Weight Loss Injections - Longterm?

[BruFord]

Sorry if this has already been covered, but I'm genuinely curious about this. If you use a weight loss medication (any of them) and reach your goal weight, do you need to stay on it really long term (i.e. years)?

If so, what's the reason? My understanding is that the medication is effective in conjunction with lifestyle changes so wouldn't those changes maintain the weight loss?

Obviously, it's different for Type 2 diabetics who need the medication to help lower the amount of sugar in their blood. They could have very serious medical consequences if they stop.

I'm wondering about the affordability of taking it long term.

It all depends. Some people are very confident they have everything they need to keep the weight off - healthy diet, more exercise, etc.
Others, me included, are planning to stay on for as long as we can. We all have our unique reasons. Often these are linked to one of the many metabolic dysfunctions and other conditions MJ has been shown to help with (or possibly may help prevent) - heart disease, T2D, PCOS, addiction, dementia, etc. In some of these situations, achieving a healthy weight is only part of the reason we started taking WLM.
So you have to make your own decision based on your knowledge of your own body, your particular risks and emerging research.

@KrankyKumquat Yes, I completely understand continuing to take a medication if it helps alleviate medical conditions.

I was curious about maintaining the weight loss aspect and whether it’s necessary to stay on them long term if you don’t have a coexisting medical condition. Are the manufacturers encouraging this for financial reasons rather than medical ones?

The vast majority of clinical trial participants regained the weight once they stopped taking the medication. Just like your BP would go up if you stopped antihypertensives.

People like to think they will maintain without the meds. Obviously there will always be outliers who manage this, but for most of us, this will not be the case.

I personally take mounjaro and expect to be on and off it for life.

I took it for a year, and had three months off due to affordability and gained ten pound . I was starving much hungrier than before so it definitely doesn't stop the hunger. This time I anticipate staying on for life

I don't think the manufacturers or more accurately, the prescribers are encouraging continued long term use. Up to about a month ago, none were offering maintenance options and were cutting people off at bmi 25 and/or after 2 years maximum. But gradually, several have now started to.
This obviously makes good business sense but is also a recognition that keeping the weight off after any diet is really hard and many find they regain all their lost weight and more. Not all do and hopefully, you'll be OK but MJ is no different to VLCD, fasting, keto, WW - it doesn't permanently change your metabolism, your appetite, your satiety levels, your willpower, your hormones, your body's tendency to lay down fat, or your body's 'set point'.

@AgathaMystery I totally get the blood pressure situation if it’s caused by medical factors (genetics, hormones, etc.) that can’t be negated by lifestyle changes.

I suppose I thought that if the weight loss medication wasn’t prescribed to combat a specific medical condition, rather to help the patient to make lifestyle changes, that it wouldn’t be necessary to continue taking it for years.

Perhaps that’s unrealistic.

You can absolutely make lifestyle changes. I’ve personally made loads. You have to. You can’t tollerate the meds otherwise.

What I am not, however, is hungry.

These lifestyle changes have been absolutely sustainable (for me) because in 7mth I haven’t been hungry. No real temptation, no real slip ups, just steady, unrelenting progress.

It feels miraculous.

@AgathaMystery That’s fantastic!

I think you need to do some reading about the causes of obesity in many people. It often isn't caused by lifestyle but more by genetics, hormones etc.

Obesity IS a specific medical condition not just a case of people making the wrong food choices/ not getting enough exercise.

@IReallyNeedThisToWork Yes, hence I’m differentiating between medical reasons for obesity and lifestyle choices.

The first absolutely requires long term (perhaps lifelong) medication, but does the second once you’ve kickstarted the necessary changes and adapted to them?
I feel like the current talk (chatter, trend, perhaps) is to stay on them.

Many of us have lost (and regained and then lost etc etc) the same weight all our lives. We've made lifestyle changes and got thinner, only for eventually the weight to go back on again. Lifestyle changes don't exist in a vacuum - personally I have never ever managed to stop the food noise, or magically retained the ability to stop at one biscuit if I start, over long periods of time. If I lose the weight (last time I did this I lost 5.5 stone, was a size 12 for the first time ever, running 10Ks and very happy) it ALWAYS feels like I'm walking a tightrope until the weight eventually goes back on.

I kept the weight off then for three years, and thought I was 'safe'. But then I had a hectic crazy year last year, work stress on top of moving house and insane teenage behaviours to manage as a single parent and...... 3 stone went straight back on.

This is the disease of obesity. This is why for me long term use of Mounjaro is attractive. I'm absolutely sick and tired of being strapped to this rollercoaster and the relief of being freed from the food noise and sense of impending failure has been significant.

Hey! Wanted some advice please. I have decided to try Wegovy or Munjaro for weight loss, however I am not sure if it’s worth paying a bit more and go with companies like Numan who provide health coaching together with medication, or use medication only? Anyone found using health coaches useful for long term weight loss?

I absolutely agree with @IReallyNeedThisToWork and I would also add environmental and social into the huge list of complex reasons for obesity.

Obesity is the symptom of a medical condition. That medical condition may not be clear like diabetes, it could be MH, addiction triggered by the environment we now live in.

I don't think it is clear if those who "succeed" to lose weight on MJ and hit goal, if they will be able to come off the medication without those triggers reengaging. For many people taking MJ will be the first time in their lives they haven't craved or obsessed about food in their adult lives. That is a medical condition regardless of the trigger.

Hopefully in time more affordable medications will become available, they are looking into oral Mounjaro for maintenance, but that is likely to be many years away. For maintenance, once you have reached goal, some pharmacies are looking at plans where you can use Mounjaro only when you need it to get back on track and before you end up spiraling downhill again. We are all explorers of this medication and how it will be best used for us as individuals, once we get to goal, may be very different.

@Muminhamp to be honest, this is something only you can answer as you are the only one who knows what you want/need.

i started out with Voy who offer a full package with coaches etc (for a lot of money!) and found I didn’t need that level of support at all. It was also impossible to get an appt with my coach at a time that was suitable for me or within the following month!!

I have since moved a couple of times as I have become more clear about what I DO and DON’T want/need.

Also remember that you don’t need to stay with one provider for ever. You can change whenever you want up until you reach a bmi that some might not accept. Good luck!

This is a really good question and something I’m totally ruminating about. I don’t want to stay on the drug long term because I’m worried about side effects.

I have turned to MJ because I’ve made all the lifestyle changes within my control, I work out 5-6x a week, hit my steps, have a PT, track my macros, I’ve had therapy for trauma, I take AD’s to help with my anxiety, I’ve rescued my working hours, I get enough sleep. I can cook - I’m an excellent cook and an all about fresh food and reducing UPF.

BUT i still find myself binge eating, and quickly gain weight whilst actively trying to diet and train.

So I just don’t know what the answer is.

@85reasons the tightrope you talk about is so true. When I’ve been slim it’s dominated my every thought. It’s a constant battle. It’s so exhausting, first put on a diet by my Mum at 8 or 9 and I’ve battled ever since.

Am also thinking what are the long term effects as it a relatively new drug, as well as cost implications for needing it for life.

Has anyone heard of this?

B-clamp or BariClip?

Seems like this is the new kid on the block as far as obesity treatment, It’s not a gastric band but a surgical clip that goes around the stomach and is apparently fully removable (unlike permanent obesity surgeries). It apparently has the same effect as a gastric sleeve and lose weight via calorie reduction due to reduced stomach size

https://www.bariclip.com/for-patients

https://gastric-clip.eu/

For me, the medication is what makes the lifestyle changes possible. The Mounjaro affects everything about my eating- my physical hunger, how much my stomach can hold and how quickly it empties, my desire to eat, how often I think about food and how strong my cravings for it are.

The fact that I could take a medication and instantly start a sustainable diet and lose significant weight with relative ease (when I’ve spent my adult life torturing myself and achieving nothing) proves to me that my obesity is a medical/hormonal condition not one of willpower. So I intend to stay on low doses of this medication forever, if I need to and it's agreed that it's safe.

I don't plan to stay on MJ once I've lost weight. I am decent at maintaining, and have done for many years but actually losing weight I cannot do without help especially with menopause symptoms making things far more difficult.

I took prescribed tablets to lose my 2st Lockdown weight gain, back down to pre 2019 weight and been stuck at this for 6m. I'm now on MJ to get down to a healthy weight for the first time in my adult life and feel I can maintain once I hit that point.