to feel uneasy about what this means long term rather than surprised by the weight regain itself?

[HazelMember]

I’ve just read a BBC article about research into weight loss injections like Ozempic and Wegovy showing that people who stop taking them tend to regain weight quite quickly.

I’m not shocked that weight comes back. That happens after most weight loss attempts whether they involve medication or not.

These drugs are increasingly talked about as something people might take for years or even indefinitely. That raises questions for me about what happens when someone cannot afford them anymore, when supply changes, when side effects become an issue or when a person simply does not want to stay on a medication for life.

If stopping leads not just to regain but to a fairly rapid rebound, it feels less like a temporary aid and more like something that is very hard to step away from once started. That sits oddly with how casually they are sometimes discussed.

AIBU to think the real issue here is not that people regain weight after stopping, but whether we are quietly normalising a treatment that may be difficult to discontinue once begun? Or is this simply the reality of managing a chronic condition?

It is known that most people who lose weight - by any method - will usually regain their weight and then some. And we know why. The hormones leptin and ghrelin, the ones affected by WLI, physiologically cause weight gain when not controlled. It’s how humans work. So it is not at all astonishing that people who stop WLI are at risk of regaining weight, especially when studied as part of a snapshot trial, without the associated motivation, mindset and lifestyle modifications that are usually present for successful weightloss.

But here’s the thing. People now have a tool to manage those pesky hormones and to lose weight successfully. I’m someone who has done just that and is delighted with the results. Not only am I slimmer and more confident, but my cholesterol, HbA1c and inflammatory markers are all improved too. So now I’m embarking on the next phase, to maintain this healthy state. I’m slowly reducing my injection dose and would like to come off completely, but if my hormones start to wreak havoc and spoil the party, I can kick them into touch once again. Of course it will take some effort to stay healthy, but it’s a much, much better place to be starting from.

Oh and I can’t remember who asked who sold food and pharmaceuticals, but Asda, Tesco and Morrisons all offer WLI

It was me. The person I responded to was talking about manufacturers not supermarkets, and presenting a conspiracy whereby they push fattening food on us so they can then make money from WLI. I was pointing out that the companies making WLI are not the same ones making UPF foods.

Yes it looked at the trials. Subsequent reviews have looked at real life participants, ie those not on a free trial and found weight loss much higher than 8kg and weight loss stays off. But yes in the trials the weight loss was limited and when folks finished the trial they regained quite quickly, unlike the people who went on the drug outwith the trials.

Do the trials mention whether people changed what they ate or whether they just ate less?

I’m not sure but I can see why folks on a trial would be less committed. I’m not even sure ghe trials are relevant now, for me the real life experiences are way more relevant and they show weight staying off and much larger losses.

That makes sense to me. In a trial you’repaid to do whatever’s asked of you during the trial period and then at the end you’re going to return to your normal life.

In contrast, someone who’s stumped up to pay for the medication out of choice because they are motivated to lose weight, and has done it all in a real life setting making the necessary adjustments to their usual habits, seems to me far more likely to keep the weight off afterwards.

Yes, absolutely, and people are on average losing much much more than 8kg, I don’t think many go on to lose that little. For me the key data is real life usage, and the studies done on that are very different.

i mean who cares really if people on the trial lost a small amount of weight then gained it back after.

Also in any of the early trials participants would have had to follow 'the trial protocol'. They would have been increasing the dose every 4 weeks from 2.5mg, to 5mg, to 7.5mg, etc up to 15mg. I would never have made it. struggled to get beyond 6mg without suffereing from nausea. However, on something between 2 and 4 mg I have lost 20kg and I have been maintaining a healthy BMI since July.

I would have been kicked out of the trials because I couldn't adhere to the schedule. I'd also not have been able to take anything other than the 'standard prescribed dose' i.e. 2.5mg or 5mg - no half doses or adjustments by counting clicks. tbh I've had the same with a prescription medicine for blood pressure where I can't take the full dose without feeling lightheaded (probably a drop in BP) but a half dose - which keeps my BP perfectly stable - is 'clinically ineffective' according to my GP. Well, actually not for my body!

Also, I think in some of the early trials the WLI just stopped. There was no titrating down, there was no long term management. There was no supportive communiity.

Having spent a lot on money on WLI I am incredibly motivated to keep on maintaining a healthy weight. I don't want to pay that all over again.

I was going to ask about the reduction, so at the end of the trial they just stopped?

There were 37 trials included in the meta analysis. Of the handful that were about tirzepatide (Mounjaro), the participants either stopped at the end of the trial or were switched onto a placebo. During the trials they were encouraged to stick to a 500 cal daily deficit and aim for 150 mins of exercise a week, but there is no analysis of whether they actually did any of that, either during the trials or afterwards.

Most people on lifelong medication, like me, have diagnosed illnesses (Multiple Sclerosis, in my case) and do not have a ‘condition’ that is self-inflicted (by eating too much and moving too little).

Dont get me wrong, I’m around a stone and a half overweight myself so please don’t take this as ‘fat-bashing’ but it hits a nerve for me when I hear someone refer to obesity as a ‘condition’ when their choices led to their ‘condition’ and there was nothing I could have done to prevent mine.

I wish everyone on WLI all the very best, I’ve heard some great success stories! 😊

I was overweight with a bmi of 29 last March. I did consider WLI's and could afford them. But I decided against die to my concern of side effects and definitely being able to come off them. I personally don't want to be on any medication for life.

I did lose weight and am now at a bmi of just over 25 as I felt like changing habits and routines was the healthier thing for me in the long term.

But the concern about rapid weight gain when coming off it was real as was being dependent on a drug for the rest of my life. And it clearly is a real concern as it is being as the issue is already being addressed by the medical community itself. So there clearly is more to it than people not being able to stand 'fatties being thin.'

Well done on your weight loss 👏@Matronic6

@Matronic6 would you have been eligible for a prescription at BMI 29? Presumably you have a weight related health condition that would have qualified you, or you qualify on ethnicity grounds where the boundary for an obese BMI starts at 27.

They're not.

I have them prescribed by my GP, so there's no charge. But they are not for weight loss. They are to manage a medical condition (diabetes).

What point are you trying to make, your post comes across that you feel obese people are less deserving than uou as in your opinion they became obese for eating too much and not moving enough. I’m sure you don’t mean this, so maybe explain more?

I do wish to be on them for life, and have had no side effects.

My primary reason to stay on are the health benefits in terms of cardio vascular, kidney, liver health, reduced inflammation, the anti ageing effect this gives on our organs, reduced cancers and now other elements being tested ie reduced dementia. So so many health benefits.

the icing on the cake is being able to stay slim, not struggling, not feeling deprived, maintaining my weight with ease, and liking my appearance again and the mental health benefits all that brings. So for Me, it’s a yes please.

I didn’t say anyone is any more or less deserving of anything. I don’t feel obesity should be classed as a ‘condition’ in the medical sense, that’s all. Have a nice evening.

What should it be classed as then?

@ladyamy is that opinion about obesity as a condition based on anything, as it’s at odds to the medical bodies that look into these things. They do classify obesity as a disease or condition in a medical sense. You believe it’s not something medical because you think it’s a simple choice and that anyone who is obese could easily become not obese if they chose not to be.

Except people with medical qualifications and expertise say otherwise.

Its classed as a disease.

I would have agreed with you post menopause and now I have put on 1 stone 5 pounds on in the space of 7 months. Admittedly some of that was going to lots of celebrations over the past few months.
Insulin resistance is a thing and it’s so hard to reverse. Of course it can be done but it’s so difficult. What worked 11 months ago doesn’t work anymore. Or it takes longer. I am in favour of these drugs, it gets people out of insulin resistance and stops food noise.

I don’t feel it should be, like I said upthread.

Because it’s self inflicted in your view? Again what should it be classed as then?