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Comment by brap | Hacker News Reader

Just want to share my own experience since were doing it:

Took Wegovy (Semaglutide) for about 6 months. Barely lost any weight, would occasionally get nauseous.

Then the doc switched me to Mounjaro (Tirzepatide) + Phentermine, and holy shit, I just don’t feel like eating, almost ever. Lost 20kg in 6 months, which is all I needed to lose, never had any side effects. None.

I did feel a little weird/buzzed the first time I took Phentermine, but it went away the next day.

I feel like for many people it’s not really the physical hunger that makes them fat, it’s that annoying voice in your head telling you to snack something for no reason at all. It sometimes felt almost like drug addiction.

Tirz+Phent are great for that.

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Dieting is hard and we still under emphasize the mental and emotional aspects of it. I've found that the easier to "be good" at dieting during the 30 minutes of weekly grocery shopping then during every hour of every day at the house. I try hard to just never buy things that I'm likely to overeat or are super calorie dense because I know I can't eat potato chips responsibly.

This is the way. Why give yourself the temptation when one slip-up can ruin the whole thing for yourself?

It's very true, but it's more difficult when you live right by the grocery store, the office has free food and snacks, and DoorDash is right there when you "need" it.

You need to be careful with phentermine. Unlike the GLPs it very much is physically addictive, basically just adderall.

I'm aware, and I was hesitant to use it when the doc first prescribed it. Personally I'm not so worried about this anymore, there are days when I don't take it (either forget or wake up too late in the day) and I don't feel any different. I never felt like I craved it or had any sort of rewarding feeling upon taking it. I never took Adderall so I can't compare, but from what I know the mental effects of Phentermine are much weaker.

Usually it's prescribed for no more than 3 months, but the doc recommended taking it for longer. He mentioned that addiction risk is negligible for most people. Very solid doctor who specializes in those thing, so I took his word for it after a bit of Googling.

Glad its working for you!

It varies case by case, but just want to point out that the research agrees with you here, Tirzepatide is more effective than Sema!

I'll echo that addiction feeling! It's amazing to me, how when I ignore the "it's time to eat" feeling (which isn't easy to do!) it suddenly starts to get weaker and even goes away...almost as if I wasn't really hungry at all!

Did you lose any muscle mass?

They most certainly did, these drugs stop you from eating, not magically burn fat and leave muscle mass alone.

It has the same effect as starving yourself. Go look up pictures of "ozempic face"

I wouldn't say "starving yourself", there's no reason to believe it's different from any other diet (except it's easier to stick to). If you get enough calories, prioritize protein, do some resistance training and get proper sleep, you can minimize muscle loss and in some cases even gain muscle while losing fat.

"Ozempic face" is just the result of excessive weight loss. The term is basically putting the blame on the drug for people wanting to continue to lose weight even after achieve a healthy weight.

It's completely unrelated to GLP-1s. 5+ years ago, we would have just called it "Anorexic face".

Most likely.

But I had a lot of muscle mass to begin with, due to years of bodybuilding. And I still have significant muscle after the diet, despite of not touching a weight during all this time (I know I should have). People still ask me about my lifting routine even though I didn't lift in like 2+ years.

Knowing myself, it'll come back within a couple of months of lifting weights and getting proper protein, once I get back to it. And I plan on doing exactly that. Being fat kind of made me lose motivation to go to the gym. It's a vicious cycle I imagine many fat people struggle with. So I prioritized losing fat first and foremost.

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