You shouldn't take weight loss drugs. Learn about healthy eating, eat less and exercise more.

[GapTshirtsAreShitQualityTheseDays]

This is like telling an insomniac "don't take tablets, just get more sleep"

I'm 41.
I have tried.

I KNOW all about healthy eating. Probably more than most slim people.
I don't have an emotional/binge eating disorder, I just have a bigger appetite than most people. I can only control it so long via willpower or low-carb diets. The drive to eat is the most powerful instinct known to man (except maybe breathing)

It's the weight loss medication that takes the edge of said appetite and ALLOWS me the space to make sensible decisions on food.

I've gone from 15 stone to 9 stone (I'm short). If these drugs had been invented 20 years ago, my life would have been much better.

And no, I didn't steal the drugs off a diabetic. I got private prescriptions for Wegovy and then Mounjaro which are only marketed for weightloss.

And yes I am quite prepared to take the drug forever if necessary.

And no, I don't care about the "potential unknown long term side effects" because they can hardly be worse than what I was facing with obesity.

And although exercise is beneficial for many reasons, it is a fairly trivial factor in weightloss.

@PrincessPeache I have given up most UPF foods and feel so much better plus I've found it easier to maintain the weight I lost.

I don't see weight as a moral issue. There's lots of factors to it and I don't think there's a simple answer to long term weight loss. I gained weight because I ate too much and too much of the wrong thing. It was as simple as that. I lost weight because I stopped eating so much and what I did eat was healthier. It was very simple for me. But that's me, it won't be the same for someone else. I eat pizza, chips, chocolate, crisps, cake, biscuits and sweets but the pizza, cake and biscuits are homemade and not often. Sweets even rarer. Chocolate is my one vice that is ultra processed unless I've bought some decent stuff. There's often a strange belief that slimmer people just don't eat the foods I've just listed. I can't speak for anyone else but I certainly do. I'm a carb fiend. My death row meal would be veggie lasagne, chips, salad and garlic bread. Or pizza and chips. Followed by apple crumble and custard or chocolate fudge cake and ice cream. I love carbs and they form the biggest part of my diet. I've forgotten my point now thanks to adhd and perimenopause 🤣

Do you not understand the importance of insulin and leptin, the signals they send, and what the receptors do when they receive this signal? The body doesn’t always ‘allow’ weight loss to happen. The mechanism is more complex than what you are saying and hormones have so much more to do with it.

@Frequency let me try to make it a bit simpler for you - you can control how many calories you take in, you cannot control how many calories you exert. You can add a lot of exercise in, and your body will pull levers in the background to drastically reduce the number of calories it’s burning to make up for the exercise if it is receiving signals from leptin that your fat stores are vulnerable to depletion. And it will believe this if you have a history of reducing calories to lose weight, regardless of what your fat stores actually are.

15 to 9 is vanity?

What could possibly be wrong with being 15 stone? Ppfft

15st to 9st being vanity weight loss is the most batshit thing I've read on mumsnet for a while

In that case, where does the body get the extra energy? Energy is vital to survival, our heart needs energy to beat.

If we eating less than we are using, but the body is not "allowing" us to lose weight because leptins then where is it getting the energy to keep us alive?

I am well aware that certain foods have different effects on our hormones, hunger, mood, digestive health, and so on but none of that negates calories in vs calories out.

We have overcomplicated something very simple with complex science that 90% of the people quoting it do not understand.

I definitely think there are massive variations in how people experience hunger. Hunger doesn’t really bother me. If it’s at an inconvenient time for me I’d rather just wait and eat when I’m home or finished what I’m doing or whatever. It’s clear the urge to eat when hungry is stronger in some people.

The body gets the extra energy from the food.

Say your TDEE is 1600 calories. If you eat this every day, you maintain a healthy weight. But then you start exercising and burning through your energy reserves. The hormones send panic signals to your brain and it slows down its processes, so they are no longer efficient. You are tired and sluggish and can’t keep burning that much energy. The hormones in your body signal to your brain that you need to take more energy in. Your TDEE decreases, because your body has slowed down its processes and now you only need 1500 calories to keep your body going. Repeat until your TDEE is around 900 calories and you’re obese because you’ve confused your body so much that it no longer trusts that it will ever be fed properly.

Hadza hunter gatherers

Research on Hadza hunter gatherers explains this well. Exercise doesn’t impact on energy expenditure in the way we have traditionally believed it does.

”Our results indicate that daily physical activity may not predict TEE within traditional hunter-gatherer populations like the Hadza. Instead, adults with high levels of habitual physical activity may adapt by reducing energy allocation to other physiological activity”

This research has been instrumental in better understanding obesity and why “calories in, calories out” is an outdated concept.

100% agree with you.

I was a "naturally slim" person for the first 30 years of my life. I felt full after eating, struggled to over eat, naturally at less at one meal and more at another. Felt satiated eating most foods which made making healthier choices much easier.

Then like a light switch, something changed. Almost over night. Suddenly I could eat and eat without feeling full. Food constantly occupied my thoughts, I was constantly thinking about my next meal. I didn't feel satisfied until I'd eaten my craving and my cravings were almost insatiable and almost invariably sugar. I tried every diet going. I'd lose weight, be miserable and constantly hungry (yes including doing high protein low carb). I'd be miserable that I couldn't eat food I enjoyed.

And yes, I exercised. I rock climb, I hike, I swim. I play netball and rounders and cold water swim, canoe and ski.

I gained 5 stone, lost it all, gained 6. Constant hunger. Constant cravings. It wasn't normal. It wasn't something everyone else just deals with. I KNOW because I didn't always feel that way.

I started on ozempic and it's like the light had been turned back on. I was suddenly not constantly thinking about food. I'd enjoy the food I cooked, I'd feel full, I could eat as much as I needed to feel full and leave the rest. I didn't take a dessert every time it was offered because I didn't always want it. I finally felt normal again.

When I was a healthy weight, I had no idea that obesity was like this. I just thought it was people who felt like me but made bad food choices, or who ate past feeling full. How wrong I was!

And I'm sure that obesity isn't like this for everyone, I'm sure for some people poor food choices are due to a lack of education or inability to cook/ lack of funds etc, but those are probably the people for whom ozempics side effects are to severe or it "doesn't work".

And yeah, pancreatitis and gall bladder issues are a possible side effect of significant weight loss, regardless of method.

But that is still calories in vs calories out. You are expending less than you are consuming.

Your TDEE cannot get to 900 calories. It is physically impossible, we need at least 1200 calories just to stay alive. our hearts, lungs, brains, stomachs, etc use more than 900 calories a day to function normally.

Your BMR can drop that low when your body starts to slow or shut down vital functions. That's how people die from starvation, but your TDEE cannot drop lower than your BMR. If your science made sense anorexics would be obese but they're not (for the most part).

Yes and I’ll be honest that was my attempt to explain it from memory of a book I read last month and I completely fucked it up so you’re not wrong, but the link I posted shortly after explains it - essentially that the amount of exercise you do doesn’t impact your energy expenditure as your body just reduces its expenditure in other ways to compensate.

The point that I’m trying to make is that we can control calories in but we can’t control calories out. And when the hormones that control hunger and satiation are fucked from years of yoyo dieting, calories in isn’t a simple case of willpower.

I appreciate that once obese that things change. The question is why are people getting obese in the first place? Why is there no off switch? Some people gain a few pounds and know to rein it in and do so. What makes others not? Disabilities aside.

@LegoTherapy I can only speak for myself, as someone who's BMI got above 50, so waaay fatter than the OP, but I can honestly say I don't know. I haven't always been obese, very skinny as an infant, barely ate, worried my parents at how little I survived on, very slim until about the age of 9-10, no crisps or biscuits in the house, sweets were a treat and a few half penny chews at that. Food was food, you ate what was on offer and then went out to play !
I had a bit of hormonal weight gain as a teenager, but never fat, just not heroin chic slim, it was the 90's.
Was just under 11 stone when I met DH, now 20 and still losing weight. I think stress, childbearing, contraceptives, and just bloody loving carbs of every savoury variety, plus wine, have been my downfall, add in a couple of stints of depression and you had a perfect storm.
Why didn't I stop when I was 14 stone, my weight after the birth of my last child and my current goal, I'm honestly not sure ?. this did coincide with one of my depressive episodes.

I am also a bit of a feeder, a trait inherited from my Father, and I didn't really 'get' the concept of leftovers until relatively recently, despite having had a freezer for years ! I just divvied up what I had cooked between the number of people eating it, and that was often two people, eating a meal that would feed 4-6. And I would merrily eat until I had finished it, despite not actually still being hungry. Or even being that hungry in the first place !
Also and probably more importantly, being fat didn't stop me doing anything I really wanted to do, people didn't treat me differently, I wasn't on the pull and have no interest in the male gaze, how I look simply isn't that important to me, which my copious and luxuriant facial hair will testify . So it didn't impact my life in a negative way.
Until it did.
I reached the point where I realised I wasn't able to do ordinary simple tasks because of my weight and quite honestly I was knackered all the time from just carrying myself around.

I'm familiar with that study but I thought it was looking more at NEET (non exercise energy expenditure) rather than the impact of calories in/calories out.

If you exercise too much, and don't take in enough energy to compensate for it, your body will likely compensate by shutting down/reducing NEET by making you feel tired and sluggish and therefore more likely to go to bed early or fidget less.

Your body can also become more adept at repetitive movements, and thus expend less energy on that movement. A new runner will burn more calories per mile than someone who has been running all their life.

I do agree it is not a case of willpower alone. That's why I said the best diet is the one you can stick to.

Sure, weight loss drugs are not without risk. Neither is Atkins or Slimming World or Fast 800 etc but they're all a lot less damaging than obesity so if that is what works for then that is the best diet for you.

Someone who eats nothing but processed food, but only eats 1500 calories worth, is not going to be as healthy as someone who eats only whole foods but if that someone does not like whole foods the point is moot. They are not going to lose weight on the whole food diet because they are not going to stick to it. If they can stick to 1500 calories of processed food to lose weight they're going to be a hell of a lot healthier than they were when they were obese and eating nothing but processed food.

I can completely relate to this.

In my case, I have always been heavy, and from a very young child I have equated that to being fat. I started making myself sick after meals at 8 years old. I was counting calories from 11. I exercised regularly and hated the way my body looked. I was a size 12 and was heavy. And then I got a part time job in a supermarket where it was easy to grab a meal deal for lunch every day. And then I went off to university as a size 16 and worked part time in a sandwich shop and would work 12 hour shifts with a free breakfast, lunch and dinner and I was skint and hungry so I made sure these were large meals. And then I met my exhusband at 21 and we lived off junk food because we were both living with our parents and didn’t really have access to cooking healthy meals and because it was cheap and easy and tasty enough not to.

And then I was struggling to fit into my size 18s and went on a low carb diet and lost three stone and got back to a 12. We got married, and then infertility hit and I ate my feelings and the weight went back on so much more quickly than it ever had because my body knew it was at risk of another ‘famine’, and then divorce happened and raising a severely disabled child all alone happened and I dieted constantly and it never fucking worked. I’d lost a stone and then I’d stall. And I’d be eating 500 calories a day and still not lose weight. So I’d eat a bit more and then gain weight. Repeat a hundred times.

And I broke my body. It no longer works the way it is supposed to because it is so damaged by years of this shit. I was exercising every day and doing everything ‘right’ and I was still gaining weight.

And then I got to 21stone and found mounjaro. And now it’s ten weeks later and I’m 17st 4lbs. And I will probably be on this medication for the rest of my life and that’s ok because it is so much better than the alternative.

If you exercise too much, and don't take in enough energy to compensate for it, your body will likely compensate by shutting down/reducing NEET by making you feel tired and sluggish and therefore more likely to go to bed early or fidget less

But this is what exercising to lose weight is. It’s doing exercise that your body sees as above and beyond, and compensates by reducing your energy expenditure. Except you can’t just go to bed when it exhausts you because you have normal adult responsibilities so your body pulls the levers it needs to to get extra energy - it makes you so ravenous that you can’t ignore it, you have to eat. And your body needs that energy hit so it craves a sugary, fatty little bomb of energy that is almost definitely going to contain far more calories than you burned through exercise.

@Frequency it's actually really easy to eat 1500 calories of processed food isn't it ? Especially if you aren't adhering to their recommendations for portion size, the bowl of cereal being a good example, portion size is usually around 30-40g, which looks tiny when poured into a bowl, I think most people have double that or more if they go by what it looks like in their bowl. Which can take the calorie content from 150 to 400 easily.

@PrincessPeache Does this depend on the type of exercise you do ? so weight training as opposed to aerobic/cardio ? I have just started by walking more, more because I am worried about injury. If you increase exercise slowly and incrementally would it have the same effect ? or will your body be able to deal with slow adjustments to your exercise levels better ?

'15 stone to 9 stone is nothing life changing, it's just a vanity loss.'

Is it fuck. Idiot.

It is sooo easy to overeat on processed foods. That's the whole point of them, I think. They are created by science bods to make us need to eat them. This is why I do not eat chicken nuggets anymore. I can't eat 1500 calories of chicken nuggets. I eat all of the nuggets or none of the nuggets. There is no balance for me when it comes to highly processed, savory foods. I can take or leave sweet things but if you put a plate of Gregg's in front of me, I will eat it all and ask for seconds.

And cereal portions are just ridiculous. Even a 3-year-old would not be sated after a "portion" of Kellog's Cornflakes, again, that's kind of the point. They want us to eat a box of cornflakes a day.

Exercise is ALWAYS a good idea and is fantastic for over all health, just not for weight loss. If you’re pushing yourself too hard you’ll be exhausted and eat more to compensate. Doing it gradually and building up is sensible.

I'm up to 56 likes on my OP! Thanks everyone. There are many of us out there who have struggled for years. Let's remove the shame and stigma of a) being fat and b) taking the injection!

I just have a bigger appetite than most people

And for as long as you believe that (because you were told it during your formative years) you'll struggle with your weight.