20lbs target opinion

[johniron]

Hello guys, in your professional opinion- I understand that this is not to be construed as medical advice- what should I use to lose about 20lb - I am not active, age 63 and I have used GLP’s previously

I can decide between
Cagrisema
Or Reta and cag
Or just cag

 

[thebigguy]

Comparison​

Here's a high-level comparison based on available trial data (averages; individual results vary). Focus is on non-diabetic adults with obesity, as trials often include ages up to 75, though sedentary-specific data is extrapolated from general older adult studies.

Aspect	CagriSema	Retatrutide + Cagrilintide	Just Cagrilintide
Average Weight Loss	22.7% at 68 weeks	~24%+ (theoretical combo; retatrutide alone 24% at 48 weeks)	6-10.8% at 26 weeks
Efficacy for 20lb Goal	High (easily achievable; superior to semaglutide alone)	Very high, but unproven combo	Moderate (may need longer use or adjuncts)
Safety in Elderly/Sedentary	Generally good; GI-dominant side effects, but muscle loss risk without activity	Higher AE risk (e.g., heart rate increase); compounding concerns	Gentler profile, but less studied alone
Status as of 2025	Phase 3 complete; promising for approval	Experimental combo; retatrutide in Phase 3 alone	Investigational; better in combos
Fit for Prior GLP-1 Users	Builds on your experience; enhanced satiety	Novel mechanisms; potential for more side effects	Milder, but may feel underwhelming

Based on the data, if I had to suggest one option for someone in your situation (sedentary, 63, prior GLP-1 use, modest 20lb goal), I'd lean toward CagriSema.
It offers robust efficacy (well above your target) with a safety profile that's an evolution of what you've used before, without venturing into unapproved combinations.
Retatrutide alone shows slightly higher weight loss potential, but adding cagrilintide lacks solid evidence and could introduce unnecessary risks, especially for older adults where simplicity and monitoring are key. Just cagrilintide might not hit your goal efficiently.
Overall, these agents work best with gradual activity increases (e.g., walking) to mitigate muscle loss, and regular check-ins for side effects. Again, please discuss with your doctor—they might also recommend starting low-dose or combining with nutrition counseling.