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

Once I have achieved a healthy weight I plan to go onto a maintenance programme for at least a year- I am lucky that I can afford to do that but for me the relief for the first time in 60 years of no food noise is worth every penny. I am hoping when I step down that some of the less pleasant side effects will also lessen- but they are a price I will continue to pay if not for the relief from waking up choking at night and self loathing. My mental health is so much better already, and I am very hopeful that in time we will also see more research into the effects on dementia which I have heard described as type 3 diabetes. As someone at high risk of diabetes due to both obesity and previous medical history I am current living with less anxiety and fear.

MJ has given me hope and for that, I am grateful. Happy to stay on a maintenance dose when I reach my goal.

And cornflakes were created to prevent masturbation. Products evolve.
If you don't want to use WLI then don't you use them but there is no reason that the millions of people who are using it to reverse their obesity should stop.

This is very heartening. It suggests I have over 60% chance of, at worse, putting on no more than 25% of my weight loss back on, which would still leave me with a healthy BMI. I’ll take those odds!

I’m about to stop MJ. I’m signed up to the Oushk plan in which I pay £20 a month to be on their books and can restart MJ if I need to. My BMI is currently 21 or so and I’m expecting it to rise a bit once I am not using the drug, but I plan to start it again if my BMI hits 24. Realistically it might be that I need to do some time on and time off long term, although I’m hoping it won’t be long before the pills are with us.

My eating habits are broadly healthy and have been for a long time. But I’ve been overweight all my life more or less. I’m now slim for the first time as an adult and will NOT be going back. I know my portion sizes were too big before and that needs to change permanently. It’s far, far easier to motivate yourself to stay thin than to be contemplating a 3/4 stone weight loss and see 2lbs off on the scales after a month of serious restriction. When one nice meal out (the type all your slim friends are able to have) seems to undo weeks of eating like you’re on a fasting retreat. Now I can eat that nice meal, feel normal and like I can enjoy food a bit, but go back to eating my small portions the next day. Mentally it’s far more sustainable.

I don’t read it like that. It’s based on the mean starting weight. They lost 20.9% of their original weight, and regained 14% of the original weight. The mean loss was 22kg and the placebo group regained 11.1kg.

Sad times for you, not only is it approved in much of the western world for obesity it’s about to be approved for cardio vascular and kidney disease too.

meducal science huh, can’t stop it progressing. Can’t keep the fatties fat.

sad times.

Oops, didn’t realise how much the thread had moved on!

It is fascinating, though - the study looked at people with a mean starting BMI of 38, which had come down to an average of 30 by the time they switched to placebo. So they were still obese even when they stopped. I wonder if you would see the same results in people who either started at a lower BMI (say 30-35) or who stayed on it until they had a BMI of under 25?

I take Mounjaro for diabetes.
I am also over weight, although I don't have a problem with overeating/nutrition and no diets or modified ways of eating have helped to address this.

Doses 2.5 & 5ml made no difference to my weight or blood sugar.

7.5ml has seen my blood sugar plummet almost overnight, so it's clearly improving my insulin sensitivity, but I've still not lost weight.

There will be plenty of cases like mine where it's not a case of "eat less move more" and everything will be fine. My metabolic issues, including my insulin resistance can't be fixed without drugs like Mounjaro. I'm hoping I can stay on it for life.

@TooExtraImmatureCheddar that's interesting what you say though so don't worry about that!

It's been a really good discussion because I was talking into the trap of 'ooh I've cracked it! THIS TIME it will be different!' as I come off MJ completely

And the reality is that this - and true for all of us - requires more thought and everyone should know what they're going to face when they reach their target

That study into semaglutide and liraglutide is massively encouraging though! In a study of over 25,000 people, over 50% of people in every category maintained or lost even more. I hope someone’s working in a similar Mounjaro study.

You won't regain the weight if you stick to a calorie-controlled diet and exercise.

You will regain the weight if you go back to old habits.

Edited to add: Unless you have actual viable health reasons why CICO doesn't work for you.

@CandiedPrincess but it's not that simple. All the studies we've talked on this thread point towards that.

Physiology plays a massive part alongside psychology

I don’t really understand what you’re saying, surely everyone knows you need to keep your eating habits to maintain and if you eat like before you will regain? I’m also not sure why you feel the study is depressing, it’s hugely positive.

are you saying you thought you could come off and rhe weight would magically stay off if you didn’t maintain your eating habits?

As I said, unless you have other reasons. And I've read all the studies...

But CICO works successfully for a lot of people, myself included. For some people it is that simple.

Depends on the reason you put on weight in the first place.

I am one of those rare people who will put my hands up and say the reason I got fat was because I ate too much, drank too much and was lazy AF. I'm okay with saying that. I don't have any health issues that made me gain weight, or emotional issues or food issues - other than I really enjoy eating and I don't like exercise.

But I've had to make a change. And if I stick to 1200 calories a day, don't eat my exercise calories and daily weigh to keep myself accountable, I maintain.

I've used Mounjaro to lose weight, I am 5 weeks MJ free now and am still losing half a pound every few weeks though my goal is to maintain now within a few lbs. Is the hunger and food noise back? Yep. But my desire not to regain weight is bigger than my desire to eat rubbish.

@Queenofthejabs no. I think what I'm saying is that people genuinely think that coming off MJ and then just sticking to a calorie controlled diet will ensure the weight stays off.

I'm saying that the studies show (so far!) that the weight will go back on regardless

However it was more just a discussion tbh. I'll remember this thread though and it'll be good to see it in a year or so as then we will have more of an idea (from MN users of WLIs) how people are getting on with maintenance

@CandiedPrincess well done, sounds like you've done brilliantly so would be great to hear how you go longer term.

The psychology behind why you eat the way you do is much stronger and pertinent to a lot of people being obese than just eating badly out of laziness etc. You need to take the time to get to the bottom of that - that is one of the biggest criticisms of these weight loss drugs, they do not tackle the root of the issue.

I'm not saying they're bad news - as far as we know, they're far from it; but they've done their bit it's now time for you to do yours. You have the advantage of breaking the physical addiction to certain types of foods, but now is the time to crack the psychological side.

Around 7lbs is perfectly reasonable and normal allowance for fluctuation. My goal weight is always one I'd be happyish with around 7lb heavier and I lose and gain that at various points of the year (currently +7, it'll be shifted by the end of Jan lol).

I expect every single person on that study swore to themselves that they’d maintain the good eating habits. I know I do every time I lose weight. But they still regained. I don’t think it’s as simple as CICO, or even just reverting to bad habits, or underlying psychological reasons for weight gain. I don’t have any psychological reasons for being fat. Talking therapy would do nothing for me. I’m just tired at the end of a long day and turn to takeaways because I don’t want to cook, plus I’m short so portion sizes are almost always too big. I think these studies are showing that there is a physiological reason why people get fat. Possibly also a tipping point above which the effects snowball. Perhaps we should start encouraging people to weigh themselves more - “weight gain is dangerous, check you’re safe, step on the scales” campaigns. Like smear tests.

Not one study I've read shows that adequately because we have ZERO information of whether the participants have made lifestyle changes. Not everyone does.

There are plenty of people on here using MJ that say that don't calorie count or exercise or diet in any way. They just eat their normal diet and let MJ do the work. That's fine. But if you're given a placebo, there's nothing doing the work. So you really are just consuming all those calories again. Which means it's not completely balanced.

There are already plenty of people on MN maintaining now.

Perhaps we should start encouraging people to weigh themselves more -

That's why I advocate weighing every day @TooExtraImmatureCheddar It's far too easy to bury your head in the sand if you don't weigh yourself for months on end - it takes no time at all to gain weight. At least if you weigh every day and see it creeping, you can take action.

I think what this conversation shows is that it's no use to just eat way less because MJ makes us feel.so lousy or suppresses a lot. Use the time and space given by MJ to figure out triggers, find healthy eating habits that suit us and yes, to whoever felt patronised in therapy, eat the avocado and not processed crap. By now we all know a portion size, calories, that processed food is addictive, designed to have you back for more and more. I think the studies are positive. And don't forget if you maintain for a year or so you massively reduce the risk iof diabetes.
I don't believe insulin resistance is worse when you come off it.

What counts as maintenance though? Is it a month? Three months? A year?

I'm not sure anyone yet could be described as maintaining just yet. Morning true sense of the word

*not in

Yes, it’s always the first thing I drop when I stop actively dieting! I must keep it up this time.