4 ms·

Is the official recommendation that you continue to take it for the rest of your life? Or, is there a schedule to "wean" people off of it?

r00fus 2y ago
Most weight management programs recommend you wean off - and also recommend other drugs if needed (metformin) to for maintenance. The method of these programs is to use the GLP-1 medications to allow you to change your habits significantly while also reducing your weight. The goal being, you keep the new habits and your reduced metabolic requirements which allows you to keep the lower weight.
- beezlebroxxxxxx 2y ago
  Interesting. If we think of effectiveness as maintained weight loss and eventually no longer requiring the drug then the next few years and decades will be fascinating to see how effective they are long-term.
  - r00fus 2y ago
    I mean, that's the goal for any weight management plan honestly - to provide the structure for you to make your own change. That GLP-1 meds are so effective will make a huge difference for tons of folks. I think many people are going to use GLP-1s without a structure - and they may find it's not as easy to taper off without making a meaningful diet change.
  - coffeebeqn 2y ago
    Even if you start gaining weight after a year or two I guess you could cycle back on it right ?
- deleted 2y ago
  [deleted]
tjohns 2y ago
Studies have show most people rapidly regain the weight once they stop taking GLP-1 drugs. The dysfunctional biochemical processes that contributed to overeating are still present if you discontinue the drug. Your body has a natural set-point for the weight it wants to be at, and the hunger and food noise comes right back as your body tries to get you back to your old weight. It's possible that after after a long enough time at a healthy weight your body's natural weight set-point will regulate itself back down. But this process take years.
- pinko 2y ago
  Is the idea of a set-point settled medical/scientific fact, or still a disputed theory?
  - tjohns 2y ago
    It's still a theory. We definitely don't know the underlying mechanism(s) of action, and it's likely there's more hidden complexity there. But rapid weight gain after weight loss (until you arrive somewhere near your old weight) is at least a well observed experimental effect. About 80% of people who lose weight, through any means, will revert back to their old weight. Source: https://www.ncbi.nlm.nih.gov/books/NBK592402/ https://www.ncbi.nlm.nih.gov/books/NBK592402/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673773/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673773/
    - karmajunkie 2y ago
      i lost about 30 lbs a couple of years ago, white knuckling my way through starving myself on a medically supervised diet. within two months of going off the diet, i was back at the exact weight i started at, to the pound, and haven’t varied >2lbs since, no matter what i eat. consider me convinced on the setpoint theory.
  - JamesBarney 2y ago
    Set-point theory is pretty much settled medical fact. The mechanism involves leptin, and you can easily see processes that defend bodyweight change in both directions. Though it will more aggressively defend weight loss than weight gain. In addition prey animals will defend against weight gain more aggressively than non-prey animals. Which makes sense from an evolutionary standpoint. If a lion gets fat he doesn't have nearly as much to worry about than if a gazelle gets fat.

r00fus 2y ago

Most weight management programs recommend you wean off - and also recommend other drugs if needed (metformin) to for maintenance. The method of these programs is to use the GLP-1 medications to allow you to change your habits significantly while also reducing your weight. The goal being, you keep the new habits and your reduced metabolic requirements which allows you to keep the lower weight.

beezlebroxxxxxx 2y ago
Interesting. If we think of effectiveness as maintained weight loss and eventually no longer requiring the drug then the next few years and decades will be fascinating to see how effective they are long-term.
- r00fus 2y ago
  I mean, that's the goal for any weight management plan honestly - to provide the structure for you to make your own change. That GLP-1 meds are so effective will make a huge difference for tons of folks. I think many people are going to use GLP-1s without a structure - and they may find it's not as easy to taper off without making a meaningful diet change.
- coffeebeqn 2y ago
  Even if you start gaining weight after a year or two I guess you could cycle back on it right ?
deleted 2y ago
[deleted]

tjohns 2y ago

Studies have show most people rapidly regain the weight once they stop taking GLP-1 drugs. The dysfunctional biochemical processes that contributed to overeating are still present if you discontinue the drug. Your body has a natural set-point for the weight it wants to be at, and the hunger and food noise comes right back as your body tries to get you back to your old weight. It's possible that after after a long enough time at a healthy weight your body's natural weight set-point will regulate itself back down. But this process take years.

pinko 2y ago
Is the idea of a set-point settled medical/scientific fact, or still a disputed theory?
- tjohns 2y ago
  It's still a theory. We definitely don't know the underlying mechanism(s) of action, and it's likely there's more hidden complexity there. But rapid weight gain after weight loss (until you arrive somewhere near your old weight) is at least a well observed experimental effect. About 80% of people who lose weight, through any means, will revert back to their old weight. Source: https://www.ncbi.nlm.nih.gov/books/NBK592402/ https://www.ncbi.nlm.nih.gov/books/NBK592402/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673773/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673773/
  - karmajunkie 2y ago
    i lost about 30 lbs a couple of years ago, white knuckling my way through starving myself on a medically supervised diet. within two months of going off the diet, i was back at the exact weight i started at, to the pound, and haven’t varied >2lbs since, no matter what i eat. consider me convinced on the setpoint theory.
- JamesBarney 2y ago
  Set-point theory is pretty much settled medical fact. The mechanism involves leptin, and you can easily see processes that defend bodyweight change in both directions. Though it will more aggressively defend weight loss than weight gain. In addition prey animals will defend against weight gain more aggressively than non-prey animals. Which makes sense from an evolutionary standpoint. If a lion gets fat he doesn't have nearly as much to worry about than if a gazelle gets fat.