10 ms·

Weight loss jabs: What happens when you stop taking them

51 points by neom 10mo ago

belter 10mo ago
TLDR: "...evidence so far suggests that, between one and three years after stopping the medication, people will see a "significant proportion of weight" go back on...Somewhere in the region of 60 to 80% of the weight that you lost will return..."
- stinos 10mo ago
  What's striking here is that this is roughly the same outcome as essentially every other diet (with the intent of losing weight) out there. It's just more expensive. And possibly more hyped.
  - mgraczyk 10mo ago
    And it works much better for most people
    - nostrebored 10mo ago
      Yeah I think this is the missing piece. Same impact as dieting but with higher adherence and duration is a huge win.
    - tartoran 10mo ago
      > And it works much better for most people I thing it takes less effort to be effective but it has pretty bad side effects.
  - geraldwhen 10mo ago
    Diet is the food you eat. If you change the food you eat, you’ve changed your diet. Any attempt at a temporary food change is already a failure for long term health.
  - blindriver 10mo ago
    It's not hyped. It's the most effective way I've seen the people around me lose weight. Some of them have lost a tremendous amount of weight very quickly. 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.
    - sixtyj 10mo ago
      It can be hyped because jabs bring immediate results. And it can be prescribed by almost every doctor so number of people who can report is big, and therefore visible results can be further disseminated (hyped). 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.
      - XorNot 10mo ago
        Most developed medical technology doesn't have "a cost". That's puritan morality theater masquerading as wisdom.
      - array_key_first 10mo ago
        > one has to ask what is behind it. 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.
    - hamandcheese 10mo ago
      > It really is just a suppression of hunger, nothing more than that. 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.
  - fuckyah 10mo ago
    [dead]
- isoprophlex 10mo ago
  Taking recovered drug addicts and placing them in a situation where everyone's using all the time would probably lead to equally bad outcomes. Our food is too rich in calories, too abundantly available, and too addictive for most people.
  - uxjw 10mo ago
    Yes, the cheap engineered "foods" don't help, and they're everywhere. This part of the article really hit home: > 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-loss-1.7584919 https://www.cbc.ca/news/health/ozempic-generic-canada-weight...
- BoingBoomTschak 10mo ago
  Surprise surprise, it's not like the drug did anything to improve the patient's discipline...
OptionOfT 10mo ago
Being overweight is a chronic disease. 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).
- true2octave 10mo ago
  What works for me is to eat highly nutritious low-glycemic food until I feel full (eggs, avocado, quinoa, etc) Otherwise I over eat crap and gain weight easily
  - skrebbel 10mo ago
    How many years have you been able to keep that diet up?
    - true2octave 10mo ago
      Particularly eating a lot of eggs daily for about 3 years
      - nradov 10mo ago
        The Time Magazine cover story in 1984 where they falsely claimed that consuming cholesterol from eggs and other sources was dangerous was a real turning point. That misunderstanding has caused tremendous harm to public health for decades. I think the journalists acted in good faith but they believed junk science. https://time.com/archive/6855517/hold-the-eggs-and-butter/ https://time.com/archive/6855517/hold-the-eggs-and-butter/ https://content.time.com/time/specials/2007/article/0,28804,1704183_1704257_1704499,00.html https://content.time.com/time/specials/2007/article/0,28804,...
jmward01 10mo ago
Other medications become lifelong medications but without this level of scrutiny. I am 100% in favor of finding a more permanent treatment, but switching blood pressure meds, and cholesterol meds, and other daily meds for a single once a week med is a massive improvement, especially since the all source mortality data keeps rolling in showing the efficacy here is orders of magnitude better than all the other medications out there. A constant issue here is that we keep calling this a 'weight loss drug' and society views being fat as a moral failing ant that you 'just don't have the will power' to overcome. We need to stop. If this is a lifelong drug it is worth it compared to the relatively ineffective, and just as lifelong, alternatives out there.
- 3rodents 10mo ago
  I don’t think that’s a fair assessment. I’m all for life-long drugs that help with weight loss, I don’t view it as a moral failing. That said, it is easy to see why so many people are concerned about these drugs: people taking them can look terrible (“ozempic face”). Gaunt, sick, hollowed out, look at people like Sharon Osbourne, that’s the public face of these drugs. And so when people are committing to life-long use of these drugs, it is being viewed with the very visible side effects in mind, and that is concerning to a lot of people after these drugs seemingly appeared overnight.
  - hamandcheese 10mo ago
    "Ozempic face" is actually just "unhealthy rapid weight loss face". Ozempic makes it easier to starve yourself, but that isn't how it's supposed to be used.
    - yellow_postit 10mo ago
      Many of the fly by night digital proscribes just jack the dosage to show rapid gains. Coupled with people lying on BMI to get a script is a bad combination and why it’s so obvious.
    - manmal 10mo ago
      It’s also accelerated muscle loss, even heart tissue. I‘m not saying it’s not worth it, but this should be kept on the radar for sure.
Asooka 10mo ago
Can't be worse long-term than inhaling nicotine, the previous widely deployed strategy to combat food cravings.
Taikonerd 10mo ago
Interesting link: a company called Fractyl Health is studying a surgical procedure they call "Revita," that they hope can keep weight off for patients after they discontinue GLP-1s.[0] 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. [0]: https://www.fractyl.com/our-platforms/revita/ https://www.fractyl.com/our-platforms/revita/
- harvey9 10mo ago
  Surprised this is still in first trial. I can recall reading about something like it in 2017. Apparently clearing the duodenal mucosa is a preparatory step for a gastric band fitting, but they found patients were making improvements before the bands were being fitted so a study was started to see if this less invasive procedure might be enough by itself.
- hamandcheese 10mo ago
  > Revita basically re-surfaces the duodenum. Does this reduce mucous production going forward? Otherwise, it seems like it would be a temporary effect.
  - Taikonerd 10mo ago
    My impression (and I'm not a scientist) is that the mucosal overgrowth comes from eating an obesogenic diet. (Some combination of too much sugar / salt / wrong types of fat?) If you get the procedure and don't go back to an obesogenic diet, then it should be permanent.
    - deleted 10mo ago
      [deleted]
- refibrillator 10mo ago
asciimov 10mo ago
> "The environment that people live in needs to be one that promotes health, not weight gain. […] Obesity is not a GLP-1 deficiency," he says. 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.
- XorNot 10mo ago
  That's what GLP-1 drugs are doing? Like...this is the premier argument as to why they work.
- kiba 10mo ago
  Until we are able to fix the environment and culture, we're stuck with medications like this. The good news is that glp1 medicine can be used to break addictive behaviors, so it is the very tool that can help change our environment by reducing demand for junk food. We still need to talk to our Congress critters.
- diziet 10mo ago
  I don't have a horse in this race, but from my personal experience eating satiating whole foods with lower glycemic index, higher fiber and protein content makes it very difficult to gain excessive weight. 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.
  - randallsquared 10mo ago
    Before GLP-1s, there was rarely any such thing as "satiation" for me. Getting full was something that happened without the feeling of having had enough. The main effect of wegovy, for me, was having a feeling of not needing to eat rather than just feeling too full to eat. It was quite an experience, and one I am not sure I had had in more than 30 years.
jeffbee 10mo ago
I guess it's a dialect thing, but I have become accustomed to disregarding absolutely every article that employs the word "jab".
- fogleman 10mo ago
  That's just what they call it in British English, and this is a BBC article.
- eterm 10mo ago
  > (British) A medical hypodermic injection (vaccination or inoculation). From https://en.wiktionary.org/wiki/jab https://en.wiktionary.org/wiki/jab I hope that helps
- XorNot 10mo ago
  The word itself is just insufferable at this point. The media collectively went bonkers for it while describing COVID vaccine delivery.
kozikow 10mo ago
I did lose 30-40kg about 2 years ago on Ozempic. 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.
- cryzinger 10mo ago
  When you restart taking it after an "off" period, do you immediately resume whatever dose you were at before? Or do you taper up each time? (Curious because I know for many people, side effects level out after they've been at a given dose for long enough, but temporarily return whenever they increase their dose; not sure how "off" periods affect that kind of tolerance.)
- paulpauper 10mo ago
  I don't count calories. I went off Ozempic (now Mounjaro) and I gain weight at about 0.5-1kg a month. 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.
iwanttocomment 10mo ago
We need to start looking at obesity as a hunger disorder, and not as the result of an addiction, a lack of knowledge about nutrition, or a lack of self control. 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.
- paulpauper 10mo ago
  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. 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.
  - shadowpho 10mo ago
Sol- 10mo ago
Then just continue to take them? The article just once seems to mention side effects and these were suspected to be related to rapid weight loss and less to the drug itself. 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.
spaceman_2020 10mo ago
If you’re substantially overweight, you have to wonder if the long term side effects of GLP-1 are better than being obese 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
maxaw 10mo ago
I definitely lost weight easily on wegovy and just as easily gained it back when I stopped taking it. The whole experience definitely drove home how I needed to improve my mental health alongside any “purely physical” intervention. Same situation when I lost weight by meticulously calorie counting. 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?
- neom 10mo ago
  Excuse the ramble: it maybe sucks more for people with eating addictions than alcohol in some sense. I am an alcoholic and I've been sober for, I dunno, years and years now. I did actually go to pubs and cocktail bars when I first got sober, I didn't drink I just sat and felt awful and wanted to drink badly. I felt I needed to learn how the feeling of the craving was going to work so I can plan for it etc, especially when stress creeps in. So, as another comment said, I got sober by stopping the first drink. For me it's very logical, if I have a drink, I will drink, I will not stop, I cannot stop, so if I take the first drink it doesn't matter that is is, it's done, so I don't drink the first drink since I decided that, hence sober. ...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.
lr4444lr 10mo ago
Question for people who have trouble losing fat (this was never my problem): have you ever tried instead of dieting to just force yourself to eat more fruits, vegetables, and protein daily while also allowing yourself free range in the remaining appetite room to have whatever? The human mind/brain/whatever doesn't do well with deprivation of a high dopamine reward, but what would happen if you started to shift your tastes by insisting that it get used to a more healthful diet as a precursor to getting what it wants? 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.
- Fire-Dragon-DoL 10mo ago
  Yes, I gained weight anyway. Sad, I hoped that was going to be my fix. 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.
- shadowpho 10mo ago
  One of my friends ate two pounds of tomatoes every evening and would not feel full. I couldn’t believe it until I saw it with my eyes….
  - iteria 10mo ago
    I feel like they should try the potato diet. I recommend it, not because I believe it is effective (it wasn't for me), but because it is very good at removing the pleasure from eating. When you are eating to survive, you will come to understand how what being sated is. From there, I found I could lose weight because I had broken the habit of eating for any other reason than to fuel myself. Although, admittedly, I enjoyed losing weight this way better than the potato diet. With some people, I think they have just lost what being sated feels like.
daft_pink 10mo ago
I basically just gained the weight back again. 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.

51 points by neom 10mo ago

belter 10mo ago

TLDR: "...evidence so far suggests that, between one and three years after stopping the medication, people will see a "significant proportion of weight" go back on...Somewhere in the region of 60 to 80% of the weight that you lost will return..."

stinos 10mo ago
What's striking here is that this is roughly the same outcome as essentially every other diet (with the intent of losing weight) out there. It's just more expensive. And possibly more hyped.
- mgraczyk 10mo ago
  And it works much better for most people
  - nostrebored 10mo ago
    Yeah I think this is the missing piece. Same impact as dieting but with higher adherence and duration is a huge win.
  - tartoran 10mo ago
    > And it works much better for most people I thing it takes less effort to be effective but it has pretty bad side effects.
- geraldwhen 10mo ago
  Diet is the food you eat. If you change the food you eat, you’ve changed your diet. Any attempt at a temporary food change is already a failure for long term health.
- blindriver 10mo ago
  It's not hyped. It's the most effective way I've seen the people around me lose weight. Some of them have lost a tremendous amount of weight very quickly. 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.
  - sixtyj 10mo ago
    It can be hyped because jabs bring immediate results. And it can be prescribed by almost every doctor so number of people who can report is big, and therefore visible results can be further disseminated (hyped). 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.
    - XorNot 10mo ago
      Most developed medical technology doesn't have "a cost". That's puritan morality theater masquerading as wisdom.
    - array_key_first 10mo ago
      > one has to ask what is behind it. 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.
  - hamandcheese 10mo ago
    > It really is just a suppression of hunger, nothing more than that. 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.
- fuckyah 10mo ago
  [dead]
isoprophlex 10mo ago
Taking recovered drug addicts and placing them in a situation where everyone's using all the time would probably lead to equally bad outcomes. Our food is too rich in calories, too abundantly available, and too addictive for most people.
- uxjw 10mo ago
  Yes, the cheap engineered "foods" don't help, and they're everywhere. This part of the article really hit home: > 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-loss-1.7584919 https://www.cbc.ca/news/health/ozempic-generic-canada-weight...
BoingBoomTschak 10mo ago
Surprise surprise, it's not like the drug did anything to improve the patient's discipline...

OptionOfT 10mo ago

Being overweight is a chronic disease. 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).

true2octave 10mo ago
What works for me is to eat highly nutritious low-glycemic food until I feel full (eggs, avocado, quinoa, etc) Otherwise I over eat crap and gain weight easily
- skrebbel 10mo ago
  How many years have you been able to keep that diet up?
  - true2octave 10mo ago
    Particularly eating a lot of eggs daily for about 3 years
    - nradov 10mo ago
      The Time Magazine cover story in 1984 where they falsely claimed that consuming cholesterol from eggs and other sources was dangerous was a real turning point. That misunderstanding has caused tremendous harm to public health for decades. I think the journalists acted in good faith but they believed junk science. https://time.com/archive/6855517/hold-the-eggs-and-butter/ https://time.com/archive/6855517/hold-the-eggs-and-butter/ https://content.time.com/time/specials/2007/article/0,28804,1704183_1704257_1704499,00.html https://content.time.com/time/specials/2007/article/0,28804,...

jmward01 10mo ago

Other medications become lifelong medications but without this level of scrutiny. I am 100% in favor of finding a more permanent treatment, but switching blood pressure meds, and cholesterol meds, and other daily meds for a single once a week med is a massive improvement, especially since the all source mortality data keeps rolling in showing the efficacy here is orders of magnitude better than all the other medications out there. A constant issue here is that we keep calling this a 'weight loss drug' and society views being fat as a moral failing ant that you 'just don't have the will power' to overcome. We need to stop. If this is a lifelong drug it is worth it compared to the relatively ineffective, and just as lifelong, alternatives out there.

3rodents 10mo ago
I don’t think that’s a fair assessment. I’m all for life-long drugs that help with weight loss, I don’t view it as a moral failing. That said, it is easy to see why so many people are concerned about these drugs: people taking them can look terrible (“ozempic face”). Gaunt, sick, hollowed out, look at people like Sharon Osbourne, that’s the public face of these drugs. And so when people are committing to life-long use of these drugs, it is being viewed with the very visible side effects in mind, and that is concerning to a lot of people after these drugs seemingly appeared overnight.
- hamandcheese 10mo ago
  "Ozempic face" is actually just "unhealthy rapid weight loss face". Ozempic makes it easier to starve yourself, but that isn't how it's supposed to be used.
  - yellow_postit 10mo ago
    Many of the fly by night digital proscribes just jack the dosage to show rapid gains. Coupled with people lying on BMI to get a script is a bad combination and why it’s so obvious.
  - manmal 10mo ago
    It’s also accelerated muscle loss, even heart tissue. I‘m not saying it’s not worth it, but this should be kept on the radar for sure.

Asooka 10mo ago

Can't be worse long-term than inhaling nicotine, the previous widely deployed strategy to combat food cravings.

Taikonerd 10mo ago

Interesting link: a company called Fractyl Health is studying a surgical procedure they call "Revita," that they hope can keep weight off for patients after they discontinue GLP-1s.[0] 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. [0]: https://www.fractyl.com/our-platforms/revita/ https://www.fractyl.com/our-platforms/revita/

harvey9 10mo ago
Surprised this is still in first trial. I can recall reading about something like it in 2017. Apparently clearing the duodenal mucosa is a preparatory step for a gastric band fitting, but they found patients were making improvements before the bands were being fitted so a study was started to see if this less invasive procedure might be enough by itself.
hamandcheese 10mo ago
> Revita basically re-surfaces the duodenum. Does this reduce mucous production going forward? Otherwise, it seems like it would be a temporary effect.
- Taikonerd 10mo ago
  My impression (and I'm not a scientist) is that the mucosal overgrowth comes from eating an obesogenic diet. (Some combination of too much sugar / salt / wrong types of fat?) If you get the procedure and don't go back to an obesogenic diet, then it should be permanent.
  - deleted 10mo ago
    [deleted]
refibrillator 10mo ago

asciimov 10mo ago

> "The environment that people live in needs to be one that promotes health, not weight gain. […] Obesity is not a GLP-1 deficiency," he says. 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.

XorNot 10mo ago
That's what GLP-1 drugs are doing? Like...this is the premier argument as to why they work.
kiba 10mo ago
Until we are able to fix the environment and culture, we're stuck with medications like this. The good news is that glp1 medicine can be used to break addictive behaviors, so it is the very tool that can help change our environment by reducing demand for junk food. We still need to talk to our Congress critters.
diziet 10mo ago
I don't have a horse in this race, but from my personal experience eating satiating whole foods with lower glycemic index, higher fiber and protein content makes it very difficult to gain excessive weight. 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.
- randallsquared 10mo ago
  Before GLP-1s, there was rarely any such thing as "satiation" for me. Getting full was something that happened without the feeling of having had enough. The main effect of wegovy, for me, was having a feeling of not needing to eat rather than just feeling too full to eat. It was quite an experience, and one I am not sure I had had in more than 30 years.

jeffbee 10mo ago

I guess it's a dialect thing, but I have become accustomed to disregarding absolutely every article that employs the word "jab".

fogleman 10mo ago
That's just what they call it in British English, and this is a BBC article.
eterm 10mo ago
> (British) A medical hypodermic injection (vaccination or inoculation). From https://en.wiktionary.org/wiki/jab https://en.wiktionary.org/wiki/jab I hope that helps
XorNot 10mo ago
The word itself is just insufferable at this point. The media collectively went bonkers for it while describing COVID vaccine delivery.

kozikow 10mo ago

I did lose 30-40kg about 2 years ago on Ozempic. 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.

cryzinger 10mo ago
When you restart taking it after an "off" period, do you immediately resume whatever dose you were at before? Or do you taper up each time? (Curious because I know for many people, side effects level out after they've been at a given dose for long enough, but temporarily return whenever they increase their dose; not sure how "off" periods affect that kind of tolerance.)
paulpauper 10mo ago
I don't count calories. I went off Ozempic (now Mounjaro) and I gain weight at about 0.5-1kg a month. 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.

iwanttocomment 10mo ago

We need to start looking at obesity as a hunger disorder, and not as the result of an addiction, a lack of knowledge about nutrition, or a lack of self control. 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.

paulpauper 10mo ago
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. 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.
- shadowpho 10mo ago

Sol- 10mo ago

Then just continue to take them? The article just once seems to mention side effects and these were suspected to be related to rapid weight loss and less to the drug itself. 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.

spaceman_2020 10mo ago

If you’re substantially overweight, you have to wonder if the long term side effects of GLP-1 are better than being obese 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

maxaw 10mo ago

I definitely lost weight easily on wegovy and just as easily gained it back when I stopped taking it. The whole experience definitely drove home how I needed to improve my mental health alongside any “purely physical” intervention. Same situation when I lost weight by meticulously calorie counting. 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?

neom 10mo ago
Excuse the ramble: it maybe sucks more for people with eating addictions than alcohol in some sense. I am an alcoholic and I've been sober for, I dunno, years and years now. I did actually go to pubs and cocktail bars when I first got sober, I didn't drink I just sat and felt awful and wanted to drink badly. I felt I needed to learn how the feeling of the craving was going to work so I can plan for it etc, especially when stress creeps in. So, as another comment said, I got sober by stopping the first drink. For me it's very logical, if I have a drink, I will drink, I will not stop, I cannot stop, so if I take the first drink it doesn't matter that is is, it's done, so I don't drink the first drink since I decided that, hence sober. ...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.

lr4444lr 10mo ago

Question for people who have trouble losing fat (this was never my problem): have you ever tried instead of dieting to just force yourself to eat more fruits, vegetables, and protein daily while also allowing yourself free range in the remaining appetite room to have whatever? The human mind/brain/whatever doesn't do well with deprivation of a high dopamine reward, but what would happen if you started to shift your tastes by insisting that it get used to a more healthful diet as a precursor to getting what it wants? 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.

Fire-Dragon-DoL 10mo ago
Yes, I gained weight anyway. Sad, I hoped that was going to be my fix. 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.
shadowpho 10mo ago
One of my friends ate two pounds of tomatoes every evening and would not feel full. I couldn’t believe it until I saw it with my eyes….
- iteria 10mo ago
  I feel like they should try the potato diet. I recommend it, not because I believe it is effective (it wasn't for me), but because it is very good at removing the pleasure from eating. When you are eating to survive, you will come to understand how what being sated is. From there, I found I could lose weight because I had broken the habit of eating for any other reason than to fuel myself. Although, admittedly, I enjoyed losing weight this way better than the potato diet. With some people, I think they have just lost what being sated feels like.

daft_pink 10mo ago

I basically just gained the weight back again. 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.