I'm seeing a lot about GLP1s. I have some worries and I'm not sure if I'm being a science dodging eejit.

[Lemonthyme]

I don't want to start on GLP1 agonists but am feeling somewhat like an outlier. It does feel like many threads on here go for so long then someone suggests it.

I'm not anti science or anti drugs if needed. I just think at my weight (BMI 26.4) there are a lot of other things I'd try first.

What I worry about is a couple of things. And feel free to disavow me of any misconceptions here if you're on them and not having problems.

Firstly I worry about what I still end up eating. If your volume reduces a lot, the requirement of the quality of those foods goes up. And as all the research I've read points to high variety of plant foods being important and high protein being important, I'd worry I'd just not eat enough to get the micro and macro nutrients I need for good health. What impact does that have long term, especially on your bowels and gut microbiome? Will it increase bowel cancer risk if fibre volume reduces? And if you have to prioritise fibre and protein when on the jabs, why not do that anyway?

Secondly I worry about muscle loss and the impacts of that into old age (ie sarcopenia). It's fat I want to lose. While you can protect a bit with strength training, you already lose some of your muscle as you age anyway.

And for it all it terrifies me starting on something that works and then not being able to come off it without setting myself back. Will it mean I have messed up my own hunger and satiety hormones?

Then there's just how much research there has been if someone was on them for 10 years, 20, more?

I don't really know if I'm actively considering it or not. If my BMI was over 30 I'm sure I really would. The benefits would be more obvious.

I don't know. I just don't think I know many people in real life using them yet there are a lot on here and a lot around my age I think (late 40s).

I'm trying 24 hour fasting which I think is working but I have to admit this was probably me trying something more drastic because I was subconsciously thinking of trying the medication route instead. Not that I could really afford it mind you.

From what you are writing it seems like the problem is portion control and/or snacking. You have all the other necessary bits in place and you are only slightly above BMI 25.

The thing that helps me to control portions is mindfulness around eating and maintaining all the healthy rituals around food: eating at the table, not eating in front of screens, not reaching for food as the first solution to stress, tiredness or boredom. Finishing my meals when I am still a bit hungry.

I’m sure it’s possible to do all of these things on WLI but it seems to me that the part about learning healthy habits is a bit off when WLIs are working because it’s for instance very easy to be mindful when there are no distractions or easy to practice hara hachi bu when hunger is suppressed. It’s a bit like learning how to swim from YouTube videos.
I don’t think you need the injections tbh.

You absolutely can get it at a lower BMI now, some online pharmacies are doing it entirely legitimately off label at 25+. I know as I am one of them!

I thought I’d give it a punt, I’m not worried about much of what you’ve written because I will only be on a small amount for a short time. If I choose to remain on it in some way it’ll be via micro dosing. I am a generally healthy and active person (lots of exercise and try to follow a UPF free and organic diet), but I have a sweet tooth and struggle with cravings, it’s nipped that in the bud for me and just enables me to make good food choices without all the additional food noise I particularly struggle with at certain stages of the month. It’s so freeing not being a slave to your cravings. It’s also completely settled my IBS which has been frankly life changing (hence why I am considering trying micro dosing long term) and it’s really cut my alcohol cravings too which can only be a good thing.

I haven’t gone above 2.5mg.

@fi89

thats really interesting how long have you been on 2.5 and gave you had any side effects.

I think OP it’s a tricky question. What’s right for you might not be for others and the other way. I have a BMI of 27, but am very short with a disproportionately large stomach. I’m definitely considering starting as a way to manage emotional eating

@hellobaby24 yeah I did struggle a bit which is why I have stayed on 2.5mg so long. Mostly they were side effects when I didnt follow the rules! So was punished with nausea/headache if I didn’t stay hydrated, drank alcohol or ate too big a portion. So my advice would be rigidly stick to the advice to start with, but my body did adjust to let me relax a little bit not too long after.

My mum says WLI is the only thing that seems to keep her stomach/inflammation down. She is post menopause and has been slim but had a tummy, she lost it on WLI, came off it, even though she stayed slim elsewhere it came back, so she is micro dosing.

I considered WLI when a few people I know went on them. I'm 55 years old and need to lose two stone but don't find it as easy as I once did. I decided in the end to give dieting one last go and started Noom as I had success with it in 2021 when I needed to lose my lockdown weight. Sadly 3 years of a very stressful family situation have caused me to gradually put the weight back on.

I am three weeks in with Noom and have lost 9lb so far.

It really has helped me with resisting temptation, cutting out mindless snacking and planning healthy meals. It's also encouraging me to walk everywhere instead of jumping in the car out of habit.

I'm not against WLI, I have friends who have had great success with them. I was just nervous about side effects and what would happen once I stop taking them.

But that’s the very definition of failure, the fact you can’t keep it off and yo yo. It’s why 80 percent of people regain the weight, they can’t maintain it after.

it’s also why the drugs are recommended for long term usage, so you don’t regain, and can stay healthy, as obesity is a relapse disease.

i see it all the time, people proclaim something works for them, but fail to take into a account maintenance is the biggest and hardest part of this journey, and if you’ve tried something and regained, then it didn’t work for you. A famous example is slimming world, which has a huge regain rate, 97 percent, people do it for literally decades, and always end up fatter than they were, but somehow don’t realise that no, it doesn’t work for you, if it did. You would not regain.

Interesting, it's worked incredibly well for me and no I haven't cut out sugar or refined carbs, don't really believe in cutting out things entirely to be honest.

i kept it off for two years but then my daughter became seriously ill and it all went wrong for me. I didn't notice the weight going on gradually as I was just too stressed.

I have a lot of the same worries as you, OP, but I went for it.

I am 5’6. I was 13 stone and just couldn’t shift the weight.

I started on lowest dose of Wegovy, went up to the second lowest dose and have stayed there.

I started it last September and I now weigh 10 stone 7.

I’ve been 10 stone 7 for a while now, I don’t seem to be losing anymore.

I don’t want to increase my dosage, so I’m continuing on the low dose for now and will hopefully come off it soon.

There are risks with everything in life and it’s all about weighing them up.

For me, I hated the way I looked. I had no clothes as anytime I went shopping I got so depressed at how I looked I couldn’t buy anything. I was turning down invitations to everything. Life was passing me by and I wasn’t setting a good example for my kids.

I feel so much better now. I see photos of myself and don’t cringe. I make better food choices.

I do understand there are risks and I don’t want to be on these forever, but for now, they have been life changing.

What you’ve picked up on around nutrient intake is probably one of the most important (and least talked about) parts.

🤔Obviously a statement from someone who hasn't hung about the WLI board, sub reddits, facebook pages etc where minimising UPF, sugar/sweeteners, increasing hydration protein and fiber have been running themes alongside the importance of exercise.

None of this is new, it is the backbone of most weight loss methods whether WLI, calorie counting, intermittent fasting, WW, SW, etc. Any method has some people who ignore the need to be more aware of nutrition when on less food.

Some people need medical support to overcome the physiological and psychological barriers to successfully lose and maintain weight; that need doesn't mean they are clueless.

For me, the release from obsessive cravings, on a low dose of GLP1, for all the wrong foods my diet has never been better - switched from big portions of pasta/rice/breads/desserts to eating foods rich in protein, lots of fish I was never keen on before, veg/salad, fruit for fiber, nuts/seeds, kefir/natural yoghurts, healthy fats the lot - and I have actively enjoyed eating this way for over a year. It now feels normal to eat this way - no weight loss method, with support on from the community boards, has done this for me before.