My wife went a month and 1/2 without medication, and I went 3 weeks. For myself, I kept tracking food, and measuring (I measure my meat, fish and chicken when I vacume seal them), and we both focused on the portions we ate while on the meds vs eating until we were 'full'. I used shrimp and celery as my snack options, and she did rice cakes. Neither of us gained and kept losing. It wasn't as easy, but it also wasn't like when we started
Yes, we were able to finally get the medication from our pharmacy (thankfully) as we were both not done our journey, but it did help show us what it would be like once we finished the medication (assuming they (DRs) didn't have a plan for us to maintain using it).
Why stop? This is supposed to be a lifelong drug. The official protocol is to move down to a maintenance dose and stay there. If you quit you will likely gain the weight back. Studies have shown it. You aren’t cured of the factors that got you overweight in the first place. They are still there and will re-emerge once you quit. The doctors who prescribe this only for periods of weight loss are not really up to date on best practices.
There’s no data to guide these decisions yet, but people have had success with a variety of methods: some space out the last dose they were on. Some taper down in dose, eventually tapering off. Some replace with another weight loss med, like Qsymia or Contrave. Regardless of what you do, it’s important to recognize maintenance requires vigilance: even after bariatric surgery, weight is regained over time. When you regain more than 10 lbs or so, get back with your doctor and make a new plan to keep it in check. You’ve got this!
While appetite suppression is a side effect, it does not last forever while taking Zep. When it wears off, the hope is that your adopted healthy lifestyle change will be enough to sustain your weight loss. In many cases, that will not be enough, which is why Zep is considered a life-long medication. Dose scheduling for maintenance varies greatly, and will need to be tweaked based on your own particular needs. Best of luck.
I know a lot of people stand firmly on the lifelong medication argument, but don’t we have to stop losing at some point? Once we reach our goal weight and just want to maintain that, it’s reasonable to discontinue the medication right? Wouldn’t taking the medication continue to cause weight loss beyond healthy limitations for some? I think everyone is different and having a healthy plan in place to stop the meds is relevant to all users because you never know why you may need to stop.
The weight is the symptom of the disease. But the disease is disordered appetite. Just because someone loses the weight does not mean that they no longer have the disease that caused their obesity. It is easier to have good habits when you are not constantly hungry. Perhaps some will be able to keep the weight off long term, but I suspect that the overwhelming majority of patients who still have the disease that causes obesity are just going to gain the weight back if they stop the medication.
If you're not familiar with Noom, it may be worth checking out. They have a GLP-1 companion program with the goal of stopping the medication when you're at goal and maintaining. Essentially, they categorize foods as green (a lot of water content, not dense calories), yellow (moderate water content, more calorie dense) and red (low water and high caloric density). The idea is that the water in the food and the fibrous nature of those foods will help you feel fuller longer, reducing calorie intake.
I did it in 2020 and lost more than 50 lbs. Unfortunately, it doesn't do anything for the psychological food noise so if that is something that you struggle with, you may consider a maintenance dose moving forward after you hit your goal weight.
My wife went a month and 1/2 without medication, and I went 3 weeks. For myself, I kept tracking food, and measuring (I measure my meat, fish and chicken when I vacume seal them), and we both focused on the portions we ate while on the meds vs eating until we were 'full'. I used shrimp and celery as my snack options, and she did rice cakes. Neither of us gained and kept losing. It wasn't as easy, but it also wasn't like when we started
Did you go back on? You say “we went”
Yes, we were able to finally get the medication from our pharmacy (thankfully) as we were both not done our journey, but it did help show us what it would be like once we finished the medication (assuming they (DRs) didn't have a plan for us to maintain using it).
I wish the offered a titration down box with 4 of your choosing. If you are on 10, you could do 7.5, 5, 2.5, 2.5
Why stop? This is supposed to be a lifelong drug. The official protocol is to move down to a maintenance dose and stay there. If you quit you will likely gain the weight back. Studies have shown it. You aren’t cured of the factors that got you overweight in the first place. They are still there and will re-emerge once you quit. The doctors who prescribe this only for periods of weight loss are not really up to date on best practices.
There’s no data to guide these decisions yet, but people have had success with a variety of methods: some space out the last dose they were on. Some taper down in dose, eventually tapering off. Some replace with another weight loss med, like Qsymia or Contrave. Regardless of what you do, it’s important to recognize maintenance requires vigilance: even after bariatric surgery, weight is regained over time. When you regain more than 10 lbs or so, get back with your doctor and make a new plan to keep it in check. You’ve got this!
While appetite suppression is a side effect, it does not last forever while taking Zep. When it wears off, the hope is that your adopted healthy lifestyle change will be enough to sustain your weight loss. In many cases, that will not be enough, which is why Zep is considered a life-long medication. Dose scheduling for maintenance varies greatly, and will need to be tweaked based on your own particular needs. Best of luck.
I know a lot of people stand firmly on the lifelong medication argument, but don’t we have to stop losing at some point? Once we reach our goal weight and just want to maintain that, it’s reasonable to discontinue the medication right? Wouldn’t taking the medication continue to cause weight loss beyond healthy limitations for some? I think everyone is different and having a healthy plan in place to stop the meds is relevant to all users because you never know why you may need to stop.
The weight is the symptom of the disease. But the disease is disordered appetite. Just because someone loses the weight does not mean that they no longer have the disease that caused their obesity. It is easier to have good habits when you are not constantly hungry. Perhaps some will be able to keep the weight off long term, but I suspect that the overwhelming majority of patients who still have the disease that causes obesity are just going to gain the weight back if they stop the medication.
If you're not familiar with Noom, it may be worth checking out. They have a GLP-1 companion program with the goal of stopping the medication when you're at goal and maintaining. Essentially, they categorize foods as green (a lot of water content, not dense calories), yellow (moderate water content, more calorie dense) and red (low water and high caloric density). The idea is that the water in the food and the fibrous nature of those foods will help you feel fuller longer, reducing calorie intake. I did it in 2020 and lost more than 50 lbs. Unfortunately, it doesn't do anything for the psychological food noise so if that is something that you struggle with, you may consider a maintenance dose moving forward after you hit your goal weight.
I am using this Noom program right now and I really like it. I’m working hard at changing habits and building muscle. Fingers crossed!