Just some points about the trial that PPs have referred to, which I think must be Surmount 4. This gave a bunch of people MJ for 36 weeks and then divided them into two groups, one group continued with MJ for another year and the other didn’t. Its headlines are that carrying on with MJ makes it more likely that you will maintain weight loss than if you stop taking it.
Firstly it’s not true that everyone who stopped taking MJ put weight back on, most of them did, but 1 in 6 of them didn’t. Hopefully there are people out there figuring out what made the difference in those cases, it’s more than just a few outliers though.
Also, it’s not true that they “piled all the weight back on”. After a year off MJ, people had still lost 10% of their starting weight.
Also, only patients who had reached 10mg or 15mg were allowed to continue to the second phase of the study. (Nearly all were on 15mg.) So people who stay at lower doses were not included and nobody knows whether this would make a difference.
I believe that gradually reducing the dose has been shown to improve outcomes when coming off MJ, but these patients weren’t allowed to do that, they went from 10mg or 15mg to nothing. A gradual reduction might help in the real world.
Finally while I’m sure this trial was done properly, and of course the funding has to come from somewhere, it would be great to see this investigated without the involvement of the manufacturers of MJ. They were involved in how the study was designed and conducted, data collection, the analysis and interpretation of the data, the writing up, editing and approval of the study, and the decision to submit it for publication. It would also be good if the authors weren’t shareholders in the company manufacturing the drug.
I am not disputing that maintaining is easier on MJ, it would be weird if that weren’t the case. But it’s not the case that everyone will inevitably put all the weight back on.