Views on regaining the lost weight after stopping?

[StrawberriesandMango]

I've been using the MJ injections and doing well. I get so worried ready so many posts about the weight will go back on once you stop. Is this really the case. Is there no success story's

The only real research study into maintenance took around 670 participants and, after 36 weeks on mj, put half onto a placebo and half continued with mj. After 72 weeks, most in the placebo group regained a substantial amount of weight whereas those still taking mj continued to lose/maintain. This study was sponsored by EL and concluded that mj for weight loss needed to be taken long term.
However, some questions remain unknown:
1 is there a point at which a desired weight has been maintained for a sufficiently long time with the support of mj that the body no longer sends signals to try and regain so mj can be stopped?
2 What a maintenance protocol looks like for most people.

Obviously, if you go back to eating what you did before, the result will be the same and, as with any weight loss, hormone signalling to eat more will be an issue.

It is also important to note that 16% of those in the placebo grouo did not regain the lost weight. However, nothing is known about the characteristics of these people eg how much weight they lost; why they were obese in the first place (eg insulin resistance, emotional eating, binge eating etc.); how they lost the weight (consciously developed new habits or just ate less of what they normally did); or what they did in maintenance (eg exercise, daily weighing, calorie counting).
The numbers are pretty small in this study in any case but it would be so useful to have more info, especially as maintenance approaches are highly variable in the UK, with a lot of pharmacies just cutting you off at a healthy BMI.

There is a thread on the other forum for weight loss about life after stopping. There is a few of us and we are doing ok after we made major lifestyle changes.

I am on the fence about maintenance doses as I can’t see how in all honesty they would change your appetite in any significant way at such a low dose after being on a higher dose (the suppression would be minimal), and is it just the cost or psychological attachment to the drug that would keep you in line or is it that you need to learn to change your lifestyle and manage hunger as a normal body function? I still get hungry it is normal but I have sunk too much time and effort (and money) into losing weight so I’ve done a lot of work on my mental health around food and my response to feeling hungry.

As with any diet, the moment you stop trying and making an effort and going back to your old habits you may gain the weight back. A lot of people do not realise that the changes you make now during weight loss need to be permanent changes for life. They then stop paying mind to what they are consuming, stop exercising and end up back at the start.

There was a large study into Semaglutide which was more optimistic about weight maintenance in the first year after stopping the drug. https://www.epicresearch.org/articles/many-patients-maintain-weight-loss-a-year-after-stopping-semaglutide-and-liraglutide

It's not Mounjaro but it does give some hope.

I'm 12 weeks in on Mounjaro and feeling cautiously hopeful because I'm using it to break my addictions to 'trigger foods (very specific junk foods)' and to develop better ways of dealing with my emotions. I've never had issues with 'real food' portion sizes and easily feel full after a reasonable meal, but over the last 20-ish years since my mid 30's I've had phases of comfort/binge eating snack foods in the evenings to cope with life's stresses. I've gained weight during these phases but maintained or slowly lost between those times. I've decided I have to view my trigger foods in the way an alcoholic views alcohol and never eat them again. I was always slim until I was over 30.

If/when I get to goal (43kg to go) I also plan to weigh daily and to have an 'upper weight limit', 3 kg above my goal weight at which point I'll cut back until I get back to goal. It's relatively easy to lose 3kg, but 30, 40, 50+kg is really really difficult to lose without help.

I may be wrong, but I think that most of us should be able to analyse our food issues and come up with effective long term strategies, based around our particular struggles with weight and food.

Who knows, I might be deluding myself, but I'm not losing anything by trying.

@Skybyrd i think you are spot on.

My way of thinking is that even if you have a very small amount of appetite suppression during maintenance, it’s this strategy ^ that’s going to work for you, not being able to heavily rely on the medication to do most of the heavy lifting when you are in more suppression.

I went to M&S today to choose my lunch as a treat. I chose the naked katsu bowl as I love this meal. It’s like 300 cals and very filling and tasty. I am at maintenance and could technically eat a dessert if I wanted, but as I stood looking at them, they were mostly 200 + calories and tiny volume of puddings/cakes and I was like… well I could eat like 3+ times as much fruit and it’s still sweet for these calories, be full up and have enjoyed the fruit… so I bought a huge pot of mango. I never would have done that 2 years ago I would have bought the small cake. I’m the same now when I choose to eat out, I never get chips with the meal because they are kind of bullshit calories to me. But I used to live on them! Enjoying the freshness of food is something to pick up now too because it makes heavily processed foods taste worse

I think you're right and the 'volume' rather than 'tiny but indulgent' is a great strategy too. It's fairly well known that we feel full when our stomach is at full capacity or is slightly stretched, so your big pot of mango did that. Plus all the great fibre, vitamins and so on that it contains!

I have done a medically supervised vlcd before that was shake-based and yeah, I gained back all the weight and more so I'm very aware of that as I do Mounjaro.

What makes me more hopeful is that MJ still involves real food, cooking, meal planning, recipe hunting etc and I have really enjoyed fresh, nutritious meals while taking it - so there are habits, lessons and recipes I can take forwards. It's not like doing weird shakes for three months and then having to figure out what to eat irl, or doing low carb or any other elimination diet and then relapsing and going back to eating that 'forbidden food'. I'm eating normal, varied food on MJ that I can carry on eating.

I think I'll be on MJ for a year to lose the weight I need to lose and that's a long time and I am wondering if that will help in terms of hormones and body adjustment - I'm not sure I've ever maintained a diet or weight loss programme for that long before. If I go a year without bingeing, will I break the habit? Maybe?

I'm listening to podcasts and reading books about intuitive eating, binge cycles and the havoc that a lifetime of dieting wreaks on the body and I'm looking up therapists who specialise in overeating and binge eating with a view to spending the injection money on a course of therapy when I come off the drug. (I've tried therapy before, but I wasn't ready to respond or maybe I didn't find the right therapist so let's go again!)

And I'm also using this time to introduce proper exercise - MJ gives me some mental space and energy to do it, so again I'm hopeful this builds good habits for life post-drug.

However, something inside me - perhaps just the voice of someone who has been dieting for three quarters of my life, since I was a preteen and has spent nearly all that time overweight or obese whatever I did - tells me it can't last. But that isn't enough reason not to try.

I'm a new starter on MJ and this worries me too. From what I've read/heard, you can't rely on the injections by themselves. It has to be accompanied by changes to what you eat, how you eat and your relationship with food and eating, doing exercise, changing to a healthier lifestyle overall. Obviously if we go back to the same habits after using it the same problems will reappear.

I am worried too as I lost 2 stone a year ago on ozempic, but had to stop due to supply issues. I rapidly gained a stone again, within about 4 months. I've then gone onto Wegovy and have lost 2 stone and am now at my target weight. I took my last dose in a pen last night and have ordered one last pen. I'm going to reduce the dose each week to make it last 6 weeks rather than 4 and hope that will help me gain control over the hunger. I also need to get to the gym. I'm hoping by having a max weight (my target weight) which is a nice round number will help but I know it will be a psychological battle with myself as I eat due to boredom and stress eat too...

I think self awareness and self honesty is very important when it comes to coming off the medication.

If you are in any way fantasising about going back to old habits and still looking for ways to eat things that you suspect you shouldn't ie. drinking a lot on weekends or eating regular takeaways or having regular days off where you don't track at all then constantly going back to a new you Monday reset, or giving yourself long periods of special time off (like I've seen people not taking the jab away on holiday so they can have 2 weeks all inclusive to basically binge eat) then these are all signs it is more likely to fail. I know it's harsh but the signs are already obvious that it won't work long term. It's your money you are wasting here, not mine so I am only being honest with you that these are the signs that you have not yet made changes that will stick long term. When you are relying on the suppression to not allow you to drink much alcohol that's one thing, but if you are dreaming of the day you are at maintenance and can eat and drink what you want, that's not true. I'm at maintenance and I can't do those things I still have to watch what I eat and drink. You can't go back to the old you

I didn't get to over 18 stone eating like I am now on MJ and this worries me.
In the past I have been such a glutton and massive secret eater. Lots of toast lots of massive bags of crisps. Lots of driving to a drive thru and eating it in a car park or getting it into the house in a plain bag so no one sees it.

What might help me is keeping an accurate diary of what I am eating now and using it in the future for reference.

I would be in treated in podcast recommendations. I have loads of books about over eating I have bought in the past but nothing really clicked.

Firstly, @sunshineandrainbow please don't call yourself a massive glutton. You weren't secret eating because you are greedy or weak, you were doing it for a reason and it was serving a purpose in your life. I think rather than keeping a food diary, you might want to write to explore why it was happening and how it made you feel, and find some compassion for yourself rather than judgement.

The podcasts and books I've been into are kind of at odds with using MJ and with losing weight in general so I am in an odd split situation right now! Podcasts are Life After Diets and The Food Psych, and I've just read The Fuck-It Diet. I have found it very interesting to open up to a humane, compassionate approach to weight, body image and eating although I cannot get on board with giving up on weight loss. It's still very thought-provoking, however, and the exercises in The Fuck-It Diet have really helped me to begin to think about how and why I have used food throughout my life.

It's absolutely addressing the WHY because if your over eating is behavioural/emotional there are things you can do to help you, I was a binge eater and I haven't had a binge for quite a long time, mostly because I have read the books and listened to podcasts and had CBT and now I understand my triggers a lot better and work on them all the time. Stress was a trigger for me, so I have learnt how to manage stress a lot better and not revert to food rewards. It helps when you like yourself too, if you are negative about yourself then you don't have a positive little voice keeping you motivated.

if you have doubts now, list them all out and break them down one by one. Work out the triggers and what other strategies you could put in place. A good one is the boredom eating pitfall - don't sit on the sofa every evening watching TV. Get up and get moving, go for a walk or find a fun hobby to distract you that keeps your hands and mind busy

What has worked when coming off Montgaro?

What also occurs to me about that EL study is that the placebo group stopped taking the MJ suddenly and of course did not know they'd stopped. I don't believe anyone has yet done research into the best way to stop to avoid regain, but it seems to be that suddenly stopping with no prep or plan might be contributory.

Until they can establish the best way to stop, I'm going to just try to plan to transition gradually and hope to work by trial and error until I get the balance right. I feel positive about the fact that people are reported to regain less when they stop WLIs than they do when they stop conventional diets, so there's a potential strength there.

Absolutely. MJ is a tool and during your MJ time you have to make lifestyle changes which will support you once your MJ time ends. The media does not help by calling it the skinny jab.

As @1clavdivs people will titrate down to ‘wean’ themselves off and some may opt for one of the developing maintenance programmes.

If I stopped and reverted back to pre-MJ normal behaviour I would definitely balloon in a matter of months. I started MJ knowing that I will need to take it (and pay) for about 8 months to lose/reduce my obesity and in all likelihood I will pay for a maintenance programme as well.

Hi there - completely agree with the views expressed here and on other threads - the meds are a tool only and the studies so far are small and without much of a ling term view.

The tool is something we've all used differently. I've regained a little weight but my issue was not food noise or binge/secret eating but portioning and eating to please others plus too much sugar. I've accepted that paying close attention to all these things all the time is my best long term strategy.

I do think that the answer for some will be a long term maintenance dose.

It felt scary going off the medication but actually the effect wore off more gradually than I thought it would. (Lower dose then spaced dose)

I think it depends on the person.

some people can come off and maintain.
ithers need to stay on a maintainance dose,

i fall into the last category. If you’re worried about regain, is it a cost or anxiety thing that makes you want to stop?

My view is that it's easier to maintain the weight rather than lose it.

Before covid I lost 2 stone and kept it off easily for nearly 2 years. Then lockdown happened and I sat on the sofa eating chocolate while depressed and the weight went back on. But before that point I wasn't regaining it.

That’s interesting, as like 85 percent of people who lose weight through normal dieting. you did regain it. That stat is over 5 years, you were less than 2. But still think maintaining is easier.

maintaining is for ever, not a short period, and there is always a reason, stress, boredom, etc, the failure rate shows it isn’t easier, far from it. It is an enormous challenge.

Of course maintaining should be easier. Someone might be able to maintain on 2000 cals (for example) but need no more than 1800 if they wanted to lose.

I get what you’re saying about that I only managed to maintain for two years. But due to lockdown went from 13 gym classes a week to none. I also had a slight mental breakdown and made a conscious decision to eat chocolate and get fat as I was sure we were all going to die within six months. Thought I might as well die happy. I can’t imagine being in that situation again. 😁

And I am saying easier not easy. 😁