Ozempic for life?

[curiousfurious]

This drug seems to be all the rage at the moment and gets good results. If you are not diabetic and lose enough weight on this to get down to a normal healthy weight do you stop taking it? Will the NHS continue to prescribe it if you are a normal weight after however long it took to reach your goal weight? If you are getting it privately because you don't meet the NHS prescribing criteria will your provider continue to provide it if you are no longer overweight?
I've read threads on here recently and there doesn't seem to be much focus on lifestyle changes or addressing the causes of being obese in the first place. I wonder if there's a danger in this being perceived as a wonder drug cure for obesity but that it's only short term. Diabetics will be on it for life perhaps but what about those who aren't diabetic? It's very expensive, prohibitively so to many, so what happens to those who can't afford it any more?

Sorry, more questions! If you are on Ozempic, how long have you been taking it for and how much weight have you lost? And how much is it costing per week/month?

I'm really intrigued as to how good it really is I suppose.

You are only meant to take it for 2 years. There was a tonight programme on at the start of last year confirming the 2 years.

It’s the same for Saxenda. I’m going to try again when home but I don’t see it as forever treatment sadly unless it changes.

In the US it is lifetime I understand but very different in this country currently. It was one thing I don’t understand with the whole reversal of diabetes whilst taking on private prescription if I’m honest because what stops someone after 2 years putting weight back on with loss of the drug and going diabetic again if they have no will power of their own.

Thank you for your reply. I didn't know it was only for 2 years. I think it doesn't sit well with me that it's so expensive to buy privately but then it's also a huge cost for the NHS. If weight comes back again then there's no long term investment for the NHS either. I think for diabetics it's for life which makes sense and for them it must be amazing but for those who are obese but not diabetic it must be much harder knowing that to keep off the weight after the 2 years they will have to make a lot of personal changes to their diet and lifestyle.

All the research is showing us that the weight comes back when someone stops ozempic. It's not about will-power or about changes in eating habits and exercise, the body wants to get back to its original set point. It's part of obesity being a disease rather than a moral failing or lack of will power. There are some people who manage to maintain but that's not the norm if you look at the research.

it must be much harder knowing that to keep off the weight after the 2 years they will have to make a lot of personal changes to their diet and lifestyle.

This is what people should be doing anyway. If someone takes it for 2 years and manages to get within a healthy weight range that's great, but alongside the NHS should (big should as it doesn't) also be addressing the underlying issues that have caused someone to be overweight. Whether this is providing information on nutrition, counselling or whatever else. There isn't an easy fix all for losing and maintaining a healthy weight forever really beyond actually recognising and working to address the causes. Money is always thrown at finding these fixes but never at the obvious things that would actually help.

It’s like any ‘diet’. If you eat the way you did to become overweight you will put the weight back on. Just like WW or SW or low carbing.

I read an interview in the FT months ago with the CE of the drug company behind Ozempic. He compared it to being on medication for blood pressure and said you would expect to be on that for life.

I am currently taking Ozempic and have been for almost a year with a couple of breaks. I’ve lost almost 3 stone. What it has taught me is that I am insulin resistant. So going forward I need to eat low carb most of the time. I am hoping to lose another two stone and gradually decrease my dosage of Ozempic while eating and exercising in a way that will help me maintain the loss. I don’t want to be on it forever. But it has been a fantastic tool to help me lose weight I have been attempting to lose for 30 years.

Not quite. There is research that does highlight that once you've been overweight it is considerably harder to lose and maintain that loss due to biological changes within the body. Its not impossible though, just hard if the underlying issues aren't solved. I agree it's not as simple as will power or whatever else it's more complex and deep rooted, but not impossible.

I used Saxenda I lost 2 stone in 3 months

A few months later it's all back on. It does absolutely nothing to address the reason you are overweight in the first place.

I did keep it off for first couple months but then the old habits creeped back in and I'm back where I started.

There is no quick fix to weight loss. Which is exactly what these injections are .

Absolutely this. All my weight came back on yet I run 20-30 miles a week and always have even at 14 stone

I lost 2 stone which was great, my running stalled while on Saxenda and it affected my energy levels . As soon as I stopped I ramped back up my miles

So far this month I've ran 114 miles.

Yet I'm exactly back to the weight I started at.

I've a very active person, but I clearly don't eat the best and my body as pulled me right back to my original weight

This is weight I've been at for years and years. I never get heavier or lose I just sit at 14 stone

It's clearly my body set point - unfortunately

That is frustrating @Ricco12. Ozempic is different to Saxenda though. It doesn’t just limit appetite but works on insulin. So I now know that I’m insulin resistant. Which I had suspected. I hope if I limit carbs I can maintain.

Although exercise is great for your body, weight loss is really determined by what you're eating. You acknowledge that your intake isn't the best, have you taken steps to address why this is? Rhetorical questions of course not for an answer but- do you eat too many calories as you're always super hungry and feel like you need to? Making the wrong choices ie high calorie but low density foods? Do you comfort eat?

Sorry posted too soon! Have you read Why we eat (Too Much)? That’s good on why we go back to where we were. There are threads on here about it. The thing is you can’t go back to eating how you did. You need to make changes. The running is great but we need to look at what we eat and do strength training too.

This is 100% true! Wish more people had this type of knowledge

@Pandaphonium oh absolutely I most definitely overeat no doubt about it

But the strange thing is I don't ever go above 14 stone , so I can lose bits and bobs yet always end up at 14 stone

I got down to 12 stone on Saxenda because basically I stopped eating because my appetite disappeared, I came off it thought because it caused gall bladder issues.

You would think i would keep increasing as my diet is poor but I get to 14 stone then sit here fluctuating a pound either way.

But I totally agree you cannot outrun a bad diet and that's 100 % me

I also full believe in the body set point and you need to take a long time to very slowly lower it otherwise your body will keep stimulating your appetite to pull you back to it.

Insulin resistance needs to be diagnosed by a doctor and I do wonder if it's the modern version of "I'm not fat, it's my glands." Insulin resistance is more likely to occur after you become overweight. Bloods will show abnormal glucose and cholesterol levels after rather than before someone becomes overweight or obese. I'd argue that insulin resistance is caused by being overweight rather than being the cause. Then it has a knock-on effect of making it difficult to lose the weight gained. I'd have to look further at the evidence but does insulin resistance disappear once someone is a healthy weight (non-diabetic)? It's really interesting but of course any so called cute needs to look at why people become overweight and that's the most difficult bit to address.

Dr Jason Fung is quite interesting on the subject of insulin resistance @curiousfurious. I’m no scientist but I think he says that the past thinking is as you say. Insulin resistance is caused by being overweight which leads to diabetes. His theory is that insulin resistance leads to being overweight which then leads to diabetes. I’ve never blamed my glands thanks. I have wondered why I was a total failure however. I am very pleased that there is now so much more known about obesity and the causes and why some people find it so hard to lose weight and to maintain a loss. I’ve read both dr Jason Fung and Dr Andrew Jenkinson and they make a lot of sense.

For years I had my MIL and some friends saying I didn’t eat enough to be as overweight as I was. For years I tried diets. All of them. For years I read articles in magazines or newspapers about people who were overweight and what they ate before and after and I got so frustrated as my general diet was much more like their ‘after’ way of eating.

so Ozempic has worked really well for me and my thinking is that it is the effect it has on insulin along with the calorie restriction that has made a difference. So I may not be clinically insulin resistant but it makes sense to me that I definitely have some issue there. I did have a very carb heavy diet when younger. Perhaps that led to issues. Perhaps that was why I craved carbs. I don’t know enough about it really.

@Peridot1 I didn't mean to imply that you had so I'm sorry if it came across that way. I'm glad you've found something that helped. Will you take it for life? Or the 2 years?

The set point thing is interesting. I've been wondering if I have one but think I've had various at different times in my life. In my early teens (before the pill which I think has a lot to answer for) I was around 7.5st. Later teens between 8 and 9stone. After dd2 I was around 10st 4lb to 11st 2 but was eating take away pizza and chip barms regularly and big pa keys of kettle chips and far too much Diet Coke. Lost it after trauma and down to 9st 4lb.After dc3 I was 9st 3 then it crept up to 10.5st. If I let myself eat what I wanted I'd be around 10.5-11 stone now and part of that is peri-menopause I think. My diet has always been carb heavy no matter what my weight has been. I find it really fascinating. Genetics play a part top of course.

.*packets of kettle chips and huge bats of chocolate too. Daily in some cases 🤦‍♀️

That’s ok @curiousfurious. I am a bit sensitive about it all really. It affected my mental health a bit for a while and I had a total turn against the diet industry as a whole. I still get a bit odd about it all.

I don’t want to be on it for life. Current plan is until I lose another two stone. Then reduce dosage down gradually and see how that affects it. Carbs are an issue for definite. I’m currently trying to low carb during the week and have a bit more at the weekends. Although this week is not great for some reason. Think I may need to increase my dose. Once I get to my goal I’m going to try to keep with five pounds of it. By low carbing and exercise.

it’s funny you should say about the pill as I definitely gained weight after I went on the pill. I can’t remember what weight I was then but definitely a size 8-10. At my heaviest I’ve been a size 22.

I also do think set point is interesting. The last few years I’ve settled at around 16 stone if not dieting. I’ve gotten down to 14 7 a couple of times but then go back up to around 16. Currently 13 6 which I’m very happy with. Will be happier if I go lower obviously! But I know that I feel so much better now. So even that is a bonus.

I know what you you mean about insulin resistance being talked about a lot more now as a “cause” of obesity. It seems to have coincided with the popularity of oxempic as a means of controlling weight.
I’m sure some people are insulin resistant but I also think some people do not record properly the actual amount of food/calories they consume. I remember going on holiday years ago with a friend. She was obese but always maintained she didn’t eat much & had a poor metabolism. I obviously believed her - until I went on holiday with her. She actually did just eat a lot more than me (a healthy weight at the time) but seemed not to acknowledge it even to herself. We would eat similar portions at mealtimes but she would be the one buying extra snacks throughout the day and after a night out.
Now I’m the one eating extra snacks here and there and I’m classified as obese. But I accept that in my case it’s just overeating not my metabolism or insulin resistance.

IMO ozempic and it’s rivals is much like cheating. The real hard work is lifestyle change of diet and exercise.

Ozempic can get you there as quick as healthy lifestyle changes if you were very focused you could lose 0.5-1% body weight per week and easily 30kg in 1 year. Problem is Ozempic is like band aid or a sticky plaster sorting the symptoms. If doesn’t sort the underlying issues of your too many calories, unhealthy lifestyle and lack of exercise. What’s more most people on fad diets or this Ozempic don’t incorporate a lot of resistance training and don’t eat enough protein so your metabolism will be even slower when you lose the weight. So where you go back to eating normally or will be even easier to put fat back on. Plus you pay a fuck load of money for a bunch of injections. You are better off getting a personal trainer.

@Twiglets1 as tdee calculators show the heavier someone is the higher the metabolism so yes, that's another false belief that some people have and a more recent reason given for obesity. Glands was when I was a child and can remember it being said. Then people said about slow metabolism. I should have used that instead as is more recent.

My ds's dad is obese. We didn't live together at any point but whenever I stayed with him or he stayed with me he didn't seem to eat regularly or a great deal but what he did eat was fat, carb and sugar heavy. I used to pay for a takeaway for us and he'd order two complete meals so he could have take away for the next day or two as well. Judging by the amount of takeaway containers scattered about the place when I visited them take aways were a regular thing. He claimed he was fat because he was brought up to always clear his plate. So was I. His lifestyle was sedentary, mine wasn't. My diet is far from perfect but it was easy to see why he was the weight he was. He had the audacity to mock me when I ate a full pizza once. I never forgave him for that. I was 9stone at the time ffs.

@S70V12 that's very true. I need to incorporate weights into my life. I walk and walk and walk because I don't drive and have no one to drive me anywhere either. I walk about 50 miles a week. It's hilly here and I work up a sweat because I'm always in a hurry. I couldn't afford ozempic or similar or a gym/personal trainer but what could I do for resistance/weights?

@S70V12 i do resistance training three times a week and was still over weight because I was ravenously hungry all the time. Not greedy, not shovelling in cake, but hungry all the time. It made it incredibly hard to lose weight

Ozempic has been like flipping a switch - I get full up and don’t want to snack.

I suspect when I stop taking it the hunger will come back and I’ll regain the weight. It seems my body doesn’t produce enough semaglutide to eat normally.

There are some gyms that are £10-20pm there might be one near you.

Otherwise find a good body weight program on the internet that incorporates resistance with body weight like press ups, body squats, lunges etc.

7 minute workout might be a good start. Walking is good because low impact exercise so has minimal interference with weight training and easy to recover from. You can also buy some adjustable dumbells or rubber bands. Find good body weight program on the internet that you can do 3X per week.

Then would add My Fitness Pal.
record calories, macros and weigh food and drink and drink 3 litres of water per day. That should get you there. As you get stronger can buy adjustable dumbells and maybe a adjustable bench on the internet so can workout at home.

Make sure eat enough protein about 120g per day maybe more.