If you are on weight loss injections, what do you make of this article?

Twenty-five years ago my BMI was 39.5. I lost around 100 lbs doing weight watchers and have kept it off, with some fluctuation, including two pregnancies. My BMI is now about 22.5. I exercise regularly and am careful about what I eat during the week, and a bit more relaxed at weekends. I have made tweaks over the years, such as introducing fat back into my diet (what a revelation that was after doing low-fat for years and years!) and fasting (I only start eating at lunch time). On the surface, I know I appear to have no struggle.

But the food noise - wow. I can't escape it. I think about food constantly. It is a daily torture that ranges from uncomfortable to unbearable, and it has never gone away. I don't want to buy WLIs privately but it is so, so tempting to get rid of the food noise and have some peace.

Do they have any side effects?

If this were true, we wouldn't see almost everyone who lost weight without medication regaining the weight, which is not the case

Totally agree. If the reasons for emotional eating aren't addressed then the problem won't be fixed.

One of my friends is on WLI and she looks fantastic (although getting a bit gaunt now), but she admits that some days all she can manage to eat is a small piece of chicken. That's it. Its really unhealthy and she cannot afford to be on them long term so as soon as she comes off it she is going to pile it back on because her body is now in starvation mode so will hang on to every calorie.

The medical and genetic causes for obesity are so under researched, it was always extremely likely that stopping medicated controls would lead to weight gain. The NHS should, and will eventually be able to offer maintenance doses where living with a healthy BMi and reduced co-morbidities means the funding can be transferred from dealing with those issues to preventative care pathways instead.

so many people who have reported so many additional benefits above and beyond the weight loss - those are the stories where people have underlying issues that are being dismissed or poorly diagnosed but the impact of managing insulin and improved digestive controls is resolving for them. Perhaps still treating symptoms rather than root cause - but it’s great progress.

Articles like this represent lazy, ineffective journalism in my view that continues to label obese people as simply a problem of overeating, of gluttony, which is irresponsible nonsense.

Fat cells have a long memory but they only live for ten years. Once you stop taking the jabs the fat cells still wants to be full. So you get the urge to eat. I’m hoping after the years all those fat cells die off and you lose this obesity memory. Time tells.

That will depend why you ate in the first place.

I ate carbs and sugar to "reward" and feel good when shit hit the fan due to a variety of reasons.

I can't eat carbs a lot anymore, my stomach hates anything processed. I have to re-learn to sort out my issues without food as the go-to solution and have started over the last 6 months finding ways to do this.

Will I crave things? Yes, I am pretty sure. But for me the jabs are more than just loosing the weight, they are a tool letting me revamp my life and I find it far more satisfying being able to walk 3 miles without getting out of breath and needing a sugar fix because my blood sugar plumbed.

Omg you solved obesity, well done!

(Seriously, do you think people start taking extremely expensive injections as their first attempt at weight loss and have no experience of dieting beforehand? Why would anyone jump straight to a £200+ per month drug without trying to conquer their cravings for free? People are on these jabs because other methods have not worked long-term for them).

You are missing the point though – you can put in all the effort you want but you are still fighting your body's chemistry. WLI alter your GL1 level to help you lose weight. If your GL1 level returns to its pre-jab state after coming off, what do you think might happen?

I would think that’s because with other methods you gradually slip back into your ways making for slower weight gain. With WLI’s if you stop taking them your appetite will come back full throttle once the effects have worn off. You will then likely binge and reach for all the things you’ve not eaten for months and months.

It’s not “caused” by the drug, it’s just a natural consequence of doing something really, really strict (ie. MJ makes it impossible
to eat very much) and then stopping it completely and quickly reverting back to how you were before.

According to this ABC news article, the pill will cost $25 in the States on prescription if your insurer approves it. Without insurance cover, the cost will vary between $149-$299 depending on dose.

So, that very likely means the NHS will be able to prescribe it to those who meet the criteria while paying the lower purchase price for it, but anyone buying via private prescription from providers like Juniper, the cost isn't going to be that different to the jab.

abcnews.go.com/GMA/Wellness/wegovy-daily-pill-now-costs/story?id=128898797

The problem is comments like this with
no evidence that people don’t put in the effort after they stop. Please don’t talk for everyone.

I am one of those who have constantly increased weight, year on year, for decades. Genetic testing a few years ago (for other issues) identified that I have inherited a gene variant, that controls the amount of serotonin released via the gut - brain axis… so I don’t release as much serotonin (a ‘feel good’ hormone) after I eat, compared to the majority (maybe 99 per cent?) of the population. This gene / its role in hormone regulation has only been established in biomedical research, and mainstream medical consultants know nothing about it.

I need to look into it more, but I suspect that serotonin somehow counteracts cortisol (the stress hormone).. as part of these health investigations a few years ago, with a different consultant at a different hospital, I was told I have high cortisol levels, but no explanation was given (they ruled out the typical reasons).

I live permanently with high stress / anxiety, and have this gnawing / overwhelming urge to eat, that has been with me for decades, but has worsened as I have got older (and coincidentally this faulty gene variant tends to get worse with age). eating does help me feel calmer. WLIs do help reduce this gnawing feeling - and I can see that I am likely to be on them for life. I have to pay for them privately; despite meeting BMI / cormorbodity criteria, my gp practice says they don’t prescribe them.

Obesity is a huge problem in modern society (forgive the pun!) and I feel deep sadness that it is considered a ‘lifestyle choice’ - that obese people are ‘just’ lazy / lacking in motivation. Why is there not a greater understanding of what physiological factors / differences are driving this, and more of an emphasis on treatment for what is clearly a metabolic disorder, probably with a multitude of different possible genetic / physiological factors? For me, I think obesity is primarily a symptom of a genetic / inherited hormonal dysregulation - my body is driving me to eat (especially when cortisol levels are high) to increase serotonin. This will never go away, so I am genetically programmed to increase weight if not on WLIs…

I think some people genetically have more food noise than others and perhaps you don’t feel this. I’m a yo-yo dieter and when I turned 50 put on 2 stone and have had the most miserable two years of my life trying to get it off again. My food noise every diet I’ve done is unbearable. I’ve never used jabs as I’m not eligible, but would love to get rid of food noise. It’s a huge thing for lots of people

They are like statins, they only work while you are taking them. What do you think people make of that? Do people not realise their cholesterol will just go up again if they come off them without changing their life style? (Of course they do)

Some nonsense on here, nearly everyone changes their diet on mounjaro, you have to eat clean or you’d be quite unwell in the main. But like any diet regain is hugely likely, diets have an 80 percent full regain rate within 5 years, slimming world and weight watchers are both over 95 percent regain rate. Obesity really is a relapse condition.

for me I’m staying on a maintenance dose, I always intended to if they worked, and figured this into my decision. I’ve been maintaining for 9 months or so now; I know full well that no matter how hard I try, at some point the weight will creep up, only a small percentage as seen by the stats can manage not to have that happen.

so I see nothing surprising here.

Been over a year since I stopped, lost 4 stones in 5 months. Put on a
Stone when I stopped and maintained the rest by myself. Happy with that.

But it's the degree of weight gain associated with coming of WLI's that is being questioned.

Also, does anyone else think "food noise" has been hyped up beyond all recognition as marketing tool by Big Pharma? I ask as someone who has yo-yo dieted since I was 15 and I'm 53 now (and can't take WLI because of the history of ED triggered by the yo-yoing). For me, it's not food noise that's the issue, it's body dissatisfaction noise that has me reaching for comfort treats and falling off the diet wagon. I don't think about food constantly or what I'm going to eat next, but how much I need to lose weight and how fat my tummy is etc, and the misery of it is what's triggering. I don't think about food every waking minute, like when I'm in a work meeting or travelling somewhere, or out with friends, or with my family. But I think about needing to lose weight A LOT.

Have the two – body dissatisfaction and food noise – been overly conflated?

The weight loss pill I now here, which should start to make affordability and access more available.

https://www.healthline.com/health-news/fda-approves-wegovy-weight-loss-pill

I’m sorry but these posts always make me agog at people’s lack of ability to think critically.

If you are doing something that makes you lose weight - no matter what method - and then you stop doing it…you will put the weight back on.

It’s really that simple.

I was on self funded Mounjaro. Lost 2.5 at in 3 months. Got diagnosed with AWFUL gall stones, got told to come off. Regained 3 stone in 3 months as my appetite was out of control. Luckily I was already on a weight loss pathway with the NHS and they offered me a nhs funded spot in a private hospital for weight loss surgery to treat my rampant obstructive sleep apnea and also took my gall bladder out. Best thing I’ve ever done and I’ve lost 70lb since August.

I’m on monjouro and have been at target weight for a few months now. I’m now titrating down with the intention of coming off completely. But I didn’t take it to shut down my appetite - I stuck to a dose which took the edge off and took cravings away and have also had a complete lifestyle overhaul. I am now working out what my calories are to maintain (I’ve been slowly increasing them since got to target) and I reckon I’ll have to track for life. I’m only 5 foot and menopausal, so although active it doesn’t take much to go off track. I’m hoping this approach will help me keep the weight off.

Yes, I have always thought it odd/concerning that people seem to forget it actually alters your body's chemistry – and that's why it's a lifetime drug. You can count all the calories you want, but unless your GL1-production is reset at the perfect level – and I don't think there's any indication that WLI can do that, otherwise we'd all be given one super-dose and be cured of obesity in an instant – you have to stay on it.

I think the explanation is quite straightforward. If you diet without WLI you have to put up with the food noise and hunger, so you get used to it and develop coping strategies. Those strategies don't disappear overnight, but it is easy to lose control gradually and start eating more/less healthily, so the weight goes back on gradually, as I know from experience.

I haven't taken WLI (not against them but wouldn't have been eligible when I was overweight due to other health issues) so I can't comment on what it feels like to stop, but if WLI have been your coping strategy for hunger/food noise, it will stop suddenly rather than being a gradual loosening of control, hence the weight will go back on more quickly.

I think it's likely prices will come down when the market opens up. Yes, people are prepared to pay a premium but different companies will want the business, so they will start undercutting one another.