What about after?

[FancyNewt]

I'm thinking of signing up for weight loss injections. But I just want to hear from anyone who has lost weight and is now trying to maintain. How does it work? Did you put the weight on?

Also, what about saggy skin? Did your face age?

I'm 50 and 14 stone size 5 ft 4. Desperate to sort this out as I'm getting bigger and bigger. But I quite like my chubby youthful looking face 😂

Whenever you diet, you lose muscles. On a classic weight loss program, no matter the flavour or hype, you lose on average 75% fat-25% muscle. On semaglutide, you lose 60% fat-40% muscle. This is the reason behind changes in the face. You have a lot of muscles in your face. Muscle loss is not just in your arms and legs. It is is everywhere, face included.
Another thing to consider is that the effect of semaglutide doesn't go beyond 60 weeks. After little more than a year, no matter the dosage, it stops working.
The regain is also a factor to consider. After 4 years, almost all participants put the weight back, however it is fat, not muscle they gain.

Do you have a link please to the scientific evidence to what you're quoting @MatchaTea ?

@MatchaTea yes, can you provide a link to scientific research done that you’re quoting and stating as facts?
@FancyNewt with every weight loss program, be it WW, SW , injections, etc, if you finish the program and go back to your old habits, of course the weight will be regained, if not and you develop and implement new habits for life, you keep it off. That’s just the way it is.
Should we just remain the way we are forever just because of the fear mongering of putting the weight back on.
With MJ, there’s also a lot of maintenance programs that people who have stopped can now start to help them in the journey to maintain as well. Main thing is do your research, be prepared to change your mindset and lifestyle for good.

@Snozzlemaid @Tohaveandtohold this has nothing to do with fear mongering. Just scientific facts. Plenty is written about weight gain rebound, and here is the links you asked about muscle loss and plateau.

in some studies, reductions in lean mass range between 40% and 60% as a proportion of total weight lost
https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.15728?af=R

Conclusion: Semaglutide displays potential for weight loss primarily through fat mass reduction. However, concerns arise from notable reductions in lean mass, especially in trials with a larger number of patients. https://pubmed.ncbi.nlm.nih.gov/38629387/

a substantial initial reduction in weight, which plateaued after approximately week 60 and
https://www.nature.com/articles/s41591-022-02026-4

This is just silly.
firstly mounjaro is not semaglutide. Ozempic is.
secondly muscle wastage on average stats are pointless, if someone consumes enough protein and exercises they will lose little to no muscle.

im constantly surprised at the people who post stuff like this and have no critical thinking behind it or understanding of either what an average is, the different types of medication available or even the human body.

I am also 50 and have been on mounjaro nearly 4 months. I have lost fairly slowly, 1.5 stone in total and down a dress size (14 to a 12, I am short)
I have been taking collagen and using as many fancy creams as I can. I have some dumb bells I use regularly too. My skin hasn’t visibly changed at all and I feel fabulous with the weight loss. I am not fussed about a target weight, I will monitor my face etc and stop when I feel I should, as you say a little bit of padding helps the wrinkles!

@FancyNewt you are asking the wrong questions.

Will it improve my heart health? Will it reduce my risk of obesity related cancers? Will it improve my mobility? Will it increase my life span? These are the important questions to base your decision on starting any diet to "cure" your obesity whether it is pharmaceutically assisted or not.

Loss of muscle mass, sagging skin or any of the other side effects are, secondary, but still a worrying risk with any weight loss and can be helped at bit with exercise, strength training, nourishment, hydration etc. This is, partly along with the other unpleasant or serious side effects, why WLI are not the "easy" answer/decision.

Cosmetically a lot will depend on genetics, age, how long you have been overweight and by how much etc. Many of the Mounjaro/GLP facebook pages show before and after face pictures and some of the woman look fantastic and so much younger, others might now look their age rather than a more "youthful chunky" face looks, but they also imo look much healthier. If you had a choice between "looking" or "feeling" younger which do you choose?

Maintenance after weightloss using WLI or any diet is a concern I think we all have. We know if we return to our old habits and the weight will return. There is an option if we struggle to maintain after using WLI many pharmacies are offering the option of maintenance plans - taking lower doses or perhaps prescribing again for a month or two occasionally to get us back on track.

Good luck whatever you decide.

Reading thread with interest.

The way I am hoping to mitigate some of these issues is -

1. Lose weight SLOWLY. It’s more expensive and takes longer but it’s healthier and may reduce muscle loss too.
2. During the weight loss period use the extended time frame to take up some weights and other exercise if possible to limit muscle loss.
3. My goal weight is higher than BMI recommendation. I think I would be too thin at BMI weight; also it’s better to my mind to have a little bit more cushion and curve once past 50.

@MatchaTea How long have you been maintaining for?

I am not saying don't go on them. I am saying they are not a rainbow-unicorn drugs. There are risks one should be aware of so you can mitigate them. People need to be mindful of this muscle mass decrease side effect, because the heart is a muscle, and decrease in heart size is now part of the research. Since people scream for sources, here it is https://www.sciencedirect.com/science/article/pii/S2452302X24002869?via%3Dihub
Therefor @WeAllHaveWings , to answer your question Will it improve my heart health? Not guaranteed, maybe yes, maybe no.

I'm trying to stay at 10am one now after losing in a Mj

I'm 53 and 5.4.

It's hard but it's a whole lot easier to be motivated with the weight gone and clothes that fit and sticking to exercise

I'm eating fruit when hungry during the day now instead of crap and I've only put on a few pounds so far.

Xmas season is hard but I ordered a pen for after Xmas instead of just stopping my meds.

It can be done but you must calorie count and still have good days to counteract the bad.

I tend to have soup and fruit days if I've had a bad weekend of socials or overdone it.

Good luck

I think that study showing a plateau after 60 weeks is a bit of a stretch to then conclude, regardless of dosage, that everyone stops losing weight at 60 weeks. They were all only on 2.4mg of semiglutide and there is no additional data about what that weight was they maintained or what they ate. They lost substantial weight and it's entirely possible they reached a healthy weight or a weight that was in equilibrium to the amount of food they ate or that maintenance was their aim. The study's purpose seems to be to see whether or not semiglutide could help with the maitainance of weight loss, which it showed it might. I don't think it was looking for the length of time the injections would be effective for weight loss, regardless of dose.

Re muscle loss. Of course there is muscle loss when you lose weight. It seems like a no brainer to me. If your body is having to carry around and move 250lbs (or whatever) and pump enough blood for that mass and intake enough oxygen for it, and then this stops being a requirement and it now has to carry around 175lbs then, naturally, it won't bother maintaining the muscles required for the heavier weight. Why would it? Of course strong muscles can be a good thing and most people look and feel better with them - but it doesn't automatically translate that all muscle loss is bad, I don't think.

Good, all round health has to be the aim. Weight is obviously a bit part of that and I think someone who is considerably overweight probably will get the most health improvements from weight loss. But it's not the whole picture and so exercise, nutrition and mental care all need to play roles too. (And probably other things I've forgotten!).

“After little more than a year, no matter the dosage, it stops working.”

That must be an entry for the bingo card!

Yes, odd comment, as this is a drug for diabetes. And about to be approved for cardio vascular and kidney disease, so of course if coesnt just stop working, it would never be approved by the different regulatory authorities globally if that was the case.

It's hard because I constantly feel like I am 'defending' these drugs - but really I'm just very interested when someone seems to post new information about risks (and benefits) and when I read the studies they are quoting, 9 times out of 10 I am underwhelmed by them. Either that or Sharon Osbourne is used as a warning - and frankly, I really do not think she is an example of the average overweight human and take what she says with a large pinch of salt.

I think there ARE risks with the drugs. The big one appears to be a possible link with increased depression or anxiety for some people. That's one that everyone needs to be aware of and those who suffer with these effects anyway should be even more on alert in case the drugs make it worse.

Even the thyroid cancer one can be called out - but in an accurate way that recognises it was only seen in mice and has (yet) to be seen or replicated in humans. So it's possible it does not have the same risk in humans as in mice.

Gall bladder and pancreas problems also worth calling out. Again, with the caveat that it's possible these are no more common in weight loss using the drugs than in similar weight loss without them. In which case it'd be about how fast you lose the weight, not about whether or not you take a drug.

The OP's original question about 'what comes after' is a fair one. There is quite a bit of anecdotal examples of people stopping, cutting down or keeping on with the drugs. But there is not yet the sheer numbers of examples that provide a clear picture that we will see in a few years time. The drugs have not been used for weight loss for long enough in enough numbers to see what will truly happen. but we are likely to see this the the US before we see in here. Also, the science in this area is moving at such a pace, it seems more likely that there will be more options in the future. Pills you take once a month, for example (currently under study). For me, personally, that is tomorrow's problem. It's no doubt doing to be a thorny one and one that requires a lot of work to solve - but my first challenge is to become a healthy weight to start with.

As somemone trying to maintain after 3 months in MJ I can say the weight will go back on. If you dont calorie count and make good choices.

You can have treats but they need to be made alongside other more healthy choices.

Those that suffer from food noise may find it comes back. And may have to stay on a low dose to prevent this.

I dont want to depress people but that's my experience.

Our western diet is the blinding issue and it is so shot the govt just blindly ignore that issue and keep quiet. They must know it's making us obese and sick.

The best option is to cook as clean as possible and just have takeout and treats occasionally but it's really really hard.

However now I'm at a healthy weight I have more motivation to at least try and keep it this way. Before it seemed impossible.

So please do go for it and worry about the after, after 😘

Here is a graph of my "muscle loss" from my Withings scales since I started MJ in August. It's not inevitable.