I'm 47 M. Two years ago I was 229kg (505lbs) and on the operating table for bariatric surgery.
The surgeons cancelled at the last minute. My blood wasn't clotting fast enough.
Then they rebooked me for two weeks later. Same procedure, same risk, no haematology referral, no investigation, no adjustments. Just "let's try again."
That was the moment everything shifted. If something was serious enough to stop the first attempt, going back under without understanding what the problem was felt reckless. I told them no, postponed past September, and decided to see if I could solve this on my own.
Going private, going systematic
The NHS had nothing else to offer me. No managed pharmacological route, no progressive plan, just the knife. So I went private and built a protocol, treating my own biology as a project I was running rather than something happening to me.
Two years in, here's where I am.
Where I am today
Tanita DC-360 BIA scan, 5 May 2026:
Weight: 175.4 kg (down from 229)
Total loss: −53.6 kg (118 lbs)
Muscle mass: 87.4 kg (lost only about 8%)
Visceral fat rating: 37 (down from 40+)
Body fat: 47% (still high, still working)
The number I care about most is muscle. Across the cut, muscle dropped from around 95 kg to 87 kg. That's an 8% reduction while fat fell by more than 50%. Not "stable", but proportionally protected. That's what the protocol is for.
Visceral fat is my real metabolic KPI. Going from 40+ to 37 is a more honest measure of progress than the number on the scale.
I've put a chart of the full 24-month body composition trajectory in the comments.
The protocol
Metabolic base. Tirzepatide, currently 12.5mg weekly, escalated through doses since April 2024. It does what it says: corrects insulin resistance, quiets food noise. The full dose history is in my tracking sheet.
Cognitive support. Selank evening, Semax morning, both intranasal. These aren't miracle anti-diet-brain-fog drugs (despite what some peptide marketing implies). They're mild anxiolytic and nootropic peptides that take the edge off the workload I'm carrying alongside this. That's the honest claim.
Coming next. A tesamorelin baseline trial pending IGF-1 bloods. Then a planned switch to retatrutide once tirzepatide plateaus, for the GLP-1/GIP/glucagon triple-agonist effect on the final stretch.
On the radar but not running. GHK-Cu, BPC-157, TB-500 for skin elasticity and tissue repair as the loss continues. They're filed and risk-assessed, not in the stack yet.
Nutrition
Nothing exotic. Beef, chicken, eggs, tuna, rice, potatoes, fruit (apples, oranges, berries). 80% cocoa chocolate when I want something sweet, kept occasional. Morning coffee with collagen, creatine, and MCT oil. Protein target 140 to 160g a day. Most days I hit it. Some days I don't, and I don't punish myself for it.
The roadmap
Target weight: 120 to 130kg. I'm not chasing aesthetics or single-digit body fat. I want healthy longevity. More capacity. More time on the planet. That's what this is for.
What I'd say to anyone reading
I didn't do this because biohacking is fun (it mostly isn't). I did it because the system that was supposed to help me stopped paying attention. When the surgeons rebooked me without a plan, I stopped trusting that they had one.
What I learned, two years in, is that data is leverage. If you're tracking nothing, you're at the mercy of whatever plan someone else decides for you. If you're tracking carefully, you can ask better questions and refuse worse plans.
This isn't a huge win. It's a journey, two years deep, still going. I'm posting it because I'd have wanted to read it from someone in my position two years ago.
If the system doesn't have a plan for you, build your own.
Edit: One crucial piece of the puzzle I missed—I'm on an NHS-managed TRT gel protocol. Keeping my testosterone in optimized ranges has been the 'insurance policy' for my 87.4kg of lean mass. It’s allowed me to maintain an anabolic baseline while the Tirzepatide handles the lipolysis (fat burning).