For those not planning on staying on WLIs forever, what’s your long-term plan?

[Waitingforthesunnydays]

I’ve been on MJ for a year, lost the 4 stone I needed to lose and gone from a bmi of 30 down to 20. However, it’s become clearer and clearer to me that this amazing and life-changing drug is simply a quick-fix, just like the Atkins diet, Dukan, and every other diet plan on the planet. People can say all they want that “it helps you create lifelong healthy eating habits that you will continue when you come off it”. No it doesn’t. It takes your appetite away so it makes it possible (and extremely easy) to eat a healthy, low-calorie diet. When you come off it all those cravings are just going to come back and you’re just going to slip back into eating too many calories. That’s the reality. I don’t think I have a problem with food, don’t think I was “suffering from obesity” in the way people talk about it like it’s an illness (although for some extremely morbidly obese people I recognise that it is, and those people probably plan to stay on it for life). But I’m just a normal woman approaching middle-age living in a society with far too many high-fat and high-sugar food options that are far too convenient, that finds losing weight very difficult. I don’t want to stay on it forever. But I’m very worried about coming off it cos I know it’s inevitable that I’ll put all the weight back on. So if you’re like me, how do you plan to keep the weight off when you come off it? I’ve already lost more than I want to, to give myself some leeway when I put some back on, but I was thinking of stockpiling some MJ pens now while I’m still eligible and keeping them in the fridge (apparently they last up to 2 years in the fridge) then trying to control my weight with the odd low-dose jab here and there. But that will probably lead to yo-yo dieting, which isn’t ideal, and what happens when it eventually runs out? Does anyone know if providers allow you to stay on low-dose maintenance (say 2.5mg every 2 weeks) for life? I’d consider that maybe..

I initially cut down to one injection every two weeks. I still felt appetite suppression, though it was less. For me, it had already stopped working as effectively on weekly doses, I simply couldn't lose any more even on a high dose.

I have put on a stone of the 3 and a half I lost. I had to eat 1000 calories a day to lose anything, which is why I'd been struggling to lose weight before, and now I'm back to a weekly dose but not really losing as I can't eat little enough anymore.. I think I'm on it forever to maintain.

In what way is it more appealing? When I was looking into this (it’s hard to find anything official as microdosing or adjusting the amount for maintenance isn’t really widely done yet) is that a steady weekly amount was better than surges at fewer intervals. A steady weekly amount keeps it in your system, rather than having bursts of it descending to nothing a couple of times a month.

I came off 2 months ago after hitting my target. I was terrified of coming off. Within 3 days 4lbs went on, despite not eating more, which mortified me and I nearly went back on. However, I did some research and this seems to be expected as your body stores water more once off. I’ve not put any more weight on since this.

I track my calories and eat 1600 a day which is mostly protein. Everything is weighed and logged on MFP and I don’t eat calories burned through exercise. I do 3x5k runs a week and a 2-3 mile walk on others.

It’s dull and I miss treats but I’ve made the decision that this is my life now as I never want to go back to being overweight. I feel so much more confident. My hunger levels are ok as long as I eat protein. If I don’t I feel really hungry.

I do allow myself a couple of glasses of fizz a week though. My tips are:

Don’t panic about a few gained pounds initially.
Track your calories carefully each day.
Weigh yourself a couple of tomes a week to keep an eye on things.
Eat loads of protein.
And exercise!

Good luck!

I stopped in July, I lost 4 stone, I’ve put on roughly half a stone, it goes up and down. I weigh every single morning and know if I need to rein it in. When I need to be good I try and pay attention. So far so good, but I was pretty sure my diet prior to starting was ok, not perfect but not stacking on the weight bad and I’m right. The weight gain was due to a lot of not paying attention due to stress etc and not giving a fuck because I weighed too much already. I’ve also started regular weight training and I’m doing more dance classes than I was previously, so my body is in much better condition. I do still have an new pen in the fridge and I won’t say never again, perhaps if the pill form rocks up properly that would be a thing, but for now keeping it off matters to me so I’m being sensible. But it hasn’t all just leapt back on. Boredom is my enemy!

Got to goal on 12.5 in September, titrated down to 5mg. Have kept within my goal window (fluctuating +4lbs) since. Intend to stay on 5mg till I’ve been at goal a year then very slowly titrate down while monitoring.

extending days like that can lead to worsening side effects as you have a very high level then levels drop right off before in heating again.

With Mounjaro the half life is 5 days and it takes 5 weeks after stopping completely for the last dose to be fully out of your system. So injecting a large dose once a month means you spike a high level, then it gradually declines to almost nothing then you go again with another high dose.

Whereas if you titrate down to a low dose more frequently, your levels are more stable and you are less likely to notice side effects. Eg 2.5 taken weekly, by day 5 half the dose is gone, by day 7, there is still some left in your system but after 5 weeks on this dose you get consistent levels each week with more suppression days 1-4, less from 5-7 then repeat.

Pharmacies will generally give you standard prescribing advice and regimes and won’t recommend or support a monthly high dose - after 2-3 weeks off they generally want you to go back to 2.5 mg and if you haven’t ordered a own for longer than 7-8 weeks, you usually have to go back to 2.5.

if you read through the maintenance threads. Most people seem to have success with gradually titration their dose back down the levels until it is very low and some then go on to extend days between jabs but at those lower doses, the peaks and troughs are much less extreme as well.

BMI down from 41 to 24 & I dread gaining weight. I'm a healthy weight (not obses/morbidly obese) for the first time since I was 18 - and I'm 58.

My diet isn't dramatically different though I now eat processed carbs very rarely. I'm tirating down slowy.

My plan is:

• keep avoiding processed carbs/sugar/UPF's - these are all huge red flags for me, I know it, I've lived it, I must accept it.
• I will have cake etc on family birthdays only.
• Stick with protein/vegetable/fruit based diet.
• I expect off GLP1's my biggest challendge will be portions. I am following a few "volume eating dieters" on line - they use vegetables to be able to eat bigger portions. I love veggies and I think this way of eating more volume while staying at recommended calories will work for me.
• Since being on GLP1 I have exercised more consistantly than I have ever in my life & I am determined to keep up with lots of yoga/workouts etc - JUST MOVE!!

I am hopeful that the maintenance pills aren't too far away - I think I may be taking these for life and I'm up for that.

gift share - Daily pill could ‘keep you slim for life’
https://www.telegraph.co.uk/gift/3b9b097cf49e8ff8

Just heard on the news that the pills are on the way!

I wonder if in the future a patch or implant (like birth control or HRT) could be a good way to deliver a small measured dose for those of us who do want to continue on it indefinitely.

It is. Its a lifelong medication to treat a condition. Yes, not everyone treats it like one but thats what it is. Some people will be able to stop taking it with no issue. Most will need to stay on the medication, in the same way you wouldn''t stop blood pressure meds. The condition is controlled with the meds, not cured.
I agree about the cost. I am able to afford it, just, but i wouldnt if i still needed higher doses

I did this the first time. I actually continued losing weight for the first three months (3 lbs in 3 months). We then had a kitchen reno so all my good habits were useless with no functioning kitchen.

A few months later I'd gained 5lbs back so cut back on food...... gained 2 more lbs!!!!!

Back on the jabs a second time, I've lost 11lbs in 13 weeks and I'm generally eating 1000 calories a day (5ft 2). I guess my hope is the pill they are developing is approved soon. I don't want to pay for jabs forever but I can't survive on sub 1000 calories without them.

I wonder how some people just never feel hungry? That's the dilemma for me.
I remember years ago, working with a younger woman who was slim. I wasn't feeling well at all and had no appetite (this was unusual for me). I remarked to her how I didn't feel like eating. She said "oh I'm always like that, sometimes I forget to eat till later on". Now I remember that conversation years later, as it struck me Ive never forgotten to eat. I cant imagine forgetting to eat, id be knawing my own arm off by teatime. Even when im full, show me a bowl of crisps and I'd happily eat them....and enjoy them. No wonder im fat. But why are we so different??

I dont believe i have a disease. Ive just got an overactive appetite. I like eating, I look forward to what im having to eat. Its more than fuel for me.

I’ve been off them for a while now and haven’t gained a pound. The following seems to be working:

staying at 1500 calories.
fasting as long as possible. I aim not to eat until after 1pm and then a 6 hour window.
weigh self daily, if dropping I up the calories and if gaining I decrease them.

I am definitely a lot hungrier and think about and plan food. My gastric emptying is much faster and I notice the gnawing hunger. I do think those of us who have a tendency to be overweight have fast gastric emptying and as a result are always hungry. It was so weird to feel full on the injections, I’d never had that feeling. Most of the thin people I know have slow guts and are chronically constipated.