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Tesofensine vs GLP-1 appetite suppression, what the actual difference feels like

Posted by tiredmira in Weight Loss & Metabolic - 1 points, 4 comments.

So I've been rotating between GLP-1s and tesofensine over the past year or so for the appetite side of things, mostly to compare how they actually feel day to day.

GLP-1s are pretty familiar territory at this point. The food noise just kinda fades, portions shrink, and I have to remind myself to eat enough. The downside is the nausea in the first few weeks and how flat my appetite stays even on training days.

Tesofensine feels fundamentally different. It's not really about fullness, more like my brain just stops chasing the next snack. Cravings drop but I still get hungry at normal times. I actually prefer eating on it.

The trade off is sleep. My resting HR went up a few bpm and my HRV tanked the first month, which is what made me rotate off it. Blood pressure also nudged up so I had to keep an eye on that.

Both work but they're not interchangeable. GLP-1s are satiety, tesofensine is more like removing the reward signal.

Has anyone else compared the two long term, or stacked them at low doses? Curious what the appetite control looks like after month 3+ on tesofensine specifically.

Comments

  • quiet_ironman: I ran tesofensine at a low dose for about eight weeks last fall while keeping my usual GLP‑1 micro‑dose on hand for rough days. ” chatter dropped off. Sleep took a hit though; my resting heart rate crept up a couple beats and my HRV stayed lower until I tapered off. Stacking a tiny GLP‑1 dose seemed to blunt the nausea I got from tesofensine alone without dulling its craving‑killing effect, but I’d definitely keep an eye on blood pressure if you try that combo. Has anyone noticed the sleep trad
  • owen196: The sleep thing hit me too, but it leveled off around week three for me. RHR came back down on its own once I dropped the dose a bit. BP is the one I watched closest since both can nudge it up.
  • tiredmira: Interesting, week three is roughly when mine started settling too, but my HRV never really bounced back to baseline until I switched off completely. Dropping the dose makes sense, were you doing 0.5mg daily or every other day? I was on 0.5mg EOD and still saw the cardiovascular drift. Also good call keeping tabs on BP, mine crept up about 4-5 systolic which my doc was not thrilled about 😅
  • tiredmira: The food chatter thing matches my experience exactly, it was more mental than physical for me. I never tried stacking them tbh, I just rotated based on what I needed that week. Sleep never really leveled out for me even after the first month, it was the main reason I went back to GLP-1s solo. How low was your tesofensine dose?

Community discussion - research and educational context only. Not medical advice.