Disclaimer: I'm sharing my experience as a participant in a retatrutide clinical trial. I was randomized to the active drug arm (confirmed after unblinding). I'm sharing this for informational purposes only. Individual trial experiences are anecdotal and should not be used to make medical decisions.

Background: 42M, SW: 267 lbs (BMI 38.4), no diabetes, previous failed attempts with diet/exercise and one year on Saxenda with 14 lb loss. Enrolled in TRIUMPH-3.

16-Week Results: CW: 224 lbs. Total loss: 43 lbs (16.1%).

Titration experience:

• Weeks 1-4 (starting dose): Mild nausea, reduced appetite. Lost 8 lbs.
• Weeks 5-8 (first escalation): Nausea increased significantly. Two days of vomiting. Appetite almost completely suppressed. Lost 12 lbs.
• Weeks 9-12 (second escalation): GI symptoms eased. Steady appetite suppression. Noticed increased body warmth/sweating (thermogenesis?). Lost 13 lbs.
• Weeks 13-16 (maintenance dose): Tolerating well. Eating about 1,200-1,400 kcal/day without effort. Lost 10 lbs.

Side effects experienced: Nausea (resolved), occasional diarrhea, injection site reactions (mild), constipation (ongoing, managing with fiber), increased heart rate (~8-10 bpm above baseline), and a strange metallic taste that comes and goes.

Positive effects: Beyond weight loss, my blood pressure has normalized (was on lisinopril, now off), energy levels are dramatically improved, sleep apnea symptoms are resolving, and my joints feel so much better.

Thank you for sharing this. 16.1% at 16 weeks is a remarkable rate of loss and consistent with the steeper early weight loss curve seen in the Phase 2 data. A few observations:

The increased body warmth/sweating you describe is very interesting and aligns with the thermogenesis hypothesis of the glucagon component. This is the kind of subjective experience that doesn't always show up in clinical trial data tables but supports the mechanistic theory.

The metallic taste is an unusual side effect that's been reported anecdotally by a few other trial participants. It wasn't highlighted in the Phase 2 publication. It could be related to changes in zinc/copper metabolism (glucagon affects mineral metabolism) but that's speculative.

Your rate of loss will likely slow as you approach the 24-48 week mark. The early phase is always the steepest. But based on your trajectory, you could potentially exceed 20% by the end of the trial.

1,200-1,400 calories "without effort" at 224 lbs is honestly wild. I'm roughly the same weight on tirzepatide and I'm eating about 1,600-1,800 and still feel hungry sometimes. The appetite suppression on retatrutide sounds significantly stronger.

Are you tracking your macros? Specifically protein? At that calorie level with that rate of loss, lean mass preservation should be a priority.

Good point about protein. Yes, I'm tracking and aiming for 130-150g protein daily, which is honestly hard at 1,200-1,400 total calories. I'm supplementing with whey protein shakes to hit the target. The trial investigators also recommended high protein intake.

I'm doing resistance training 3x/week (started at week 4 once the initial nausea settled). The trial includes DEXA scans at baseline, 24 weeks, and 48 weeks, so I'll have hard data on body composition eventually. Subjectively, I feel like I'm losing mostly fat — my waist has gone from 44 inches to 38 — but I won't know for sure until the DEXA.

The clinical context you're providing is invaluable. A few things I'd encourage you to discuss with your trial investigators:

1. Heart rate increase of 8-10 bpm: This is within the range seen with GLP-1 RAs generally, but the glucagon component may contribute additional chronotropic effects. Worth monitoring closely, especially during exercise.
2. Caloric intake at 1,200-1,400: While effective for weight loss, this is below the threshold where micronutrient deficiencies become a concern over extended periods. Make sure your trial protocol includes regular nutritional bloodwork (B12, folate, iron, vitamin D, etc.).
3. Coming off lisinopril: Great that your BP is normalizing, but make sure the BP medication discontinuation was done under medical supervision and not self-directed.

Thank you for sharing this responsibly and with appropriate caveats. First-person trial experiences are rare and helpful for the community.