To wonder what happens when you reach a healthy weight on Wegovy etc?

[Milsonophonia]

I have three friends who were mildly overweight who've used Wegovy. All are now looking very slim - one looks a bit frail - she's lost 3 stone. Two of them lied online about their weight to get it. Anyway, they are happy with their new thinness and the new reasrch that it's a potential wonder drug.

What happens when you stop? Do you get the anti inflammatory benefits forever? Or does everything on your body return to how it was - hunger back, no anti inflammatory benefits?

I'm constantly tempted - have a bmi of 29 and need to lose a good stone and a half - but can't seem to find anything about people who have stopped the drug.

Also I'm slightly worried one of my friends is going to disappear, as she's already thin but still taking it. Can you just take it forever?

Quite a few people had told you that maintenance doses can now be prescribed.

But everyone is different. I am a fattie and only lose on 800 a day. On any more I don’t lose at all.

Then that is what people can do if they choose to. Why is that terrible?

I don’t get this at all 🤷‍♀️

Have they?

@Milsonophonia you already know that this friend has lied about her weight and faked the required photos in order to be prescribed in the first place. A sensible assumption is that she is still duping them to continue to get a prescription. Or she's over ordered and stock piled pens. Or she's acquiring it illegally.

Yeah. I'm sure it's one of these.

I wasn't sure if she was now on a maintenance dose or something as @Wonkypictureframe says that can be prescribed apparently.

Yes. I had! And I wasn’t the first.

Wow this is amazing. Congratulations

I do really wonder about the narrative that your weight is down to your choices.

My DP battles to be a healthy weight everyday. I am a healthy weight and I've never dieted. As a teenager I was underweight and found food 'boring'. Everyone describing their appetite on these weight loss drugs sounds like me as a teenager. I frequently 'forgot' to eat

Just makes me wonder if some people naturally have higher hunger hormones, and there's not much you can do about keeping a low weight when food is plentiful. I don't think if you're overweight it's your fault

I don't think I ever heard the phrase "food noise" until these drugs emerged.

Possibly because people who experience it didn’t know they did until it was gone?

I guess it was like me on Sunday

I'd eaten breakfast and was quite full

But I still ate a croissant because I 'fancied it'

Presumably mj etc takes away the fancying part

Or there was no need to give it a name until people were trying to describe its absence.

Mounjaro works by regulating insulin production which reduces your blood sugar, by a) mimicking the hormones that create insulin so you produce more and (b) making you more sensitive to the insulin you do produce.

We know that at minimum 10% women have PCOS, it's highly likely that this number is higher as many people do not get diagnosed either because they don't seek diagnoses or because they are fobbed off by doctors.

A common trait amongst people with PCOS is insulin resistance.

Common symptoms of insulin resistance are:

Over time, insulin resistance can get worse, and the cells in your pancreas that make insulin can wear out. Eventually, your pancreas is no longer able to produce enough insulin to overcome the resistance, leading to elevated blood sugar (hyperglycemia), which does cause symptoms.
Symptoms of high blood sugar include:
• Increased thirst.
• Frequent urinationon (peeing).^
• Increased hunger.
• Blurred visionon.^
• Headacheses.^
• Vaginal and skin infections.
• Slow-healing cuts and sores.
Many people have no symptoms of prediabetes, often for years. Prediabetes may be invisible until it develops into Type 2 diabetes. Some people with prediabetes may experience the following symptoms:
• Darkened skin in your armpit or back and sides of your neck, called acanthosis nigricansns.^
• Skin tags (small skin growths).
• Eye changes that can lead to diabetes-related retinopathyhy_.^

Thirst is often confused as hunger, and increased hunger is also a symptom. So it's very possible that many overweight people are actually experiencing symptoms of high blood sugar, which make them eat more, which increases weight, increases blood sugar and leads to a vicious cycle of constant gnawing hunger.

It was so normal for me that I didn't even think about it. It's been the same for pretty much my whole adult life. And a lot of my teens. I used to be really amazed at people who could forget to eat, or who could eat and then stop even if they were enjoying the food but were just full.

From the first day that I started on Mounjaro, all that mental process just disappeared.

It absolutely does. I was always fancying big chunks of cheese as I made my kids’ tea. Don’t even think about it now.

Do you know why this happens? Have you had your thyroid checked?

But everyone is different. I am a fattie and only lose on 800 a day. On any more I don’t lose at all.

What is your BMR? Have you had this checked out? If you genuinely only lose on 800 calories (and are accurately counting your cals) then there is something going on which should be looked into.

She will likely be in a maintenance dose for up to 2 years.

I'm one of the overweight but not obese people taking it. I've been on it 2 weeks and lost 6lbs which I'm really happy with. I get mine from a completely regulated and legit online pharmacy, you just have to lie about your weight no photos needed. My friend tried all the different providers to work out what the requirements were and found this one.

I am fully aware all the loopholes will be (and to be honest should be to stop anorexic people getting hold of it) closed eventually, hence why I wanted it now. Personally I'm reasonable at maintaining my weight, but absolutely awful at losing weight. I seem to have quite a wide range of calories I can maintain on, but need a very small amount to lose. I'm also an extremely greedy person with no willpower, so as soon as I knew this was available, I wasn't ever going to stick to my low carb diet I was doing before. If it's not possible for me to get, then I'll be more likely to try other means.

I'll take it for a month, then see if I can keep up the reduced portion sizes I have been eating. I already ate a varied and balanced diet and do a decent amount of exercise, it's volume of food that's my problem. I don't eat much processed food at all, but I love good food, cooking, baking, eating out etc and I have a huge appetite. If I don't keep it off and go back up to my original weight, Ive not lost anything. I have felt a bit sick, but that's it really. My BMI was 27.

In my experience when this happens a GP will check your thyroid and when that’s normal will shrug and/or assume that you eat more than you think. I have several symptoms of PCOS or similar hormone imbalance, which could be a reason for such a wonky metabolism, but was told I could only be referred if I were either diabetic or experiencing fertility issues. Weight gain is ‘just one of those things’.

Thanks for being so honest.

Exactly. If people are reporting visible muscle loss, what on earth is happening to muscle such as heart muscle?

I was on a related drug, Trulicity (dulaglutide) for 5 years. It is prescribed for diabetes rather than obesity, but weight loss is listed as a possible side effect. I initially lost about a stone and a half on it although subsequently regained some of that. Suffice it to say that the variations in my weight due to other factors were greater than the change related to Trulicity.

I have been obese my whole adult life, morbidly obese for most of it. Not for want of trying, believe me.

Once Wegovy etc became available for weight loss, the availability of the related drugs for diabetes became a national problem. I couldn’t get my Trulicity in February, got it in March, and then could not get it in April.

Happily, though, I had embarked on a major lifestyle change in January, after being told that my diabetes was way out of control and I needed to start an additional drug. I declined. Instead, I cut down on snacking and puddings, gradually transitioned from a lot of processed food towards whole food, reduced carbs, and then a few months later added intermittent fasting. Thanks to these, I now have near normal blood glucose WITHOUT the Trulicity and without the metformin I also took for over 20 years. I have also stopped the statin I was on. I have lost over 4 stone.

What I have learned is this:

1. the modern diet (a lot of processed foods, especially carbs, and frequent eating) causes chronically raised insulin levels. That causes insulin resistance, and makes gaining weight easy and losing it hard. It also causes type 2 diabetes, PCOS, high blood pressure and a load of other issues.

2. Insulin resistance and it’s sequaelae can be massively improved, if not removed entirely, by eating less frequently, real food, lower carbs.

3. When you eat that way, hunger and cravings rapidly diminish. The food noise, which the GLP-1 drugs help with, are a consequence of the modern diet. And they will go away if you change what and how often you eat.

At my heaviest, my BMI was 48.5. In January it was 41.5. Now it’s under 32. And I am most of the way towards putting my diabetes into remission after having it over 26 years.

I now have multiple proofs from my own experience that the more often I eat, the more I want to eat; also that processed carbs, and to some extent seed oils, stoke up my appetite. But give me a few days of natural low carb foods, and the cravings fade to almost nothing. I’m also not that hungry any more, even when fasting.

Ha ha ha what medical school did you go to?