Piling the weight back on when stopping MJ

[Richtea67]

Hi all....I'm so disappointed. I lost 3 and a half stone, have been off injections for a month and regained nearly 7lbs 😩. I was a slow loser (1-2lb per week) and focused on changing habits and reducing portion size rather than diets/calorie counting (this has led to binging previously). I have kept up with a lot of the habits (smoothie for breakfast, cutting out alcohol and healthy high protein snacks). But portion sizes have definitely gone up as I'm hungrier! And I've been more tempted by the biscuits at work and the kids treats! Any advice?? I'm considering re starting if I put too much weight on, but financially this would be a struggle, which is part of the reason I came off them. My starting weight was 14.5 stones, weight when stopping injections 11 stones and at present nearly half a stone back on!! Help!

@FortyElephants right, that's why I noted that some people are indeed biologically and hormonally driven to overeat whole foods - they are likely to gain weight whenever surplus calories are available. I think this subset of the population is the one that these drugs can really help - people who are excessively hungry most of the time and don't experience satiation even on a whole foods diet. But overweight and obesity as a epidemic absolutely is UPF driven. The work I've done in over the past 5 years has convinced me (as has the behaviour of certain industry players). Caloric surplus has been available a lot longer than these "foods" have. Almost 65% of adults in the UK are overweight or obese. That's shocking, but not surprising. In a society with caloric surplus, some people will get fat. In society with caloric surplus that is also saturated with UPF, most people will.

@Burnserns exactly my feelings - and some of us haven’t been constantly gaining - we gained in a very specific period - I stayed around the same give or take a stone ( but wasn’t dieting ) for many years - had a perfectly good diet to ‘maintain’ - just not to lose

@Blackcordoroys I was accused by the poster of not following the overwhelming research on this and using anecdotes- but I do indeed know lots who have maintained having lost anything between 2 and5 stone - in all fairness I don’t know anyone close enough who has lost more than that -

Im with you. My BMI was high 30's, ive lost 40kg, or around 6st5lb and im now in the maintenance phase, which for me, doesnt involve stopping the jabs. I have reduced the jabs from 12.5mg to 7.5mg, hoping to go to 5mg but we shall see. But this is a life long solution for me, not a quick fix and leanr new habits. I was overweight as a child and a teen, i hit obese when i had my first baby as a teenager at 18. Ive battled my weight my entire life, now nearly 25 years later, this is the only time in my adult life i have hit a healthly weight. Im also in healthcare as a nurse, i understand the psychology of overeating, i understand calories in v out, i understand portion control, i understand regular exercise, but that doesnt make it possible for me. I believe i am resitent to GLP1. Looking back at how much i could eat and still feel genuinely hungry 2 hours later is crazy. The inability to resist sweet snacks. The endless scrolling of tiktok food videos, id even browse just eat and uber to see what new places were online and what they offered, as all the time, thinking of food consumed my time. I would go on weight watchers, slimming words, the kelloggs diet, slim fast, cambridge, lighterlife etc etc and it was unsustainable, as the constant food thoughts were more and more overpowering when i was hungry. It wasnt a choice, it was a need. Its a completely different thing to those a who have gained a couple of stone due to whatever reasons, this was my life, mounjaro has made that not my life, so if i have to budget £40 a week for my entire life to privately pay, i will, because this is the ONLY thing that has worked for me. Its also the reason why gastric surgery was never an option, i knew it wouldnt work, as it doesnt adress the thoughts and the need. This does. Its changed my life.

Same. I know three others maintaining now

Not read every post but it's close to irresponsible that WLI were approved for use but no one (regulators) is yet giving good guidance for when people stop taking it.

There needs to be some and soon.

I envisage that there will be development of maintenance level doses available at life long affordable prices if that is what patients desire.

It's pretty daft to say you can take it when you are X bmi but then you are fucked if you successfully lose weight but regain weight but under prescribing levels. Have they never come across the concept of yo yo dieting?

Honestly, I have realised that whilst we are mostly all on this board due to taking WLI (with the odd concern troll), we are all on incredibly different journeys. I once was slim and maintained that with the odd fluctuation for most of my life before children and a traumatic event. And even I don't know if I'll maintain after I come off the WLI, I need medicating for ADHD so until I stabilise that, I probably will continue taking this as it's reducing the symptoms massively.

Morbidly obese people who are taking WLI may need them for the rest of their lives due to how their bodies function and that's absolutely fine. Some people will come off them and go back on them, and that's fine too. They need to make these injections easier to access for those that come off and can't keep the weight off. People don't need to justify their choices to anyone - I hope your weight loss journey brings you joy and happiness, here's to our health.

The lack of guidance is a noticeable. Some pharmacies have stuck their neck out devising maintenance plans (like Oushk have) but it's not been based on guidance from NICE. I suspect this will chance as things progress and new treatments become available.

Same, I know lots maintaining off the jab including me. I’m not fighting any demons or even going hungry. I just have more clarity and because I’m not breastfeeding anymore, I’m not experiencing the kind of hunger I had with bf that made me tip into the obese category.
Everyone has a different journey and how they became obese in the first place, and for some people to come and insist that everyone has to be on the jab for life is just plain ridiculous.
There is no one size fits all, some people will need this Jab for life and we all acknowledge that. It’s also nice to read about those maintaining off the jab and the methods that are working for them.
The constant negativity from that poster whenever someone comes to talk about what they’re doing since being off the jab when no one is talking to them or about them is just so intense.

If you mean me, the negativity is against those who come and tell everyone (including those who have/had significantly more than a stone or 2 to lose) to just learn to eat less/better and how silly we are for not doing so so of course if we just learn these simple things then we can all be slim without medication forever. I find that incredibly negative. And patronising. And ironic. I really don't understand why your view/anecdote/belief/ experience is more valid than mine(and very many other morbidly obese people, and all the studies). I'm glad it worked for you and you lost your weight and can maintain without the drugs. For some (most) this is not possible (as proven by very large studies) so a thread about maintenance is important and shouldn't just exist to be patronised and told to learn to eat less. Which many of us have tried to do our whole lives.
Maybe we don't care about your stone loss and how you've learnt to be a good slim happy girl. Just like you don't seem to care to listen to rhe other side. It's pathetic and entirely smacks of the usual fat phobia.

I also note that the majority of smug i lost and can maintain now without meds tend to be younger/post baby etc when weight gain and loss is easier. Come back in 2 or 3 decades post years of yo yo dieting and menopause.
Both views are equally valid but you seem to dismiss mine as negative because you (and a few mates) have had a different experience.

Why are you so rude and aggressive towards posters sharing their opinion though? Fine, you don't like what they're saying, but there's no need to be so belittling and hostile in your replies. I'm sure you don't mean to be but you're coming across as pretty horrid and dragging down the tone of the thread which overall has been really interesting with lots of different opinions.

To me, in very simple terms, it’s like money. I need to stop spending so much and save money (stop eating so much and lose weight), so I cut back on spending (eating) and get a healthier bank balance (healthier weight). Then once I’ve achieved that I go back to overspending (overeating/eating too much of the wrong thing) and bemoan my bank balance (weight) wondering why the tightening the purse strings (diet) didn’t work. It did. I just didn’t carry on with the better habits yet expected my bank balance to stay healthy (weight remain healthy) while reverting to old habits. It’s not a tightening of purse strings (diet) that will make the difference long term, it’s being able to make better choices long term. That’s where most of us fall down. For me it’s spending as well as weight because there’s always another Lego set I need to have and always another xyz I want to eat. I lack long term focus for every aspect of my life. I hate talk of diets. I prefer to think of healthy eating overhauls that can be maintained going forward. Balance is always key but so tricky.

Had a little giggle, well said.

This isnt unique to this thread though, this is ongoing societal wide view point that obesity stems from uneducated, lazy, no willpower or self control, personal behaviour, and it is not always that simple. Theres people within this thread that have been told that their weight is 100% a result of thier lack of control for years and years and years, and it really isnt so simple for everyone. It is undenyably proven by medical science now that there is a biological genetic hormonal reason why some people are predisposed to being obese, and that isnt their fault.

Theres posters on this thread unilaterally stating that maintaining losses is possible with education and learning. It isnt true for everyone. Yes it may be true for a proportion of people, but even then, research suggests that for most people, that isnt true, most users of WLI's will be, by some method, dependent on them for their entire lives if they wish to maintain a healthy weight.

I dont think @BurnoutGP 's frustrations on this thread are necessarily aimed at the individual posters, its because, for their entire life, much like myself, this eat less move more mantra has been thrown at them, they have been told they are lazy, uneducated, making poor decisions because in v out works for everyone, and it just isnt that simple

We need change with in society, which is very nearly impossible, increase understanding, and basic empathy, that weight isnt a simple thing to manage for all due to the biological differences. This isnt about to happen, and its ok for those directly affected by this to be frustrated at attitudes towards them.

Totally get where you're coming from, but as you so eloquently and politely demonstrate here, it is possible to disagree with posters and still reply in a way that's not rude and aggressive.

The evidence from clinical trials is that most of those who stop taking it are likely to regain weight within 2 years.

No regain after a few months is not meaningful - all of us who have been on diets before will have managed that, but, over a longer period of time we have regained, why is why we ended up taking MJ.

The other evidence from clinical trials is that those who continue taking a maintenance dose maintain their weight loss and even lose a bit more.

This is the results from the SURMOUNT 4 trial for 1 year post weight loss:

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.

BECAUSE of this trial result, Mounjaro is licensed to be used as a maintenance drug. There is no NICE guidance as to what this should consist of because each person will react differently to maintaining. Some will be able to up their calories and stay on their final dosage, some will need to drop a dose or several, and some may find on/off periods or increased dose spacing works for them. And some, a very few, will actually not need MJ to maintain.

A maintenance friendly pharmacy will need to be able to prescribe to all those situations, including acting as a safety net for those who wish to stop and then find they need to go back on the drug a whole year later.

Personally I am glad that I do not have to stick to some 'advised' maintenance plan that might work for many but not for me, for example. Just the same as the way people titrate up at different rates - going up a dose every pen would have been mad overkill for me personally. I lost almost the whole of my 33% weightloss on 2.5 and 5mg, and only used 7.5 for the final 6lbs.

Oh I agree that maintenance plans should be a discussion between you and the prescriber based on your individual cirsumstance. My main concern about the lack of maintenance guidance is the pharmacies that cut people off cold at 23 BMI or insist the maintenance dossage must be 2.5mg, or don't allow people to restart if they been off 12 weeks and have started to regain and want to go back on the meds. The person the has no where to go and no choices, and will regain the weight.

Wow. Mine was a nice reply - trying to be helpful

and same. I was over 17s. If I had done that I wouldn’t have gained 6s

hindsight is an easy thing lol

and Damn easier to lose 4/7lb then 4/7stone

but hopefully I will keep the almost 6s off by doing what I said

if I gain. I will cut back

You can do that with mj

Mj doesn’t let you count the clicks (at least not with the pens we have available where I live). The new pens should be introduced next year afaik.

The pens in the UK or EU do

Not accurately they don't. Which is part of the issue in advising part doses as you really don't know what you're getting

Good to know. They don’t (yet) in Switzerland.

my general point of counting clicks still remains 🤷‍♀️🤷‍♀️

They do? How is it not accurate to count the clicks?