestyle change — not looking for long-term medication.

Question:
Would Tirzepatide or Retatrutide be more effective for this use case — moderate weight, NAFLD, short-term intervention for a permanent shift?

Any input is appreciated.

 

[Ghoul]

Reta, or for the most potent liver fat clearance Reta combined with low dose rHGH for the max possible liver fat clearance in 12 weeks. 80%+. rHGH will help preserve lean mass as well. and you should see a decent recomp all around while the Reta will offset the GH insulin resistance.

Not suggesting it'll be fun, but you want it in 12 weeks.

Good thing you caught this. Lean NAFLD tends to progress to fibrosis and worse fast.

 

[dinfar1337]

retarutride will give you a nice initial boost if you run it high enough.

 

[Ghoul]

I would use a fast titration protocol like two weeks each or increase as tolerated:
.5, 1, 2, 4 mg Reta.

Being lean often means being more sensitive to low doses of reta, hence the caution, but you really need the highest dose you can tolerate to get the liver fat clearing effect,

2iu rHGH before bed or morning.

FWIW Tirz reversed my stage 1 NAFLD,

 

[ii337]

I would use a fast titration protocol like two weeks each or increase as tolerated:
.5, 1, 2, 4 mg Reta.

Being lean often means being more sensitive to low doses of reta, hence the caution, but you really need the highest dose you can tolerate to get the liver fat clearing effect,

2iu rHGH before bed or morning.

FWIW Tirz reversed my stage 1 NAFLD,

Thank you!

Something like that?
Daily 130-140g Protein
Alot of water and electrolytes
No sugary and fatty food
3x Gym / week
2-3x Cardio / week

Be mindful to hit calories (500 below maintenance)
Try to hit calorie and protein goal

Protocol:

• Week 1: 0.5 mg
• Week 3: 1.0 mg
• Week 5: 2.0 mg
• Week 7: 4.0 mg → maintain this through week 12

Check each week how the symptoms are.
No to light symptoms - fine
As usual without - up the dose by 0.5
Symptoms too heavy scale down 50% (week before)

 

[Ghoul]

Thank you!

Something like that?
Daily 130-140g Protein
Alot of water and electrolytes
No sugary and fatty food
3x Gym / week
2-3x Cardio / week

Be mindful to hit calories (500 below maintenance)
Try to hit calorie and protein goal

Protocol:

• Week 1: 0.5 mg
• Week 3: 1.0 mg
• Week 5: 2.0 mg
• Week 7: 4.0 mg → maintain this through week 12

Check each week how the symptoms are.
No to light symptoms - fine
As usual without - up the dose by 0.5
Symptoms too heavy scale down 50% (week before)

That looks perfect. If you want to be very cautious you could start on 1iu rHGH the first week but given your age I doubt you'll have any issue on 2iu.

I wouldn't split the Reta dose up in this case, Once a week. All the data on GLP related NAFLD reversal is based on pharma protocols, and it may depend on hitting a high peak, rather than lower stable levels from split dosing. The bottom line is we know once a week works very well for NAFLD, even in lean people, but have no idea if split dosing is as effective.

 

[ii337]

That looks perfect. If you want to be very cautious you could start on 1iu rHGH the first week but given your age I doubt you'll have any issue on 2iu.

I wouldn't split the Reta dose up in this case, Once a week. All the data on GLP related NAFLD reversal is based on pharma protocols, and it may depend on hitting a high peak, rather than lower stable levels from split dosing. The bottom line is we know once a week works very well for NAFLD, even in lean people, but have no idea if split dosing is as effective.

Anything important I should keep in mind during the first few weeks?

Things to do or avoid? Specific foods that help or make things worse?

Also, any “hidden tips” that come to mind — even small things you wish you’d known early on?

Would love any practical advice or lifehacks for a first-time user — like syringe tips, injection timing, or managing early side effects. I’ve done a lot of research, but I tend to be overly cautious and want to cover all bases.

 

[bananafeet]

No mentions of survodutide? It's been awarded a breakthrough award:

https://www.boehringer-ingelheim.com/human-health/metabolic-diseases/survodutide-us-fda-breakthrough-therapy-phase-3-trials-mash

I'm waiting for the ultrasound to tell me if I resolved my NAFLD. But anecdotaly taking glutathione intramuscularly helped lower my ALT.

People with NAFLD often have glutathione insufficiency where the glutathione is all inactivated.

My endocrinologist recommended post prandial walks. Good luck

 

[gettinginshape]

Anything important I should keep in mind during the first few weeks?

Things to do or avoid? Specific foods that help or make things worse?

Also, any “hidden tips” that come to mind — even small things you wish you’d known early on?

Would love any practical advice or lifehacks for a first-time user — like syringe tips, injection timing, or managing early side effects. I’ve done a lot of research, but I tend to be overly cautious and want to cover all bases.

Something to be mindful of noting your initial statement of not wanting to be on any medications long term...users of GLP-1RAs frequently exhibit rebound weight gain following cessation, and it's not uncommon to rebound to a higher weight than starting. This review is a year old, but references a few good studies on the topic:

A Comprehensive Review on Weight Gain following Discontinuation of Glucagon-Like Peptide-1 Receptor Agonists for Obesity - PMC

Obesity is considered the leading public health problem in the medical sector. The phenotype includes overweight conditions that lead to several other comorbidities that drastically decrease health. Glucagon-like receptor agonists (GLP-1RAs) ...

pmc.ncbi.nlm.nih.gov

Why I would note this...rapid increases in weight, particularly if it's in the form of fat, tends to result in a worsening of fatty liver / fibrosis measures from baseline.

Given you're targeting <10kg mass reduction, a strict diet regime (and possibly rHGH as noted by Ghoul) may be a better path to long term success. Particularly if you focus on reducing intake of high-glycemic foods in favor of a diet that is higher protein, low-moderate fat, and any carb intake being complex carbs. And it probably goes without saying...zero alcohol intake.

 

[Musmadar]

Glutathione is the magic word in this context ... along with Reta of course.

If you want a boost ... 1500 mg glutathione dissolved in 5 ml L-carnitine ... ideal would be to make it i.v. (dissolved even more) if not i.m. also would do ... e.d or e.o.d.

 

[sterlingschrute]

...users of GLP-1RAs frequently exhibit rebound weight gain following cessation, and it's not uncommon to rebound to a higher weight than starting. This review is a year old, but references a few good studies on the topic:

A Comprehensive Review on Weight Gain following Discontinuation of Glucagon-Like Peptide-1 Receptor Agonists for Obesity - PMC

Obesity is considered the leading public health problem in the medical sector. The phenotype includes overweight conditions that lead to several other comorbidities that drastically decrease health. Glucagon-like receptor agonists (GLP-1RAs) ...

pmc.ncbi.nlm.nih.gov

Why I would note this...rapid increases in weight, particularly if it's in the form of fat, tends to result in a worsening of fatty liver / fibrosis measures from baseline.

Given you're targeting <10kg mass reduction, a strict diet regime (and possibly rHGH as noted by Ghoul) may be a better path to long term success. Particularly if you focus on reducing intake of high-glycemic foods in favor of a diet that is higher protein, low-moderate fat, and any carb intake being complex carbs. And it probably goes without saying...zero alcohol intake.

The clinical trials and all published data we have is based on reta tested on mega obesers with (likely) lifelong issues with (abstinence from) proper diet and exercise. OP has a BMI of 24.2 which puts them at the higher end of the healthy range. OP also mentions walking 20k+ steps daily and seems to have a good grasp of diet.

It makes sense that obese test subjects frequently exhibit rebound weight gain, sometimes even higher than starting, because too many people use the GLPs as a wheelchair. They don't change their diet, they don't change their exercise routine, they don't change a single thing about their life except for now pinning drugs in their body once or twice a week. They let the drug do the heavy lifting, and wonder why the weight goes back up when the injections stop.

That article would be very different if people focused on maximizing their GLP experience by building healthy, sustainable habits that could be followed long after their GLP regimen ended. I call it using the GLPs as a crutch. With a crutch, you still have weight on your feet and must put forth effort to move towards your goal.

There is nothing wrong with using the GLPs as a short-or-medium-term solution. Especially in a forum like this, where, assumedly, we aren't talking about soccer moms or run of the mill fat fucks. It would be stupid to avoid GLPs for fear of rebound, especially when OP could benefit tremendously from Reta's added benefit of offsetting the GH insulin resistance.

I can't speak to anything regarding the NAFLD angle, but imo, it's a wild take to suggest avoiding reta (or any of the GLPs) because of the potential for rebound. You could rebound from anything if you don't hold yourself accountable.

 

[ii337]

Just to clarify - I’m fully aware that any drug is just a support tool, not the solution.

I’ve already made significant changes on my own: I dropped 9 kg last year and have maintained a weight about 7 kg below baseline since then. My lifestyle has been fully overhauled - clean diet, consistent activity - and I don’t find it challenging anymore.

Also worth noting: I’m not obese or significantly overweight. My interest in compounds like Retatrutide is to accelerate fat loss and support metabolic/liver health in a structured, short-term intervention — not as a long-term dependency.

If I expand it to a 6 month "experiment" and take the fat loss slower I could also do that but I dont know if being longer on the drug does any difference than titrating it up early

 

[Almoister]

27M, 170 cm, 70 kg, recently diagnosed with NAFLD.


Been on ~1,800 kcal/day and walking 20k+ steps daily for 2 months with minimal fat loss before I got diagnosed. Never used peptides before. I did some research to just boost this process up. (Goal is 7-8KG loss)

I’m considering a short-term protocol (around 12 weeks) with the goal of kickstarting fat loss and liver recovery, then maintaining the results through lifestyle change — not looking for long-term medication.

Question:
Would Tirzepatide or Retatrutide be more effective for this use case — moderate weight, NAFLD, short-term intervention for a permanent shift?

Any input is appreciated.

In the trials with trizz there was up to 60% reduction in i think and with retatrutide i saw like 80% but not sure if its Purelly to the weight loss or does it target the vis fat first definetlly atleast something

 

[Nidus]

In the trials with trizz there was up to 60% reduction in i think and with retatrutide i saw like 80% but not sure if its Purelly to the weight loss or does it target the vis fat first definetlly atleast something

I believe with Retra it was even 92% to be precise

 

[OldGHGuy]

The protocol looks great - keep us posted! NAFLD is actually fairly easy to reverse, even with lifestyle changes, so the Reta + rHGH (if you add it) should be a slam dunk. I'll wager in 12 weeks your issue will be resolved...

 

[gettinginshape]

The clinical trials and all published data we have is based on reta tested on mega obesers with (likely) lifelong issues with (abstinence from) proper diet and exercise. OP has a BMI of 24.2 which puts them at the higher end of the healthy range. OP also mentions walking 20k+ steps daily and seems to have a good grasp of diet.

It makes sense that obese test subjects frequently exhibit rebound weight gain, sometimes even higher than starting, because too many people use the GLPs as a wheelchair. They don't change their diet, they don't change their exercise routine, they don't change a single thing about their life except for now pinning drugs in their body once or twice a week. They let the drug do the heavy lifting, and wonder why the weight goes back up when the injections stop.

That article would be very different if people focused on maximizing their GLP experience by building healthy, sustainable habits that could be followed long after their GLP regimen ended. I call it using the GLPs as a crutch. With a crutch, you still have weight on your feet and must put forth effort to move towards your goal.

There is nothing wrong with using the GLPs as a short-or-medium-term solution. Especially in a forum like this, where, assumedly, we aren't talking about soccer moms or run of the mill fat fucks. It would be stupid to avoid GLPs for fear of rebound, especially when OP could benefit tremendously from Reta's added benefit of offsetting the GH insulin resistance.

I can't speak to anything regarding the NAFLD angle, but imo, it's a wild take to suggest avoiding reta (or any of the GLPs) because of the potential for rebound. You could rebound from anything if you don't hold yourself accountable.

Ultimately, I only mentioned this in the name of harm reduction, given I don't think any of us want OP to end up in a worse state than he's starting out at. He's aiming for a fairly limited amount of weight loss meaning any rebound could land him in a worse place, and I tried to emphasize that alternate paths may be more appropriate and the decision to incorporate a novel drug into the mix should be duly considered regarding benefits and risks, not that I am recommending he avoid them entirely. So mea culpa if it didn't come across in that manner.

I leverage Tirzepatide for a plethora of reasons, so I'm not on some anti-GLP1/GIP/GCGR crusade, but these are drugs that are intended for and most effectively utilized in the long term. For what it's worth...GLP1-RA studies up until fairly recently were primarily focused on diabetes, not the morbidly obese. Yes, they've become incredibly popular in the past few years as a result of obesity observations in early studies and the resulting approvals, but there are more than a few studies that involve "normal" BMI individuals that with T2D / Pre-T2D. Albeit, these were randomly sampled individuals and as you stated, not members of a community akin to meso, but you'll always have a difficult time finding these kinds of subjects in broad studies.

Finally, I agree that self control and accountability is the largest part of the equation. But OP needs to be prepared for the fact that upon cessation, the following weeks will be more difficult to maintain a calorie deficit while everything stabilizes hormonally akin to ending a cycle of any other PEDs, as more than a few folks have been blindsided by the effects. The data backs this up pretty strongly with GLP1 drugs, and with tirzepatide you're adding another receptor into the mix and with reta, you're now talking about a triple receptor agonist. So there's a lot of additional variables to be disrupted upon cessation.

 

[Photon]

I did take a look at a bunch of GLPs back then.
These numbers may not be the latest, take them as you will.

Reta (24v48w)


Pemvidutide 24w


Survodutide 48w


Mazdutide 24w


TLDR:
Pemvidutide is probably the best due to strongest GCGR, but it uses proprietary tech which no lab has managed to reproduce. Either way it won't be cost effective.
The rest are too expensive to use at doses required at trials.
Just use Reta.

 

[bananafeet]

I did take a look at a bunch of GLPs back then.
These numbers may not be the latest, take them as you will.

Reta (24v48w)
View attachment 337931

Pemvidutide 24w
View attachment 337933

Survodutide 48w
View attachment 337934

Mazdutide 24w
View attachment 337935

TLDR:
Pemvidutide is probably the best due to strongest GCGR, but it uses proprietary tech which no lab has managed to reproduce. Either way it won't be cost effective.
The rest are too expensive to use at doses required at trials.
Just use Reta.

I think the issue here is that Tirz and Reta are basically GIP centric drugs. Whereas survodutide and mazdutide leverage GCCR (glucagon).

I can't find concrete numbers but mazdutide may be a 1:1 GLP1/GCCR. Survodutide is probably 6-8x GLP1 vs GCCR.

Retatrutide favours GIP by 6-8x GLP1 and activates GCCR as well. But apparently the GCCR effect is quite weak.

For weightloss GIP+GLP1 is superior. However targeting liver fat directly is where GCCR shines.

I will go for mazdutide is my NAFLD hasn't resolved.

 

[Photon]

I think the issue here is that Tirz and Reta are basically GIP centric drugs. Whereas survodutide and mazdutide leverage GCCR (glucagon).

I can't find concrete numbers but mazdutide may be a 1:1 GLP1/GCCR. Survodutide is probably 6-8x GLP1 vs GCCR.

Retatrutide favours GIP by 6-8x GLP1 and activates GCCR as well. But apparently the GCCR effect is quite weak.

For weightloss GIP+GLP1 is superior. However targeting liver fat directly is where GCCR shines.

I will go for mazdutide is my NAFLD hasn't resolved.

These numbers are not available, and even if they are, they are usually in vitro or rats or something. Which is why i used the closest benchmark, liver fat reduction.

Maz 9mg - 73.3% in 24w ~ 10mg kit ~ 200$
Reta 8mg - 81.4% in 24w ~ 10mg kit ~ 105$

 

[bananafeet]

These numbers are not available, and even if they are, they are usually in vitro or rats or something. Which is why i used the closest benchmark, liver fat reduction.

Maz 9mg - 73.3% in 24w ~ 10mg kit ~ 200$
Reta 8mg - 81.4% in 24w ~ 10mg kit ~ 105$

Interesting

But wasn't mazdutide only studied in asians? Maybe they respond differently to GIP.