Keto and carnivore diets aren’t any better than a balanced diet. Sure, you’ll drop water weight faster, but the actual fat loss difference is minimal, if it even exists. What you really need is to address your eating habits, not avoid carbs. Your body needs energy, and GLP-1 is perfect for this - it can also help break bad habits, often reducing cravings for sugar, alcohol, and even cigarettes.
I’ve tried both keto and carnivore myself, not for fat loss but just to see what they’re like, and honestly, it’s nonsense. People convince themselves they’re “eating like our ancestors,” but avoiding carbs is just another fad. In short, focus on eating a complete, balanced diet. If you’re not hitting your carb targets while on GLP, that’s fine - just make sure you’re getting enough protein and healthy fats, and you’ll be good.
I wouldn’t stress about muscle loss right now - at your weight, there’s probably not much to lose. Your main job is to walk and stay active - that’s your path to success.
As for why I’d pick Tirz over Reta: it’s better at appetite suppression, works great for insulin resistance, is cheaper than Reta, and it’s already FDA-approved. Plus, with your stats, you could likely get pharma-grade Tirz covered by insurance, which is a big win.
It’s great to see you reading up on Reta and GLP-1, but don’t overthink it - your first step is to change your lifestyle and start eating right. Also, a heads-up: with your height (5’10”) and 380 lbs, loose skin will be inevitable. Start putting a little money aside each month for a skin removal surgery down the line. Sometimes insurance can cover it, but
@Ghoul could probably explain that better.