Weight loss injections v calorie deficit

[LynnAP]

I wonder if someone can answer this as I cannot find any info on this on the internet.

When people use weight loss injections and lose weight, is all it doing putting them in a calorie deficit?

Like if 2 identical people ate 1000 calories a day, one in injection one not, would they lose the same amount?

Because all then info I can find is that injections put you in deficit cos they stabilise bloods etc and also reduce food noise, so you can easily maintain a deficit, but then when I see people's results and the amount they are losing I can't believe that that is just from a deficit alone, it's like stones in a few weeks some of them!

I believe so. Weight loss only comes from calorie deficit, however you achieve that. Weight loss injections suppress appetite, making it easier to cut calories. My own thoughts are that it's better to deal with the psychology behind what causes you to eat too much, but it's complex and can be difficult. Losing weight has many health benefits so ultimately maybe it matters less how you achieve it.

Yes. It makes being in a calorie deficit much much easier. You feel fuller for longer. You feel fuller quicker. You want healthier food. That’s my experience anyway.

Basically yes. You eat less and lose the cravings so chocolate, cheese etc are all easier to cut down on.

I agree that in some cases the amounts of weight being lost seem extraordinary but if people are obese to start with they are likely to have higher calorie needs so they may be maintaining a 1500 or more calorie deficit per day, even though this might not be recommended. Additionally the weight loss is often much faster at the beginning than later on, which applies to most diets and is usually referred to as losing "water weight". So it may be that people are losing quickly to start with but if you looked at their progress over 6 months it seems more sensible.

edited to add: in some cases

No. If 2 people ate 1000, calories per day, one with the injection, one not, they would each have 1000 units of energy. The impact of that 1000 calories in the body would be the same.

All the injection does is alter the metabolism, and stabilise the blood sugar by increasing insulin production. What that means is the person who has the injection is more likely to feel satisfied by their 1000 calories and the person without it might feel hungrier.

The thing is, it's not just psychology. It is very much hormonally and genetically driven, which is why psychology isn't enough.

I was eating for stress earlier in my life, and I went to considerable lengths to fix that, lost a huge amount, and sustained the weight loss for a few years before Long Covid got me.

The weight came back on, and although I've lost some, I know I won't be able to dedicate the same attention to it as before. I'm considering the injections to deal with the hormonal side of hunger pangs BECAUSE I know how hard it is the other way. And I'm confident that I don't have the capacity for that right now.

Don't forget that the heavier someone is, the higher their basic need for calories to maintain their weight. So for me, not overweight, 1000 calories might represent a 500 calories deficit, which means that if I keep that deficit daily, I might lose 1lb in a week.

For someone who is very overweight, that 1000 calories might represent a 1000 calories deficit, which means they might lose 2lbs per week.

The other thing to remember is that not all calories are equal...
the calories gained from eating a plate of vegetables and fruit / pulses / beans / etc. is likely to be far more nutritious than getting the same number of calories from chocolate.

So any form of weight loss needs to consider the wider needs as well.
The injections work (roughly speaking) by saying stop after xxxx number of calories - but they have no perception of how good those calories were for you - a lot of overweight people are so because of badly managed diets and inappropriate balances of sugars / carbs / fats / etc. - just taking the injections doesn't magically cure the diet... but it could help alongside a better diet

It just blocks the hunger so that going into calorie deficit is much much easier than not using the injections. I think sometimes people think they are a magic solution but you still have to work at losing weight and eat less to lose weight.

It works by doing 2 things

• increasing insulin production, how receptive your body is to that insulin and reducing release of sugar from your liver. If you have too much sugar in your blood then your body converts it to fat. So that in itself can help you to lose weight.

• decreasing the speed at which you digest food, so you feel fuller longer.

So the injections will make you use the 1000 calories more effectively and less likely to create more fat as a result of the 1000 calories you eat.

I'm prescribed it for diabetes and its effect on my blood sugar levels is remarkable, I have better results with Mounjaro than I do with insulin.

And I'm losing weight.

Tirzepatide, which is Mounjaro, boosts the body's ability to burn fat. The injections do something with your hormones; it's how they regulate your appetite but also switch on something called lipolysis - I don't know - it's a fat-burning mechanism anyway. So you are eating less food and burning more energy too. Semaglutide, which is Ozempic, works on one receptor but Mounjaro on two so you get this dual action taking place. I believe works are in progress on an injection that will activate three different types of receptor.

I know most people believe they're purely an appetite suppressant, but there is actually a lot more to them.

It also tends to create some desire to make better food choices as well. No idea why. But I don’t eat junk anymore.

It's the hormonal regulation, it changes your appetite as well as reducing it - I think of it like pregnancy when you crave some foods and lose interest in others or are even revolted by them. That's all because of hormonal changes - it's really fascinating. So the weight loss injections have been shown to reduce people's desire for alcohol and sometimes sweet foods or snacky type foods, making that lower calorie intake also a healthier one.

Thanks that’s really interesting to know.

Yep.

I'm on mounjaro and now count calories to make sure I'm eating enough.

Don't even care or think about food anymore.

It's definitely changed my taste too. I can't drink tea or coffee anymore and haven't had bread or chocolate for 5 weeks and couldn't care less.

I wonder if there is a particular type of person that it helps. I know someone who has been on the injections for weeks and tbh, if anything, they seem worse with their ability to control their eating. It genuinely seems to be a compulsion and the injections do not seem to be affecting their appetite. They're not in a place to mentally engage with the process, though, either. There is no desire to lose weight, or rather, no desire to engage in weight loss behaviour.

I didn’t really start lose weight until month 3 so for some people it can just take longer to work. Some people see results almost immediately.

You start on a very low dose and increase. The first month is not actually a therapeutic dose, it's just to get your body used to it to reduce the likelihood of side effects. So some people won't feel any different until they increase up to the second month, or maybe even later in the process. However, a lot of people do respond to the first dose, and some people are even 'super responders' and never need to increase.

For a lot of people the nausea caused by weight loss injections makes them eat at a huge calorie deficit, even more than if they were dieting. My friend has been on them a couple of weeks and she can barely manage 600 calories a day.

It's incredibly unhealthy.

That is bad @ficklebricks but also not the case for everyone on the injections. Side effects do wear off and suppression fades but I'd be very worried on 600 calories a day as that's terrible for someone's health. I would think the ideal is for someone to eat a healthy and sustainable amount while on them to lose weight as a reliable and steady rate, but there will be people who get really adverse reactions and it is really worrying to think of people literally starving their bodies. I will say, I did a 'medically supervised' vlcd once of 700 calories a day for three months through a clinic and I look back in horror now, but these very low intakes do seem normalised in the pursuit of weight loss and it is scary. I hope your friend adjusts soon, or finds another way that doesn't put her at risk.

You still need to work at it though. It cuts the food noise and slows digestion so you feel fuller, longer. I still calorie count and I exercise regularly.

A lot of the critics on here have never been obese, or had health issues caused by being overweight, or felt the compulsion to eat. There is a lot of scaremongering, judgement and fat shaming masquerading as 'concern'. You need to do your research, there's a lot of info from the manufacturers, including the negative stuff.

Also, these drugs are not new, they have been in use for diabetes, and weight loss was one of the noted side effects. The 'new' things is getting the license to prescribe them for weight loss.

Absolutely not the case for me !

My positives are :

Cornish pasty or roasted veg ? RV every time as a CP makes me feel nauseous..

Toast for breakfast of a single weetabix with just milk to make it soft ? The WB every time .

Wine or vodka and tonic ? Actually neither ! Because a glass of water is so much more delicious with a slice of lemon !!

THIS is why they are literally 'miracle' drugs .. they haven't just changed my diet but my behaviour. Now I literally count the hours until I am free to go to the gym !! (Previous gym avoider) .

107 kg to current 73kg

6 months ..

That's 16 st 11 to 11st 4IBs

Can I maintain it ? Who knows but for now I am 'over weight' as opposed to 'morbidly obese' .. and all the pills and potions that costs the NHS. (It was a lot. !)