I've posted about this before, but appetite mechanisms are set hard at a physiological level and weight tends to rebound regardless of how you lose it. Cautionary tale: As someone who did all the...
I've posted about this before, but appetite mechanisms are set hard at a physiological level and weight tends to rebound regardless of how you lose it.
Cautionary tale:
As someone who did all the "right" things - exercise, healthy diet, etc. and gained weight when my ability to exercise declined, I started taking a GLP-1 agonist knowing it was likely to be a permanent medication add. In no way did I "expect the drug to do all the work".
I've achieved a healthy BMI, and I'm still losing weight. What I'm most concerned about now is that there's little information on tapering the dosage so that I have enough appetite to maintain my goal and enough energy to exercise at something closer to my former intensity. Since I'm using compounded semaglutide, not prefilled syringes, I've attained the desired results at half (1.25 mg) the typical dosage (2.4 mg). I'm one of the lucky (?) strong responders. And yet there's no data on how quickly or how much I can reduce the dosage, and what effects besides weight gain might occur. It's going to be a process of experiment and guesswork.
My weightlifting benchmarks are down about 10 - 15% from the start of GLP-1 use, not terrible for a 30% bodyweight loss over 11 months. The problem is, I literally can't consume enough protein to ramp up again. More than 3x/week 30 min. cardio or HIIT is exhausting beyond measure, and I'd like to get back to 4 - 5x again - that's not going to happen if I can't eat more.
I've tried to make an informed choice about my health. I generally feel good at my current weight, and my cardiovascular risk factors are now normal or better. I understand that the existing incentives in healthcare and drug sales may not be working entirely to my benefit. It's certainly not in the drug maker's interest to sell less medication. There is data on longer term safety for semaglutide and other GLP-1 agonist drugs in Type II diabetes treatment, and more limited data on weight loss-only patients. Again, I expect that I'll be taking some dosage of semaglutide indefinitely, and it's already substantially lower than studied.
I feel like this would be the expected outcome anyways, no? You can’t just let the drug do all the work, unless you plan on taking it for the rest of your life, in which case there’s probably...
I feel like this would be the expected outcome anyways, no? You can’t just let the drug do all the work, unless you plan on taking it for the rest of your life, in which case there’s probably other side effects to worry about.
I’m willing to bet the cardiovascular/metabolic improvements wouldn’t go away as drastically if you also took steps to change your lifestyle to, for example, integrate physical activity into your daily routine more after the initial weight loss; just like with the eating habits themselves which will come back to sabotage you if you only rely on the drug to lessen your appetite without actively changing behaviors while you’re still on it.
The actually interesting conclusion from this seems to come from the “at least one” study that found
the regained weight after intentional weight loss may end up being proportionally higher in fat mass
– if this still holds for people who are physically active even after ending their treatment, it’s basically actively sabotaging the person trying to stop taking the drug…
I am however also pretty much certain that drug makers will have an answer to this, too, someday – the addressable market is just too many people to ignore the issues with the currently “best” medication for obesity (read: $$$ potential).
Also,
[The study authors] highlight that the study involved an abrupt withdrawal from the drug. In contrast, many patients may be interested in slowly weaning off the drugs, stepping down dosage levels over time.
I’m guessing this had a major effect on their results, too.
Why so? There's plenty of drugs that people take for life. Blood pressure medication, or diabetic medication (of which Ozempic is, for that matter), for example.
unless you plan on taking it for the rest of your life, in which case there’s probably other side effects to worry about
Why so? There's plenty of drugs that people take for life. Blood pressure medication, or diabetic medication (of which Ozempic is, for that matter), for example.
Very good point… and thanks for making me think about how I got to this conclusion: I actually completely confused the main takeaway from recent news about Ozempic’s effects and the correlation to...
Exemplary
Very good point… and thanks for making me think about how I got to this conclusion: I actually completely confused the main takeaway from recent news about Ozempic’s effects and the correlation to Alzheimer’s – I believed it was newly found that it had a negative correlation (worsening symptoms), whereas the finding “only” was that it doesn’t help improve the condition… two wholly different issues.
Kinda baffled right now that my reading comprehension apparently went radio silent around two days ago when I saw that article posted elsewhere and skimmed it. Doesn’t usually happen I swear 🥲
Edit: I think part of that was due to the mention of a noticeable stock price drop after these results were published. I probably mentally/subconsciously figured only an actually bad announcement could cause that, not a “neutral” one.
GLP-1 agonists probably aren't curative or able to slow existing neurodegeneration, but they might be long-term preventatives if started before the damage becomes symptomatic. Hypertension and...
GLP-1 agonists probably aren't curative or able to slow existing neurodegeneration, but they might be long-term preventatives if started before the damage becomes symptomatic. Hypertension and hyperglycemia are risk factors for Alzheimer's that are known to be reduced via weight loss and glycemic control.
Sarcopenia (muscle loss) happens in the context of weight loss by any method, if it isn't supplemented with aerobic and resistance training exercise plus a very high protein intake. GLP-1 agonist...
Sarcopenia (muscle loss) happens in the context of weight loss by any method, if it isn't supplemented with aerobic and resistance training exercise plus a very high protein intake.
GLP-1 agonist drugs aren't magic in this regard, either positively or negatively. Yes, there's research on combining them with medications to prevent muscle loss, but ultimately I'd agree with you that there needs to be wholesale lifestyle modification and counseling for healthy long-term maintenance. It's just that the research shows relatively few, very highly motivated people can maintain those restrictions in the face of all the detrimental highly palatable foods available, time constraints, and other limiting health conditions.
I don't think they did expect the drug to do all the work. [Emphasis mine]
I don't think they did expect the drug to do all the work. [Emphasis mine]
Then the participants were split into either continuing with the drug for another 52 weeks (88 weeks total) or getting a placebo for that period of time. Both groups were told to continue a reduced-calorie diet and an exercise plan.
You’re right, but “were told to” doesn’t imply they actually followed up whether the participants did do so. I don’t feel like actually checking right now (might later), but I’m guessing not...
You’re right, but “were told to” doesn’t imply they actually followed up whether the participants did do so. I don’t feel like actually checking right now (might later), but I’m guessing not everyone stuck to that program.
There were 54 people that continued losing weight. I bet those folks were the ones that made diet changes and started exercise plans then stuck to it. Ozempic doesn't let you defy calorie in...
There were 54 people that continued losing weight. I bet those folks were the ones that made diet changes and started exercise plans then stuck to it. Ozempic doesn't let you defy calorie in calorie out, it helps you reduce your calorie in.
Makes sense. I'm on a medication for my cholesterol for life, knowing that my quality of life is dependent on continuing to take it. For anyone whose health depends on it, this isn't a surprise,...
Makes sense. I'm on a medication for my cholesterol for life, knowing that my quality of life is dependent on continuing to take it. For anyone whose health depends on it, this isn't a surprise, it's how it works. It certainly cuts down on the usefulness of it as a general purpose weight loss drug, though.
An analysis published this week in JAMA Internal Medicine found that most participants in a clinical trial who were assigned to stop taking tirzepatide (Zepbound from Eli Lilly) not only regained significant amounts of the weight they had lost on the drug, but they also saw their cardiovascular and metabolic improvements slip away. Their blood pressure went back up, as did their cholesterol, hemoglobin A1c (used to assess glucose control levels), and fasting insulin.
At least one study has found that the regained weight after intentional weight loss may end up being proportionally higher in fat mass, which could be harmful.
“These results add to the body of evidence that clinicians and patients should approach starting [anti-obesity medications] as long-term therapies, just as they would medications for other chronic diseases.”
I think treatments like this need to be done in combination with some exercise in order to build up some muscle mass so if you do stop taking the treatment you have some long term health...
I think treatments like this need to be done in combination with some exercise in order to build up some muscle mass so if you do stop taking the treatment you have some long term health improvements to fall back on. Appetite suppression alone will never be a permanent solution unless you're solution is to be permanently on the treatments.
I've posted about this before, but appetite mechanisms are set hard at a physiological level and weight tends to rebound regardless of how you lose it.
Cautionary tale:
As someone who did all the "right" things - exercise, healthy diet, etc. and gained weight when my ability to exercise declined, I started taking a GLP-1 agonist knowing it was likely to be a permanent medication add. In no way did I "expect the drug to do all the work".
I've achieved a healthy BMI, and I'm still losing weight. What I'm most concerned about now is that there's little information on tapering the dosage so that I have enough appetite to maintain my goal and enough energy to exercise at something closer to my former intensity. Since I'm using compounded semaglutide, not prefilled syringes, I've attained the desired results at half (1.25 mg) the typical dosage (2.4 mg). I'm one of the lucky (?) strong responders. And yet there's no data on how quickly or how much I can reduce the dosage, and what effects besides weight gain might occur. It's going to be a process of experiment and guesswork.
My weightlifting benchmarks are down about 10 - 15% from the start of GLP-1 use, not terrible for a 30% bodyweight loss over 11 months. The problem is, I literally can't consume enough protein to ramp up again. More than 3x/week 30 min. cardio or HIIT is exhausting beyond measure, and I'd like to get back to 4 - 5x again - that's not going to happen if I can't eat more.
I've tried to make an informed choice about my health. I generally feel good at my current weight, and my cardiovascular risk factors are now normal or better. I understand that the existing incentives in healthcare and drug sales may not be working entirely to my benefit. It's certainly not in the drug maker's interest to sell less medication. There is data on longer term safety for semaglutide and other GLP-1 agonist drugs in Type II diabetes treatment, and more limited data on weight loss-only patients. Again, I expect that I'll be taking some dosage of semaglutide indefinitely, and it's already substantially lower than studied.
I feel like this would be the expected outcome anyways, no? You can’t just let the drug do all the work, unless you plan on taking it for the rest of your life, in which case there’s probably other side effects to worry about.
I’m willing to bet the cardiovascular/metabolic improvements wouldn’t go away as drastically if you also took steps to change your lifestyle to, for example, integrate physical activity into your daily routine more after the initial weight loss; just like with the eating habits themselves which will come back to sabotage you if you only rely on the drug to lessen your appetite without actively changing behaviors while you’re still on it.
The actually interesting conclusion from this seems to come from the “at least one” study that found
– if this still holds for people who are physically active even after ending their treatment, it’s basically actively sabotaging the person trying to stop taking the drug…
I am however also pretty much certain that drug makers will have an answer to this, too, someday – the addressable market is just too many people to ignore the issues with the currently “best” medication for obesity (read: $$$ potential).
Also,
I’m guessing this had a major effect on their results, too.
Why so? There's plenty of drugs that people take for life. Blood pressure medication, or diabetic medication (of which Ozempic is, for that matter), for example.
Very good point… and thanks for making me think about how I got to this conclusion: I actually completely confused the main takeaway from recent news about Ozempic’s effects and the correlation to Alzheimer’s – I believed it was newly found that it had a negative correlation (worsening symptoms), whereas the finding “only” was that it doesn’t help improve the condition… two wholly different issues.
Kinda baffled right now that my reading comprehension apparently went radio silent around two days ago when I saw that article posted elsewhere and skimmed it. Doesn’t usually happen I swear 🥲
Edit: I think part of that was due to the mention of a noticeable stock price drop after these results were published. I probably mentally/subconsciously figured only an actually bad announcement could cause that, not a “neutral” one.
GLP-1 agonists probably aren't curative or able to slow existing neurodegeneration, but they might be long-term preventatives if started before the damage becomes symptomatic. Hypertension and hyperglycemia are risk factors for Alzheimer's that are known to be reduced via weight loss and glycemic control.
Sarcopenia (muscle loss) happens in the context of weight loss by any method, if it isn't supplemented with aerobic and resistance training exercise plus a very high protein intake.
GLP-1 agonist drugs aren't magic in this regard, either positively or negatively. Yes, there's research on combining them with medications to prevent muscle loss, but ultimately I'd agree with you that there needs to be wholesale lifestyle modification and counseling for healthy long-term maintenance. It's just that the research shows relatively few, very highly motivated people can maintain those restrictions in the face of all the detrimental highly palatable foods available, time constraints, and other limiting health conditions.
I don't think they did expect the drug to do all the work. [Emphasis mine]
You’re right, but “were told to” doesn’t imply they actually followed up whether the participants did do so. I don’t feel like actually checking right now (might later), but I’m guessing not everyone stuck to that program.
There were 54 people that continued losing weight. I bet those folks were the ones that made diet changes and started exercise plans then stuck to it. Ozempic doesn't let you defy calorie in calorie out, it helps you reduce your calorie in.
I believe the new ones also increase the calories out by turning up the basal metabolic rate as well.
Makes sense. I'm on a medication for my cholesterol for life, knowing that my quality of life is dependent on continuing to take it. For anyone whose health depends on it, this isn't a surprise, it's how it works. It certainly cuts down on the usefulness of it as a general purpose weight loss drug, though.
I think treatments like this need to be done in combination with some exercise in order to build up some muscle mass so if you do stop taking the treatment you have some long term health improvements to fall back on. Appetite suppression alone will never be a permanent solution unless you're solution is to be permanently on the treatments.
That is what drug dealers, um... pharmaceutical producers want.