Our Weight Loss Journey

Cheryl and I started on GLP-1 medications in late 2022. She took Ozempic (semaglutide) and I took Wegovy, also semaglutide, just the higher weight-management dose. GLP-1s work by mimicking a gut hormone that signals your brain to slow down hunger, reduce cravings, and regulate how quickly your stomach empties. In the landmark STEP 1 clinical trial published in the New England Journal of Medicine, people on semaglutide lost an average of 14.9% of their body weight over 68 weeks, results that were, at the time, unprecedented for a non-surgical treatment. [1]

Over about the first year and a half, those results held for us. I started at over 400 pounds. Cheryl was around 300. We each lost roughly 100 pounds. I hit a personal low of 282.6 in March 2024, a number I hadn't seen on a scale in 25 years. That was one of the best mornings of my life.

Then the floor fell out.

Our insurance stopped covering our medication. What had been a $25/month copay became $1,300+ per month in cash pay. We simply couldn't sustain it. We went without GLP-1 medication for about a year, and this is one of the cruelest parts of these drugs that doesn't get talked about enough: stopping isn't just "going back to where you were." Your metabolism has adapted, your hunger signals reactivate, and the weight comes back faster than it went. I gained about 30 pounds during that year, climbing back to 309.

In March 2025, Cheryl and I took a trip to Portugal. And a small miracle happened in a pharmacy there.

We were able to get prescription Tirzepatide, a more advanced GLP-1 medication sold as Ozempic's successor, at about $400/month for legitimate, pharmacy-dispensed product. We brought back six months' worth. Tirzepatide is what's known as a dual agonist: it activates both the GLP-1 receptor and the GIP receptor, essentially targeting two separate metabolic pathways at once. In the SURMOUNT-1 trial published in the New England Journal of Medicine, participants on the highest dose lost an average of 22.5% of their body weight, meaningfully better than semaglutide alone. A direct head-to-head trial (SURMOUNT-5) confirmed it: tirzepatide outperformed semaglutide for sustained weight loss over 72 weeks. [2, 3]

I dropped back down quickly. Currently sitting at 271.6, a new all-time low for me in 25 years.

As the Portugal supply started to run low, we started looking hard for sustainable alternatives. This led us to two overlapping paths.

The first is compounding pharmacies. When name-brand drugs are in shortage or out of reach financially, FDA-regulated compounding pharmacies can legally prepare patient-specific formulations of the same molecules, same semaglutide, same tirzepatide, at significantly lower cost. These require a prescription from a licensed provider, but services exist that make this reasonably accessible. This was legitimized during the period when Wegovy and Ozempic were on the FDA's drug shortage list.

The second path is harder to explain, but I want to be honest about it. In August of 2025, I started seriously exploring what's known as the peptide gray market. Here's the honest framing: there is a space, not illegal, but not FDA-approved for human use, where peptides are sold as RUO (Research Use Only) compounds. They're synthesized to the same molecular standards, but sold for research rather than human therapeutic use, because they haven't gone through the FDA approval pipeline. People who fall through the gap, those who can't afford prescription GLP-1s but have seen real results and don't want to go backward, find each other in communities, largely on Substack and private forums, and share what they're learning about sourcing, dosing, monitoring, and safety.

What that community has given me access to, beyond lower-cost semaglutide and tirzepatide, is Retatrutide.

Retatrutide is a triple agonist: it activates three separate metabolic receptors simultaneously, the GLP-1 receptor (which slows digestion, reduces appetite, and regulates blood sugar), the GIP receptor (which amplifies insulin response and appears to enhance the fat-burning effect of GLP-1 when both are activated together), and the glucagon receptor (which drives the liver to burn stored energy and boosts overall metabolic rate). It is still investigational, not yet FDA-approved, but the trial data is extraordinary. In Phase 2 data published in the New England Journal of Medicine, the 12mg dose produced 24.2% weight loss at 48 weeks, already exceeding tirzepatide's results. [4] In December 2025, Eli Lilly announced Phase 3 results from the TRIUMPH-4 trial: participants on the 12mg dose lost an average of 28.7% of their body weight, roughly 71 pounds on average, over 68 weeks. Seven more Phase 3 readouts are expected in 2026, with potential FDA approval projected for 2026–2027. [5, 6]

For someone who started at over 400 pounds, those numbers are not abstract. That's the difference between getting my life back and not.

One side effect worth naming from the TRIUMPH-4 data: a phenomenon called dysesthesia, an odd, abnormal sensation in the skin, something like a mild tingling or low-level electric feeling. It showed up in the trial data and I've experienced it firsthand. It's a strange one to describe, but it was never constant, never debilitating, and for me it largely faded out after the first couple of months. Worth knowing going in, not worth being scared of.

Cheryl and I are doing this together, which matters more than any molecule. We pay attention to how we feel, we stay curious, and we take our health seriously, we just don't always have the luxury of doing it the way a textbook says you're supposed to. I believe with everything in me that the tools now exist to solve this problem, not just for us, but for the millions of people being priced out of them.

If you want to talk more about any of this, I'm an open book. And if you're on your own journey, I'm genuinely happy to share what we've learned.

, Cliff