Considering GLP1 for weight loss with a healthy starting BMI

[Dipytique]

Does anyone have experience of starting a GLP1 with a healthy BMI to start with? I have a BMI is 24.6. I’m really not comfortable at this weight and have lost the 10lbs -1st that I need to lose many times, but always found it hard to maintain.
A doctor I know has an obesity clinic and has offered to prescribe/sell me the GLP 1 injections. As much as I’d rather lose the weight naturally, so far it hasn’t been possible. I’m seriously considering it and not sure what to do.
They also mentioned the new drug called retatrutide which sounds like it’s something I would prefer but it seems like it may not be legally available for a couple of years. Any advice would be great.

If a doctor is offering you retatrutide I'd be very wary of said doctor, seeing as that drug is not available legally in the UK either privately or via the NHS.

I really really wouldn't. Those drugs are for people who are severely obese with other health conditions as a last resort.

Sorry if I wasn’t clear - they weren’t offering retatrutide, they just told me about it and it sounds more appealing to me, but it’s not available yet as far as I know.
They were offering Ozempic or one of the usual others.

What goes wrong when you try to maintain a lower weight? How many calories can you eat to maintain the lower weight compared to now?

How do you plan to maintain your weight once you reach your goal?
if it’s really that difficult to lose a relatively small amount of weight then you’ll struggle to maintain it unless you plan to stay in the jabs indefinitely. Speaking from experience.

There are private clinics who will prescribe healthy weight people what they call “micro doses” of Mounjaro or Wegovy. They decant the medication from the injection pens they come in, into pre-filled syringes and sell you a very small dose at a higher price. If you’re determined to take an anti obesity prescription medication then that would be a legitimate and safe route.

Retatrutide hasn’t even finished its clinical trials yet, let alone been submitted for MHRA approval in the UK. I have no idea why a doctor would be mentioning that to a person of healthy weight. It’s a triple action medication and so far seems to produce larger weight loss than Mounjaro, but also more side effects. It’s a heavy weight medication aimed at people who are obese and need to lose a lot of weight. Using it for cosmetic weight loss seems like a risky option to me. Why do you think you would prefer to use it?

I also agree with PP that losing a few pounds is not the hard part, it’s maintaining that weight loss for long enough for it to be embedded. That would mean preparing to be on prescription medication long term.

They really aren’t a ‘last resort’ . They are a very sensible way to effectively lose weight and most importantly maintain the loss. Mounjaro has also been shown to have some rather amazing inflammatory reduction properties.
If he is a registered doctor you can check his registration at the BMA . If he is happy to prescribe then why not.

I have lost 8 stone and maintain on 5mg having lost most of that over a 9 month period. Maintained for 2 years now.

contrary to urban myth the side effects if you get them (I never have) usually run to a bit of diarrhoea or constipation. I have several friends on it - and probably several more who don’t admit it. About 1:6 of them have had some mild manageable side effects. Majority have none.
My physical and mental health has improved beyond all expectations.

I guess I thought I’d probably just microdose long term. I can lose in a moderate deficit, at 1500 cals a day but it takes absolutely ages (which is probably normal) and my maintenance calories are 1800 which is where it all goes wrong. I’m a carer and I work full time, so I don’t have a lot of time to dedicate to my diet. This seems like it could help.
I’m not really sure why retatrutide appealed more. It just sounded less extreme but I could easily be wrong about that.

1500 cals is actually fairly high for a cal deficit. I think unless you are prepared to overhaul your diet long term to include more protein and whole foods etc then yes, you would need to look at maintaining on something like 2.5-5mg. Plenty of people do this but you’re looking at around £150 a month. Hopefully the cost will come down at some point.

Yes, you were misinformed by this doctor about what Retatrutide is like.

Being in a 300 cal deficit per day means less than a pound a week weight loss, which is very normal and what you’d expect for that deficit. I think all of us that work full time and have caring responsibilities and generally full lives find it hard to find the time and headspace to focus on diet, and maintain that long term.

Do you manage to fit in any exercise at the moment?

I probably should have said I went through a few years of eating disorder, being underweight and majorly under eating and then when I managed to gain some weight I went straight into Orthorexia. I’m recovered now (hence the weight gain) but I don’t restrict too much because of the history. Not sure how that fits in with GLP1.

@SilenceInside i can’t fit in much exercise, I do walk everywhere, so daily step count is high and I do a Pilates class if I have time.

But 8st is very different to a few pounds. The OP may only weigh 8st so a loss of a stone will reduce BMI significantly. One of the reasons they are well regulated now is to avoid misuse by individuals with EDs.

Although there is evidence of benefits health wise they are specific to individuals with underlying metabolic problems. We have no idea how they will impact in a perfectly healthy pancreas. They were designed for type 2 diabetics, weight loss was an observed side effect. However in diabetics the dosage is often much lower because it is gradually increased until the diabetes is reversed. If this happens at 5mg that is the prescribed dose. Increasing the dose can have an undesirable effect on blood sugars.

Weight loss in diabetics is often much lower than when the drug is used for weight loss. The long term studies have been done in diabetics so it will be some time before any long term problems become apparent in obese patients without diabetes. In healthy weight individuals there has been no longterm research.

I was diagnosed with an endocrine problem in my 20s. I was part of a clinical drugs trial for a new drug. It worked amazingly fast. And at the dose I took during the trial caused rapid weight loss. However, the side effects were not great, but post trial my dose was adjusted to a level that was effective but it no longer suppressed my appetite significantly.

Unfortunately, 25 yrs later they found that the drug caused damage to heart valves so I now have echo cardiograms every 4 yrs to monitor a mild valve issue I have and I have essential hypertension as a result.

I don’t regret taking the drug, I would have had more health problems without it. But it does make me cautious about taking any new medication.

GLP1s are not usually prescribed to people with a history of eating disorders for obvious reasons.

But they are available to them on the black market. I would consider being offered meds by a “doctor” friend not exactly legitimate I’m afraid.

Yes all sorts of things are available from dodgy people and from illegal websites and round the back of a gym or beauticians. Perhaps the OP is not so desperate as to consider that as a reasonable option.

@Crwysmam thanks for sharing your experience, it’s definitely something to think about.

Yes I would consider the offer not exactly all above board but then a doctor is definitely better than someone round the back of a gym.

if this doctor is not properly prescribing to you and you aren’t a genuine patient at their clinic or on some kind of patient record then it most definitely not above board. If this doctor just sells you prescription only medication then they are committing more offences than someone who sells you a black market version. They are also behaving in a way that would lead to professional sanctions. Not someone I’d want to deal with. Especially when there are potential legitimate routes that you could access this anti-obesity prescription medication if you are certain that it’s the right choice for you, as I described earlier.

So I do have the experience you are looking for, but based on your previous eating disorders, I really think you should stay away. Your mental peace and recovered body is worth more than 1 stone.

I wouldn't trust a doctor who was doing something against the rules/law. Can't they lose their licence for that?
If a doctor was prescribing drugs for someone in agony-but doing so illegally-I'd have some sympathy, but not for something that isn't even health related (as you say you aren't doing this for health reason).
I'm not on the drugs so if it isn't against the rules, then ok, but from what I read it was only allowed for certain people who have too high a BMI.

@namechangeforthispo are you really recommending that a person with a significant history of eating disorders and who is a healthy weight should buy illegally sourced black market vials and mix their own medication to self inject?? Why would you suggest that as a sensible course of action?

i don’t recommend anything. OP asked about using WLI at a healthy bmi so I responded with my experience.

I did it through Voy , I was 10.7 stone, and got down to 9 in around 3 months , I’ve maintained for nearly 6 months without taking anything, have joined a gym and am fitter than I’ve ever been. I go 3 times a
week for strength training, walk around 8k steps a day, still enjoy take aways and meals out, but I weigh myself every week and if I go a few pounds up I cut back for a week. I had tried for 10+ years to lose that 1.5 stone, and it’s honestly changed my life! Cost me about £400 in total, but I’d have paid much more to be like this!

I’m 5ft 4 and was “overweight” at my previous weight and am now classed as “normal “ BMI with no health conditions.

@namechangeforthispo yeah, of course, definitely not a recommendation.