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’m 60+ and can see myself maintaining MJ for life, if possible. I am hopeful it will have a positive effect on my mobility, ability to exercise a little (I have me/cfs) and arthritic knees. I believe I am overweight because of genetics, chronic health issues, being an ex smoker (affects your metabolism), issues with my thyroid, being unable to do vigorous or regular exercise, my age, and some yo-yo dieting in the last 15 years; none of which I can control through will power!

Re. expense it will probably work out about £30 per week, but I consider that worthwhile for quality of life. I’ll probably save £15 per week on food perhaps? And so the other £15 isn’t that much when you consider what people play for membership of slimming world, gyms, personal trainers- none of which I would pay for! Plus I can wear a lot more of my clothes and dont need to buy anymore (well maybe a new pair of jeans at some point, a treat). All my swimwear will fit me - at the moment only can fit into two swimsuits and I won’t have to buy anything bigger hopefully.

I’m only starting week 4 so this is all a trajectory but what seemed impossible despite my efforts now seems at least possible.

@IDontHateRainbows I've not noticed any food savings - unfortunately I find eating healthier way more expensive. Junk food is cheap. That's a societal problem though!

In the summer, in just a few weeks, where I let my eye off the ball - 7lb back on in a blink of an eye - and its been bloody hard work to get that 7lb off again in time for Christmas

@suki1964 It's so hard isn't it. That's why I say weighing frequently helps - not because it's a miracle worker but because it helps to nip any weight gain in the bud before it becomes insurmountable again.

I do save some of the cost but not all. Never a snacker, I am/was huge portion person, loved the feeling of feeling full (if that makes any sense) so there are some savings in a meal I used to cook before lasting two dinners rather than the one. Only on my third pen, so may notice it a bit more in the future x

I was both- snacker and feeling full person. Now I am neither and I love it!

It's absolutely wild. I get it so badly normally and I knew something had been different this year but couldn't put my finger on it.
Also my completely gone sweet tooth. Had a sip of a friend's hot chocolate earlier and didn't fancy it at all. Normally I would be the first to buy one and get marshmallows on it and everything.
Would love it to sort out my horrendous peri periods but you can't have everything 🤷🏼‍♀️😅

I did a lot of research before I started and accepted that I would need to be on this medication for the rest of my life (or until I am too old to care!).

I have lost 2 stone in three months and have another stone to go. I am hoping I can maintain on 5mg or even 2.5mg.

At the moment MedExpress will let me maintain for two years - hopefully to guidance will have changes by the end of that (and hopefully the price will have dropped!).

I have been listening to an audiobook called “ Why we eat ( too much) by a Dr a Jenkinson and his explanation is very enlightening.

it also explains how MJ and the like work.

put simply, we all have a set point in respect of our weight. This is individual , and if we move too far away from this our body will ensure we get back to it. It’s why diets do not work long term

The body uses leptin to determine where we are in relation to our set point ( I am simplifying)

MJ basically replaces the leptin effect to tell you you are full, along with the slowing of stomach emptying being etc

So logically, once off the drug, you are back to square one with the leptin signals and set point etc

This also explains why people can lose weight but really struggle to keep it off. Because your subconscious wants that set point weight bac k

But again that doesn’t make sense, as it’s proven people off the drug only regain on average 14 percent of their body weight back, so 1,4 stone for a ten stone women, where as those who lose without gain on average 100-120 percent of what was lost. So if loss of 5 stone, they will gain up to 6 stone back

Take it up with the dr

or maybe apply critical thinking and recognise when something is nonsense?

I don’t think it’s proven that that’s the case - don’t the studies only follow people for around a year after stopping the medication? I don’t think it’s the case that as soon as you stop taking it, you’re immediately swamped with overwhelming urges that you can’t contain - this board is full of people who are managing to maintain in the first few months/a year or so.

But keeping the weight off is really only something you can say that’s been achieved over the longer term. As other posts on this thread demonstrate, all the while people continue that close monitoring - counting calories, weighing, watching themselves closely - they are likely to succeed. It’s more that if you look at say a five year period, keeping that tight rein on things becomes less feasible. Because that is what people are experiencing, by the sounds of it: a continued sense that they must be controlled otherwise the weight goes back on.

This is not how a naturally slim and metabolically healthy person experiences life. For those of us who have weight issues, we need this constant (and very difficult to sustain over the longer term) monitoring - it’s this that is the problem I think, because it’s exhausting!

Andrew Jenkinson is a bariatric surgeon and obesity expert. I don’t think he’s likely to be spouting “nonsense” on this subject.

@Donttellempike that's a good and reasonable explanation.

We can all be absolutely resolute that this time we've cracked it, that we have the tools etc etc but past experiences don't bear this out

Concentrating on the science/ physiology may be the way forward

And yet factually it is inaccurate. No way round it.

I have a dear friend who did the same after Cambridge. She's now got the same in balance after regaining the weight.

My worry is about why I've struggled with my weight.
I suspect it's genetics. Until I got married I managed to get by at the top of my healthy weight at around a size 14.
After marriage and pregnancies I started yo-yoing dramatically.
If "all" that's required is an iron will, calorie counting, exercise and weighing daily, I can do that.
But if I've actually got a health issue, which Mounjaro fixes, then I'm fucked.
I've got about 2.5 stones to lose now, so I guess I'll find out.

What exactly do you find "factually inaccurate, @Queenofthejabs ?

@GrimDamnFanjo I don't have any imbalance if I'm a normal weight. It's only if you put weight on

I just found it interesting, and it made a lot of sense to me. In the early chapters he explains clearly why weight issues are not due to lack of moral fibre or greed. And that dieting causes metabolism to go down.

I don’t have a weight issue now, but did as a child. And was constantly on bloody diets !

No need to be quite so rude , this author is an expert on the subject. Are you?

There is a school that the set point can change over time and with support - Van Tukellen or Jenkinson

The lack of respect in the way people talk to each other on MN at times is an argument for moving to the outer Hebrides and becoming a shepherdess. Sometimes it feels all-pervasive. And so ugly.

@Donttellempike I've listened to that audiobook too and found it excellent. He provides plenty of evidence to support his views, which are compassionately supported with insights from years of experience helping patients suffering from obesity.

There is no permanent mechanism in GLP-1 medication so it stands to reason that weight regain patterns will largely follow that of other weight loss methods. It doesn't mean this will be true universally and I'm sure some people will find they do sustain it - but there's nothing wrong with acknowledging what the latest obesity science suggests which is that for many people an ongoing maintenance dose will be necessary. I just feel very fortunate these drugs have arrived at a time when I can take advantage of them.

I just found it interesting, and it made a lot of sense to me. In the early chapters he explains clearly why weight issues are not due to lack of moral fibre or greed. And that dieting causes metabolism to go down.

I'd respect it more if it said some weight issues^ are not to lack of moral fibre or greed, because it's not to true to say that weight issues as a whole aren't.

The reason I was fat was because I was eating and living like a greedy pig. There's nothing wrong with admitting that! ^
^
I firmly believe there are a billion reasons people gain weight but the trend at the moment is to gloss over some of them because of the "science", when it's also a fact some people simply eat too much because they can - and I am one of them. It's lovely that I can now plausibly blame my weight gain on metabolism and set point and insulin resistance - but it wouldn't be true.^