Sobering (depressing?!) studies on life after MJ and worth consideration?

[RoastedPickleAndChips]

I'm at my target weight more or less after 8 months on MJ. Lost 5 stone and am now 9 stone 12 so quite happy with all that

As most of us are aware, there's not huge amounts of information surrounding maintenance, mainly because people are only just getting there on the whole due to MJ being relatively new to the UK for weight loss

So I've been doing some reading and digging and it makes for pretty depressing discoveries

I always knew that I didn't need to 'educate myself about heathy eating and portion control etc etc.' I could practically qualify as a dietician tbh and I always felt that the MJ does far far more than just suppress appetite

Have a look at this study .... https://jamanetwork.com/journals/jama/fullarticle/2812936 .... it shows that for a fact pretty much everyone will regain the weight they have lost once coming off MJ

I also read this comment from someone well informed ....

MJ is not for suppression. That’s not ever been a planned target effect.

It’s a physical, mechanical, method of action. What the drug DOES do is increase insulin sensitivity, suppresses glucagon secretion, and slows gastric emptying. These are known as the target effects.

Once you stop taking the drug, the body reverts back to higher insulin resistance, high glucagon secretion, and faster gastric emptying.

And the studies show this. There’s lots and lots of information if people spend half an hour reading the studies and trials.

SURMOUNT-4 proves that “changing behaviour” alone doesn’t work. And SURMOUNT-3 applied the drug AFTER people tried to change behaviour - and we see clear massive difference in subjects there too. So the clinical effect is clear. It’s not a tool to help you get over a hill or learn how to be healthy. No more than wearing body armour makes your skin thicker.

Anyway, thoughts? Of course I want to believe that I'll be the exception, that this time I'll keep the weight off, that of course just 'eating less and moving more' is the key

But it's not is it? MJ seems to be more than just a tool - it looks like the effects on the body are far more than I'd realised and understood

So is the answer a dose for life? (Currently not available to my knowledge?)

Thoughts? I'd love to be told the above is a load of shit Thought it might be interesting to discuss anyway

Well I know that some pharmacies definitely do offer maintenance doses - I think for life, although willing to be corrected on that one.

I'm planning on taking a small dose for life but realise that, at age 58, this is a very different prospect than that being faced by someone in their 20s, 30s or 40s. My prescriber supports this as things stand currently. I also fully expect a long term maintenance medication to become available in the not so distant future, which will hopefully be cheaper and make it easier to customise optimal doses and dosage schedules.

I've lost a lot of weight several times previously and know I'll eventually regain my weight this time too, so it's time for another approach. No disrespect to those who believe they can go it alone, I just know that I'm not the exception and that willpower and a healthier diet will not still be working for me in a year or more and, tbh, I simply haven't got the time to get obese and then do 5st weight loss every few years.

The surmount 4 trial showed that the average weight regain of those that were switched to a placebo was 14%. Those that continued to take Tirzepatide lost a further 5.5% rather than regained.

I'm not surprised that those on a placebo regained some weight, on average. Some may have maintained and some may have rapidly regained and many will have been in the middle. I've read that research article many times before and it's useful knowledge.

Mounjaro is a tool to use to lose weight. It's also a tool that you might need to keep using to some degree to maintain weight loss. It's certainly going to guarantee that my weight never returns to the BMI ranges of 35 or over ever again. If I stop taking it and regain then I will restart when my BMI gets to 30 or 27 if I still have weight related health issues. It's a great relief to know that my BMI doesn't ever have to be 40, 45 or 50 ever again.

I guess the question is how long does it take to regain. It took many of us years to reach our weight slowly gaining 5/10lbs over the years.

I intend to take for life its been almost two years already. I've almost reversed NAFLD and have reversed high cholesterol, plantar fascitis my SAD hadn't appeared this year.

I don't want to take it for life I must admit but then nor do I want to be 15 stone again as I was really feeling the effects of that.

And my BMI is 23.5 so not sure if I could have it prescribed long term.

I think it's just struck me that the majority of people on this drug right now, doing so well, are going to regain a lot of the weight

The study linked doesn’t say everyone will regain the weight they have lost: it says they will regain (on average) 14% of what they have lost. That’s a huge difference!

@EBoo80 ooh so that's slightly more palatable then isn't it? I could possibly cope with that

La la La can't hear you op!

@wizzywig if I have to know it then you do too

Sorry

I lost my desired 1.5 stone in 6 months on wegovy.
Put it all back on in 3 months.

Putting the physiological aside, the psychological aspect is surely the biggest obstacle when stopping? Your 'desire' to eat will revert back to whatever was normal for you pre jabs.

So you might lose 4 stone and regain 7lbs. Sounds bearable.

@SassK I'm not sure. I thought that but now I just don't know

There was a lady on here who said she very slowly started to spread out the maintenance doses ie every 8 days, then when that was working, 9 days, 10 days ect .

obviously that is hear say and not personal experience, but I did file that away for future reference, it would make the monthly payments stretch

I’m aiming to have lost 6stone by the end… that’s 84LBs…. I can handle putting on 14-% of 84lbs!

I see a lot of people saying that they now understand how to calorie count/ how to healthy eat etc etc

I've never needed to learn that. For me, I have in the past felt compelled to eat junk food. Never a big meals eater but I can quite happily scoff chocolate after chocolate with no off switch

I currently have that off switch but reading the above gave me pause. I now understand the physical effects its having on my body which will reverse once I'm off it

Yes I could probably stand to regain half a stone but 5 stone would be depressing

@Grumpyoldthing I am considering titrating down but again, there's no official word on this or how to do it

The studies I've read (on the BBC and such like) suggest two thirds of weight loss regained.

My opinion is that these jabs have a great deal of potential. But I think there needs to be more than just prescribing, there needs to be a multi approach (including maybe a form of talking therapy, as well as nutrition and exercise - so that people are learning and preparing for life after the jabs).

Also I suppose the hope that if you have lost lots of weight, you are much more likely and able to exercise which would help

That's the thing. Its was never meant to be about suppressing the appetite that's a side effect. It is meant to deal with insulin resistance which won't go away it's a life long medication hence why you get a maintenance dose.

@SassK I wouldn't sign up for compulsory talking therapy. The last thing I want to do is talk to someone about how fat I am and how much I overeat. I know why I over eat. I know about nutrition and about exercise. That's not the issue.

Surely common sense dictates that it is a lot easier to restrict eating to achieve weight maintrnance, than it is to restrict eating to lose 5 stone

I've read the whole article and this would not be my interpretation.

The -5.5% for those remaining on tirzepatide and +14.0% for those on placebo refers to "the mean percent change in weight".

I’ve been on Ozempic prescribed by my private GP (not in the UK). After 6 months I went down from 1mg to 0.5 (I was struggling with the side effects). I’ve been at 0.5 for 8 weeks with a tiny bit of additional weight loss. Food noise is up but I’m eating more normally now and trying to be careful. GP advises at least 6 weeks at each step down. If it’s manageable and no weight gain then step down further when comfortable. I’m planning 12 weeks at 0.5 then if I’m feeling ready 12 weeks at 0.25. Then maybe every second week for 6 weeks then stop. That will be weaning off over just over 6 months.