What are everyone's plans once they reach target?

[DappledOliveGroves]

I'm a few pounds off my target weight. I've been on the injections since July and lost around 14 kilos since then.

I'm currently still on a 5mg pen, but find it's getting less effective at the end of the week, and food noise and hunger is coming back strongly.

I spoke to my provider, Voy, about maintenance plans and was told that once your BMI drops to 22.5, their policy is to ensure that you wean off the pens, by dropping to a lower dose every month, and then to nothing. I asked whether, if the weight starts going back on, you can go back onto a pen, or if you have to have a BMI of over 30 (or over 27 with associated conditions) to start again. They confirmed the latter.

I have a consultation appointment with Oushk tomorrow, as I know they offer long-term maintenance options, but whether they'll prescribe now that my BMI is under 23, I don't know.

I have no confidence that, as soon as I have no Mounjaro in my system, that I'll do much different eating or exercise-wise than before. I've lost weight because I have no food noise and no hunger. Once I have food noise again, I can't see how my mindset will be any different to a few months ago, when I ate crap and sugar and alcohol to get the sugar boost I craved. If I had no will-power then, why will I have it now?

Is anyone who is approaching their goal weight, confident in making good food decisions once the mediation has stopped? If not, what are your plans?

I agree with what you said about the lack of food noise being what helps you to do what you need. I always find it interesting when people are going on about learning strategies while on MJ for when they get off MJ. Unless you didn't know strategies to proper diet and exercise, there are no strategies to learn to fight what's going on inside. Hence why we need MJ to help with that.

If it was just about diet and exercise, then we shouldn't be looking for MJ to quell the food noise so we can do what it takes to lose weight, we should be learning to fight the food noise and cravings then, perhaps with the lowest dose but you see how people panic once they can feel a bit of it while on MJ. These are the issues and I doubt most will be able to overcome it without Mounjaro.

Good food decisions are easy to make when MJ is the only aid helping you/me with the thing that is stopping you/me from making them. So I plan to stay on the right dose (for me) of Mounjaro to keep helping me do that. For now, 5mg it is.

I'm seeing MJ as a boost for me to get to my ideal weight. I'm very near to that now, and I'm enjoying life so much more in every way - exercise, clothes, seeing friends, shopping, eating. Also I've spent quite a bit of money on this so I'm determined to not just let that be a total waste.
I've eaten the same lunch pretty much every day since I started MJ, so I plan to stick to that. And just not snack, not finish food off my kids' plates, etc.
For evening meals I've eaten normally but cut my portion size. I plan to keep doing that.
I've always exercised but I'm ramped it up in the last few months and seen a brilliant difference. So again, I'll carry on with that - I really enjoy it, and exercise is so much easier with 40lbs gone. I have a really positive mindset and I won't let this beat me, I'm absolutely determined to stay slim now that I've finally achieved it.

I have a consultation appointment with Oushk tomorrow, as I know they offer long-term maintenance options

Please do let us know how that goes

I have a pen sat in my fridge that I am reluctant to use (it’s my first) because of this fear. I am concerned that if I start, that’s it. I’m essentially signing myself up to a life of using this drug. I know food noise is my issue, it’s not a lack of knowledge about food or exercise or laziness. It’s the evening night urges to eat UPF foods and a total lack of control around food.

@VioletCrawleyForever - I shall update!

I mean, weight loss injections are great in that losing weight with them is far, far easier than without. I haven't calorie counted once - I just can't eat a lot and am barely ever hungry. But in the real world, will I be able to stick to what I eat when I'm on Mounjaro (yoghurt and fruit for breakfast, chicken soup and a roll for lunch, normal, healthy dinner) or will I want to eat crap again? It seems unlikely.

It's tricky, because on the injections, I don't care about food, whereas I used to love eating out, going to fancy restaurants etc. Also, I find that I have zero sex drive now (to be fair, it wasn't high to start with, but it's disappeared entirely) and am I happy to remain like that for the foreseeable future if I do find a long-term maintenance provider?

I wish there would be some legislation to ban UPFs. People 50, 60 years ago didn't have to worry about what they ate, or becoming obese. Now, with all the additives in foods, it's nigh-on impossible to eat normally or healthily.

"Now, with all the additives in foods, it's nigh-on impossible to eat normally or healthily."

@DappledOliveGroves I don't think that's necessarily true, but it depends on your own circumstances. I'm self employed and work from home, and I have time to go to the gym every day, and make all my family's meals from scratch. So we don't really have UPFs, although when I lived on my own and had a much busier job, I did rely on them a lot more.
Batch cooking, meal planning, shopping for fresh fruit and veg rather than frozen, it all takes time, and a lot of people just don't have that. (hence the popularity of things like Hello Fresh. But that costs a fortune!!)

I’m a lawyer. I work full time. I work every evening. I also have a toddler and a distinct lack of sleep. If I’m in the office then I’m often not home until 9pm. If I’m wfh then I don’t get a chance to start cooking until gone 8pm. I try and cook everything from scratch but my biggest downfall is snacks and treats. If I could have a private chef, that would be ideal!

I feel like your post is a fake post to put down people using this drug to lose weight. Oh how will I change if never did before!!!

What exercise should you do ? I used yo go to the gym years ago but the only time I saw a real difference was when I was doing hours and hours per week

I'm slightly concerned - however I've been on Saxenda for 18 months, and still have a few more months to go. I'll have lost 7st, or 100lb or 45kg. Whatever way you look at it, it's a hell of a lot of weight.
I've known for the last 10 years how to lose weight. And I did - I lost 5 st previously and kept it off for 3 years using slimming world. But I put it back on, and an extra 10lb for good measure.
This time, I've changed my lifestyle. I'm not following a diet. I calorie count, I have changed little things like walking to school, to the shops, parking further away when I need to drive. I've prioritised me over everything. So 6 hours a week, I'm in the gym. I'm doing cardio, I'm doing weights and resistance training. None of this I'd done before. I've kept up the gym regime for 7 months and made it in to a habit - a way of life.
I've used saxenda to change me. Yes I like food still, no saxenda hasn't kept the food noise away for the entire 18 months - but it has done a LOT to help me achieve this. I'd quite like to stay on it for life if I'm honest. I'm on the 2nd lowest dose anyway. But I know it will need to stop. I don't think my provider will keep providing much longer (my bmi has gone from 43 to 27 now). So I'm hoping I've done enough both with diet and lifestyle to make the difference this time.

I think all of us have the fear of going back to old habits, I certainly do. I'm really trying to put in a lot of effort to meal planning, being considerate of my TDEE and macros. I'm taking a variety of supplements too. Exercise alludes me right now but I know that needs to be part of the future too. I've lost weight before and regained, but I can't ever remember being quite this mindful about it all - so I hope this is what different looks and feels like for when MJ ends.

I suppose I'm relatively lucky in that it's only taken my less than four months to get to my goal weight and truth be told, it's been super easy to lose the weight. I know some people don't have the same reduced food noise, or have to keep switching to much higher doses, but honestly, it's been an easy journey for me to lose 14kg.

But I cannot say, in those four months, I've done anything much to change my lifestyle. I walk a fair amount - around 9000 steps a day on average - but I always have done. I don't do any other exercise as my back issues have caused so many problems that I'm so wary of going to the gym. I will not do any kind of weight training, as it was weight training that gave me a herniated disc in my back and required me to have surgery.

All I've done differently is to eat a lot less and not to buy snacks, because I have no cravings and no interest in eating them.

Anyhow, I had a call with Oushk today and it went very well. They take a tailored, individual-focussed approach to maintenance and will keep prescribing, without any real limitations, for an indefinite period. So I could either try and come off and see how I go, and then go back on again if the weight starts going on, or I could keep on a low dose for the coming months and see if I can get to a point where my weight stabilises and where I stop losing.

I don't think exercise is necessarily about seeing a real difference (unless you really get into heavy weights), it's more about keeping fit and healthy, and shaving a few calories off your day.
I run a few times a week and I do a different exercise class 5 times a week (spin, body combat, body pump which is weights, step & tone, boxing).
Each class only burns about 280 calories, which you could easily eat back in no time, but it makes me feel great and I don't 'reward' myself with a treat for having exercised. It's just part of my daily routine.

Good to know re Oushk, I'm also speaking to them tomorrow

Not sure about my plan tbh. I always think that a good way to predict what may happen in the future is to look at what happened in the past and well, when it comes to weight maintenance I've spent many decades not being able to do this - so I'm realistic about the future

My BMI is currently 22.5 so I'm at a point where I need to consider and discuss what I want to do. I agree - this is not about implanting good habits that I've learned - trust me, I could write my PhD thesis on what to eat and what not to eat! I know what to do. I fully grasp nutrition. But can I do it? Dunno

Given my history of yo yo dieting and not just a couple of stones.. losing 5+ stone multiple times I fear that I will be taking this medication for a long time after reaching goal. I don’t want to but if it keeps me from gaining it back it has to be done.

I feel very similarly to you, although am not near goal weight. I have a very demanding career, and am (foolishly) doing a masters in my spare time.. plus parenting teens solo - life feels incredibly 'hemmed in' and without MJ I always feel like I'm walking a tightrope before my eating leads to weight gain.

I'm with Oushk and very much intending there'll be an ongoing need for MJ for me long-term in order to remain at my ideal weight. 25 pounds to go!

So I took the plunge and have started. The suppression was instant. I can often set my mind to it and eat well for the first half of my cycle but binge like mad in the second half. I’ve spoken to someone else who uses MJ every 10-12 days to maintain, planning it around her social life. She says she doesn’t bother with the pen being out the fridge too long - I need to read more about that part. But that sounds like it might be a good approach to me. Ie if I’m due on my period and find I’m binging like mad, have a shot to tide me over.

I think I’m going to move to Oshuk who have a process for maintenance.

www.oushkpharmacy.com/maintenance

I think people are just being realistic and responsible. Every method of weight loss involves most people putting at least some of the weight back on, and unfortunately, more weight than before in many cases.

Personally I think we have to accept this is what happens, and either work out what it would take to end up in the minority who keep it off through sustained behaviour change, or, we wait and see whether these classes of drugs become licensed for weight maintenance use over the long term. There's a lot of research interest in this area.

I have 7-14lb to go. I'll buy one more pen from my current supplier than move to Oushk for maintenance at around BMI 23/24 I'd guess. For me I'll be on Mounjaro for life I think but will titrate down as currently on 12.5mg.
There is evidence of it being beneficial in treating/preventing dementia..this is a massive and very real concern of mine and so I will do all I can to avoid the fate of my mother and grandmother.

I understand these considerations. But I don't think there is a route to long term access at the moment though is there, unless one remains obese (or BMI 27< if other risk factors are present?)? Presumably no-one is prescribing outside the manufacturer's guidelines?

The manufacturer doesn't have a time limit guideline for Mounjaro. Pharmacies are beginning to realise this and lifting their 2 year limit (which was for Semaglutide).

@rhubay for most of us this isn't our first weight loss rodeo and we've lost weight before, made all the lifestyle changes, bought the new wardrobe, and then put the weight back on.

I've probably read a mountain of diet and nutrition books over the past 30 years, this isn't a matter of me needing to learn anything new about how to manage my life, it's a physiological condition causing me food obsession and faulty satiety sensors which cause me to overeat.

Nobody is trying to be deliberately negative, we're just long in the tooth and being realistic.

Lots of prescribers prescribe below BMI 27 and several are offering long term maintenance options beyond the initial two years.

Is the BMI issue the limiting factor though?

@rhubay - no. Some cut off at BMI 25 but others will continue maintenance is your BMI is 22/23