What’s your strategy for stopping? Mine clearly hasn’t worked.

[somedogsdo]

So I had to stop MJ about 8 weeks ago. The first couple of weeks were ok, but then appetite came back with a vengeance. I’ve put on over half a stone in 6 weeks!
I’m hoping to start again, but think I need to rethink my strategy.
Up until now I’ve just eaten when I’m hungry and stopped when I’m full. Over time I lost around 3st (pretty slowly but I was fine with that) and my BMI had just dropped below 30 when I had to stop.
So now I’m thinking I need to either be on these meds for life or alter my strategy.
Obviously when I’m off the meds my appetite goes right back to normal and I eat too much. So what do people do? Do I need a different strategy when I’m on the meds to help me transition coming off? Do I just accept I need them forever?
I’ve really enjoyed not having food rule my life but as soon as I’m off the meds, I’m ravenous. I’m aware I’m eating more but, because I haven’t had to think about it on MJ, I’m just eating until comfortably full, as I was on the meds, which is actually probably more than I was eating before I started them!

I'm the same. I came off Wegovy and the food cravings were insane. I'm back on it now and think I'll be on a maintenance dose for a long time.

I think a lot of us are expecting to be on these meds for life, at least in some measure. I am hoping to get to target then titrate down and stay on a low dose.

I am not planning to stop until I have been a healthy weight for a long long time, and then I will restart if I gain more than a few pounds. I am happy to take some form of GLP1 or any newer equivalents long term if needed.

In general, when I am happy that my weight is long term stable in the healthy range, I will plan to gradually reduce my dose of Mounjaro and stick to the increased exercise routine. There's some evidence that consistent exercise helps with maintaining weight loss after using GLP1s. I may swap to one of the cheaper tablets for maintenance if I am stable on a lower dose of Mounjaro.

I think that I was so used to overeating and eating in a disordered way (not clinically disordered but uncontrolled and chaotic) for so long that it will take a long time to get used to eating less and eating in a more controlled way, with or without medication.

Did you change what you ate while on the medication? You need to be prioritising protein and fibre. They are both filling so should help with stopping you being too hungry.

But a lot of people will be on them for life. I am expecting that for me. I’ll reduce my dosage down but be aware of how I’m eating and find the sweet spot where I am maintaining, not getting too hungry and eating well.

I pinched this rough timeline about how successful people graduated from a GLP1 from a much longer Reddit thread. Definitely worth a read.

On meds, pre taper:
Your habit building window. Lock in protein, meal structure, exercise, and a tracking method now while it's easier to do

Tapering:
Step down dose or space out shots, keep habits steady, increase calories in step if you're reverse tapering

0 to 3 weeks post last dose:
Often deceptively easy

3 to 6 weeks post last dose: Rebound hunger typically hits. Expect it, lean on volume eating and distraction

6 to 11 weeks post last dose:
For most people, hunger settles to a normal, predictable level

Months 3 to 12+:
Ongoing maintenance. Weigh ins, set a trigger threshold, strength training, staying alert to stress eating drift

1+ years off:
Long term grads describe this as a fully embedded lifestyle at this point. Still needs attention, but it doesn't feel like a fight anymore

Quick reference checklist:

Protein target hit daily, before the taper even starts

Volume eating as your default strategy

A tracking method chosen on purpose, not defaulted into nothing

Strength training 2 to 3x a week, building over months

Daily walking, high step count

Frequent weigh ins with a small, clear trigger point

A taper plan discussed with your prescriber, not an unplanned stop

A support system, whether that's a therapist, doctor, partner, friends.

Room for planned treats, not total restriction

Patience with the hunger phase as something temporary and hormonal, not a verdict on whether this will work

I think it's easy to forget the jabs don't just reduce your appetite, they're doing a lot including inflammation and insulin sensitivity. Even if you managed to make your diet identical to when you were on the jabs there's a fair chance you'll gain weight. I can eat more in calorie terms now than I could before the jabs.

Anyway my plan is to stay on a minimal dose, maybe lengthen the period too.

There are two things for me. First of all, when I started on GLP1s I changed my diet completely to the Mediterranean style diet. Essentially this is low carb and means cutting out bread, rice, pasta and potatoes to a large extent. I'm now completely used to this diet and find it far easier to stick to it now than when I first started. I will continue with this diet forever.
Second, I am coming off the GLP1s very slowly. I got up to 12.5mg and have currently been on 10mg for three weeks. I will give it at least another month before I move down again.
It will therefore be a log time before I get back down to 2.5mg. At that point I'll review what I want to do long term - come off completely or maybe microdose. We'll see.

Those who are saying you’ll stay on long term, will your providers actually let you?

Thank you. Some really good points and strategies here.
I think I need to try and do all I can to avoid this sudden stop again. The point about rebound hunger seems to be v relevant in my case!
I didn’t have much choice unfortunately (v bad constipation that ended up with having to do a fecal
impaction laxative regime - not fun!) but if I ever need to stop again will look at dose reduction I think rather than a complete stop.
Also ideally sounds like I need to have a proper plan if stopping/reducing.
I only ever got up to a regular dose of 5mg and was just starting to try 6mg. I was happy losing about 1lb per week and if that didn’t happen for a few weeks I’d increase slightly. So it was quite a gentle approach but seemed to work well over time.
I used to have weetabix/cereal for breakfast. Snack on either nuts, cheese, fruit, biscuits, raw veg or smoothies during day - rarely a proper lunch as wasn’t v hungry. Then Normal dinner I’d cook for all but small portion, freshly prepared, balanced - usually protein and veg chilli/curry/tagine/stew with rice or occasionally pasta/potatoes. And nearly always a small piece of chocolate after meal.
When I came off it, I stuck to the same but the snacking went through the roof, especially in the evening.
Also thinking I may need to just stay on the meds in some form for life. Although that feels quite a scary prospect somehow.

@PoweredBySheerSpite do you know of any that wouldn’t? Mounjaro has certainly been approved for long term use. If your BMI gets too low of course then that would probably trigger questions and possibly withdrawal of the prescription.

The Foundayo tablet is suggested by the manufacturer as suitable for maintenance after weight loss on injectable GLP1s, so that’s an option too.

Definitely will be on for life or i will put it back on as will most, we got overweight as we love food and that hasn’t stopped, the meds are blocking it

I haven’t had much, if any, suppression compared to most people. And while it’s been frustrating to not lose as quickly as other, it’s really taught me to eat well and use willpower over the past 15 months. I went up to a 15mg pen, and have gradually reduced the dose since May. Also lengthening the time between doses. I’m currently at 2.5mg and am sitting there for a few weeks as I felt I was picking more. Also, very strangely, suppression kicked in for the first time last week and so I’m making the most of having a much smaller appetite. Very strange when I didn’t have suppression at 12.5! I’m also doing considerably more exercise and can feel that making a difference.I still have a stone to go, I was coming off as it was expensive considering the little effect it had on me. Now I’m dithering! If suppression continues this week I may try to get another pen.

I’m expecting to be taking the medication for life.

I’m currently 25 days since my last dose so still very early days. My approach is to carry on as if I was still on the jabs, calorie counting and reviewing macros each day, prioritising protein and exercise. No real surges of hunger yet but still very early days.

I have a 2.5mg pen left in the fridge if needed and have confirmed from my provider that they will still prescribe until January providing I’m above a BMI of 19 (20.4 at the moment). I’ve gained around a pound so far.

i wobble frequently and bore ChatGPT with all my woes! I’m seeing this time as an experiment to see what works and what doesn’t. I’ve lost over 80 lbs since the beginning of August last year.