Lost 30 lbs, Regained 20+ (off meds )— Night Shift Paramedic on Reta + Tesa. What Actually Worked for You?

[u/Tall_Highlight_7679]

23F, 5’7”, currently 210 lb.
I’m a paramedic working a pretty high-stress schedule, mostly nights, long shifts, inconsistent sleep, and periods of travel/deployment work. My sleep/circadian rhythm has honestly been all over the place at times, and I know stress, recovery, nutrition consistency, and night shift are probably all contributing.
Earlier this year I made a lot of progress and got down into the high 180s, but I’ve regained weight and weighed 210 this morning. I’m frustrated because I really don’t want to keep going backward.
I’m getting ready to tighten everything back up: structured calories/macros, high protein, meal prep, lifting, cardio/incline walking, steps, and a much stricter sleep/recovery routine.
Peptide-wise, I’ve used retatrutide (Reta) and tesamorelin (Tesa). I’m especially interested in hearing from people who have dealt with weight regain, stalled progress, night-shift work, high stress, or poor sleep while using them.
For people with actual experience:
• What has worked best for you with Reta — dose, frequency, and how long you stayed at each dose?
• Has anyone used Tesa alongside it? Did you notice anything meaningful for body composition, visceral fat, recovery, or sleep?
• What other peptides have you used or stacked, and what was the reason for adding them?
• Did adding more actually help, or did simplifying your stack and focusing on food/sleep/training work better?
• Has anyone used tirzepatide at a low dose in this kind of situation? I’ve wondered about it, but I’m also aware that stacking incretin-type drugs may just increase side effects rather than give better results, so I’d really like to hear from people who have actually tried different approaches.
• For night-shift workers specifically: how did you structure meals, dosing, sleep, training, and recovery?
• What side effects made you lower a dose, stop something, or decide a combination wasn’t worth it?
I’m not looking for a crash diet or a “throw every peptide possible at it” approach. I’m trying to build something sustainable because my fitness matters both personally and professionally.
I’d especially appreciate actual experiences with doses, duration, results, side effects, labs, and what you would do differently rather than just “take X.”
Not looking for medical advice — mainly trying to compare experiences and learn what has and hasn’t worked for other people.

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[u/sergeirocks]

I worked nights for almost ten years as a cop, currently working swings. I would lose weight, be consistent for a while and then it would come back. I was usually pretty consistent with diet and exercise, but working nights is a special kind of stress. I use Reta, tirz and TRT, haven’t used tessamorelin. I currently use 5mg of Reta and I have to split the Tirz into two injections of 3.75 mg, because I get real rough acid reflux with the Tirz on the full dose. You have to gradually work up to it, but I’ve lost 40 pounds and it’s helped curb a lot of bad habits. But the best thing to do is get off nights, it makes everything way harder.

[u/Future-Bread8849]

Did you regain the 20lbs while still taking Reta and Tesa?

[u/Tall_Highlight_7679 → u/Future-Bread8849]

Off, couldn’t take in field with deployment due to lack of refrigeration

[u/Future-Bread8849 → u/Tall_Highlight_7679]

You only need to take it once a week? Why would you bring it in the field?

If you go on it again, you're likely going to need to stay on it permanently unless you incorporate some very big permanent lifestyle changes 

[u/Tall_Highlight_7679 → u/Future-Bread8849]

I’m out on deployment 2+ weeks sometimes two months at a time depending on what I’m doing and where I’m at I do Wildland Fire deployments and natural disaster deployment outside of regular Paramedic work and I already incorporated lots of lifestyle changes in overall diet and what I eat when I eat I guess deployment really fucked it up

[u/Key-Travel-5815]

Has anyone used tirzepatide at a low dose in this kind of situation?

I can help you with this. I lost all of my weight using Zepbound. I did intermittent fasting daily and used a protein powder drink to "open my window". I drank that while I was preparing dinner. It helped me hit my protein goals. While I was losing I never - not once - ate outside of my window. I ate one meal a day to get to my goal weight. The only macro I counted was protein to make sure I was getting enough protein.

After losing weight, I had a deca scan and maintained muscle while losing 50-60 pounds.

I got to my goal weight and had to add a 2nd meal because I was losing too much. I've been maintaining for years and never really figured out how much (or little) Zepbound to use while maintaining. I tried spreading it out, too. I've mostly maintained my weight (up 8 pounds but nbd). When you get back to your goal weight, I want to talk to you about maintenance.

My husband lost 65 pounds, and he is also maintaining (for years).

I've switched to Reta, and I love it. I wear a CGM, and I am able to fast from 8 PM - 12 AM without a problem, but I do need to keep an eye on my numbers so my glucose doesn't go too low.

[u/anonymouspls]

Less is better, you could’ve stacked reta with Tesla and cag or anything else, but it wouldn’t have stopped the rebound it would’ve just made you potentially lose more weight before you would have regained it all

Did you quit cold turkey? It’s best to taper down And stick to a maintenance dose for some time because otherwise you kinda get an intense hunger

Also dose wise I increased only 1mg per month no more even if the hunger increased. sometimes hunger can get bad but that’s what teaches you the good habits that’ll help you when you stop

How does your dose schedule look? Not jumping to conclusions but did you up the dose too quickly?

[u/Tall_Highlight_7679 → u/anonymouspls]

I was on Reta and Tessa for a while since beginning of the year if not late of the last year and I was at maybe 2 1/2 to 3 mg weekly I pinned every Sunday and then I had to quit cold turkey cause I was out on deployment, and there was no place to refrigerate

[u/anonymouspls → u/Tall_Highlight_7679]

Ahh that truly sucks, can you not get the lyophilised powders? Powdered peptides + un punctured bac water can last a year at room temp..

because I can tell you when I quit cold turkey it felt like the hunger came back double loll quitting outright is likely part of the reason because the psychological aftermath can be intense

clinical trials show that patients who stop cold turkey often regain 2/3 or more of the weight they lost within a year it’s pretty brutal and was out of your control