How can I ever come off GLP1 meds?

[WoIsMe]

I’ve only been on Wegovy for three months and I’ve lost 12 lb in that time - which is great - but the other effects are life changing. The food noise is the biggest one. I’m not hungry and thinking about food all the time - to the point where I can’t do anything else because I just have to eat something. I’m enjoying food and savouring it more because I’m not eating quickly to overcome the hunger. I’ve actually started to prepare food more carefully and plate it up nicely because the experience is so much more enjoyable. I feel calmer internally, not so anxious and stressed, which may be a direct result of quieting the food noise. I’ve finally managed to give up caffeine and chocolate, which I’ve been attempting for years but the dopamine-dampening effect has really helped with quitting. I don’t feel “dampened” though, I’m still happy and enjoying life. My back feels great thanks to the reduction in inflammation, despite having osteoarthritic degeneration of the facet joints and a collapsed disc. I’m taking noticeable fewer painkillers. And that’s just the external stuff, without considering the effect on heart health, diabetes risk and insulin resistance. Honestly, weight loss is less than half of what this medication is doing for me.

The cost though. I can afford to take Wegovy for about a year but I can’t manage it in the long-term. I’m sure there’s an offset in terms of reduced food noise and impulse food purchases - no more impromptu trips to Costa - but nowhere near enough to support the cost of the medication. What am I going to do in nine months time when I run out of money? I’m hoping that microdosing will be better supported by then, to be able to take a low maintenance dose, at lower cost. But I don’t know how much drive there is for that as I’m sure the pharmaceutical companies want people to stay on a normal dose for life.

I would look at seeing if there's any way at all you can manage the costs and afford to stay on it long term. If you don't already, I would change pharmacies each month to use their new customer discounts. When/if you run out of new pharmacies to change to, look for one of the low cost pharmacies that don't need new customer discounts like Medicine Market Place who are usually one of the cheapest options. What dose are you on at the moment and what are you paying?

At some point, it may be that the NHS may be able to prescribe to people specifically for osteoarthritis or other conditions, not for weight loss. There is emerging evidence that GLP1s like semaglutide actively improve osteoarthritis independent of any weight loss. It will take the MHRA and then the NHS a fair while to get to the point where they may be able to prescribe GLP1s for these sorts of conditions, but that may well be where things are heading in the long term.

It's so interesting. I'm on MJ not W but feel the same positives. I feel like MJ has given me so much regarding food but also is a real tonic for so many other areas of life. Less muscle pain, better life focus, all sorts.

I'm just hoping that in about 8 months when I'm looking to maintain there will be more and cheaper options.

It’s hard that’s for sure. I was priced out of mounjaro, came off and was more hungry than ever and piled most back on. I’ve now gone on wegovy and in 6 months I’m 1lb more than where I was up to with mj but I am finding suppression on wegovy sooo much better. I’ve taken up the gym, running and on a nutrition plan high in protein and fibre and you just really have to keep it up when you come off and have more drive to continue that way than succumbing to cravings which is hard as that’s why most of us ended up needing help from the medications in the first place

Most of the pharmacies should support included so if you haven't talked to them already do use their services to help you come up with a way forward.

I agree the GLP1s are helping support other health issues, but also think some of the inflammation is due to the shit food environment we live in and I was eating!

I am on Mounjaro so it may be different and I was fortunate to be able to stick to lower doses. My rough plan - which may or may not work - is to continue focussing on my diet as I did during weight loss while using Mounjaro to support and reduce dose as much as possible to make it more cost effective. Dose is now 2mg and so far previous inflammation has not returned, but I am having to work harder on the diet side and nipping the bad habits that triggered the food noise for me in the bud.

I had a consultation with my provider and they are supportive of using a Mounjaro pen bi weekly over 8 weeks - saying some patients are finding that effective (they are not keen on click counting). Ideally if I can get to either 2.5mg every two weeks or 1.25mg weekly that would be ideal and cost would be around £17-18/week which is affordable for me.

Over time, maybe a couple of years maintaining, if I can sustain the diet side and inflammation stays away, I hope to come off, but I will review as I go along.

Does your provider offer psychological support?

I haven’t looked at what support is available as I’m only a few months in. I had planned to take it at a low dose to lose weight and then try and maintain without the medication. I hadn’t realised the other benefits would make so much difference. I used to ask my children to pick things up for me as my physiotherapist said not to bend over to pick things up off the floor. Now I don’t even notice any back issues. That’s quite a change.

I’m making a pen last 12 weeks although without the golden dose will be 10. I click count. I share an account with my sister (we were ordering separately so now just do together). On this basis it’s affordable for me longer term, £159 a pen, assume 5 pens a year so that’s £15 a week. Probably eating less to cover it but I can afford it regardless.

Im not coming off it. Ive lost all the weight and Im staying on a maintenance dose of 5mgs for at least the next 2 years.
I ate some crisps today first time in 2 years and they were so oily and revolting I ate 2 and threw the whole pack in the bin. My tastes have completely changed.

I know. It’s amazing. My IBS went away, my work became easier because my mind felt crystal clear, I gave up alcohol and my skin is clear, eczema the best it’s ever been. I lost 3st too.

Id have stayed on it forever if DH hadn’t got sick. But yeah, no money left now. We will see how it goes.

How long have you been off it @MyDarlingRose and how is it going?

A couple of weeks since the pen ran out. It’s ok so far but that’s because it’s still in my system a bit. I think it’ll be completely done by 30 days after.

I definitely think about food. So far I just go for fruit.

I hope you manage to push through.

No one should be starting on these without understanding they are a forever drug. And no one should be prescribing them without making that clear. The evidence is not only do most people regain weight by a few years later but actually your metabolic state will be worse

Well until they are cheaper circs mean that people aren’t always going to stay on them. Our income has gone from circa £6000 a month to £1200 within the space of 8 months. There’s no room in the budget for meds.

@WarthogWoman where have you found the evidence that metabolic state is worse after taking weight loss medications?

I plan to reduce dosage when I have lost one more stone and then micro dose hopefully at a much cheaper price than I'm currently paying. I've lost 4 st 8lb to date.

Can you point to the evidence please? I was prescribed MJ by the NHS and would be really interested in reading anything you have that proves this.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12702299/

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2841273?guestAccessKey=d27e8e8b-cc68-47ac-b2f9-32f27bc745cf&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=112425

https://www.bmj.com/content/392/bmj-2025-085304

someone sent me some other ones I will try and find them.

basically we are all perfectly capable of weight loss. We have all done it many times. We need to not look at these as diet medications- they aren’t, they are long term treatments for obesity and metabolic issues. I will hunt out the other stuff

Switching to an oral will be cheaper than injectables - Lilly's new oral will be available soon which is intended for weight maintenance and offers an advantage over NN's in that it can be taken at any time of day.
https://www.bbc.co.uk/news/articles/c2359vy8ze9o

Surely weight regain, and potentially effects on the metabolism, are common with any form of weight loss, though. This isn’t a situation unique to GLP1 medications. I had hoped when I started that, at the end of my treatment, I’d have established a healthy eating and exercise pattern that will help me to maintain my weight. But the food noise and anti-inflammatory benefits are going to be tough to lose so I may have to find funds to pay for a GLP1 maintenance dose.

@WarthogWoman so I can see that people will regain weight after ceasing WLM. It goes without saying that if you cease dieting and revert to unhealthy eating habits you are going to re-gain weight.

What I am less clear about is the evidence that metabolic state is worse after taking WLM. The Post Hoc Analysis of the SURMOUNT-4 Trial results show that those who do not keep the weight off have a greater reversal of their initial cardiometabolic parameter improvements compared with those who maintained weight reduction. But that is a reversal of improvements, not a decrease in overall metabolic state. Again, that just seems like an obvious outcome. If you go back to eating too much and unhealthy foods, you are going to see all the unhealthy biomarkers creep back up again.

I suspect that there are people who will significantly benefit from long-term use of WLM. However, I don't think that needs to be seen as something bad or frightening, although the budgeting aspect does need consideration. Hopefully, as time goes by and more research is conducted maintenance options will improve and people can continue to reap the very many rewards of not being overweight, obese, pre-diabetic, diabetic, have reduced mobility, high blood pressure etc etc etc.

@WoIsMe I think prices will only come down. Soon we will see new suppliers come on board as the Ozempic patents expire and other pharmaceutical companies can make their own brand versions of the drug.

I’m extending my working life by two years to finance being able to take the medication forever. It’s absolutely life changing.

Just adding. If you lose weight, regardless of the method without a serious focus on retaining muscle then you’ll lose muscle mass which will significantly lower your metabolic rate. This is basic science. To maintain muscle you need to both prioritise protein. Worse case drink it as a shake (eg myprotein clear whey). And lift weights. Needs to be heavy enough to indicate to your muscles that they are really needed. Legs have biggest muscle groups (quads, glutes, hamstrings, calves, adductor etc) so that’s where the focus needs to be. Some handheld 2kg/5kg dumbbells will not make any difference to your leg muscles.

Which provider are you with that allows the pen to be used for 8 weeks?