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

Makes a lot of sense @Lilac72929 . I think health issues, lack of exercise and age also come into the equation. Speaking from personal experience I get a sense that my body is always fighting to get to its highest previous “set point” weight, even if my calorie intake is lowered. This “drift” seems to be especially the case after a certain age, after menopause etc. By my mid-50s I found it very difficult/ impossible to lose any significant weight without being uncomfortably hungry. I had to go under 1000 calories and just could not keep this up. On a modest 1400 calories my extra weight simply would not shift (I was 3 stone overweight). Lots of exercise could have possibly helped fire up my metabolism to some degree but chronic health issues also limited this option. Hence why I’m on this board.

As someone who has lost and regained many stones I have never felt dieting and common sense have any connection,

It's not about life circumstances which removes self responsibility. It's about what we put in our mouths.

Absolutely @AmICrazyToEvenBother I can weigh myself one day and be 3lb "heavier" (physically impossible to have gained weight really when I've stuck to under 1200 calories...) but that would be crushing on a weekly weigh-in day. Whereas as I can see that it's a blip because of bad sleep or hormones or eating salty food and it's gone again in a day. I tend to focus on the weekly average which often shows a downward trend even if the official weigh-day results show an increase or maintain.

I have been on these injections for over two years with a couple of short breaks and some dose reductions due to supply shortages in the early days. Every time I have stopped or cut down I have gained weight - rapidly in the breaks.

I agree that it is 14% of the start weight that the study refers to, not 14% of the weight lost. Makes a big difference.

My set point and appetite is being artificially held so low. It is not surprising that my body fights back so hard when I remove the drugs holding it down. The more recent study is encouraging but I know from personal experience that I am not one of those that can keep the weight down by lifestyle changes and will power alone.

If people go into maintenance with a mindset of "I won't be able to maintain it" they're setting themselves up to fail from the start. I don't get that mentality at all.

Why not head into maintenance with a positive attitude. Maybe you can maintain, maybe it will be too hard but going into it with a defeatist attitude in the first place blows my mind.

I have been on these injections for over two years with a couple of short breaks and some dose reductions due to supply shortages in the early days. Every time I have stopped or cut down I have gained weight - rapidly in the breaks.

Interesting @BackToWegovy. Can you pinpoint why you put the weight back on?

For example, Is it because you do overeat during that period without the MJ 'control' or is it simply the other elements of the medication not working (as is suggested earlier on in this thread - that it's not as simple as what you're putting into your mouth?

@CandiedPrincess it is quite shocking to me how insistent you are on overriding the fact I've repeatedly said I've been here before - several times. You don't magically have a wiser perspective than myself or others who know that keeping weight off for 6 months is no indicator at all of long term success.

Of course nobody goes into maintenance with that mindset - for me this time however, with the benefit of experience and having read up on obesity science, I'm happy to continue on GLP-1 medication as a tool to help me maintain. I will also weigh myself regularly. But please don't assume you have any more knowledge or capability to maintain weight loss than the thousands of other people who are choosing the same maintenance strategy to include continued medication.

Interesting. Can you pinpoint why you put the weight back on?
For example, Is it because you do overeat during that period without the MJ 'control' or is it simply the other elements of the medication not working

Probably both. I know when I am on the medication I can’t finish big meals and that goes away so even healthy meals involve eating more when off the drugs. Then there is the craving for snacks which massively ramps up - toast and banana for example on a good day. Chocolate bars from the petrol station on a bad day. I am just not as tempted on the injections as I am off them. So you could say that it is because I am not sticking to the lifestyle changes and you would be right but I think my homeostatic mechanisms are fighting hard to get me to eat more to get back to the weight I was before.

If you've been here "several times before" you clearly have bigger issues than some other people @85reasons.

I'm not insistent about anything - I've repeatedly said for me - and I won't be alone.

I also have no problem with those who want to continue using MJ to maintain if they feel they need it. That's personal choice.

I purely said I don't understand going into maintenance with a negative mindset. That's my opinion, and I'm allowed to have it whether you like it or not quite frankly.

You're so needlessly hostile on this. You expect everyone to see your point of view but you won't accept that others will have different experiences. You just want to run them down and tell them why they are wrong. What a ray of sunshine you are ☀️

@BackToWegovy Thanks for sharing your insight, it's really interesting.

Yeah, willpower is hard to come by and easier on some days than others. If I'm busy at work or in a good mood then it's far far easier to stick to healthy choices and feel good about it but on a bad time I am more likely to just think, oh what the hell.

Office days are easier as I can literally only eat when I take in with me. Work from home days I feel I get bored quicker and start to look for snacks - so I've stopped buying them. Happy me thinks this is a great strategy, grumpy hormonal me thinks happy me is an idiot

I guess MJ takes away that inner struggle. Now I am not on it and do miss not thinking about food so much, but I'm also enjoying being able to enjoy food again when I go out for instance as my suppression was ridiculously high at some times. I would love the urge to snack to disappear though!

@CandiedPrincess I think I was slightly triggered by someone announcing in a "hold the front page" fashion that maybe we all just need to weigh ourselves daily.. one moment let me write that down..! It's what the 95% of people who regain weight after weight loss have been missing all this time! 😁

You do you @85reasons

I know the reason I gain weight is because I take my eye off the ball. If you can see the scales increasing you can take action before you suddenly wake up and go "shit" I'm 20lb overweight. Much easier to lose 3lb.

Can't see why that would be triggering. Just because it doesn't work for you?

But just because it doesn't work for you doesn't mean it doesn't work for someone else. Or will work for someone else.

I'm not saying it doesn't work. I think I was very clear in saying I've done it before for months and even years at a time. Did you read my posts?

These are exactly the mechanisms at play which explain why these medications are so successful. Without them our bodies are fighting to return us to the higher weight levels, so whilst yes we can be mindful and track and log food, weight etc, for the vast majority of people suffering with obesity they/we are fighting against the 24/7/365 instinct of our metabolically broken bodies to put the weight back on.

What has been liberating for me whilst on MJ is finally realising my success or otherwise at losing and maintaining weight loss is not some failing of mine to know enough, have enough willpower, make sufficient lifestyle changes, pay sufficient attention. I’m absolutely over thinking this is about anybody suffering with obesity’s LACK of effort.

I’ve not lost weight through injections but via slimming world. I’m a long term goal member and have found over the years that what keeps me at goal has been weekly weigh ins and staying to group. If I take my eye off the ball, even for a couple of weeks I start to eat mindlessly again and a few pounds go on. It would be maybe helpful for those losing weight on injections to have similar support groups to keep them on track.

Have a read or listen to the Zoe podcast with obesity expert. Especially the last half. The food noise and satiety mechanisms are worse for some.

I'm on Wegovy once my bmi is under 25 my prescriber doesn't l prescribe anymore. So that's it now. Im extremely worried about regain.

Thanks for the response.

How do you know if you have insulin resistance or not? I would have no clue. Is it through blood tests?

The nhs doesn’t test for it, as they’d no way of really fixing it past advice.

a clear tell tale sign is the amount of belly fat out of proportion to the rest of you. The swollen look, not the apron one. But the nine months pregnant look.

Also in my case, injecting large amounts of insulin and it making little difference to blood sugar levels.

Can also go hand-in-hand with other metabolic disorders like high BP, fatty liver etc

Hbaic test

I’m not surprised about those studies.
And not hugely depressed by it as I always knew for me that would most likely be the case.

My target weight will bring me to BMI 27, then I’m hoping to take a maintenance dose or try without but in the full knowledge I’ll most likely gain, but don’t feel too awful about that if I can take it again when BMI hits 30.

what would worry me more is if they said that it’s effectiveness wanes over time or each time you have another course it’s not as effective. That would terrify me 😆
But I don’t think that any studies have said that yet.

i too hope they look at a maintenance programme maybe with oral tablets. But of course the manufacturers will probably do better financially if people YoYo, have multiple courses and go on and off it.

I don’t know what the stats are but you must be one of a very small proportion of people on SW that have lost it and kept it off