Weight Back After GLP-1s -- Inevitable?

Health_Chick134

Health_Chick134

Active member
I saw this interesting study recently:

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(26)00043-X/fulltext

It suggests that people might only put back around 75% of what they initially lost on GLP-1s, which translates to an overall long-term weight reduction of about 5%. It's not huge, but better than nothing. I'm now thinking that a 20-30% loss is achievable with drugs like tirzepatide or retatrutide, especially if people stay on them. Possibly more with higher doses or experimental combos.

The weight regain curve seems to flatten out after a while. I wonder why that is and what's changing long-term. I'm skeptical of the article's explanation about better food choices.
 
I think most folks will need a maintenance dose to keep the weight off. Maybe some people who gained weight due to a temporary situation like a specific medication or pregnancy can use a GLP-1 to lose it and then maintain on their own.

But for most, obesity has been a lifelong struggle. Their brains are wired to overeat.
 
I tried to post a graph from the article, but it didn't work. It's in the journal article if you want to check it out. I've uploaded PDFs before, so I'm not sure why the image isn't working.
 
The weight-loss curve from diet and exercise alone is probably even steeper. Imagine where this curve would be if insurance didn't cut everyone off...
 
If the lower dose was fine, dial it back to see if the sickness goes away. Started at two, had nothing in terms of nausea or hunger, dropped to one after six weeks. Still losing, still not hungry, but enough appetite for one meat meal. Some of us react stronger to this stuff, which is honestly great for the wallet.
 
I think the other health *perks* are worth taking it for life. It's cheaper than a bunch of supplements, and meds for high blood pressure, cholesterol, and insulin. It only gets pricey when you start chasing every new peptide. But you're improving your healthspan. One bypass surgery or a few stents costs more than a lifetime of GLP-1s.
 
Here you go:


Some committed people keep up a healthier lifestyle after stopping GLP-1 RAs, maintaining or even losing a bit more. You can't just sit around eating and expect to shrink.

Edit: Some people cycle it - take 4 weeks off to refeed, gain back ~10%, then start the reta again. That might be cheaper.
 
I totally agree with that statement about grey market GLP-1s being a no-brainer. But it's harder to justify at full retail prices.

Every cost-effectiveness analysis I've seen says they're too expensive per QALY gained (quality of life year) until they get much cheaper. If that changes, countries like Australia might subsidize them more widely. But it won't help in countries that don't subsidize medication costs. I'm not sure the studies fully account for the long-term medical cost savings, but the science isn't all conclusive yet.
 
I find it fascinating that the weight regain rate isn't closer to 100% in these studies. I'd expect most people to be back where they started within 5 years of stopping treatment (assuming no major lifestyle changes).
 
Charlie_2009 said:
Basically, these meds are for the long haul. It's a reminder for those using them to drop a few vanity pounds.
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Yeah, the WSJ article said when you stop, "the hunger and food noise symptoms come back with a vengeance."
 
In the article, the doctors said it's still worth starting the drugs even if you can’t stay on them long-term, but they caution the need for proper counseling and lifestyle changes...
 
I'm tapering off Wegovy after about 10 months and 95lbs down. Hoping to be completely off by summer and not gain it all back 🙏. It's scary!
 
Izzy_35 said:
I'm tapering off Wegovy after about 10 months and 95lbs down. Hoping to be completely off by summer and not gain it all back 🙏. It's scary!
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Wow, congrats on the weight loss! How's the tapering process going?
 
planning to start mounjaro tonight with my first shot but had a normal dinner a couple hours before. will that cause more nausea or stomach stuff than if i'd eaten less? bit stressed about it.
 
Physical therapy really helped me after the weight came off. Dropping 70 lbs changed everything about my body mechanics - my core was weak and my back took the hit. Some targeted work in the gym made a huge difference.
 
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