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?

Is fuel inefficiency a good thing in humans?

You haven't explained why a drop in fuel required is a bad thing.

What is your position? Stay fat because if you eat less for the rest of your life and are slim you will eat less and be slim and that's BAD!

Not getting your point!

Obviously because it makes it virtually impossible to maintain weight loss long term - hence why the statistics are that under 5% of people are able to maintain weight loss.

If an individual who has always been a healthy weight burns 2k calories a day, compared to an individual who was previously obese at the same size burning as little as 1000-1500 calories a day - you genuinely cannot understand how this has a huge part to play in why statistically long term weight gain is only achieved by 5% of people who lose weight?

Thanks for asking my position - based on the several books which I have read on the subject, and all existing literature, it is best to lower carbohydrate intake permanently and have some intermittent fasting mixed in to give yourself the best chance of keeping the weight off. Doing both of these things contributes towards lowering your ‘set point’ - avoiding certain foods such as nuts and focusing on your omega 3-6 ratio are also really helpful.

Sadly, just focusing on calories in, calories out, puts you firmly in the group with incredibly poor long term weight loss outcomes statistically.

So having read several books (!) you consider permanently lowering carbohydrates the best chance of keeping weight off but also that needing to permanently lowering calories is bad?

This is contradictory.

Yes exactly, because carbohydrate intake drives insulin which drives regaining fat.

Keto or VERY low carb is unnecessary, but focusing meals around protein and healthy fats, with limited healthy carbohydrates, seems the best bet. It is how I stayed at a healthy weight throughout adulthood, after being a very obese child, until I was put on steroid medications.

This is a brilliant book which goes into it all @Scyla , it explains it really well. (Hopefully pictures attach!)

This is also really informative for anyone who is interested in this stuff.

That was old news in the 90s!

So why are you making out that you don’t understand? 😂

I don't understand why needing less food is bad.

You tell me it's bad because people statistically don't eat less food.

If your body will function on less food concentrate on putting less food in it. If you don't your body will get bigger again.

You can’t understand that needing possible 1,000 calories a day less than someone your same size and weight might be difficult? So if your same size and weight friend needed 1,800 cals to maintain her weight you might need to only consume 800 calories. You don’t think that would be hard?

Hard? What in the literal sense that buying and eating less food is more work than buying and eating double the amount.

So eating 100 grams of something is harder than eating 200 grams of something?

It's actually not.

You might not like it but it's actually physically less work and costs less.

Are you bring deliberately obtuse?
Of course she doesn't mean hard in that way. She means that living with perpetual hunger and eating very small amounts to sustain your new lower bodyweight is physically, emotionally and psychologically difficult and is one of the things that can lead to rebound weight gain and yo-yo dieting.

That said, there are other studies that show that the difference isn't always that extreme.

The book Conquering Fat Logic by Nadja Hermann is a good read, she lost a huge amount of weight so is speaking from personal experience and she debunks quite a few myths and beliefs about obesity, weight loss and maintenance.

Anyone seen the programme “My 600lb Life”? It shows consistently that when participants significantly limit their calories…they lose weight. One 28yr old woman, who claimed that she was following a 1200kcal diet and had increased exercise, couldn’t explain the 30lbs she had gained in one month. She got quite aggressive with the doctor who did not believe her. So they agreed to admit her as an inpatient for a month on a strictly controlled diet of 1200 kcals and a very gentle exercise regime. Guess what? At the end of the month she had lost 90lbs!

Thanks @Athena51. That’s exactly what I meant. I will check out that book too.

@HappenstanceMarmite - that programme annoys me so much! They are put on a supposedly low carb 1200 calorie a day diet straight away. If they just ate low carb for a month they would reduce cravings and lose weight without being hungry. Then they could drop to 1200 calories low carb. So many of the people on there have significant trauma issues too. Some are given psychological support but not all. Some more support and education would help them so much.

Yep, the issue is actually keeping the weight off!

Yeah I don't overeat ice cream and chips because not eating them is "difficult" emotionally.

Being fat is "difficult" emotionally.

It's like stopping hitting your self on the head isn't it? The pain will go away if you stop overeating.

Yes but if eating over 1,000 calories a day means you are overeating to maintain that is going to be very difficult. Because you will be hungry constantly.

To be honest , I believe the old adage , you can't be too rich or too thin. You don't see v old fat people, they simple don't exist. They are all thin
There is an obvious tipping point into eating disorders etc , I'm not talking about that but modern people live such sedentary lives that we don't need as much food as we consume.
I wouldn't take Ozempic as I don't have a weight problem but if I was obese I certainly would. Benefits far outweigh the negatives.

I've enjoyed following this thread, some really good discussion bar one person trying to derail it!

I considered Ozempic but when I thought about the total cost over even 1-2 years I couldn't really justify it. Also I have followed a lot of the main Ozempic thread in the past month. One thing that stands out is it appears to be absolutely based on appetite suppression. People starting out struggling by day 5 because it's wearing off on a low dose.

Not obvious how many people are changing their diet at the same time or are they just eating smaller portions of unhealthy meals.

I am a fan of low carb and am just starting this again. This I find to be a reasonable appetite suppressant as it breaks away from the fast turnaround sugar dependency that the first world has been conned into.

I also remember a quote, not sure where I saw it but "it's ok to be hungry". That is a mindset issue and assuming people have good access to food if you're eating 3 meals a day you shouldn't be that hungry.

My 600 Lb life is a terrible show for multiple reasons, but: at the beginning they tell you how bad the odds are.

The participants, if they follow the diet (which is incredibly difficult, actually, although the show makes it out that they're lazy if they don't) they will lose weight rapidly, because dieting does work in the short term, and the participants are all people who are massively overeating. They have so much weight to lose that the initial weight loss is very dramatic. Then they get surgery, which puts things in a whole different category, especially the older episodes where they get RNY (gastric bypass). RNY is malabsorptive and causes hormonal changes as well as restricting eating. This can be a game changer for people if they are able to stick to the post-op diet. (sleeve gastrectomy only reduces stomach size; it's an easier surgery and has fewer post-op complications, but it is easier to sabotage.)

the participants on that show are honestly chosen for maximising the shock value. Many of them have trauma or other issues and should be in intensive supportive therapy programs before they try to lose weight, and they should be working with dietitians from day 1 rather than just given a diet sheet.

I don't know where you are looking but there are absolutely fat old people.

Yes it has been really interesting @DoormatBob. Other than some posters obviously!

I think a lot of people haven’t researched much about Ozempic. For me I didn’t think Saxenda was going to be right but I was interested in the insulin effect with Ozempic. It’s not like Saxenda where it’s purely appetite suppression. I do think some people would be better on Saxenda but they prefer the weekly injection or Saxenda hasn’t worked and I think someone said it’s more expensive.

Ozempic is definitely a tool. It works better if you limit carbs too.

I also think that people get disappointed by paying so much and being put on the lowest dose. When I started I was advised to start on 0.5 and it’s better for weight loss.

Its not a quick fix but it has been a game changer for me. And this thread has been really informative and helpful about the way forward too. Especially @Cappuccinopup‘s posts.

I’ll accept that metabolism can change as lose weight, Howrver that isn’t an excuse to not lose fat. After reached desired weight need to go to calorie maintenance AMG not go back to old habits. As for Leptin, ghrelin I don’t know enough about it but you have to accept hunger is part of dietting. If very overweight / obese hunger should settle down quickly. If very lean it might become an issue. For women sub 22% BF.

Some people are maybe more likely to put on fat.
not an excuse though to think sod it I’ll have Ozempic or whatever.

solution
count calories and macros
exercise
stop reading silly diet books they ain’t going to help you lose weight
if you want to read one read Fat Loser by Steve Siebold.
take personal responsibility and don’t have wine every night and wonder why not losing fat
fat loss is easy anyone can do it

Wine is the only thing that gets me through life! (light hearted - I know it’s empty calories!)

I've lost 5 stone so far so why don't you stick your "advice" where the sun don't shine?