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 it’s fantastic news. I am surprised you think otherwise. The trials show people regain on average 14 percent of their body weight back. So 1.4 stone for a ten stone woman. Compare that to 100-120 percent regain on Amy other diet. So you’d regain the whole 5 stone.

for me. I think it’s fantastic.

But surely it took you quite a long time to gain five stone?

So if you started to regain perhaps half a stone, then you might take action rather than letting it get out of control again?

@UnderTheStairs51 it's not like that. Did you read the article and subsequent words?

Happy to be on it for life. I am terrified of suddenly getting bad side effects that mean I won't be on it for life!

If the metabolic changes that MJ treats are due to obesity would it not stand to reason that those changes would reverse after some time of not being obese allowing people to come off the drug?

I always assumed it would be analogous to the way that people can reverse Type 2 diabetes (and other conditions too) and come off medication for that by losing weight and reversing their insulin resistance.

My point is that you don't have to rely on behavioural change because physiological change will also happen after losing weight.

very interesting reading…..
I’ve only started on MJ this month, so far a loss of about 5-6lbs….ideally looking at losing about 3st. I never had weight issues when younger, I’m in my 60s now, even when going into my 40s I was hovering around 9st. I had my son at 40 and my average weight stayed around 11st thereafter. Then into my 50s when menopause hit it rocketed up to nearly 14….virtually double that I was in my 20s. About 3-4 years ago I managed to get myself down to just over 11 by the Fast800 method with little effort…..all going good so far. Then 2 years ago I was hit by a disease that meant I had to go on high dose steroids for a few months, with all its side effects 😩 and here I am back up to nearly 14 stone. Unfortunately this seems to have left me with a lot of food noise, as steroids can make you permanently hungry……even though I’m now on a low dose.
I'm really hoping MJ can help lose this weight AGAIN, and switch off this bloody preoccupation with food.
I thought I’d read somewhere that the manufacturers were looking into producing MJ in pill form? Maybe that would work best as a maintenance programme.

@Queenofthejabs Yes but look at the timescale of surmount 4. This was after 88 weeks from start to finish, so just a year on maintenance. Plus factor in the placebo effect and the motivational impact of being in a trial, with extensive diet and lifestyle advice and support, and imagine the likely difference to people going 'cold turkey' on their own outside of a study...and for long term beyond a year. I'm betting it's much worse than 14%.

'What the drug DOES do is increase insulin sensitivity, suppresses glucagon secretion, and slows gastric emptying'

I always thought that was what it did but that's not what people taking it report is it? They universally report appetite suppression and this seems to be the main mechanism of weight loss which makes me think that there must be other mechanisms such as the known effects on dopamine reward systems.

If the reason we become insulin resistant in the first place is obesity, surely, hopefully over time of not being obese we will revert to having normal insulin responses and therefore lower risk of obesity again?

Personally I used to weigh between 10.5 and 11 stone with minimal effort. I weighed this for 15 years until I had a baby and gained 4 stone in 9 months. After that I lost the same 9 lbs over and over, always reverting to the weight I was when I gave birth (16 years ago!). I wasn't insulin resistant or obese before I gained all that weight, and I hope that if I can stay 'not obese' for long enough with the aid of mj that I will be able to stay at that weight again, with minimal effort. However if not, I'll stay on Mounjaro for life. I'm not getting obese again if I can help it.

Not to mention the barrage of highly fattening, processed food advertising everywhere you look and listen. fast food, sweet treats everything you can think off just at your fingertips 😠
yes, we all know it’s us who puts the bloody stuff in our faces but it’s just relentless sometimes.

I started this having read the weight regain studies (one reason I chose mounjaro rather than wegovy as the regain percentages were better) - I'm fairly resigned to either having periods of time on the drug to maintain a weight just at the upper ends of healthy BMI ceiling, or being on a maintenance dose permanently if providers go that way.

I mean I hope I might be one of those miracle people for whom it's a one-shot measure that doesn't need revisiting so I never need to fear the egg burps again - but I know the odds are not in my favour there. I'm doing this to regain my mobility in the hope that that will increase my ability to be more active and maintain weight that way - but I'm under no illusions that I have the brutal combination of obesity in my genes and biological makeup, a history of being in the morbidly obese category and the fact that cake tastes fucking nice to fight against endlessly.

I keep seeing people saying "once you stop you'll put on the weight". I must confess to eye rolling at its obvious and I don't understand the point. If you stop doing what you're doing to lose weight you'll stop losing weight and gain weight .. that's not rocket science. I'm just very grateful to have the tool. MJ has helped me a great deal and many many others.

It is like that and we know it. It's easier to lose a cheeky pound than 4 stone. Don't get me wrong - I'm on MJ and worried how I'll do off it but I'm not kidding myself.

It is like that and we know it. It's easier to lose a cheeky pound than 4 stone. Don't get me wrong - I'm on MJ and worried how I'll do off it but I'm not kidding myself.

No it's not impossible, it is what a lot of people do (Liz Hurley famously, me far less famously!). But I think what people on these drugs have said, at least on these threads, is that their food noise is very different and they cannot do this.

Obese people often seem to be painted as one homogenous group but there is a lot of variety in the nature versus nurture / environmental/ behavioural causes between individuals. Some people will have spent their whole lives severely overweight/ obese but others become obese after various life events/ stages…the former group who may have a metabolic cause may be those who stay on it for life. Seeing as there has been such a big increase in obesity since the 90’s , when UPF’s and alcohol started to become the norm for many women, I do wonder if some can break this cycle ( like other addictions) by having significant time without them . I know for me, if I abstain from alcohol totally I don’t experience the cravings that occur if I have some on occasions.

I'd quite like to see if I can maintain without it but I don't feel particularly hopeful. I've been a functionally compulsive eater, looking back, since I was about 7, then developed PCOS, and stayed a reasonable weight only at times when i took lots and lots of exercise (like, 2-4 hours a day). Quite clearly that's a good bet from an evolutionary point of view but unless climate collapse means I have to dig my own swede to survive, I'm going to regain. I can gain a kilo a night ON mj if I'm not extremely careful so it seems likely that if I want to keep it off, I'm going to have to find a maintenance route.

I was 95 ky and taking statins, bp medicine for life. I was also struggling to sleep well due to sleep apnoea .. had to use a machine for 6 years.. multiple low level obesity issues.. that take up GP time..

A maintenance jab once a week seems a small price to pay to maintain my now healthy weight and BMI (65kg)

It is a drug to manage diabetes. That is where it should stay.
Most fat people have lost lots of weight before and put it back on,

@FlappingMadly yeah I worded that badly. And yes, on paper it's very much easier to lose 10 lbs than it is 5 stone

But I wonder why then, we don't do that? Why don't we get on the scales one day and see we are 10 stone 7 (for example) but still fitting in our size 10 clothes and think 'ooh I'm more comfortable at 10 stone so I'll just crack on now and lose a few lbs?'

I can only speak for myself but I enter into a cycle of avoiding the scales and self loathing and before I know it, I feel out of control and that's that. Doomed

Like others this isn’t my first rodeo so I know how easy it is to regain weight back after vowing that this time will be different. So I am afraid as a 40 year old I will prob on this medication for a very long time.

Surely regaining weight is the same problem with all diets. Not just linked to WLI

Interestingly the newest research on this is not as damning as the original trial.

https://www.epicresearch.org/articles/patients-with-higher-initial-bmis-and-greater-weight-loss-while-on-glp-1s-most-likely-to-maintain-or-continue-weight-loss-after-stopping-glp-1s

They found that a significantly lower lercentage regained.

" One in four patients who started a glucagon-like peptide-receptor agonist (GLP-1) medication at a BMI of 40 or higher doubled their weight loss one year after discontinuing semaglutide or liraglutide.

Two in three patients who lost at least 40 pounds on semaglutide or liraglutide maintained or continued their weight loss one year after discontinuing the medication.

More than half of patients who were prescribed semaglutide or liraglutide for at least 90 days were able to maintain or continue their weight loss one year after treatment. "

@Pumpkinforever you'd think so but no not really. MJ and its like reduce insulin sensitivity, suppresses glucagon secretion, and slows gastric emptying. These are known as the target effects which reverse once you stop

It will never be as easy as just moving a bit more and cutting down on cakes

Are you saying that these drugs shouldn't be used to manage obesity? If so, why?