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

There's no need to put the word science in inverted commas @CandiedPrincess - it just is science.

If it was as simple as you having been a greedy pig and now deciding not to be one, you wouldn't need to weigh daily, surely? Naturally slim people don't need to do that, because there's no faulty leptin or ghrelin signals causing them to want to overeat, even when they're not hungry.

All too easy to go over calories without realising @85reasons hence the daily weighing. I'm on maintenance calories now which for me is 1600 but it's still incredibly easy to go over that even with healthy eating. Which is why I will daily weigh, and if weight starts creeping up I'll drop back down to 1100 calories for a few weeks/months as needed.

My problem isn't being naturally slim or otherwise - unfortunately I am naturally short, therefore don't need as many calories as many other people.

(When I say greedy pig I mean that - truly. I paid no attention to diet. I'm not being controversial. I'd thinking nothing of having pizza one night, followed by an Indian the next, burger and chips after that...with a McDonalds in the day or bacon sandwiches for breakfast, big baguette for lunch, washed down with probably 2-3 bottles of wine over the weekend. And did zero exercise, averaging 2-3000 steps a day. That's not sustainable for anyone and looking back I don't know what I was thinking. It's not hard to see why someone would put on weight. I still have those things of course but in much much more moderation).

I've been you @CandiedPrincess - so emphatic that I'd cracked it and all it needed was willpower and keeping a close eye on the scales

and like I said earlier on in the thread, I genuinely hope you have cracked it. Keep us posted in 2025/2026? Because you can't say you're maintaining before then surely? You're still riding the wave

Science is science is science.

Me too @RoastedPickleAndChips - lost 70lb in 2020 and kept it off for 2.5 years before a 9 month insane period of nightmare teens, moving house, and promotion at work led to rapid regain of 45lbs. I thought I really had it sussed and was so happy and fit at my low weight.

I will definitely keep you updated on my journey @RoastedPickleAndChips

I don't doubt for one minute I will put on weight. I'm realistic about that. Holidays, Christmas, life...all gets in the way but I am committed to not letting it spiral out of control. I'm allowing myself a fluctuation by about half a stone which I think is realistic.

I'm not scared to put some weight back on - I just hope to control it and take action sooner.

You are missing the point entirely , I thought the book interesting, and that some others on a weight loss thread may also find it so.

Not everyone is you, but you do you hun.

As a matter of fact, the reason post industrial societies have become increasingly overweight is because of societal reasons, mainly the industrial processing and distribution of food . Which empasises profit above all and bulks up cheap ingredients with sugar and seed oils which do not register as food in the human body and lead to excess consumption of calories.

I hadn’t expected such rudeness and lack of basic manners. I’m out on

I've also never lost and gained and lost and gained before so it will be interesting. I've maintained a healthy weight for 30-odd years while having three kids, and only gained when I got lazy and complacent which leads me to believe, that I don't have other issues.

Of course, there are some other factors coming into play now like menopause in the future but I also now know I have a serious heart condition where weight will be a huge risk factor so to be honest, gaining a lot of weight again isn't something that I can just accept so there's also that as a motivator (hopefully )

You can drop the hun @Donttellempike I'm not that easily patronised if you hadn't noticed yet

@85reasons yep I hear ya

The only thing that's making me think I may have half a chance this time is A potentially micro dosing MJ or just stating on a low dose and B I just can't, simply CAN NOT put on 70 lbs again. My body just can't take it again. Although I look fine and slim now, the reality is I have lost muscle mass and therefore my focus for 2025 has to be gaining some strength.

Which makes a nice change from starting the year on another diet!

Ditto re loss of muscle mass..! I'm about a stone from my goal weight now, and yes my main focus is getting focused on fitness for 2025.

@RoastedPickleAndChips
Me too. I've lost so much muscle but I know my underlying health is 100% better than it was when I was 5st heavier. Exercising will be so much easier now I'm not fat or too depressed and embarrassed to be out in public!

@KrankyKumquat well done on your achievements! I definitely look a lot better but my bottom is non existent

See photo evidence

Wow, what a change!
Yes my bum has disappeared too.This is me in my first ever pair of 501s, 28in waist, bought last week at age 58!

Ooh you look amazing! Congrats on the jeans!

I haven’t read the whole thread, but read a very interesting article yesterday on microdosing MJ. Apparently people have been doing it for a few years already-taking 1/10th of the “standard” dose (I’m taking it that means 2.5mg?) for the rest of their lives. I will happily do this if it works for me, as I have a real problem with food noise and ghrelin.

I would definitely be open to long term micro dosing once I reach a weight I want to maintain.

Another alternative I haven't heard mentioned much is maintaining through up/down pre-emotive strike dosing! My weight gain doesn't tend to be steady... my compulsive eating is often triggered by something really bad/stressful happening to me. Eg last upward climbs were a loved one getting cancer; a breakup ; my dad dying. Once I fall into them., they can easily last six months- and of course add to how shit I feel mid crisis... then post crisis, I'm already exhausted and licking my wounds, and don't have the will to turn it around.

I love the idea that I could be on nothing or a micro dose, then if a crisis hits, I could start ordering a higher dose again..... cut off that 'I put on 20lbs in four months' syndrome I've had in the past. So a sort of preemptive strike on major binge triggers.

Oh- this is what I'm talking about on my previous post! Well done for maintaining that long.... and maybe now something like MJ can help at the start of one of those shit periods to avoid losing your progress?

@financialcareerstuff
I think a lot of us like the idea of micro-dosing but in the UK, we hit the problem of the 30 day open pen issue. The Americans do it a lot but they have single dose pens which avoids this issue (but they are insanely expensive). I'm planning on trying one month on, one month off when I get down to 2.5 - which my prescriber supports.

This was what I meant in my earlier post.

If you have discovered a method that works, if weight gain starts to get out of control you'd take it again but hopefully only with the need for a relatively small loss rather than facing a five stone plus challenge.

Or is this where it becomes tricky and aligns with some of the other posts about 'cheating' i.e you'd have gained weight but not be at a BMI to qualify?

I'm a bit confused by that part that it is okay to be on it down to slim weights but not to start it at the upper end of healthy BMI. I think that's where some of the 'its not fair' feelings might come in.

I've mostly been obese since I was a young teenager, I definitely don't need talking therapy to discuss it more than I already have in my life.

I'll quite happily be an ozempic lifer if it means I can just get on with my life and not just be 'the fat one'

I think everyone should actually read the Surmount 4 trial results rather than making incorrect conclusions based on other peoples incomplete statements.

The trial looked at people who had all been taking Mounjaro for 36 weeks. At this point some continued taking Mounjaro ("Maintenance dose") and some were given a placebo, ie no Mounjaro. They were measured again at week 88, so 1 year after that 36 week point.

-At week 36 when this trial started, looking at all the participants, an average of just under 21% weight reduction had been achieved.

-At week 88, the percentage of participants who maintained 80% of their weight loss was
93.4% for those carrying on with Mounjaro and
13.5% of those who took the placebo

-At week 88 those carrying on with Mounjaro had lost a further average 5.5% of their week 36 weight but
of those taking the placebo 86.5% regained an average of 14% of their week 36 weight.

-The overall mean weight reduction from week 0 to 88 was 25.3% for those taking Mounjaro and 9.9% for those who took the placebo from week 36.

So, to come back to your example 10 stone woman.

If she conformed to the study average in the way you describe her, then at 36 weeks she had lost 21% of her starting weight. This makes her starting weight 12 stone 9, or 177lbs.

At 88 weeks:
Her weight loss would have been 37lbs.
Her weight regain would have been 19lbs.

Her overall weight loss would have been just 18lbs (1 stone 4),* leaving her final weight at week 88 at 159lbs or 11 stone 5, which is a loss of 9.9% of her starting weight.*

If she had continued taking Mounjaro as a maintenance dose her overall weight loss would have been 44lbs (3 stone 1) leaving her at a final weight of 133lbs or 9 stone 7lbs, 25.3% of her starting weight.

And this is only at 1 year after stopping Mounjaro. Would this example woman carry on regaining weight, or would it magically stop there at 14%?

I do not understand where you have got the notion that weight regain after Mounjaro is in some way so very different to weight regain after any other diet?

Thanks @IrisPallida, your numbers are clearer than mine but that’s how I read it too - a lot of the weight goes back on.

@IrisPallida thank you for explaining that so clearly and better than I ever could!

A lot of the weight goes back on. Regardless of good intentions / daily weighing / 'this time I mean it!' etc

So is the answer some sort of micro / maintenance dose and if so, are there long term health implications of staying on MJ for life? Don't suppose anyone knows definitively yet

@IrisPallida perfect illustration and explanation - thank you.

I think there is a contingent of users who believe they will not follow the weight regain patterns of serially obese people who have lost and regained weight repeatedly. I’m not sure of the statistics for that kind of overweight person and their tendency or otherwise to maintain weight loss, but agree with you in that MJ is no different to any other form of weight loss so whatever those patterns are elsewhere, they will be replicated with MJ.

I think this view is compounded with the belief that MJ is some sort of magic opportunity to “learn better habits” and make permanent lifestyle changes. I don’t see how this is any more likely than on any other diet, but know from my own experience that I can believe I really have changed for good and will never go back to how I was before, only for the wheels to inevitably fall off at some point.

I don't expect to be on Mounjaro for life, but long term maintenance medication is being developed now. These drugs aren't new and have been around decades. I suspect they're less of a risk than long term obesity and that's the comparator rather than someone who hasn't ever been obese.