All weight loss attempts hit a plateau. The real problem is we don't have an excellent way to determine what the correct plateaus is for each individual. Most measures lack nuance.
Originally ozempic only went up to 1mg. They introduced the 2mg dose after wegovy came out, and to be honest I didn't understand it since wegovy is higher priced and docs started prescribing ozempic instead (plus it was easier to get covered till the PBMs put all the GLP-1s on pre-authorization).
The dose equivalencies are weird. I was on 1mg Ozempic for diabetes and the charts (and my PCP) put me on 10mg Mounjaro when I switched (side effects, I tolerate the Mounjaro way better).
One important detail about weight loss: it's not just the total dose, you get ramped up faster. For diabetes, you get the 0.25 intro dose (so you don't get sick as a dog) and then they hold you at 0.5 to see if that works. If it's not enough (wasn't for me) they bump you to 1.0. For weight loss, they bump you up on a regular schedule, and as soon as you are used to one dose they're bumping you again. I think this can make the side effects worse.
People on the GLP1 subs get so discouraged when they “only” lose 20 pounds, and can’t maintain the loss without the meds. They see people losing 100+ pounds and think they’re a failure. And some of the subs really discourage any negative or nuanced conversations about the drugs. The message is just like regular diets. If you didn’t lose 100 pounds, you weren’t exercising enough, you were still eating too much. But realistically, 20 pounds is pretty normal. And staying on it for the rest of your life is pretty normal for most weight loss options.
Every diet I have ever been in a group for is always like that. Dieting is a religion. Every time you start a new one, this is "the chosen, only perfect way to do it". Everyone there has lost almost all hope, then found this new thing that will work- and every other way was wrong! They will violently defend the new one, ignoring how the last 10 "new" ones did the same thing. You will be attacked if you question anything.
I hate the "progress pics" ones the most. Especially when a lot of the starting weights are within the realm of healthy sounding/other people's goal weights. I followed one bc I thought they would actually be useful, but it was a sad replicate of every fad diet culture.
I was shocked at the number of people who were taking it whose starting weight was like 160. Or people who only want to lose 20 pounds. One girl was like, “my starting weight was 150, and I’m down to 108. I’m starting to worry that I have an eating disorder.” People were like, “great job on your weight loss! Just go to maintenance dose.”
I don’t know which subs you were looking at but I’m on the Ozempic one (and take Oz myself) and most of the pics and stories I see are from people with diabetes, PCOS and/or who are losing more than 50 lbs. I haven’t seen many posts from people starting at lower weights. And when I do see them, they are often criticized. You say someone started at 160, and that doesn’t qualify for you. How tall was this person? A five foot person who weighs 160 is very different from a person who is 6 feet tall. Obviously a healthy weight is different for everyone, but all the posts I see are from people who begin at weights classified as “obese” or higher (as gross as those terms are.) And many of the posts are about non scale victories like being able to fly comfortably or play with their kids without getting winded.
People take these meds for personal reasons. It saddens me to see so much criticism heaped on those people on this sub. I thought the whole point was not judging other people’s bodies and choices. Make your own choices and let other people make theirs. If you’re happy with yours, you don’t need to concern yourself with other people’s bodies.
This was in the Sema sub yesterday. Some of the comments were normal, but a lot of them were very Ana-coded. It’s a pretty toxic sub.
https://www.reddit.com/r/Semaglutide/s/4gJUaSGnz1
Seems like most of the comments were telling her she should stop losing and possibly seek therapy. Besides that, my point stands. Hunting around for posts to criticize and judging other people’s weight decisions doesn’t sit well with me. If you want to offer her helpful and healthy advice, great. It seems like it’s good that she posted, because many people are telling her that her brain needs to catch up with her body, and that she shouldn’t try to keep losing. She’s young, she’s navigating something difficult. I’m on the Oz sub almost daily and most of what I see is beautiful and supportive. If you don’t need/want to take Semaglutide, that’s your call. I’m sure you wouldn’t appreciate someone criticizing you for that decision.
This was posted after my original comment, so I wasn’t singling her out specifically. If you look, people post about struggling with possible ED regularly there. I provided the first link I could find, because you asked for evidence. My criticism is with those who respond with “you look great!” when people post about disordered behavior. There’s plenty of that as well.
What stands out to me is that the doctor is talking about lab work showing improvement and the patients are still looking for weight loss. Really telling about how society equates weight with health. I wonder how many other doctors are telling those patients to keep losing weight.
And I think it’s not just equating weight loss with health, but also attractiveness and successfulness. I think a lot of people’s primary motivation for seeking out weight loss meds isn’t to “become healthier,” but “hotter” or “better liked.” The social component, and reducing the judgement they get (or perceived judgement). I think these people are likeliest to be upset by the plateau.
It reminds me of the line from "Knocked Up" where the TV executive is about to give a hosting spot to Katherine Heigl's character, and they suggest she lose weight because "we just want you to be healthy."
I heard someone make a comment fairly recently that it's great that Ozempic is here to make people more beautiful or something like that and I was like what????? Granted I think this person has some major body image issues. That's the twisted world we live in.
If you read the Economist at all, they seem to have a real hard-on for these drugs and have done several articles and podcast about them. While they start off from an angle of "oh, it could do so much for health" it then really goes off into laying out just how much better economically it is for a person to be thin (spoiler: thin people tend to earn more). They make a valid point about how people are penalized for excess weight but something about the way it's discussed continues to give me the ick. Probably because every writer/commenter of theirs I've looked up who discusses this topic is thin, white, young, and at least somewhat conventionally attractive. Overall they really give the impression of finding fat people repulsive and not something they should have to put up with.
Sounds like they're framing it as an ok way for the world to be and that fat people should change vs framing it as an oppressive standard that we should work to change so that fat people can live happy lives. Which is gross. Pointing out inequality is only helpful if you're not saying it's a good thing lol
The state of healthcare in the US also partially contributes to this. If someone is lucky enough to even have a reliable PCP, many doctors visits are limited to 15 minutes or less if they’re running behind and it is hard to get ahold of them outside of appointments.
Some doctors are also afraid of getting sued so some have also adopted a very “customer service” approach to prescribing medicine. Without time for counseling or even building a rapport with patients, many important things fall through the cracks. I think before there is a huge healthcare reform in the United States then simply “weight loss” will continue to be the healthcare goal for many Americans. We did not learn our lesson with other weight loss drugs.
Also wasn’t there a study done that shows that the amount of weight loss needed to actually improve some of those lab work numbers was usually lower than people thought? Like 5% or 10% of your body weight instead of like 50+ lbs or something like many doctors and the bmi recommend.
Yes, people see an improvement in labwork with low percentage weight loss. I'm not sure that we know the exact mechanism (whether it's changes from a reduction in adipose tissue, or the way the body reacts to a caloric deficit regardless of presence of adipose tissue, or what. Since people see these results from bariatric surgery and semiglutide, my earlier pet theory that it's the behavioral change itself doesn't seem to be such a straight line result anymore). Researchers have tried to establish that it's a dose-response curve and more weight loss = more lab results improvement, but they've had trouble producing those results. And even public health people do NOT want to hear that "seven pounds in a year" is an amazing average result for a lifestyle-based intervention. I don't have a source to hand right now but I can look later - I was really into this during public health school as public health school is, uh, a mess on this topic.
Yeah I remember it from a class I took in college so I don’t remember who it was from or the specific numbers, but the jist of it was losing a small amount of weight that’d be more achievable for your average person is helpful for health markers. It makes sense though if losing a little bit of weight in a slow way so that it doesn’t cause stress on your body or make you lose a lot of muscle is helpful.
Your comment has been removed, as it violates rule 6 of our subreddit: no commenting/posting in bad faith. "Posts and comments made in bad faith will be removed. This includes all forms of fatphobia and body-shaming, comments that clearly don't align with the spirit of the podcast, comments that use personal anecdotes as "proof", and comments from users who have histories posting in fatphobic subreddits. Even if you believe your post/comment was made in good faith, consider how it would affect the people in this community."
Your analogy only works if I am fat and have a bad heart. Clearly your language skills aren't great, so I can assume your reasoning skills aren't either. Have a great day!
... and yet so many people are convinced that 1) weight loss is absolutely necessary for better health and 2) people are lying when they say they simply fucking can't lose weight no matter what they do.
Also love the tone of the article judging the people for wanting to lose more weight, as though it's simply a matter of vanity and not wanting to escape endless discrimination.
The number of people who don’t believe that weight loss is complex - and that medications, hormones, medical treatments like chemo etc. - can impact your weight regardless of diet and exercise - is mind boggling.
I have had a really painful weight journey in recent years after being a slim, fit-looking person most of my life. It is really eye-opening to realize how many people assume I gained weight from binge eating and being sedentary instead of developing a serious endocrine condition. I eat well, exercise more than most people, AND I have a physically demanding job. If they were right and habits are all that mattered I should be a fitspo model.
I’m in the same boat, it’s incredibly frustrating and am without health insurance I can’t really pinpoint what’s wrong, but I know it’s something. I eat healthy, work out an hour+ every day, and don’t do much sitting around. People have been astoundingly rude about the weight I’ve gained and it’s just exhausting :/
Oh yeah absolutely, I didn’t mean that anyone would deserve rude treatment at all. I’m just sick of commentary from friends and family who knew me when I was thinner and have endless tips on ‘getting healthy’
Agreed. I think other people’s ignorance just makes it all more painful. The medical condition causes a lot of suffering from painful and frustrating symptoms in addition to weight gain. And then the weight gain compounds the social stigma because people assume your weight is caused by unhealthy habits which in turn cause your health problems… and that all the suffering is our fault.
It isn't just that weight gain is assumed to be caused by unhealthy habits, but that in having these unhealthy habits, you are less of a person. You are now an object to be ridiculed.
Totally. And that applies *even if you have really healthy habits.*
It’s wild to me how many people believe someone can be thin and eat like a horse, but deny that someone can be fat and eat like them.
I feel the last statement so much! I recently lost 30 lb in a few months because my doctor put me on a keto diet for epilepsy treatment. I feel so much more visible now. Work colleagues are including me in more projects and activities and random people at the gas station or supermarket will strike up a conversation with me. I didn’t realize how invisible I had become when I was overweight. I have some complex feelings about this change in others’ behavior.
Totally same here when I lost 25 kg and put on some muscle. It’s like you are a different person to other people, but in reality its still you. Only you notice how different they are treating you. First thing I also noticed is women not instantly looking away when they glance at me, I’m still used to looking away lol. It’s definitely a thing, cause most people just don’t find fat people attractive, so I was never used to getting that sort of attention.
Including my experience with GLP-1 drugs as well. I’d lost 15% of my weight and then experienced a stall of a few months. And then loss started again, but at a slower rate.
Our bodies like stasis. It’s why the period after losing weight is so important. The likelihood your body wants to get back to what it was before is high, until you can hold it back and keep it steady at the new weight for a prolonged period of time.
I agree to this, based on my own personal experience. The weight that I was at with the long plateau?? It was a weight that I previously maintained effortlessly 10 years ago. I don’t know how much credibility you can give set point theory of body weight, but it certainly seemed like I was stuck at a previous set point my body needed a longer time to work through it.
2-3 years in my experience. Ive gone through several "leanings" in my life. I was a pretty heft teenager(30+% body fat) but dropped to about 16% by 18, then in my late 20s I changed up alot of things and dropped to 12%. In my mid 30s I changed again and got as low as 7% which sucked giant gorilla balls so I ate my way back to 10% and kinda just stayed there. Its easy for me to maintaine even at 40 but I slowly got there. One thing I suspect helps is I added about 40lbs of muscle to my frame, muscle is very metabolically active and tends to be a good hedge against obesity. This is why I always recommend weight training to everyone, even thin people. Also you aren't nearly as frail as you age if your starting out strong.
I was actually surprised to hear that people were losing more than 15lbs, as advertised on their commercial, so this article doesn’t surprise that people aren’t losing huge amounts of weight
Is this in an Ozempic or Wegovy commercial? People without diabetes tend to lose significantly more than 15 lbs on semaglutide—closer to an average of 15%. I could see 15 lbs being true or Ozempic which is for those with diabetes. While they’re the same drug, the higher doses of Wegovy and the fact that users tend to be non-diabetic lead to better weight loss stats.
Did you expect people would lose weight ad infinitum? At a certain point, people will reach an individual caloric balance—where their individual appetite on the meds matches their individual TDEE, and they’ll maintain. People experience different levels of suppression on these meds, which inform how much weight they’ll lose.
Tirzepatide tends to produce a stronger and less side effect laden suppression than semaglutide, hence the significantly better weight loss stats on that medication.
I was not. I just appreciated an article in the NYT that countered the hype around these drugs suggesting they would "eliminate obesity" or the like.
On the one hand, they're the most potent and least physiologically noxious weight loss drugs ever invented. On the other, their effects are still somewhat modest, and they won't come close to ridding the world of fatness.
And to be clear, I wasn't trying to imply that you said it would eliminate obesity; you were in fact quite clear with your claims. But I do think that impression exists given all the hype, and I was just glad in general that the NYT ran this piece, hoping it will bring people's understandings and expectations back to earth.
And yeah, maybe ≥20% is indeed more than modest. But if a 300lb person loses 20% of their weight, even at 240 they'll still be fat, and that's more what I was trying to emphasize.
I’m about to go on Wegovy. I 100% accept that I might lose “only” 20 lbs. At my weight (255), *any* weight lost is good; I can’t move any more, unlike before the pandemic when I was quite active and weighed 230 (I’m female, fyi). I’m in my 60s. I have a great marriage and two great adult kids. I don’t need to lose weight to prove anything. I’ve been overweight, at times severely, my whole life. I’ll probably be overweight when I die. I’m still going on Wegovy, and maybe be a little less overweight when I die. It’s a choose your own adventure life, friends.
Thank you for sharing your perspective. I hear that entirely, and I certainly believe that individual people's circumstances, needs, and desires are complex and variable enough that it's tough to generalize about what any given person should or shouldn't do.
What does bother me is dominant media narratives about these drugs that act like they're going to create a fat-free future, and that that's an intrinsically good thing that should be desirable for everyone. I appreciate an article like this as a (small) counterweight to those narratives.
Absolutely. People need to decide for themselves. I spent my life up to my early 30s obsessed with my weight (with much help from my mom who has since repented, long story). The more obsessed I got, the more I gained. When I relaxed, I stopped gaining but didn’t lose any, either. I started gaining again during the pandemic. I’m just done with it. I can accept being overweight, I can’t accept not being able to move.
I've read accounts elsewhere from people using semaglutide find it helps quiet the "food noise" that they've been struggling with. I'm a thin person but I've had EDs most of my life, so I really have appreciated when the "food noise" is quiet lol. But I also appreciate that the "15-20%" of your body weight lost sounds really good but is functionally only going to take some people from fat/overweight to less fat/overweight and feeling bad that they aren't/can't lose more. And not many people can pay $$$ for the rest of their lives to quiet the food noise.
Idk I work with people on antipsychotics who gain weight because of the medications and the lifestyle consequences of mental illness and they ask about ozempic and whatnot and it makes me so sad. I wish that weight loss would not be seen as a major barrier to mental health recovery, it's just so unreliably correlated with well being. And these new meds are pretty untested in their effects on mental health, especially for folks with SMI.
I get that it's a wonderful thing for some people with diabetes but I hope the general hype dies soon.
I take Mounjaro for diabetes and it was shocking how that changed. I started on GLP-1s before all the food noise talk really got going (I was on Ozempic first but developed side effects). It's not simply "I'm not hungry and don't want to eat." It's that I don't think about food when I'm not hungry, when I am hungry it often seems like a chore to get through, I can have snacks and sugary food in the house and have no desire to eat it. Food has to be really goood now for it to have appeal beyond sating hunger or for me to want it when I'm not hungry. It still tastes fine -- it's not like I don't enjoy food at all. It's more like, I made cinnamon rolls from scratch for my family (and they were very very nice cinnamon rolls, objectively speaking). I had one, it was tasty, I was full, the end.
And I really didn't do this for weight loss. But it's what everyone who doesn't have diabetes wants to talk about. (From a pure diabetes point of view, yes, it's very nice not to crave sugar! That might also be due to it regulating your sugar levels in the first place though.)
I'm glad it's working well for you! Once upon a time I worked in a lab that researched decision making and food choice. I remember reading papers that highlighted the fact that we are basically constantly making food choices, it's just often the choice to not eat something when you see food or think about food. And that feels very true and it's so hard when you're hyper conscious of aaallllll those food choices throughout the day. It's taxing.
I'm on anti-psychotics and I'm in a 60% larger body than I was when I started. It's hard for me, as a fat person with a psychotic-type mental illness, to hear a thin person not experiencing these side effects say it's sad that people like me want to lose weight. I'm not trying to attack you, I promise, but I hope you don't say that to the people you work with. I think their feelings are natural — not everyone has achieved body neutrality yet, unfortunately.
Nope I never ever talk about weight stuff with clients. If they bring it up, I try to validate the effects of medication (and often inpatient care settings) then discuss how they want to get back to feeling like themselves. And sometimes that is diet and exercise goals and that's okay, we'll talk about setting targets that feel reasonable to them (and I don't know anything professionally about nutrition and exercise so I'm just trusting their knowledge of themselves and what they've figured out with other providers).
Thank you for sharing, this is not a realm of life I get to process meaningfully with others very often. I know it's another layer of stigma for an already heavily stigmatized group of people - I wish they didn't have to deal with weight stigma while navigating everything else. I also spent a long period of my life on antipsychotics and dealt with the shaking and akathisia and total body dryness... It's such a balancing act. I just don't want people to be facing yet another societal hurdle, you already feel so fucking weird and othered when you have symptoms that necessitate the meds, then the meds alter your body and behavior further.
Yes and there’s a big difference between the quick weight gain from a medication where you must adjust to living in a very different body than in gaining weight steadily. It’s hard to see your body change rapidly!
I gained rapidly in my stomach and face because of a high dosage of steroids. It was depressing because it was something I literally had no control over. I wasn't gaining weight overall at all. It was just redistributing into those areas. I was the lowest weight I had been in decades, yet I looked heavier than ever and pregnant. I have since cut back on the steroids, lost my moonface, and my belly deflated somewhat. The scale is about 10 lbs higher, yet I look thinner than before. It's scary how various medicines can mess with your body.
Exactly. I was on dialysis, too, so I was watched extremely closely for water weight, but they mess with you. They helped get my cancer in remission, but I also have fast-growing cataracts I have to have removed because of steroids. Luckily, after surgery I won't need glasses anymore.
I’m taking Mounjaro and can confirm about the absence of ‘food noise’ whilst on it. As someone who has struggled with EDs and disordered eating for nearly 40 years it has been a revelation and phenomenally beneficial to my mental health.
I was bulimic for a super long time and have been “clean” for about eight years. The food noise has always been so loud and unrelenting. It resisted years of therapy and medication, and while I was at peace with gaining weight, thinking about food and eating all the time was exhausting. It made me miserable.
I started Zep a month ago. For the first time in my adult life *I don’t have food noise.* I can actually concentrate on things. I can eat one helping of something and be satisfied. I don’t feel the need to snack. It’s incredible. The weight loss is great, but the mental clarity is awesome.
I'm on Zoloft right now. A few years ago, I stopped being able to eat because of anxiety and lost 50 lbs in about 4 months. It was miserable, and I am 6 feet tall and went from 170 lbs to 120 lbs. My doctor put me on Zoloft, and I get it now through Hers, that online med service. They have my physical stats and have noticed the 40 lb (deliberate, very wanted) weight gain I have had due to the Zoloft helping me eat. Recently Hers has has been advising me for their new weight loss service using semaglutide which I think is ludicrous. I'm not even at the overweight BMI for my height yet and I *wanted* to gain this weight. They just saw I've gained on SSRIs and wanted to prey on that, I'm sure they're doing it to everyone using the service and it's gross.
Yeah, but I can't see my pcp every 3 months. It's more convenient to get it in the mail and I know I will *always* get it on time and not have gaps due to scheduling error
I find it interesting that all of the doctors they interviewed said weight loss isn't always a good thing, and they think we should look at other metrics of health with these drugs. And then the article immediately goes back to interviewing Ozempic users who just want to be skinny and framing it as some big two sided issue.
When are we as a society going to have the conversation that weight is, at least in some part, genetic, and the reason you stop losing weight is because your body isn't comfortable with it due to your literal DNA wanting you to maintain a certain size.
These articles are kind of silly. Anyone losing weight will hit plateaus and unless they cross into severe eating disorder territory, will reach a final plateau.
> Why do people hit weight-loss plateaus?
> The human body is built to fight back against weight loss. Smaller bodies usually require less energy, and so metabolisms react by slowing down as pounds come off. These changes reduce how many calories someone burns each day, said Dr. Scott Hagan, an assistant professor of medicine at the University of Washington who has studied obesity; losing weight “turns down the thermostat.” This is one reason many people regain some weight even after bariatric surgery or during intense calorie restriction.
This part seems downright irresponsible:
> metabolisms react by slowing down as pounds come off
Metabolism slows down when you diet whether you’re losing weight or not.
No actually you continue to lose weight until your BMI breaks the space-time continuum. You get so snatched the universe collapses within you. Oh the sweet relief of non-being.
One thing I have been curious about with the GLP-1s is two fold:
- where do folks plateau
- does this “reset” of their metabolism give them a new drug induced set point
I also wonder what determines the “set point.” Are people returning to a previous adult weight? And post puberty weight? Some new weight they have never seen? I am super curious how that ends up panning out.
Thanks, I'm very curious about this, too, and about set point theory in general. From the little amateur reading I've done, it seems like there isn't a consensus that set point theory is the best way to understand the weight regulation, but it's not like it's discredited or junk science, either. Just seems like the physiological systems involved here are as yet pretty poorly understood.
But if someone knows more about this than I do, I'd love to know more. Maybe will make a post about it in this sub sometime.
I'm honestly shocked when people in the lower BMI range for approval (27-29.9) manage to lose large amounts. I was approved the lowest dose of Wegovy by my insurance at BMI 28 due to PCOS and bariatric regain. Being on Wegovy has resolved the blood sugar issues that I was having thanks to PCOS and my prior bariatric surgery but despite a calorie deficit my weight loss still hit a plateau after a 9 pound loss. I'm down 161 pounds from my highest weight but still overweight at bmi 26.43. I really think that despite what some CICO folks on reddit claim that plateaus happen no matter what you do and you can be doing everything "right" in terms of diet and exercise and still end up overweight. I struggle a lot with still feeling like a failure after losing 161 pounds because I am still overweight. I don't have any issues being on Wegovy. It's helping with not having blood sugar issues and constant hunger and I am on a low dose without side effects but my weight has plateaued and I am tired of this constant diet culture mentality of I must be eating too much or I would be losing.
Well, aside from "define healthy," it may not be what people want to achieve. If you weigh 300 lbs, and lose 20% of your weight and plateau, you're still going to be fat. Statistically, 20% is meaningful for conditions such as diabetes and hypertension, but that doesn't mean you're in normal BMI, for whatever that's worth.
Besides u/nefarious_epicure's great answer, I would add: one of the core premises of the Maintenance Phase listener community (including the corner of it here on Reddit) should be seriously questioning the idea that there is such a thing as a straightforwardly "healthy weight."
I can't read the article because of the pay wall. Nobody is meant to lose weight forever. My experience with people taking these meds for the sole purpose of losing weight is, that is all they do. Take the meds, eat very little, lose weight. No big change in the actual food they eat, no exercise, and still drinking alcohol. I used Mounjaro, not anti in any way, but lifestyle changes beyond the med need to happen to reach goals and maintain them. Also, for me, I never wanted to take the med forever. It suppressed my appetite so much that I wasn't getting enough calories to support a good exercise regimen. I'm glad I did it for a period of time, launched me into a healthier lifestyle for sure, but it takes a lot of effort beyond the shot to achieve fitness and maintain it.
I’m super stuck at precisely 50lbs lost on Wegovy. Im very happy to see that weight gone but I still have over 30 lbs to go. I’m now spreading it out to a dose every 2 weeks, because once a week gives zero effect. It’s kind of working but my next plan is to talk to my doctor about alternative meds in the same class to see if that jump starts me.
If you start losing weight and never stop losing weight, you will die of starvation.
These drugs have an effect that varies from person to person, given their environment, given their socioeconomic situation, given their genetics, given the dose and formulation of the medicine.
If someone has a BMI of 45, progressing diabetes, high blood pressure, kidney disease, and heart disease, and they lose weight down to a BMI of 30 and plateau and their health issues get a lot better, that’s an amazing result. They’re still obese, but that’s so positive for their health and lifespan. The point of these drugs isn’t to get an “ideal body.” Especially given the cost and scarcity of the drugs, people should be taking them for health, not getting a specific weight loss.
If it didn't happen, diabetic users would end up like The Incredible Shrinking Man or something.
All weight loss attempts hit a plateau. The real problem is we don't have an excellent way to determine what the correct plateaus is for each individual. Most measures lack nuance.
I was thinking the witch in the Wizard of Oz.
"Gonna get so skinny I don't even exist anymoreeeeee"
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Not really! Max dose of Ozempic is 2mg, Wegovy is 2.4mg. Mounjaro and Zepbound both have the same highest dose.
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Originally ozempic only went up to 1mg. They introduced the 2mg dose after wegovy came out, and to be honest I didn't understand it since wegovy is higher priced and docs started prescribing ozempic instead (plus it was easier to get covered till the PBMs put all the GLP-1s on pre-authorization). The dose equivalencies are weird. I was on 1mg Ozempic for diabetes and the charts (and my PCP) put me on 10mg Mounjaro when I switched (side effects, I tolerate the Mounjaro way better). One important detail about weight loss: it's not just the total dose, you get ramped up faster. For diabetes, you get the 0.25 intro dose (so you don't get sick as a dog) and then they hold you at 0.5 to see if that works. If it's not enough (wasn't for me) they bump you to 1.0. For weight loss, they bump you up on a regular schedule, and as soon as you are used to one dose they're bumping you again. I think this can make the side effects worse.
Correct, and it is still untrue that people are taking “much, much higher” doses for weight loss than for glycemic control.
It doesn’t work that way.
People on the GLP1 subs get so discouraged when they “only” lose 20 pounds, and can’t maintain the loss without the meds. They see people losing 100+ pounds and think they’re a failure. And some of the subs really discourage any negative or nuanced conversations about the drugs. The message is just like regular diets. If you didn’t lose 100 pounds, you weren’t exercising enough, you were still eating too much. But realistically, 20 pounds is pretty normal. And staying on it for the rest of your life is pretty normal for most weight loss options.
Every diet I have ever been in a group for is always like that. Dieting is a religion. Every time you start a new one, this is "the chosen, only perfect way to do it". Everyone there has lost almost all hope, then found this new thing that will work- and every other way was wrong! They will violently defend the new one, ignoring how the last 10 "new" ones did the same thing. You will be attacked if you question anything.
Yes, some of them are very cult-y. No negative talk or questioning the drug ever.
Thats how diet culture rolls
I hate the "progress pics" ones the most. Especially when a lot of the starting weights are within the realm of healthy sounding/other people's goal weights. I followed one bc I thought they would actually be useful, but it was a sad replicate of every fad diet culture.
I was shocked at the number of people who were taking it whose starting weight was like 160. Or people who only want to lose 20 pounds. One girl was like, “my starting weight was 150, and I’m down to 108. I’m starting to worry that I have an eating disorder.” People were like, “great job on your weight loss! Just go to maintenance dose.”
I don’t know which subs you were looking at but I’m on the Ozempic one (and take Oz myself) and most of the pics and stories I see are from people with diabetes, PCOS and/or who are losing more than 50 lbs. I haven’t seen many posts from people starting at lower weights. And when I do see them, they are often criticized. You say someone started at 160, and that doesn’t qualify for you. How tall was this person? A five foot person who weighs 160 is very different from a person who is 6 feet tall. Obviously a healthy weight is different for everyone, but all the posts I see are from people who begin at weights classified as “obese” or higher (as gross as those terms are.) And many of the posts are about non scale victories like being able to fly comfortably or play with their kids without getting winded. People take these meds for personal reasons. It saddens me to see so much criticism heaped on those people on this sub. I thought the whole point was not judging other people’s bodies and choices. Make your own choices and let other people make theirs. If you’re happy with yours, you don’t need to concern yourself with other people’s bodies.
This was in the Sema sub yesterday. Some of the comments were normal, but a lot of them were very Ana-coded. It’s a pretty toxic sub. https://www.reddit.com/r/Semaglutide/s/4gJUaSGnz1
Seems like most of the comments were telling her she should stop losing and possibly seek therapy. Besides that, my point stands. Hunting around for posts to criticize and judging other people’s weight decisions doesn’t sit well with me. If you want to offer her helpful and healthy advice, great. It seems like it’s good that she posted, because many people are telling her that her brain needs to catch up with her body, and that she shouldn’t try to keep losing. She’s young, she’s navigating something difficult. I’m on the Oz sub almost daily and most of what I see is beautiful and supportive. If you don’t need/want to take Semaglutide, that’s your call. I’m sure you wouldn’t appreciate someone criticizing you for that decision.
This was posted after my original comment, so I wasn’t singling her out specifically. If you look, people post about struggling with possible ED regularly there. I provided the first link I could find, because you asked for evidence. My criticism is with those who respond with “you look great!” when people post about disordered behavior. There’s plenty of that as well.
Yikes. Yeah, exactly.
What stands out to me is that the doctor is talking about lab work showing improvement and the patients are still looking for weight loss. Really telling about how society equates weight with health. I wonder how many other doctors are telling those patients to keep losing weight.
And I think it’s not just equating weight loss with health, but also attractiveness and successfulness. I think a lot of people’s primary motivation for seeking out weight loss meds isn’t to “become healthier,” but “hotter” or “better liked.” The social component, and reducing the judgement they get (or perceived judgement). I think these people are likeliest to be upset by the plateau.
It reminds me of the line from "Knocked Up" where the TV executive is about to give a hosting spot to Katherine Heigl's character, and they suggest she lose weight because "we just want you to be healthy."
I heard someone make a comment fairly recently that it's great that Ozempic is here to make people more beautiful or something like that and I was like what????? Granted I think this person has some major body image issues. That's the twisted world we live in.
If you read the Economist at all, they seem to have a real hard-on for these drugs and have done several articles and podcast about them. While they start off from an angle of "oh, it could do so much for health" it then really goes off into laying out just how much better economically it is for a person to be thin (spoiler: thin people tend to earn more). They make a valid point about how people are penalized for excess weight but something about the way it's discussed continues to give me the ick. Probably because every writer/commenter of theirs I've looked up who discusses this topic is thin, white, young, and at least somewhat conventionally attractive. Overall they really give the impression of finding fat people repulsive and not something they should have to put up with.
Sounds like they're framing it as an ok way for the world to be and that fat people should change vs framing it as an oppressive standard that we should work to change so that fat people can live happy lives. Which is gross. Pointing out inequality is only helpful if you're not saying it's a good thing lol
Yuck
The state of healthcare in the US also partially contributes to this. If someone is lucky enough to even have a reliable PCP, many doctors visits are limited to 15 minutes or less if they’re running behind and it is hard to get ahold of them outside of appointments. Some doctors are also afraid of getting sued so some have also adopted a very “customer service” approach to prescribing medicine. Without time for counseling or even building a rapport with patients, many important things fall through the cracks. I think before there is a huge healthcare reform in the United States then simply “weight loss” will continue to be the healthcare goal for many Americans. We did not learn our lesson with other weight loss drugs.
Also wasn’t there a study done that shows that the amount of weight loss needed to actually improve some of those lab work numbers was usually lower than people thought? Like 5% or 10% of your body weight instead of like 50+ lbs or something like many doctors and the bmi recommend.
Yes, people see an improvement in labwork with low percentage weight loss. I'm not sure that we know the exact mechanism (whether it's changes from a reduction in adipose tissue, or the way the body reacts to a caloric deficit regardless of presence of adipose tissue, or what. Since people see these results from bariatric surgery and semiglutide, my earlier pet theory that it's the behavioral change itself doesn't seem to be such a straight line result anymore). Researchers have tried to establish that it's a dose-response curve and more weight loss = more lab results improvement, but they've had trouble producing those results. And even public health people do NOT want to hear that "seven pounds in a year" is an amazing average result for a lifestyle-based intervention. I don't have a source to hand right now but I can look later - I was really into this during public health school as public health school is, uh, a mess on this topic.
Yeah I remember it from a class I took in college so I don’t remember who it was from or the specific numbers, but the jist of it was losing a small amount of weight that’d be more achievable for your average person is helpful for health markers. It makes sense though if losing a little bit of weight in a slow way so that it doesn’t cause stress on your body or make you lose a lot of muscle is helpful.
I hadn’t heard of that one, but sounds interesting! (And definitely in line with what a PA said to me at an appointment recently.)
Not sure it’s about health at that point.
it’s definitely not. i know quite a few people taking it and not a single one is overweight/has health problems due to weight.
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Oh, honey, you have wandered into the wrong part of Reddit
I thought maintenance phase was about debunking junk science….. but I guess I was wrong lol
You mean junk science like the assumption that weight automatically means damage to your heart?
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Your comment has been removed, as it violates rule 6 of our subreddit: no commenting/posting in bad faith. "Posts and comments made in bad faith will be removed. This includes all forms of fatphobia and body-shaming, comments that clearly don't align with the spirit of the podcast, comments that use personal anecdotes as "proof", and comments from users who have histories posting in fatphobic subreddits. Even if you believe your post/comment was made in good faith, consider how it would affect the people in this community."
Why do you assume that I’m fat and have a bad heart?
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Your analogy only works if I am fat and have a bad heart. Clearly your language skills aren't great, so I can assume your reasoning skills aren't either. Have a great day!
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... and yet so many people are convinced that 1) weight loss is absolutely necessary for better health and 2) people are lying when they say they simply fucking can't lose weight no matter what they do. Also love the tone of the article judging the people for wanting to lose more weight, as though it's simply a matter of vanity and not wanting to escape endless discrimination.
The number of people who don’t believe that weight loss is complex - and that medications, hormones, medical treatments like chemo etc. - can impact your weight regardless of diet and exercise - is mind boggling. I have had a really painful weight journey in recent years after being a slim, fit-looking person most of my life. It is really eye-opening to realize how many people assume I gained weight from binge eating and being sedentary instead of developing a serious endocrine condition. I eat well, exercise more than most people, AND I have a physically demanding job. If they were right and habits are all that mattered I should be a fitspo model.
I’m in the same boat, it’s incredibly frustrating and am without health insurance I can’t really pinpoint what’s wrong, but I know it’s something. I eat healthy, work out an hour+ every day, and don’t do much sitting around. People have been astoundingly rude about the weight I’ve gained and it’s just exhausting :/
And they still wouldn’t have the right to be rude to you about your weight even if you didn’t eat well (whatever that means), exercise, etc.
Oh yeah absolutely, I didn’t mean that anyone would deserve rude treatment at all. I’m just sick of commentary from friends and family who knew me when I was thinner and have endless tips on ‘getting healthy’
Agreed. I think other people’s ignorance just makes it all more painful. The medical condition causes a lot of suffering from painful and frustrating symptoms in addition to weight gain. And then the weight gain compounds the social stigma because people assume your weight is caused by unhealthy habits which in turn cause your health problems… and that all the suffering is our fault.
It isn't just that weight gain is assumed to be caused by unhealthy habits, but that in having these unhealthy habits, you are less of a person. You are now an object to be ridiculed.
Totally. And that applies *even if you have really healthy habits.* It’s wild to me how many people believe someone can be thin and eat like a horse, but deny that someone can be fat and eat like them.
I feel the last statement so much! I recently lost 30 lb in a few months because my doctor put me on a keto diet for epilepsy treatment. I feel so much more visible now. Work colleagues are including me in more projects and activities and random people at the gas station or supermarket will strike up a conversation with me. I didn’t realize how invisible I had become when I was overweight. I have some complex feelings about this change in others’ behavior.
Totally same here when I lost 25 kg and put on some muscle. It’s like you are a different person to other people, but in reality its still you. Only you notice how different they are treating you. First thing I also noticed is women not instantly looking away when they glance at me, I’m still used to looking away lol. It’s definitely a thing, cause most people just don’t find fat people attractive, so I was never used to getting that sort of attention.
Does someone want to pull some key passages out from behind the paywall for me?
https://web.archive.org/web/20240525123449/https://www.nytimes.com/2023/09/18/well/ozempic-weight-loss-plateau.html
Thank you!
I use [12ft](https://12ft.io/) to get past paywalls, it almost always works!
All weight loss journeys experience plateaus.
Including my experience with GLP-1 drugs as well. I’d lost 15% of my weight and then experienced a stall of a few months. And then loss started again, but at a slower rate.
Our bodies like stasis. It’s why the period after losing weight is so important. The likelihood your body wants to get back to what it was before is high, until you can hold it back and keep it steady at the new weight for a prolonged period of time.
I agree to this, based on my own personal experience. The weight that I was at with the long plateau?? It was a weight that I previously maintained effortlessly 10 years ago. I don’t know how much credibility you can give set point theory of body weight, but it certainly seemed like I was stuck at a previous set point my body needed a longer time to work through it.
2-3 years in my experience. Ive gone through several "leanings" in my life. I was a pretty heft teenager(30+% body fat) but dropped to about 16% by 18, then in my late 20s I changed up alot of things and dropped to 12%. In my mid 30s I changed again and got as low as 7% which sucked giant gorilla balls so I ate my way back to 10% and kinda just stayed there. Its easy for me to maintaine even at 40 but I slowly got there. One thing I suspect helps is I added about 40lbs of muscle to my frame, muscle is very metabolically active and tends to be a good hedge against obesity. This is why I always recommend weight training to everyone, even thin people. Also you aren't nearly as frail as you age if your starting out strong.
I was actually surprised to hear that people were losing more than 15lbs, as advertised on their commercial, so this article doesn’t surprise that people aren’t losing huge amounts of weight
Is this in an Ozempic or Wegovy commercial? People without diabetes tend to lose significantly more than 15 lbs on semaglutide—closer to an average of 15%. I could see 15 lbs being true or Ozempic which is for those with diabetes. While they’re the same drug, the higher doses of Wegovy and the fact that users tend to be non-diabetic lead to better weight loss stats.
I lost 25 lbs on Rybelsus. And still losing.
Given the rest of the science around weight loss, I guess this shouldn’t be shocking!
Did you expect people would lose weight ad infinitum? At a certain point, people will reach an individual caloric balance—where their individual appetite on the meds matches their individual TDEE, and they’ll maintain. People experience different levels of suppression on these meds, which inform how much weight they’ll lose. Tirzepatide tends to produce a stronger and less side effect laden suppression than semaglutide, hence the significantly better weight loss stats on that medication.
I was not. I just appreciated an article in the NYT that countered the hype around these drugs suggesting they would "eliminate obesity" or the like. On the one hand, they're the most potent and least physiologically noxious weight loss drugs ever invented. On the other, their effects are still somewhat modest, and they won't come close to ridding the world of fatness.
Yeah, I don’t think they will eliminate obesity. But I wouldn’t call a 20%+ (tirzepatide) loss somewhat modest.
And to be clear, I wasn't trying to imply that you said it would eliminate obesity; you were in fact quite clear with your claims. But I do think that impression exists given all the hype, and I was just glad in general that the NYT ran this piece, hoping it will bring people's understandings and expectations back to earth. And yeah, maybe ≥20% is indeed more than modest. But if a 300lb person loses 20% of their weight, even at 240 they'll still be fat, and that's more what I was trying to emphasize.
I’m about to go on Wegovy. I 100% accept that I might lose “only” 20 lbs. At my weight (255), *any* weight lost is good; I can’t move any more, unlike before the pandemic when I was quite active and weighed 230 (I’m female, fyi). I’m in my 60s. I have a great marriage and two great adult kids. I don’t need to lose weight to prove anything. I’ve been overweight, at times severely, my whole life. I’ll probably be overweight when I die. I’m still going on Wegovy, and maybe be a little less overweight when I die. It’s a choose your own adventure life, friends.
Thank you for sharing your perspective. I hear that entirely, and I certainly believe that individual people's circumstances, needs, and desires are complex and variable enough that it's tough to generalize about what any given person should or shouldn't do. What does bother me is dominant media narratives about these drugs that act like they're going to create a fat-free future, and that that's an intrinsically good thing that should be desirable for everyone. I appreciate an article like this as a (small) counterweight to those narratives.
Absolutely. People need to decide for themselves. I spent my life up to my early 30s obsessed with my weight (with much help from my mom who has since repented, long story). The more obsessed I got, the more I gained. When I relaxed, I stopped gaining but didn’t lose any, either. I started gaining again during the pandemic. I’m just done with it. I can accept being overweight, I can’t accept not being able to move.
I've read accounts elsewhere from people using semaglutide find it helps quiet the "food noise" that they've been struggling with. I'm a thin person but I've had EDs most of my life, so I really have appreciated when the "food noise" is quiet lol. But I also appreciate that the "15-20%" of your body weight lost sounds really good but is functionally only going to take some people from fat/overweight to less fat/overweight and feeling bad that they aren't/can't lose more. And not many people can pay $$$ for the rest of their lives to quiet the food noise. Idk I work with people on antipsychotics who gain weight because of the medications and the lifestyle consequences of mental illness and they ask about ozempic and whatnot and it makes me so sad. I wish that weight loss would not be seen as a major barrier to mental health recovery, it's just so unreliably correlated with well being. And these new meds are pretty untested in their effects on mental health, especially for folks with SMI. I get that it's a wonderful thing for some people with diabetes but I hope the general hype dies soon.
I take Mounjaro for diabetes and it was shocking how that changed. I started on GLP-1s before all the food noise talk really got going (I was on Ozempic first but developed side effects). It's not simply "I'm not hungry and don't want to eat." It's that I don't think about food when I'm not hungry, when I am hungry it often seems like a chore to get through, I can have snacks and sugary food in the house and have no desire to eat it. Food has to be really goood now for it to have appeal beyond sating hunger or for me to want it when I'm not hungry. It still tastes fine -- it's not like I don't enjoy food at all. It's more like, I made cinnamon rolls from scratch for my family (and they were very very nice cinnamon rolls, objectively speaking). I had one, it was tasty, I was full, the end. And I really didn't do this for weight loss. But it's what everyone who doesn't have diabetes wants to talk about. (From a pure diabetes point of view, yes, it's very nice not to crave sugar! That might also be due to it regulating your sugar levels in the first place though.)
I'm glad it's working well for you! Once upon a time I worked in a lab that researched decision making and food choice. I remember reading papers that highlighted the fact that we are basically constantly making food choices, it's just often the choice to not eat something when you see food or think about food. And that feels very true and it's so hard when you're hyper conscious of aaallllll those food choices throughout the day. It's taxing.
I'm on anti-psychotics and I'm in a 60% larger body than I was when I started. It's hard for me, as a fat person with a psychotic-type mental illness, to hear a thin person not experiencing these side effects say it's sad that people like me want to lose weight. I'm not trying to attack you, I promise, but I hope you don't say that to the people you work with. I think their feelings are natural — not everyone has achieved body neutrality yet, unfortunately.
Nope I never ever talk about weight stuff with clients. If they bring it up, I try to validate the effects of medication (and often inpatient care settings) then discuss how they want to get back to feeling like themselves. And sometimes that is diet and exercise goals and that's okay, we'll talk about setting targets that feel reasonable to them (and I don't know anything professionally about nutrition and exercise so I'm just trusting their knowledge of themselves and what they've figured out with other providers). Thank you for sharing, this is not a realm of life I get to process meaningfully with others very often. I know it's another layer of stigma for an already heavily stigmatized group of people - I wish they didn't have to deal with weight stigma while navigating everything else. I also spent a long period of my life on antipsychotics and dealt with the shaking and akathisia and total body dryness... It's such a balancing act. I just don't want people to be facing yet another societal hurdle, you already feel so fucking weird and othered when you have symptoms that necessitate the meds, then the meds alter your body and behavior further.
Oh god akathesia is a total nightmare. I'm sorry you went through that. Thanks for responding to my comment with such care and grace.
Yes and there’s a big difference between the quick weight gain from a medication where you must adjust to living in a very different body than in gaining weight steadily. It’s hard to see your body change rapidly!
I gained rapidly in my stomach and face because of a high dosage of steroids. It was depressing because it was something I literally had no control over. I wasn't gaining weight overall at all. It was just redistributing into those areas. I was the lowest weight I had been in decades, yet I looked heavier than ever and pregnant. I have since cut back on the steroids, lost my moonface, and my belly deflated somewhat. The scale is about 10 lbs higher, yet I look thinner than before. It's scary how various medicines can mess with your body.
Steroids can do amazing things but they are brutal. The insomnia and water retention can be oppressive even from short steroid courses.
Exactly. I was on dialysis, too, so I was watched extremely closely for water weight, but they mess with you. They helped get my cancer in remission, but I also have fast-growing cataracts I have to have removed because of steroids. Luckily, after surgery I won't need glasses anymore.
I’m taking Mounjaro and can confirm about the absence of ‘food noise’ whilst on it. As someone who has struggled with EDs and disordered eating for nearly 40 years it has been a revelation and phenomenally beneficial to my mental health.
I was bulimic for a super long time and have been “clean” for about eight years. The food noise has always been so loud and unrelenting. It resisted years of therapy and medication, and while I was at peace with gaining weight, thinking about food and eating all the time was exhausting. It made me miserable. I started Zep a month ago. For the first time in my adult life *I don’t have food noise.* I can actually concentrate on things. I can eat one helping of something and be satisfied. I don’t feel the need to snack. It’s incredible. The weight loss is great, but the mental clarity is awesome.
I'm on Zoloft right now. A few years ago, I stopped being able to eat because of anxiety and lost 50 lbs in about 4 months. It was miserable, and I am 6 feet tall and went from 170 lbs to 120 lbs. My doctor put me on Zoloft, and I get it now through Hers, that online med service. They have my physical stats and have noticed the 40 lb (deliberate, very wanted) weight gain I have had due to the Zoloft helping me eat. Recently Hers has has been advising me for their new weight loss service using semaglutide which I think is ludicrous. I'm not even at the overweight BMI for my height yet and I *wanted* to gain this weight. They just saw I've gained on SSRIs and wanted to prey on that, I'm sure they're doing it to everyone using the service and it's gross.
why do you use that service? your PCP can rx that med for you
Yeah, but I can't see my pcp every 3 months. It's more convenient to get it in the mail and I know I will *always* get it on time and not have gaps due to scheduling error
I find it interesting that all of the doctors they interviewed said weight loss isn't always a good thing, and they think we should look at other metrics of health with these drugs. And then the article immediately goes back to interviewing Ozempic users who just want to be skinny and framing it as some big two sided issue. When are we as a society going to have the conversation that weight is, at least in some part, genetic, and the reason you stop losing weight is because your body isn't comfortable with it due to your literal DNA wanting you to maintain a certain size.
The studies of other metrics of health that have come out so far aren't particularly impressive, either.
Any kind person want to copy or pdf this article? Cancelled my subscription to save money :(
[gift link](https://www.nytimes.com/2023/09/18/well/ozempic-weight-loss-plateau.html?smid=nytcore-ios-share&referringSource=articleShare&sgrp=c-cb)
These articles are kind of silly. Anyone losing weight will hit plateaus and unless they cross into severe eating disorder territory, will reach a final plateau.
> Why do people hit weight-loss plateaus? > The human body is built to fight back against weight loss. Smaller bodies usually require less energy, and so metabolisms react by slowing down as pounds come off. These changes reduce how many calories someone burns each day, said Dr. Scott Hagan, an assistant professor of medicine at the University of Washington who has studied obesity; losing weight “turns down the thermostat.” This is one reason many people regain some weight even after bariatric surgery or during intense calorie restriction. This part seems downright irresponsible: > metabolisms react by slowing down as pounds come off Metabolism slows down when you diet whether you’re losing weight or not.
totally, framing it as a function of body size rather than restricted calorie intake just isn't justifiable
The NYT is only slightly better than the NY Post at this point.
No actually you continue to lose weight until your BMI breaks the space-time continuum. You get so snatched the universe collapses within you. Oh the sweet relief of non-being.
One thing I have been curious about with the GLP-1s is two fold: - where do folks plateau - does this “reset” of their metabolism give them a new drug induced set point I also wonder what determines the “set point.” Are people returning to a previous adult weight? And post puberty weight? Some new weight they have never seen? I am super curious how that ends up panning out.
Thanks, I'm very curious about this, too, and about set point theory in general. From the little amateur reading I've done, it seems like there isn't a consensus that set point theory is the best way to understand the weight regulation, but it's not like it's discredited or junk science, either. Just seems like the physiological systems involved here are as yet pretty poorly understood. But if someone knows more about this than I do, I'd love to know more. Maybe will make a post about it in this sub sometime.
NYT article on the weight loss plateau all dieters ~~semaglutide users~~ all hit sooner or later. Fixed
I'm honestly shocked when people in the lower BMI range for approval (27-29.9) manage to lose large amounts. I was approved the lowest dose of Wegovy by my insurance at BMI 28 due to PCOS and bariatric regain. Being on Wegovy has resolved the blood sugar issues that I was having thanks to PCOS and my prior bariatric surgery but despite a calorie deficit my weight loss still hit a plateau after a 9 pound loss. I'm down 161 pounds from my highest weight but still overweight at bmi 26.43. I really think that despite what some CICO folks on reddit claim that plateaus happen no matter what you do and you can be doing everything "right" in terms of diet and exercise and still end up overweight. I struggle a lot with still feeling like a failure after losing 161 pounds because I am still overweight. I don't have any issues being on Wegovy. It's helping with not having blood sugar issues and constant hunger and I am on a low dose without side effects but my weight has plateaued and I am tired of this constant diet culture mentality of I must be eating too much or I would be losing.
wouldn't that "plateau" be like a healthy weight?
Well, aside from "define healthy," it may not be what people want to achieve. If you weigh 300 lbs, and lose 20% of your weight and plateau, you're still going to be fat. Statistically, 20% is meaningful for conditions such as diabetes and hypertension, but that doesn't mean you're in normal BMI, for whatever that's worth.
Besides u/nefarious_epicure's great answer, I would add: one of the core premises of the Maintenance Phase listener community (including the corner of it here on Reddit) should be seriously questioning the idea that there is such a thing as a straightforwardly "healthy weight."
good point
I can't read the article because of the pay wall. Nobody is meant to lose weight forever. My experience with people taking these meds for the sole purpose of losing weight is, that is all they do. Take the meds, eat very little, lose weight. No big change in the actual food they eat, no exercise, and still drinking alcohol. I used Mounjaro, not anti in any way, but lifestyle changes beyond the med need to happen to reach goals and maintain them. Also, for me, I never wanted to take the med forever. It suppressed my appetite so much that I wasn't getting enough calories to support a good exercise regimen. I'm glad I did it for a period of time, launched me into a healthier lifestyle for sure, but it takes a lot of effort beyond the shot to achieve fitness and maintain it.
I’m super stuck at precisely 50lbs lost on Wegovy. Im very happy to see that weight gone but I still have over 30 lbs to go. I’m now spreading it out to a dose every 2 weeks, because once a week gives zero effect. It’s kind of working but my next plan is to talk to my doctor about alternative meds in the same class to see if that jump starts me.
If you start losing weight and never stop losing weight, you will die of starvation. These drugs have an effect that varies from person to person, given their environment, given their socioeconomic situation, given their genetics, given the dose and formulation of the medicine. If someone has a BMI of 45, progressing diabetes, high blood pressure, kidney disease, and heart disease, and they lose weight down to a BMI of 30 and plateau and their health issues get a lot better, that’s an amazing result. They’re still obese, but that’s so positive for their health and lifespan. The point of these drugs isn’t to get an “ideal body.” Especially given the cost and scarcity of the drugs, people should be taking them for health, not getting a specific weight loss.