Did you lose weight on WLI and then ‘pile it back on again’?

[scatterbrainy]

I’ve been on MJ for 11 months now and it’s been slow and steady losses - 3.7 stone and another 2 to go. When people ask me how I’m doing it, I’m open about the fact I’ve overhauled my diet and have had some help from medicine. However, I keep seeing (and occasionally hearing) this everywhere - ‘you’ll only pile it back on again’. Nice, eh!

So while the studies seem to indicate that’s likely, surely it’s only like every other diet and only happens if you return to your old ways of eating? I will always have to watch my weight and so my plan is to get to goal and give myself a healthy buffer of around 7lbs. If I start gaining, I’ll cut back for about a month or so and get back down to goal. For me, I forever sabotaged my own weight loss because losing 5 stone seemed utterly insurmountable whereas 7lbs seems so much easier.

I know there’s a maintenance thread but just wondering if anyone did lose a lot and then have a big regain? Am I being naive to think I can avoid it? For you, how did you tackle the regain or are you still struggling?

Just trying to get a realistic idea of what might be ahead.

Obesity is a disease, so you did have it, a disease is ‘an abnormal condition that negatively impairs the normal functioning of an organism (human, animal, or plant), typically characterized by specific symptoms, physical signs, or structural changes”

and obesity falls into this category, I think people get confused and think it is caused by pathogens or is infectious disease only, thays not the case, being obese is a disease as it impacts normal functioning and negatively impairs it.

You are describing the experience of a great many obese people

Ah thankyou! And well done to you too, you must feel amazing! Yes if you look at the maintenance dose as a low dose of a medication your body needs then why wouldn’t you take it, the benefits of not being obese are endless. My main worry was cancer.. I’d always associated cancer with smoking, drinking and sun damage but saw a stat about obesity being a big cause of it. Hopefully in decades to come there will be a fall in disease rates

This has brought me to tears as it gives me hope.

I have a lot to lose and am losing steadily on the lowest dose. I am finally getting to eat how I want to rather than what I feel compelled to eat. My biggest fear has been getting used to it and needing to go up to a higher dose as I can't afford to. But at the same time, I can't afford not too as I'm recovering from cancer and I must get control of my weight.

It's so reassuring to read that it will keep working the way it currently is.

i think people can understand stand it they just don’t want to as being fat is seen as a failure. It’s ingrained deep in our society to see fat people as lazy and having little self control or ambition.

I have lost 6 stones on MJ and the difference in how people especially men treat me is astounding. Eventually when all the hysteria and pearl clutching calms down I believe this medication will become as normal as blood pressure medication etc.

I've been tapering off with 1.5 stone still to lose and it's very very hard already. I haven't been bingeing or anything like that but the hunger is intense at times. I deliberately under-dosed the whole time and lost 4.5 stone while overhauling my diet and exercise, with the hope that it was a more stable place retain control from. 5mg on the way up was incredible, on the way down it's not so effective. Ultimately over the year I created a calorie deficit that I will always struggle to maintain. I will HAVE to exercise to give myself leeway with that otherwise yep, it'll all go back on. That's not exclusive to WLIs - the deficit is hard to maintain for people who are used to eating more, whatever that reason was. Obesity and the effects of it are always there because weight loss is treating a symptom, it's not the end game.

Its likely with any diet and everyone intends to have a buffer. I’m a yo-yo dieter and always will be as being 5ft I can’t eat much without gaining and you have to live too

They always use the expression “pile the weight (back) on”. Such a tabloidy phrase and full of judgment for everyone to join in with.

I agree.

I certainly find your posts helpful! It's great to hear from someone who has experience of long term maintenance with weight loss. I can also understand why you like to be part of these threads; you've mentioned you have to work hard at maintenence, and so being able to give and receive support here will be a valuable part of your on-going success, I would imagine. Well done!

Aww thankyou! I wasn’t planning on staying away from here but your post is really nice to hear! 😊 I just want to help and give realistic advice especially as people are starting to get to maintenance weights. I know how happy and confident I’ve felt since I lost it and want others to keep that feeling too, being obese is miserable but the body seems to want to go back to that constantly!

Dr. Kevin Hall, a NIH researcher modelled that for every kg of body weight lost, appetite increases by 95 calories while expenditure decreases by 25 calories per day.

That's frightening.

Well done on losing the weight and maintaining, But your experiences aren’t really relevant to this board as you haven’t used WLI to lose the weight in the first place?

The majority of seriously obese people won’t ever lose weight by calorie counting and exercising alone! That’s why we’re on WLI.

Current medical thinking is that as a seriously obese person who has lost a lot of weight using WLI, you’ll need to titrate down and stay on a maintenance dose for up to 2 years after reaching your target weight to help retrain your brain and body into behaving differently to keep the weight off.

Going cold turkey from the injections and trying to calorie count/exercise won’t work for the majority of formerly obese WLI users and they will put the weight straight back on again. 🤷🏻‍♀️

Her experiences are relevant to this board if there are people reading who find them interesting and helpful. Not everyone will he planning on staying on wli long term, or titrating down for years. For posters like me, who plan to come off once at goal, reading about others' long term success at maintenance is certainly helpful and relevant, regardless of how the weight was lost in the first place.

Thanks! 🖤 and even people who stay on a maintenance dose have to work hard to keep calories down and exercise so it’s all relevant. It’s still restriction and resisting temptation, keeping up healthy habits. I think some people just don’t want any outsiders in here. But others might want to hear what it’s really like. (For people like yourself who plan to come off)

I really hate the phrase 'PILE it all back on'. It is so perjorative. Yes, after most diets there is some regain - faster or slower depending on what you are eating and how you are moving, and how you decide/manage to respond to an increase in weight - but that particular phrase seems to have been applied particularly to people who have taken WLI's. It feels like a continuation of fat shaming.

Anyway... I was on Mounjaro steadily for 10 months, managed to keep to lowish doses. Got to target weight in June. Maintained on the lowest dose for a couple of months, even dropped a couple more pounds. Since then I've been on the lowest dose at one month on, then one month off. Still at a steady weight.

The difference for me is that on previous diet regimes, I could stick to it for 3 or 4 months but then I was desperate for toast or pasta or a takeaway, or my regular wine habit. With WLI's I stuck to it (almost) effortlessly for 10 months. That gave me a good long time to re-evaluate my food and my exercise. My standard shopping list has completely changed. The variations I eat for breakfast have completely changed. The way I meal plan and shop has completely changed. Planning high protein, high fibre meals has become normal. Serving myself a small portion has become normal. Swerving a huge pudding has become normal (at least 90% of the time).

Plus I have been part of a really supportinve community here on mumsnet - not something than people in any of the clinical trials had!

Over the 18 months my blood sugar levels have stabilised - which they never did with other shoter dietary approaches. And that helps me to manage my feelings of hunger - which are less intense anyway. I think my stomach is used to smaller portions and I feel genuinely uncomfortable if I over-eat.

I am using a one month on / one month off approach so that I can gradually get used to the feelings of normal unmedicated hunger and to cement the lessons of how I manage my diet and lifestyle. By the summer I will probably move to a one month on and two months off. Hopefully while still remeining at a steady healthy weight. I feel an emotional and physical reassurance by still having the option to take WLIs for imtermittent periods. I helps me to be reassured that I can remain at this healthy weight, that I can adapt to a lifestyle where I'm eating only what I need. Maybe by summer 2027 I'll be doing it all on my own. We shall see.

But I don't belive I'd ever have got to (and stayed at) this healthy weight without WLIs.

Just FYI the first part of this is nonsense - both fat cells and muscle cells use calories (glucose/glycogen) to create ATP and also use ATP to perform functions. So they both burn calories. Muscle cells just use MORE ATP (ATP is the body’s ‘energy’).

Well yes, but it is incredibly minimal and your bmr drops, so technically yes you are correct, the point remains.

here is an ai summary.

Yes, fat tissue burns calories at rest, but it is not metabolically active compared to muscle. While adipose tissue (fat) burns approximately 2–4.5 calories per pound daily, it mainly functions as storage, whereas muscle is much more efficient at burning energy.

Key Facts on Fat and Resting Calories:

• Minimal Burn: Fat tissue burns very few calories compared to other tissues.
• Muscle is More Efficient: Muscle tissue burns roughly 6–7 calories per pound daily—two to three times more than fat.
• Higher Body Fat = Lower Metabolism: A higher percentage of body fat generally results in a lower resting metabolic rate (RMR).
• Weight Loss Implications: Losing weight requires consuming fewer calories than you burn, as fat stores energy rather than actively consuming it.
• Mayo Clinic +3

This is still so new that everyone is still learning, we are all different and have different experiences before starting WLIs so there will be a mix, people will have different stories.

I do think though that if your daily calorie consumption on the medication is so low you wouldn't be able to maintain it long term then it makes sense that people would regain weight when they stop.

I am still titrating off (very slowly) but while I do that I am increasing my eating (reverse dieting), focusing on protein and fibre, while actively building muscle with a progressive overload - my aim is to build a body that needs at least 2000kcal a day to maintain because that feels sustainable to me. I know myself well enough to know I can't live life on only 1200 or even 1500 so I want some leeway. I was inspired by one of the female gladiators who said she needed thousands of calories per day - I don't want that to be my life but it made me aware there is a liveable middle ground. I have stopped my negative talk about that, I used to think myself weak willed but I now know it is a biological urge and I wouldn't beat myself up for not being able to hold my breath long enough to be a free diver.

I am loving how strong I am getting, and while I am staying the same weight I am actually getting leaner not bulky and body analysis scales are showing not only is my skeletal muscle increasing (and fat decreasing) my bones are improving too, which for a perimenopausal woman is fabulous. My skin is tightening up, I am even thinking about sleeveless tops when summer comes, for the first time in my adult life I have no jiggle.

I did those VLCD shakes for years on and off, spent thousands of pounds on them. I met hundreds of people doing the same and only 1 person I know of kept the weight off afterwards.

I did the daily then weekly jabs on and off for a couple of years. When there was a shortage I ended up putting the weight back on and was bigger than ever before with obesity related problems like gout and reflux. My BMI was 39. Then 2 years ago I had a private gastric bypass in the UK. My BMI is now 24.

For me I had to have something physical that stopped me over eating. With a bypass they say you are not to have more than 7g of sugar per 100g and that helps as a lot of my over eating was a sugar addiction.

I want going to go back to my old habits. I wouldnt be one of those stats.

At one point I was on 15mg for a few months and lost 6 stone in total. I had titrated down to 2.5mg and then had to come off abruptly after Xmas due to money. In that time I have gained a stone and I believe its because if the abrupt end, I had always planned a methodical exit and old habits came in too fast because I had no plan ready. I always had the plan but no time to implement it.

So I look to get this stone back off and implement my true exit plan (v slow titration to microdose) with personal trainer muscle building and work out my maintenance cals/macros.

I dont want to be beholden to cal counting etc so it will be a rough guide or maybe if i cut back two days a week when creeping up.

I think the reason it is tougher keeping it off when you’ve lost it through WLI is that many people haven’t made the mental shift. The drugs do that for you. So when you stop taking them, you have no protection against going back to your previous mindset.

There is no evidence to suggest it is tougher, in fact the evidence coming out now is people are keeping it off, because the drugs allow them to change fheir diets and make healthy choices.

I have never experienced hunger like the hunger I had after coming off MJ - and that was even after tapering off the dose for weeks at the end. I absolutely ballooned. Obviously not the same for everyone

I really hate the phrase 'PILE it all back on'. It is so perjorative. Yes, after most diets there is some regain - faster or slower depending on what you are eating and how you are moving, and how you decide/manage to respond to an increase in weight - but that particular phrase seems to have been applied particularly to people who have taken WLI's. It feels like a continuation of fat shaming. @20bloodypounds

Totally agree! When people say things like that, it’s almost like they’re wishing for that to happen. Can’t they just be happy that right now I’m losing weight and getting healthier, rather than telling me there’s no point in even trying?

Over the years, I’ve lost and regained more stones than I would be able to count. All the family on my mum’s side have weight problems in varying degrees and weight is something I know I will always struggle with. One of my relatives is 35+ stone and seeing him recently, really motivated me to finish the job properly. He’s so unhappy and likely trapped in a food addiction. He’s been on Wegovy but has managed to eat through it and is in denial. Ever since the age of 11, I’ve been aware of weight gain and post MJ, it’ll continue to be a struggle. I just wish some people could be happy for me right now instead of suggesting there’s no point. 😌