Are reta and other weight loss drugs meant to be long term use? Whats it like coming off them?

[Smiter]

Sea

Its sad that asking for citations to read is taken negatively

??? Who took it negatively? It's an excellent thing. But, if a joke offended you, though I usually wouldn't give a damn, you caught me in a charitable mood today. So, I will make recompense. Okay, listen close. Get a nice black marker and paper. Save the following name, and don't tell anybody, okay. You be on the lookout for the guy when he comes out. So here it comes.....

Mibavademab.

I know..It's too much...But I can be overkind sometimes. No thanks needed.

 

[rettta]

You need to look at weight gain as a side effect of being metabolically unhealthy and weight loss a side effect of being metabolically healthy. Why would you want to come of a drug that keeps you metabolically healthy? Do you want your A1c to go back up again? Then yo yo to get that under control again? This isnt steroids , all this cycling sounds like instagram bro science. The studies are long term, most of the cycle bros are at a healthy weight and want to get "shredded" on their next roid fueled cut and thats fine if thats what they want. Most of us are fatties trying to get to a healthy weight.

 

[Crowreap]

So im a bit older and got on reta to jump start my weight loss with plans for a 3-6 month cycle before stopping use and just maintaining a lower daily calorie intake than I was eating before I got on the reta. I understand it's going to be hard, but I think it's doable. BUT I dont know what it's like after getting off reta. Is it a lot tougher than I am expecting? Food noise was never too bad....except for weekends. Weekends ruin me and the reta has really helped with that.

Also, are reta and the rest of these weight loss drugs meant to be used long term...or potentially even for life? I cant imagine the answer is yes to the permanent one...but im wondering if maybe 1-3 or even 5 years on is how doctors prescribe these drugs?

I know there's no long term data, but I don't think there's any reason to get off these weight loss drugs because you could just stay on a maintenance dose for longevity purposes. So you get better nutrition, partitioning, better insulin sensitivity, better fat oxidization, and better whole host of things that I can't think of right now and the only negatives are some short term nausea and fatigue, depending on the person. So I think for longevity purposes, it's not a good idea to get off of it. And a lot of people do gain the weight back after getting off of it, it's because they have not had developed good habits before taking these drugs, during, and after. So if you're kind of locked in with your habits, Especially during a weight loss drug cycle, then it shouldn't be too hard to keep the weight off if you plan to get off of it. But as I said, there's no long term usage on these weight loss drugs. So just YOLO it and hope for the best And I say that jokingly, but in reality, I feel like there's not much benefit you get by going off, and might as well keep the benefits of a maintenance dose; theres more benefts than downsides.

 

[bay_area_schizo]

So everything I've read indicates that you really are not supposed to just stop taking them, you're just supposed to titrate down to a much lower maintenance dose. These things alter your metabolism, in addition to the food noise and appetite suppression. Going off of them will basically yank that control away, and when you gain weight back, it will make restarting the meds significantly less effective, you'll need much more to get back to where you were.

I love that movie!

 

[Smiter]

but in reality, I feel like there's not much benefit you get by going off

Maybe true, but I can think of two: one physical, and one fiscal. physically, if you're like me, allergic to pain, being injection-free could be attractive. But the big one is fiscal. Dude, with the money you save, you could be a rich passport bro and get a slice of heaven

 

[Crowreap]

Maybe true, but I can think of two: one physical, and one fiscal. physically, if you're like me, allergic to pain, being injection-free could be attractive.

Bro, come on, ain't no way that needle we inject on a weekly basis is painful!

But the big one is fiscal. Dude, with the money you save, you could be a rich passport bro and get a slice of heaven

And LOL. These Chinese research chemicals are way too cheap to be a fiscal issue. Unless you're getting your peptides from these shitty online research websites that 10x the markup of the vials that they buy from China themselves lol. Or maybe, I don't know, maybe your dosage is so high that you consume a lot of mgs per week

 

[Smiter]

Bro, come on, ain't no way that needle we inject on a weekly basis is painful!

And LOL. These Chinese research chemicals are way too cheap to be a fiscal issue. Unless you're getting your peptides from these shitty online research websites that 10x the markup of the vials that they buy from China themselves lol. Or maybe, I don't know, maybe your dosage is so high that you consume a lot of mgs per week

It's all a matter of perspective, my guy. If you think these Chinese chemicals are cheap, why don't we ponder how economical Chinese poontang pie will be???!!!

Oh my dosage is not that high, but at the end of the day, what are we doing all this for? It's for the cake. And if we do get the best cake because of the passport, at the cost of a few peps, shouldn't we strive through strife for it?

ain't no way that needle we inject on a weekly basis is painful!

I admit it's a bit of a hyperbole, but given my colossal indolence and my incredible aversion to the most infinitesimal pain, I had to mention it. The main one is the poon, I submit. But hey, if you can swing the GLP continued use to keep quality cake on the table, I am all for it.

 

[bockscar]

It's all a matter of perspective, my guy. If you think these Chinese chemicals are cheap, why don't we ponder how economical Chinese poontang pie will be???!!!

Oh my dosage is not that high, but at the end of the day, what are we doing all this for? It's for the cake. And if we do get the best cake because of the passport, at the cost of a few peps, shouldn't we strive through strife for it?

I admit it's a bit of a hyperbole, but given my colossal indolence and my incredible aversion to the most infinitesimal pain, I had to mention it. The main one is the poon, I submit. But hey, if you can swing the GLP continued use to keep quality cake on the table, I am all for it.

youre an absolute menace sir!

 

[Shesins 54335]

It's all a matter of perspective, my guy. If you think these Chinese chemicals are cheap, why don't we ponder how economical Chinese poontang pie will be???!!!

Oh my dosage is not that high, but at the end of the day, what are we doing all this for? It's for the cake. And if we do get the best cake because of the passport, at the cost of a few peps, shouldn't we strive through strife for it?

I admit it's a bit of a hyperbole, but given my colossal indolence and my incredible aversion to the most infinitesimal pain, I had to mention it. The main one is the poon, I submit. But hey, if you can swing the GLP continued use to keep quality cake on the table, I am all for it.

What are you talking about? Are you genuinely asking how much a chinese sex worker charges?

 

[Smiter]

youre an absolute menace sir!

Why, thank you, kind sir. Flattery aside, My original point to your question remains. You can stay on GLp's until things like Mibavademab becomes accessible. The main reason why GLp's work is due to the hunger suppression that helps us obese folks manage food noise. All other effects are complementary. The food noise is often due to leptin resistance which will remain if GLp's are not around. So, until that can be permanently dealt with, we got to keep stabbing ourselves. But, hey, better to stab oneself with a GLp once a week, than with insulin every day, eh?

 

[staffn1]

You can get off them after losing weight if you could have lost the weight and kept it off without them in the first place.

 

[BNLFL]

Why, thank you, kind sir. Flattery aside, My original point to your question remains. You can stay on GLp's until things like Mibavademab becomes accessible. The main reason why GLp's work is due to the hunger suppression that helps us obese folks manage food noise. All other effects are complementary. The food noise is often due to leptin resistance which will remain if GLp's are not around. So, until that can be permanently dealt with, we got to keep stabbing ourselves. But, hey, better to stab oneself with a GLp once a week, than with insulin every day, eh?

I've had no suppression in 4 weeks on my last 2 6mg, and 7mg was useless. I've still lost weight. Can you explain that?

 

[Smiter]

I've had no suppression in 4 weeks on my last 2 6mg, and 7mg was useless. I've still lost weight. Can you explain that?

No clue, it could be anything from calorific deficit, increased TDEE, increased thermogenesis, etc.

 

[anhydrous]

You seem a little naive but well meaning. Why stop at 180-200? For someone 5'7 that is still obesity territory. If you were capable of maintaining the strict discipline of a bodybuilder then you wouldn't need these drugs. Accept the fact that you aren't and that you do.

 

[ambot88]

I'm with Joseblo - I maybe COULD rawdog keep my new weight but I really don't want to. I love not being hangry all the time. Drugs for life, no regrets.

 

[lastresort]

I have battled with a very resistant plateau for years, so much that I badgered my endo to give me a referral for a university. medical geneticist.

Unless I find a definitive cause of my abnormal weight loss resistance, I can't imagine getting of retatrutide. Ozempic and Zepbound failed me, and this is the only drug that helped me lose weight.

Caving into ozmepic already took a hit on my self esteem, and being on a weight loss drug forever is such a bleak future for me. After all, retatrutide is a treatment, not a cure.

 

[lessthanhalf]

So from 260 lbs with a target of 180 to 200 lbs at 5'7" is start BMI of 42 and end 180 of 29. Could not find age other than a bit older so guessing 40's?

If you have not already , make sure you get a basic cardiovascular risk assessment, so blood pressure, blood sugars, hb1ac, lipids, liver function, kidney function. Mainly useful as the worse those numbers are, the more important it is to do something about it before damage occurs, and it argues for staying on GLP's long term. At a BMI of 42 the odds are you have metabolic syndrome, and are at high cardiovascular risk already, so you may or may not need statins as well.

I have yet to see convincing scientific evidence that lower doses or less frequent dosing works as a long term strategy for weight loss maintenance. In the context of a study with intensive support and follow up, you are going to get less weight regain after stopping or slowing down GLP's than in the real world without that extra support. And all the lower dose studies show weight regain, not as much as stopping it but still pretty substantial. The reality is much more long term studies on maintenance need to be done.

The only evidence I have seen for low dose weight loss maintenance is several people on this forum, and this is anecdotal, not clinical trial evidence and it is a highly selected, highly motivated group, and getting better than usual responses in such cherry picked data is not really surprising.

The long term, large scale follow up studies to the original studies on semaglutide and tirzepatide, show weight loss slowing , then stopping a bit more than a year after starting , and the weight loss being maintained on that dose for a further 4 years. My logic is further weight loss would happen if that maintenance dose was too high, and weight regain if that dose was too low, but with the dose used to lose the weight, weight was perfectly stable for 4 years. I think this is pretty solid evidence.

The other concerning bit of research was a mouse study where stopping and starting ozempic in mice produced much less weight loss than staying on it, suggesting that stopping and starting or the weight cycling process might make the drugs less effective in the long term. This needs to be replicated and shown in humans. study included. at this stage it is not obvious how to interpret this. If this turns out to be real in humans, which is not likely to be known for years, stopping and restarting after weight regain might be a bad idea.

The simplest approach is to lose the weight first, and once you have, then if you do not like the idea of being on them long term try reducing the dose very slowly, and keep an eye on weight, if it starts going back up, then if you do not want to regain the weight , then increase the dose.

I think staying on them long term is a good idea, especially at higher start BMI's like 40+, as diet and exercise are just not that good at maintaining weight loss in the long term, and GLP drugs are good at it, and at the same time reduce long term health problems like heart disease, stroke, diabetes and cancer. Trying to maintain weight loss long term by calorie restriction is hard and stressful, on GLP drugs it is not.

 

[RJ760]

So from 260 lbs with a target of 180 to 200 lbs at 5'7" is start BMI of 42 and end 180 of 29. Could not find age other than a bit older so guessing 40's?

If you have not already , make sure you get a basic cardiovascular risk assessment, so blood pressure, blood sugars, hb1ac, lipids, liver function, kidney function. Mainly useful as the worse those numbers are, the more important it is to do something about it before damage occurs, and it argues for staying on GLP's long term. At a BMI of 42 the odds are you have metabolic syndrome, and are at high cardiovascular risk already, so you may or may not need statins as well.

I have yet to see convincing scientific evidence that lower doses or less frequent dosing works as a long term strategy for weight loss maintenance. In the context of a study with intensive support and follow up, you are going to get less weight regain after stopping or slowing down GLP's than in the real world without that extra support. And all the lower dose studies show weight regain, not as much as stopping it but still pretty substantial. The reality is much more long term studies on maintenance need to be done.

The only evidence I have seen for low dose weight loss maintenance is several people on this forum, and this is anecdotal, not clinical trial evidence and it is a highly selected, highly motivated group, and getting better than usual responses in such cherry picked data is not really surprising.

The long term, large scale follow up studies to the original studies on semaglutide and tirzepatide, show weight loss slowing , then stopping a bit more than a year after starting , and the weight loss being maintained on that dose for a further 4 years. My logic is further weight loss would happen if that maintenance dose was too high, and weight regain if that dose was too low, but with the dose used to lose the weight, weight was perfectly stable for 4 years. I think this is pretty solid evidence.

The other concerning bit of research was a mouse study where stopping and starting ozempic in mice produced much less weight loss than staying on it, suggesting that stopping and starting or the weight cycling process might make the drugs less effective in the long term. This needs to be replicated and shown in humans. study included. at this stage it is not obvious how to interpret this. If this turns out to be real in humans, which is not likely to be known for years, stopping and restarting after weight regain might be a bad idea.

The simplest approach is to lose the weight first, and once you have, then if you do not like the idea of being on them long term try reducing the dose very slowly, and keep an eye on weight, if it starts going back up, then if you do not want to regain the weight , then increase the dose.

I think staying on them long term is a good idea, especially at higher start BMI's like 40+, as diet and exercise are just not that good at maintaining weight loss in the long term, and GLP drugs are good at it, and at the same time reduce long term health problems like heart disease, stroke, diabetes and cancer. Trying to maintain weight loss long term by calorie restriction is hard and stressful, on GLP drugs it is not.

This was a great read. I see people on here pretty regularly telling others they’ll need to be on these forever and I get where they come from but I don’t think the evidence is quite that clear cut yet. There was actually a real world study published just last month showing nearly half of people who stopped GLP-1s maintained their weight loss a year later, which is a lot more encouraging than the clinical trial data alone suggests.

I like the approach of titrating down slowly and watching what happens. There’s also some emerging research around extended interval dosing, like stretching to every 10-14 days, as a potential maintenance strategy. Not a ton of long term data on it yet but it’s an interesting middle ground between staying on a full dose forever and stopping cold turkey.

For me the biggest unknown is what the food noise looks like when I start pulling back. That’s why I’m focused on building habits around eating better now so it’s not as big of a battle later. I’d like to see myself off them entirely at some point however.

 

[lessthanhalf]

Caving into ozmepic already took a hit on my self esteem, and being on a weight loss drug forever is such a bleak future for me. After all, retatrutide is a treatment, not a cure.

After reading the scientific literature on weight loss for the past 35 years or so, hoping they will finally find something that actually works, the reality is they have made some drugs now that really do work, and I am extremely happy to keep taking them. Every diet before now has resulted in me losing weight then putting it all back on. After losing 70kg without glp drugs and keeping it off for a year, I was permanently hungry, with GLP drugs I was able to lose another 10kg, and with much more tolerable levels of hunger and as a result improved quality of life.

I think the issue is almost entirely your cognitive framing of it. The vast majority of diseases do not have cures, a few can be cured by antibiotics or surgery, but most are managed with long term medication, and most metabolic and endocrine disorders are as well. The only difference really is that obesity is now something that can be treated, rather than something that cannot be treated, except with diet and exercise, with very very poor long term success.

The way I see it is that the big advantage of GLP drugs is that they remove guilt and willpower from the equation. And they work without those being needed, and make long term weight loss maintenance much easier , simpler and less stressful. Trying to maintain weight loss without them is very hard, and I had a year of that fairly recently and for me the bleakness was having to accept that keeping the weight off would require tolerating very high levels of hunger every day for the rest of my life, or put the weight back on. GLP drugs are an escape from that problem.

Ideally self esteem, needs to be based on making rational choices that benefit your current and future situations. Making a choice to improve long term health and quality of life, and achieving those aims are reasons for more self esteem not less. The idea that willpower alone can fix obesity is fundamentally flawed, the reality is diet and exercise work short term, but long term have very poor results. It is difficult to overcome societies' inherent biases against people with obesity , and everyone with obesity has absorbed those biases to some degree, but it is possible to not accept the unreasonable and inaccurate logic those biases are based on.

It is not like GLP drugs are addictive or bad for you, they rather uniquely have an amazing array of health benefits with long term use and very few downsides.

I personally an very happy these drugs exist and I can access them, they improve my quality of life and significantly reduce long term health risks for me. It is worth trying to argue yourself out of some of those viewpoints about long term GLP drugs, so that you get the physical and psychological benefits from them.

 

[DinosaurSoftRocks]

The relevant questions are how overweight are you ?, and have you lost weight before and put it back on?

If you have significant obesity, and especially obesity with health consequences, like diabetes, pre diabetes, high blood pressure, high lipids, heart disease, even osteoarthritis, there are very good arguments to just stay on it long term, for the health benefits in the long term both from the drug itself and it weight loss effects.

The sad reality is most people who lose weight by any method, will put the weight back on if you stop doing whatever caused you to lose the weight, glp drugs included, GLP drugs are so far the best method of keeping weight off long term that has ever existed, except bariatric surgery.

Trying to stick to a calorie restricted diet to maintain weight loss is difficult, weight loss makes you hungrier, and weight loss makes you use less calories just to exist, and you need to maintain a less than average calorie intake to maintain the weight loss, which is hard. GLP drugs make this less hard, especially over the longer term.

I think in 5 or 10 years , once they are cheaper and preferably tablets rather than injections, Doctors are going to be wanting half their patients on them, and on them long term, like blood pressure pills or statins to prevent long term health problems caused by obesity with the bonus effect of making you lose weight.

Beautifully said!!!!