The Recomp Stack

‘Recomp’ — simultaneous fat loss and lean mass preservation — is the precise framing the metabolic and fitness research community uses for what this stack produces. Retatrutide and Tesamorelin address body composition through different receptor systems, making them mechanistically complementary.

Why these two compounds

Retatrutide is a triple receptor agonist — simultaneously targeting GLP-1, GIP, and glucagon receptors. No approved drug does this. The glucagon receptor activation is the critical differentiator: where GLP-1 agonists reduce caloric intake, the glucagon signal increases energy expenditure directly. In Phase 2 NEJM trial data, Retatrutide produced 24.2% body weight loss over 48 weeks — ahead of semaglutide (~15%) and tirzepatide (~21%). The fatty liver reversal data is equally significant: 93% resolution of metabolic-associated steatotic liver disease in the same trial. Phase 3 trials are underway; the cardiovascular outcomes signal (14% arrhythmia rate vs 3% placebo) is the one to monitor.

Tesamorelin is a synthetic analogue of Growth Hormone Releasing Hormone (GHRH) with FDA approval for HIV-related lipodystrophy — one of the few peptides with human regulatory clearance. Its mechanism is specific to visceral adipose tissue: it stimulates physiological GH pulsatility from the pituitary (rather than replacing GH directly), which selectively reduces visceral fat without the side effects of exogenous GH administration. It also preserves lean mass, making it the recomposition complement to Retatrutide’s fat oxidation driver.

Retatrutide works at the systemic metabolic level via triple agonism. Tesamorelin works at the GH/IGF-1 axis, specifically targeting visceral adipose through a different signal entirely. Together they address fat reduction through two non-overlapping pathways.

Protocol reference

Research protocol: Retatrutide per Phase 2 trial design (weekly subcutaneous injection, titrated dose); Tesamorelin 2mg subcutaneous daily, typically before sleep. Monitor cardiovascular markers when running Retatrutide — the glucagon signal has a cardiac output effect that warrants monitoring in any protocol context.