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

I think the main thing I have learnt after being on MJ for 5 months (with at least 5 months more to go) is I need to eat less food. A LOT LESS FOOD!

I can eat healthy etc and I do, but on MJ and when I have finished losing weight I need to eat a lot less calories for the rest of my life. I am facing up to the fact I will need to consume a third less food than I did pre MJ when I was gaining weight.

How I will manage that I don't yet know.

I need to sever the connection between food and pleasure. This is what MJ does, but I need to be able to disconnect food & pleasure, enjoyment, socialising, entertainment etc permanetly.

I am working on accepting that for some of us food must become a fact of life & fuel, not a pleasure.

But I am hoping the rest of my life will not be food focused - it can't be, unless I want to gain weight. Im hopeful an affordable MJ maintance pill will be available sooner rather than later.

I'm not sure who you mean by 'official'. There is a growing level of knowledge/experience among prescribers. The landscape has changed a lot in just the last 3 or 4 months and, if you choose the right company, you can be supported very well during maintenance . There's a lot of info on here and Reddit about maintenance in the UK.

i have been overweight/obese for nearly 30 years. Like others on this thread I know how to eat healthily and over the years have lost the weight, and then regained it plus a bit more.

I started on Mounjaro in April end have lost 4.5 stone. I have no side effects and have reversed my type 2 diabetes into normal range, reduced my cholesterol and blood pressure into healthy range and am just generally healthier and happier. I am happy to take the medication for the rest of my life, which will be significantly longer now my weight isn't making me ill on a daily basis.

If my diabetes, blood pressure and cholesterol had continued in the way they were I'd have been on at least 3 different meds to manage those - and that still wouldn't have helped my joints or the other risks that obesity brings.

I am lucky enough to be able to pay for a private prescription for Mounjaro, and i'm hopeful that costs will reduce soon to make it more accessible - but I do think using it as a short term fix is generally unrealistic for anyone who has struggled with their weight for a long time. I think if you have post pregnancy weight to lose for example, i'm sure it would be a helpful tool. My brain and body are wired to be constantly hungry, food obsessed and insulin resistant - and I'm grateful that that no longer means a life of being uncomfortable, unwell, self conscious and unhappy!

I think this is such a rapidly evolving area that there will be lots of movement on what maintenance looks like. Things I've had read most recently seem to suggest that gradual titration back down helps with maintenance.

I started thinking I wanted to be on the medication for as short a time as possible, but now I'm quite coming round to 'if a maintenance dose is needed, so be it'.

Really @eqpi4t2hbsnktd ?
because 5 days ago on another thread you posted

"Honest skinny person here... we resent fat people being able to loose(sic) weight as we want to feel superior."

I am 56, I was morbidly obese. It was likely to kill me in my 60s or early 70s which are really not that far away.

I have been taking MJ for 6 months and lost nearly 5st on low doses. I am now "just" obese and would like to lose maybe another 4st.

My current thinking is, if I can stay on low doses I am ok being on this (or a tablet form if it comes out) for some form of maintenance forever.

I needed MJ in my 30s and 40s, if it had been around I would probably be more concerned about how the long term picture looked at that age (I wouldn't have been able to afford it at that age anyway).

I'm hoping for a longer term maintenance dose , I think it's the same way that if you lose weight doing SW or WW but resort to previous eating habits you will regain weight. You have to change what you eat. Yes if will be harder without the MJ but you are in a far better position trying to keep it off than to lose it.

The drug suppresses appetite so without it, appetite comes back and if you eat the weight goes back on. You'll need to figure out how to lower insulin resistance on your own - ie a low GI diet plenty of exercise etc.
you need to ensure you e tackled the root cause of overeating otherwise, yes, the weight is just going back on.

@KrankyKumquat , who is your supplier please?

@ribiera the drug is not about appetite suppression though. That's the whole point really

It's about what it does to your body, the whole physiological effects. Effects that reverse when you come off it

It's not about understanding why you eat too much. Most of us probably know that

I am slowly coming round to the idea that obesity is a disease. Something I'd dismissed before

It's Oushk.

Im hopeful an affordable MJ maintance pill will be available sooner rather than later.

a friend of mine is on a trial for a pill iteration - not Mounjaro but another newer GLP-1. I reckon in a few years or so most adults will take some form of these pills to maintain a healthy regular weight

What are the potential side effects for remaining on MJ for life? Or several years? I wonder if they increase as time goes by

Do people use face to face/ private doctors for their weightloss supplies? (rather than just online sites that sell it remotely?) Otherwise, where do you get a maintenance dose prescribed from? How does it work when you are within a healthy BMI of 23.5, to get it prescribed going forward if you need to be a BMI of 30+ or 27+ with other considerations, to still have it prescribed if you are under BMI 25?

Really curious as to how it works once a healthy BMI looms into view and how it is prescribed going forward. I've not tried it because ordering from the websites puts me off together with tales of patchy availability, so I'd preferably have a prescription from a private doctor.

Quite a few pharmacies now prescribe for maintenance. As long as you were the correct BMI to be eligible for starting it, they will prescribe down to a healthy BMI and then ongoing for maintenance, whatever that might look like for you. As part of maintenance, they may want video calls, pictures of you regularly, discussions about your goals, etc.

Oushk and Chequp offer maintenance doses.

I'm not sure this applies to everyone. I've only put on the weight in the past 3 years. I was skinny until then. A combination of stress (ie stress eating) and DEPO led to me rapidly gaining loads of weight. I'm expecting to maintain my weight once I've lost it. However, someone else who has been obese for decades might find it tougher. I could be wrong- will find out!

I've had talking therapy for my eating disorder and honestly, it's all bollocks. The vast majority of people in my support group already knew WHY they used food to cope and they knew how to eat healthily, they just couldn't do it. The therapists were so sure they could get us all to have a eureka moment and as soon as we realised the triggers we would be able to control ourselves. Needless to say it didn't work.

I was told to take a bath or do some crochet to calm myself down when I felt the urge to binge, as if somehow that's going to interrupt a literal lifetime of programming, insulin imbalance and PTSD.

For every person who benefits from talking therapy around food, there will dozens it does nothing for. Fat people know more than anybody how they SHOULD eat. They don't need a patronising therapist telling them to choose avocado toast instead of chocolates.

@surreygirl1987 I think that's where 'set weight' might come into it. I've spent decades going up and down to 14/15 stone and probably hovering around 13 stone usually. The occasional foray to where I am now

So my set weight is probably higher than yours as you've always been slim. And I understand my body will fight me to return to my set weight

I always think that good predictor of the future is looking at what's happened in the past.

And well, I know what's happened weight wise in my past

Yes I think you could right about 'set weight'. I guess we'll all know more in a few years when thousands of people have stopped taking the injections! Goof luck to you (and all of us!)

@Ficklebricks yeah I'm one who doesn't need to talk about why I was overweight. For me, it's not really much deeper than I like chocolate and cakes. I don't need to talk about it

I need to sever the connection between food and pleasure. This is what MJ does, but I need to be able to disconnect food & pleasure, enjoyment, socialising, entertainment etc permanetly.

Surely that's basically impossible? We are programmed to experience pleasure in things that keep us alive and thriving and pass on our genes.

@surreygirl1987 thank you. And to you! I'm sure you'll be absolutely fine with your previous good record

It's useful to talk about this though because I just know there's going to be so so many people out there right now on who won't consider what the drug is actually doing and how that'll all go once they stop

It's wise to be prepared I suppose

This is so true and I'm so glad to read it on here from someone else. Everyone seems so glib about 'oh just tackle the reasons you overeat' - they are insurmountable for some of us and all the therapy in the world won't do it, we need drugs to help.

I am not worried about maintenance because these drugs are generating billions in profit and there will be enormous motivation for companies to provide maintenance doses. I have about a year to go to lose the weight, I'm a slow loser on a low dose. I am confident that there will only be advances in maintenance programmes and management/mitigation of any ill effects.

Quite simply, it has never been in the diet industry's interests before to help people keep the weight off. They needed rebound dieters to keep coming back to Weight Watchers or Slim Fast or whatever. Now there is a goldmine available for those who figure out how to keep people on these drugs for life, safely and effectively.

I knew from my first dose of MJ that I'll need to take it forever. I can feel the change in how my body physically handles food and appetite. It put something right in me that was always wrong. So yes, I'm prepared to be on it for another forty years because I couldn't make my body work in the last forty years and it wasn't for lack of trying!

I assume that the damage of long term obesity will mean I need long term medication to manage. Like others I hope this will be a cheaper alternative in pill form for maintenance