Weight loss jabs: What happens when you stop taking them
bbc.com
bbc.com
There's no free lunch or wonder drug. While it's effective at weight loss it has a lot of unwanted side effects. And when stopping the drug the weight gain comes back so not sure if it's worth it.
No, it doesn't, weight loss does this. I've lost weight before via starving and even as a man, all my muscle went poof. If you look at someone like Ariana Grande, who clearly is anorexic, here arms are like sticks and here face looks tautly stretched over her bones.
This is just what happens when you starve your body of nutrients. Your muscles are some of the first to go because they're the least vital. Your organs and brain are much, much more important. Your body will have no issue taking your muscle away to give it to your organs. Regardless of ozempic.
It’s not like others like myself, currently on a cut cycle, don’t experience hunger. The idea that we are just “lucky” ignores all the willpower and discipline we fight through to do it ourselves.
I’ve eaten about 800 calories today and it is 4pm. Just finished 90 minutes on the indoor bike. My stomach feels hungry. I experience that and just sit with it. That is the difference.
https://eastermichael.com/book/
It's winter in the Northern hemisphere right now. Try going for a walk tomorrow deliberately undressed to the point that you're deeply uncomfortable but not risking serious injury or death. Anyone can do this, and over time it makes tolerating other forms of discomfort easier.
I know many ultra endurance runners and they are all in very good - healthy - shape. The only thing they all have in common is that they are very, very disciplined people.
Right, but are you not seeing that this is orthogonal?
Meaning, is it that running MAKES YOU disciplined, or rather that people who are already predisposed to being disciplined are more likely to be runners? This says nothing about the genetic component of it.
And you would have to be born yesterday to truly think there is no genetic component. Even with alcoholism, we know it's hereditary. We know when it comes to compulsions there is a genetic component. This is not opinion, this is fact. We know this.
But specifically with food habits, you truly believe this is not the case? Do you not see how incredibly bold of a claim that is? How atypical, how surprising, that would be?
I'm not saying that some people are blessed and some are not. Everyone has the power to change their lives. But I AM saying that it's not the same for everyone. From the beginning, I have known some things come easier to some people. I thought this was common knowledge, a part of the human condition we were all aware of.
But it's just obviously not true. From the beginning, it is clear life is unfair. Children die from cancer. Are they losers? Should they have ate more veggies?
When everything happens for a reason, that has some unsavory side effects. This is all philosophical, but also real.
We are an amalgamation of what is in our control, and what is not. I could sit here and pat myself on the back for being skinny and attractive. Really, I could. But does that not seem, maybe, a bit pathetic?
I did have something to do with it, but it was not all me. I shouldn't take all the credit, and frankly I don't need it. Maybe some people do need it, in which case they should do other things to be proud of. There's no pride in being proud of something you did not achieve.
I think, for both you and me and for most things in life, the reality is that most things were given to us. Yes, we have achieved - off the shoulders of giants. Whether that be genetics, time, place, family.
From there, we have a few options on how to view the world:
- conclude that, since we've achieved nothing on our own, we must be losers, and kill ourselves.
- denounce the notion, and live in the delusion that we did do it all on our own. Essentially, lie at a fundamental level to boost our ego. Is there a lower low a person can sink to?
- embrace humility, and acknowledge that we are blessed and favored. Acknowledge that we do not know it all, and that our success is based off of practically infinite random things going right in our favor.
Other people might have it worse and it might stay with them longer.
Could you keep it up if you were 10x as hungry as you are now for next 5 years?
Okay... how?
You can't just make incredibly bold claims, say "it's a fact!" and then move on. No, you have to back them up otherwise you're just a bullshitter.
I don't know what other people, anyone else, is feeling. How do I know my hunger is their hunger?
I have noticed much less moralizing over the issue now compared to 2-3 years ago. I think more people realize these drug are safe and effective and not 'taking the easy way out', but rather a treatment for a medical problem than just blaming laziness or gluttony.
I took chemotherapy for cancer treatment, and it was very effective. Chemo is not a root-cause solution. It's a shotgun solution, a hammer even. It just kills cells that look like cancer. It doesn't stop cells from being cancerous, or turn cancerous cells back into normal cells. It's also carcinogenic, meaning it actually causes cancer. I am now much more likely than the general population to develop another cancer.
But it also saved my life. We do not measure effectiveness of medicine by if you think it's morally just. Nobody cares what you think, actually. We measure it in the real world, by if it works.
I know several people who were formerly obese and have achieved sustained weight loss without drugs or surgery. The common factor seems to be that they "hit rock bottom", sort of like a drug addict, and decided to make permanent lifestyle changes in order to survive and stop letting down those who depended upon them. These lifestyle changes are often pretty drastic, and involve more than just eating less and exercising more.
If people want to take GLP-1 drugs and understand the risks then I have no problem with that and don't see it as a moral failing. But they might want to evaluate whether this is just masking the symptoms of some deeper mental health condition.
This is just as weak as a counter argument. If every argument that concludes that lifestyle changes are necessary, in most situations and for most patients, are just written off as some sort of moral high ground and not necessarily something to take seriously, then what do we have left?
Is there seriously no functional difference between healing a broken bone and getting someone to stop smoking? The only problem is just that we haven't found the right medication for the latter? Evidence of necessary lifestyle changes as part of some moral crusade?
The science is pretty clear on the subject and it is up there as one of the most well studied in medicine. Yes, anyone can stop smoking and anyone can gain or loose weight. Yes, lifestyle changes are the most imporant factor in a treatment being successful.
No. The way GLP-1 drugs work is by lifestyle changes. People on GLP-1 agonists will, on average, eat smaller portions, are more inclined to eat healthier food, and will even exercise more.
If you take GLP-1s and don't do the lifestyle changes, they don't work. So are these drugs useless? No. They make the lifestyle changes more attainable. In your smoking example, it's similar. We have cessation drugs, I know because I've used them. No, they don't magically make you stop smoking. But they do make it easier.
We need to rewrite how we view these drugs. They don't take away your power, your strength. No, they help you find it. You had the strength all along, but these are tools to help you exercise it.
The premise, IIUC, is that obesity is driven partly by mucosal overgrowth on the duodenum. This thicker-than-expected layer of mucus is less porous, which leads your digestive system to underestimate the number of calories you've consumed. Revita basically re-surfaces the duodenum.
So, the idea is that you get to a lower weight with the GLP-1 drugs, and then Revita can hopefully reset your set point there.
Their first clinical trial is still in progress, but I think it's interesting to watch.
Does this reduce mucous production going forward? Otherwise, it seems like it would be a temporary effect.
If you get the procedure and don't go back to an obesogenic diet, then it should be permanent.
You can find evidence of this in the literature, but it’s absurdly understudied, because big pharma would rather sell you a subscription to life.
Fortunately there are many good people in the world, especially in the field of medicine, who want to help their patients unconditionally. So there are glimmers of hope, like some of the top cardiologists in the world going against status quo and treating patients with fasting regimes instead of surgery.
https://www.mdpi.com/2072-6643/16/1/128
which says that the changes reverted quickly after resuming normal feeding
Fascinating.
Just like alcoholism, or any kind of other addictions.
I've struggled with alcohol abuse, and once you come to the realization that you're abusing it, the fix FOR ME was relatively simple: I stopped (under medical supervision) drinking, or to be more precise: I stopped starting to drink. I have no problems not drinking, I have a problem that when I start I cannot stop.
I have the same issue with food. Not eating is a lot easier than stopping to eat. But I cannot completely stop eating.
Yet with alcohol people are like: hey, good for you.
With my weight issues people are like: dude, just eat less, or exercise more.
(I stopped sharing the food story with people).
Otherwise I over eat crap and gain weight easily
https://time.com/archive/6855517/hold-the-eggs-and-butter/
https://content.time.com/time/specials/2007/article/0,28804,...
I was pre-diabetic at 100kg and went down to 70kg over a year of low carb diet and intermittent fasting
It’s a daily struggle trying to NOT eat until literally feeling pain in the belly, and even then, I know if I wait 30 minutes more I can keep eating
Yes, but this is sort of the point. If we can make it not a daily struggle, probably a lot more people would be successful.
Generally, I think the solution of "just suffer" is a bad one. If people's solution requires a certain amount of pain, it's probably just a suboptimal solution, and we can do better.
"Just Eat Less" is roughly the way to lose weight, but the problem is not that fat people are so unbelievably stupid that they didn't know this. I am sure for some people it really is that simple. Not us.
My weight has been a bit of a rollercoaster. I've never been terribly thin, but I've been "not technically obese" from time to time. I'm currently back on the downswing, but God, what a pain in the ass. It feels like gaining weight is incredibly easy and losing it is incredibly hard (and I do believe this is validated by the science, because you wind up with more fat cells when you first gain weight, which I guess is both relieving and terrifying.)
No matter how many attempts it takes to fix my body, I'm obviously going to just keep trying, because obesity is horrible for you in so many ways. It saps your energy, it's carcinogenic, it increases your blood pressure and risk of heart disease, but it feels like one of those struggles that is never-ending. I've improved my diet numerous times but it never feels like it's quite enough.
I don't suggest this applies to you, but even a small amount of searching around and reading stuff on the web will reveal a substantial subgroup of outright thermodynamics deniers.
I’m familiar with people who believe that there are details of how a body metabolizes fuel , expends energy, and generally operates that escape analysis focused on fuel volume and physical activity. I am familiar with people who characterize this as denial of the laws of thermodynamics, but I am not familiar with anyone who seems to believe that there are situations in which the laws of thermodynamics are outright suspended.
I've heard people say this before, but when reading those arguments it mostly turns out to be people who think there's something more complicated going on with digestion, excretion, or metabolism such that eaten calories are more efficiently used for some, and burned off or passed through without full processing to some degree for people who self-reportedly "can't gain weight".
There have been studies on ababolics, synthetic testosterone, that demonstrate this. Taking steroids and doing absolutely nothing leads to more fat loss and more muscle gain than not taking steroids and working out. Which... yeah duh.
But people will still deny this, because of the implications. We all have different baselines, and nobody likes to hear that they got lucky in some ways. Everyone wants to believe the world and human condition is perfectly fair, so they feel that they deserve what they have.
the data is pretty clear . the vast majority of dieters fail, even when the bar for success is set really low, like a 2-5% long-term weight loss of starting body weight for an obese person is considered a success.
I feel like there is more to it.
Obviously, I sympathize with you, and I noticed that when I switch from a bulking cycle to a cutting cycle, it is a bit difficult to adjust for the first couple of weeks as well.
But by god, I truly am struggling to switch the other way around, and it takes me months to adjust to the bulking cycle, even with the help of stuff like weed. And when I don’t work out aggresively and don’t keep track of my cycle, it feels just natural for me to default to eating way less, as opposed to the other way around.
To be clear, this isn’t meant to be a dig at your take. All I mean is that, I feel like the whole issue is a bit more complex.
You could just have good genetics in which your body is resistant to weight gain or you have a low appetite to begin with. As shown by the worldwide obesity epidemic, this is apparently quite an uncommon problem. 75% of country overweight or obese.
This moral judgement whereby losing weight is "good" in absolute, is such bullshit. For most of history, humans have fought starvation literally every day, and often had to make do with minimal caloric intake for weeks or months - in that context, genetics that kept you thin were definitely very bad.
There's an equal and opposite level of messaging to keep eating, which is less conscious and runs under the radar.
Snacks are literally designed to be addictive. TV ads start from birth. Most restaurants have huge portion sizes. "Family" and "Festival" events assume overeating is expected. Junk food is cheap and quality food is expensive. Overeating is framed as being "naughty" but also indulgent and nurturing.
All of this is a huge social problem that's not acknowledged at all.
It's very, very hard to Just Eat Less when there's a constant barrage of messaging encouraging you to do the opposite, and you're not even aware of it.
The contradictory messaging is actually a classic crazy-making psychological double bind. So of course it's very difficult to make a dent in this, and even harder to permanently change habits so all the contradictions no longer influence you.
ppl keep blaming this, but this is contradicted by shrinkflation, yet people still are getting fatter than ever. There is nothing to stop someone from buying more food to offset smaller portions.
After eliminating caffeine its like a switch entirely flipped in my brain turning off all the usual cravings I'd have for carbs/sugars/etc.
The quitting caffeine part was pretty horrible though. Not just because of the headaches (which weren't actually super bad for me) but I went through a couple of weeks of what I assume was for-reals depression/anhedonia as my brain figured out how to operate with non-blocked adenosine suddenly suppressing my dopamine levels.
Maybe the messaging should be "eat healthier"? How many obese people cook for themselves and eat exclusively from the outer aisles of the grocery (fruits, vegetables, seafood, meat, eggs, dairy)?
I could be wrong but I have to imagine the average obese person has a terrible diet. Portion control won't work at that point, you're already doomed to fail.
To be fair, most people have a terrible diet, it's just that some lucky individuals have the metabolism to overcome it. It seems like those people are increasingly the exception and a bad benchmark for how humans should eat.
It is issue of food and ingrediences. Too many sugars, fructose syrups from corn... If fat american moves to asian country, he loses fat, without changing a diet.
When an obese person regulates their eating and loses weight, the hunger often doesn't go away - and often increases. This is physical, not psychological hunger. When the obese person almost inevitably returns to eating to fullness, they regain weight.
When a person takes GLP-1s, hunger is greatly reduced, and an obese person can eat less food while still achieving satiety without gaining weight. When they stop taking the GLP-1s, the hunger returns, and when they return to eating to fullness, they regain weight.
Similarly, when a person takes stimulant weight loss medication, they can eat less food while experiencing less hunger, and thus lose weight. Similarly, when they go off of the stimulant (or develop a tolerance), the hunger returns and when they return to eating to fullness, they regain weight.
In many obese people, the hunger is present even when they eat a nutritious meal at the appropriate number of calories to maintain their weight. Common advice is to say "this mix of macros or foods makes me satisfied!" and, well, that's great for you but not universal.
People who naturally feel reasonably satisfied with an appropriate number of calories to maintain their weight still experience hunger, but not with the intensity or insatiability of that hunger that many obese people do.
While it does occur with some who have severe eating disorders, most obese people do not overeat themselves into obesity by continuing to eat long after they're full. They eat until the hunger goes away.
It's the hunger. Take away the hunger, and the weight goes down. Bring back the hunger and the weight goes up. It's simple, it's obvious, and few say it.
Yup..the high failure rate of dieting is true regardless of the type of food or the macros. Lecturing to 'just eat healthy' as the default mode of advice does not work for the large majority of obese people..this is supported by the literature and anecdotal evidence.
I don't count calories. I went off Ozempic (now Mounjaro) and I gain weight at about 0.5-1kg a month.
As I am resistance (gym) training, significant % of that ends up being muscle mass rather than fat.
So I end up taking Mounjaro for about 1-2 months every 3-4 months, approximately 33% of the time being "on".
Funnily, I end up with bulk/cut periods without doing them explicitly. This ends up working well for growing muscles.
Notice all people in the story are women. I guess pairing GLP-likes with bodybuilding works quite well for men. As times goes on, I end up needing mounjaro less due to my increased muscle mass.
yeah that is how ppl become obese. over 2-5 years it adds up
Notice all people in the story are women.
Probably due to social media. Women may be more inclined to show off their success online. Also, women respond better to these drugs compared to men.
This is my biggest issue with weight healthcare, the idea that if only the patient would eat correctly they wouldn’t be overweight. It’s not some moral failing a person often over eats, it very well could be some physiological issue that should be treated. It would be like telling someone with asthma that they just need to get into better shape to breathe better.
We still need to talk to our Congress critters.
On the asthma front, from experiences with someone close to me -- getting in great physical shape (with caveats regarding training) DID indeed help greatly with broncho-constriction and higher scores on FEV. Basically symptoms and inhaler use went down tremendously over a few years and a physical transformation.
Altitude is another factor, due to dry and colder air and lower oxygen -- a double whammy for asthma.
https://www.penguinrandomhouse.com/books/547761/breath-by-ja...
I ask this because when I was younger, I also had tastebuds warped by hyper-palatable foods, but after incrementally getting my diet to such a clean and optimized place, I literally feel bad even while chewing and tasting something like a donut, heavily salted and oiled potato chips, or candy. It's probably like how I would have felt if I literally mixed a tablespoon of oil and sugar or salt together and swallowed it.
Is it that hard to shift the system toward better habits by incremental introduction of better ones, and crowding out the bad? Exercise helps here, because once you begin to enjoy fitness, you get a stronger feedback loop with the bad food creating bad outcomes.
Also, not everybody enjoys fitness.
I don't like it. I still go 5 times per week and have been doing it consistently for the last 2.5 years
I'm muscular, a bit overweight.
With some people, I think they have just lost what being sated feels like.
I think obesity is hard to fix even when you are not a “thermodynamics denier” (as another commenter said) because all you can practice is moderation from the get go. How many people would fail to fix their alcoholism if complete abstinence, even just a period of complete abstinence to rewire the brain, was never an option? They actually had to go down to the pub and practice stopping everyday at 1 pint?
...I suppose it's hard for someone who struggles with eating to stop food all together. That said, after I got off booze, I started on sugar, never been into sugar in my life, didn't like cake, ice cream any of that stuff, but getting off booze that started, I craved ice cream and stuff all the time, and gave in not realizing what was happening, once I told my dr and he explained the body was substituting the alcohol... so I stopped sweet stuff (mostly all of it, honey and fruit juice seem fine, I don't crave them). I don't have very many cravings any more, I know that "you're going to crave this if you have it more than a few times" feeling as soon as I consume something now, and, I just, don't. Is it hard? Every time, but I prefer the control more tbh.
Maybe I live a kinda boring life now, oh well, at least I feel great.
Pointless human interest story with some rent-a-quote expert sprinkled in that tries to imply some ominous danger but can't come up with any hard data on that themselves.
That said, its a little disheartening to see people who are 10-15kg overweight also resort to these drugs - this kind of excess weight can be fought with simply diet and exercise
I missed doses long enough that I had to start at the beginning, but I avoided that because I had to book and appointment with my doctor and get prescribed the lower dose, etc.
So I gained the weight all back and then lose it again when I got back on the doses.
I thing it takes less effort to be effective but it has pretty bad side effects.
Any attempt at a temporary food change is already a failure for long term health.
But a know a couple of them that went off it and the weight came back pretty quickly. It really is just a suppression of hunger, nothing more than that.
But… treatment is working.
Question is at what cost.
If something is too good to be true, one has to ask what is behind it. But perhaps it is a similar situation to when antibiotics were invented.
The human body is stupid and makes a lot of mistakes. It's very obvious to me that our bodies and minds were not built for their current environment.
When someone's brain has a bug in which is has seizures, we do not ask them "what's behind" their epilepsy medication. No, we understand their brain has a problem that should be fixed. There is no ulterior perspective, some secret hidden ability they might possess. It's just bad.
But when it comes to food, we forget this is how we view things. In it's place comes moralizing.
It is actually a lot more than that. Many people on Ozempic report better impulse control (food or otherwise). Many stop or significantly reduce alcohol intake. It seems that gut hormones are linked to reward pathways in the brain.
Our food is too rich in calories, too abundantly available, and too addictive for most people.
> He is worried that without additional support for people making the transition, society's unhealthy relationship with food means little will change.
> "The environment that people live in needs to be one that promotes health, not weight gain.
Also generic versions of Ozempic are coming to Canada soon: https://www.cbc.ca/news/health/ozempic-generic-canada-weight...
From https://en.wiktionary.org/wiki/jab
I hope that helps