Well this is depressing!

[Puppylucky]

New research published by the Guardian - so not a notable scare monger. Makes my MJ journey feel a bit pointless unfortunately. Edit : it's not letting me share the link for the article which is annoying but the upshot is that studies now show all the weight loss from MJ is regained within a year - much quicker than previously thought. Hey ho.

Why is it not reasonable or realistic?
obesity is a chronic condition. Once you have it it's extremely difficult to recover. If we need medication long term to stay healthy then so be it.

I suggest not wasting any time, and ignoring those on the thread who clearly think they know more that qualified medical experts. I am not interested in anyone who has lack of understanding on the subject and is just here for a bun fight. Not to mention their "arguments" are lacking in any substance or facts and they come across as tedious and small-minded people I would avoid in real life as well.

I skim read the article, there doesn't seem like much new in it that hasn't been said before.

If the article is news to you - similar articles were news to me when I first read them last year - read the article, don't despair, reflect on it, use the new knowledge to reflect on how you are using this medication now, and how you can use it now to support getting to how you plan to maintain. Maintenance is going to be the hardest part of all and this knowledge is going to help you for the future.

Remember all those posts saying Mounjaro is not a magic jab, it is a tool, this is what it meant. None of us are going back to our target weights, coming off this and eating/living like some of our slimmer friends do - obesity is a chronic disease that you now have and you will need to manage it for the rest of your life (whether that is medicated or not) or it will return. Took me a while in the beginning to realise that and I had to work on that part now for longer term success.

My expectation is I will be on this medication for at least 2-3 years, my strategy is to remain on the lowest dose possible to help me, not seeking suppression, while working on new habits. It will be 1-1.5 years to get to (nearly) healthy BMI, then another 1-1.5 years maintaining, trying out reducing doses, working to sustain new habits (eating and muscle preserving exercises), watching carefully how my body (and mind) responds and deciding next steps. I am open to perhaps needing to stay on Mounjaro (or possibly a new GLP1, perhaps in pill or annual injection form) for life if need be.

Nice, shame and judgement, lovely
it's not an insult to anyone to categorise obesity as both a disease and a chronic condition that may require long term medical treatment.

But this is where it is clear that it is better to use the injections over a period of time and drastically change the way you eat. But it's obvious that for those people who are using the injections and then eating say a banana a day it's not going to help in the long term.

It's all about a slow and steady weight loss whilst you retrain yourself to eat three meals a day of a smaller portion and make good choices about those meals.

Your palate gets used to more healthy options, lots of vegetables, salads, fruit and good proteins and at the same time less carbs. You cut out the sweet cakes, biscuits etc.

Then you continue to follow this way of eating. But for those that are just denying themselves food and not eating much it's certainly going to be a problem as they aren't establishing good eating practices going forward.

The other valid point is that for those seriously overweight presumably this has accumulated over a significant period of time. Therefore, for a significant period of time (presumably forever) you now need to constantly be mindful of eating patterns going forward.

Sharon Osbourne is full of shit. WLI don't stop you gaining weight, quite obviously. She's probably had a dodgy weight loss surgery that has wrecked her ability to eat normally and process food.

If it continues to be available via online pharmacies then some will continue to pay for maintenance but the price will be prohibitive for many ongoing. I saw someone on FB selling a left over pen last week so wonder how widespread obtaining it illegally is? If it is widespread then it might start becoming a lot more restricted on who they prescribe to (or even if they can prescribe remotely). Guess it depends how problematic it really is as people seem have polarised stances about weight loss jabs so it’s hard to get a balanced report.

most of the conditions you have mentioned are not caused by lifestyle choices.
I’ll come off the thread now as, as many have mentioned, it’s not relevant for me.
but using chronic conditions and mental illness as a ‘gotcha’ for supported weight loss is, imo, disgusting.

Psychiatric medications are very widely abused and traded illegally. It doesn't stop them being prescribed for those who need them.

I think you have to do major lifestyle changes or it's going to pile back on. I'm fasting and having cereal and one meal now. Walking more. Also I'm going to try to be off the injections within six months and only get to my upper bmi.

It's got the be realistic and maintainable. Going from 15 stones to 8 isn't going to be maintainable but loosing 2-3 stone I hope will be.

Also going to rejoin slimming world soon

Disgusting is the word. We know what you think of us.

Cannabis use is a "lifestyle choice" and it contributes to relapse of psychosis. We still prescribe antipsychotics long term to cannabis users.

It's not that easy though. Or no one who didn't want to be would be overweight. This take on things ignores the psychological issues people who are overweight may have. I know consuming fewer calories than you expend will result in weight loss. Whether I can stick to this and find the mechanisms to deal with the issues causing over-eating is another matter.

hasn’t there also just been some research to suggest these types of drugs have lots of wider health benefits for people outside of WL? Prevents claimed cancers apparently, So we might all end up on them regardless of weight!

either way, don’t worry about it OP. Take the drugs if you need them, from what we know it’s healthier to be on them than not if you are obese. Worry about keeping it off later.

For people with diabetes that have been prescribed it because of the significant improvements in blood sugar regulation without the usual side effects of weight gain that comes from insulin there is a strong likelihood these people will stay on it forever, it appears to be an excellent drug for that cohort.

As with all weight loss it is still about what you eat and how you move. But some people have strongly differing levels of GLP and some will benefit from medicated support longer term.

I've used Mounjaro to lose weight successfully and I'm early in the steps towards maintenance but I know the changes I've made to lose weight will need to be long term.

We've moved to 2 meals a day, occasionally 1 if it's a bigger meal. Our plates and bowls have been changed to much smaller versions to resist portion creep. I do still buy some snack type food that is portable and quick but it is protein based, small pieces of chicken, small servings of nuts and seeds rather than crisps, bread etc.

For me there has also been a radical increase in metabolism as it has interacted with my thyroid condition and changed the level of T4 in my system. An unexpected side effect but there have been a number of reports of positive impacts on various immune conditions, hashimotos being 1.

If I have to stay on a low dose longer term I'm not afraid of that, anymore than I'm concerned about taking Levothyroxine for my thyroid condition. The 20 years of research isn't indicating any issues with taking longer term at the moment. In fact there are reports of reductions in some cancers and inflammatory conditions.

It felt like your post was intended to look down on people that take Mounjaro, I'm not sure that was your intention. But often people that struggle to lose weight feel looked down upon by those that are naturally slim, as if we lack will power and are lazy. I can honestly say having the extra GLP has given me an insight into what slim people feel like on an average day, it's so peaceful not constantly thinking about food, whether hungry or not, not constantly grazing for a small hit of dopamine. Never feeling hangry due to low blood sugars. I'm not sure I'm ready to give that up and go back to the constant background noise yet.

For now I'll stay on a low dose at my target weight and see if my body can get used to a new norm at this size

Along with other concerns for example the side effects, putting the weight back on is a big worry. I’m pretty sure losing the weight and then putting it back on, is worse for your body than staying as you are.

I have been off Mounjaro since September and have maintained the weight loss. I have changed my habits, what I eat, what I drink, I move more, drink lots of water now. It taught me to be more conscious about what and how much i was putting in my body. For example if I wanted chocolate before I would eat a whole bar (big bar!). Now if I want chocolate I have some greek yogurt with chocolate protein powder mixed in (and I prefer it, i don't feel sick after and it's filling). Or I now add mozzarella cheese instead of normal cheese to meals. I use egg whites to bulk out my omelettes, quiches, etc. It's little things like that. I cook more from scratch, make better choices in the supermarket. I order chicken kebab when DH gets takeaway, or a chicken curry with brown rice and only every now and again. I force myself to eat a piece of fruit a day - I hate fruit - but a bit of banana on my weetabix I can get away with.

I think it’s a difficult one with the obesity vs chronic condition argument. Until the jabs (which we don’t have the long term data for), the only way to lose weight and keep it off was lifestyle changes unless you get surgery. Although diets work in the short term most fail and people put the weight back on unless the person makes changes for life. Until people have been using the jabs for a number of years we won’t know if it is a miracle cure that means the weight stays off forever or if a certain percentage will regain- hopefully it works and will make a positive difference on individual and societal levels.

The same doesn’t apply for many of the other chronic conditions, lifestyle etc won’t make any difference to bipolar for example (although it does burn out in some people).

Things like cholesterol and high BP can be compared in that lifestyle changes might mean they can come off the meds (i have high BP and on meds and hope to not need them forever).

We just need to wait and see. If in 10 years the stats are amazing it might become easier to get on the NHS.

Interestingly I’ve read the opposite. There is research saying that it’s better to lose the weight and regain it than never to diet at all.

https://evidence.nihr.ac.uk/alert/weight-regain-does-not-eliminate-the-long-term-benefits-of-weight-management-programmes/

https://pmc.ncbi.nlm.nih.gov/articles/PMC6208150/

it definitely has to go hand in hand with a complete overhaul of your lifestyle. For those who are obese because they’ve been eating poor quality (not to be confused with cheap!) obesogenic food and have only used MJ for the appetite suppression to eat less of it, they are the most likely candidates IMO to end up back to square one off the medication. Those who completely change their diet, exercise etc alongside and long enough for it to become an ingrained habit are much more likely to succeed.

I have come off it now and so far am maintaining fine, I’ve even lost another 5lbs unintentionally. I’ve changed my entire diet, cut out pretty much all UPFs, I do exercise classes, 15k steps a day, etc. MJ gave me the ability to introduce those changes and stick with them and be motivated long enough until they were ingrained as just my new way of life, not a temporary change. But if I went back to eating the same foods etc as I did pre MJ I would gain weight again because those foods promoted overeating so volume would become an issue and I was overfed and undernourished.

It was my intention to stay on it for life when I started over two years ago. I'm only a sample of one. People ising it as a short term fix might find this. I think those of us who have been obese all our lives might treat it as a lifelong journey

If you are using WLI to simply just lose weight and drop a few dress sizes without making robust dietary and lifestyle changes then just as with other weight loss methods you are at risk of putting some back on when you stop taking the medication.

Using WLI for let’s say 12+ months, reaching goal having made significant changes to what you eat, portion sizes, getting more active, reducing alcohol intake to minimum, sleeping better, drinking plenty of water, taking supplements gives you a far stronger chance to maintain and eventually wean off them. If you have lost 5st and you gain 1st in the first few months of being off them you need to heed the wake up call and either go back on them or reassess what you are doing.

No one’s regaining all that weight if they are monitoring their behaviours and taking appropriate action.

Until you’re off them you don’t really know how you will be. Some are lifers others may just need that temporary off switch to realign themselves.

Losing weight and gaining it back over time is better than never losing it and gaining more over the same period of time

Another thing that I do might be OTT to some people is that I weigh myself pretty much every single day in the morning when I brush my teeth and record it in my app. I have a range I am happy to remain within but if I start to creep towards the upper end of it, I make some changes and reduce my calories for a few days to get back in a comfortable range. I need to have that level of accountability to myself, now. That may well be a lifelong thing for me, another tool that I have to use, because for whatever reasons in the past I’ve found it harder obviously than some other people to maintain a healthy weight so for me it is obvious now that I have to work harder at it.

I have realised that my slim friends are actually eating virtually nothing, that is how they are slim. When I realised that I was conditioned to eat three meals a day when in fact I can easily survive and thrive on a fraction of that volume was a game changer for me.

I eat one meal a day
With a small snack

I need nothing more given I don’t do a manual job or spend my day toiling in the fields. I will never deviate from this now. My grandmother ate the same and loved to 96. I used to think she was bonkers, now I realise how much we are being sold to, forced fed literally. We just don’t need all of this food, the sedentary lives we lead. I exercise for fun. Enjoy my life not stressing about food

This is exactly how I manage it too. Weigh every morning, and if it starts to creep up (over and above normal fluctuations) I make some instant changes.