Consideration: There is no "stopping" these meds.

[tncc_rn]

So it's my understanding that these meds, if you opt to use them, are a "forever" thing. It looks awfully well-studied that if you use sema or tirzep and prolly reta when the studies get that far, you lose a bunch a weight, hooray you're healthy, and then you stop....then you are probably going to start slowly regaining "a lot" to "all and more" of that weight back over the course of a year; and there's no indication I saw that at the end of that year, your body goes "all right buddy, I tried my best, but I see you really don't want to do this so we can stop gaining weight now." Maybe you'll be in the exceptional minority posting on reddit "I lost it all six years ago, stopped the med, and haven't gained an ounce!" But you probably won't be.

Roughly 1/3 of my office is on some kind of glp1, either sema or tirz. The ones who are very near goal weight talk about how excited they are to be done and get off the meds, or that they only have X weeks of the meds to go. And of course the insurance companies who cover these meds stop when you're not obese anymore, because "all better!"

This seems pants-on-head insane to me. Far as I know, glp1 drugs mostly make it so that you can stand to eat the amount that would put you at a healthy weight. Remove that, and you lose that ability, and regain. The studies seem to support that.

But it feels like everybody's walking around saying with a straight face that that's not true, and blinking twice at me when I say "No, I'm never coming off these drugs. This is a lifelong med." I'm starting to feel like I'M the crazy one here.

Would welcome perspectives.

Unless you can control all the things that made you obese (psychological issues, caloric surplus eating, age) you have to accept these are lifelong drugs no different than blood pressure medication. You have a disease process that these drugs keep controlled. Why would you stop taking them????

 

[randompersonrandom]

I expect to take it for life and don’t really see why that is a big deal to anyone

oh yeah, don't get me wrong--nobody's being mean or judgy or scoldy about it. It's just that everyone I know in real life who is on it (which is just a HUGE amount of people, because they all come and tell me about it since I'm public about being on it) is acting like when you finish losing the weight, you can just stop and it's fine. Insurance companies are ALSO acting like that, because they stop covering when you get below the threshold. And I know almost nobody I'm talking to is genuinely stupid. I don't understand why it's not a known thing that no man, this is like ADHD meds; you don't just stop taking them because you feel much more focused and are cured.

 

[cookieguggleman]

I know all people who stopped and didn't gain the weight back, but they weren't food addicts. But I think for many of us who are food attics, it will be a lifetime drug.

 

[rsmith]

It's a good question and yes they're technically considered meds.... It's just that they’re quite different from most medications in how they work and how people experience them, so it deosnt seem like medication is exactly the right word.

Here's why. They’re biomimetic, meaning they imitate a hormone your body already produces — so rather than forcing a single reaction (like a stimulant or appetite suppressant), they restore a signal that’s supposed to be there.

They impact multiple systems — blood sugar regulation, digestion speed, inflammation, even brain signaling related to reward and cravings. Again this is because they're channels and are present all over the body.

They can be used short-term or long-term. Some people use them for a therapeutic reset, others stay on a low or “micro” maintenance dose indefinitely, more like ongoing hormonal support than a classic medication cycle.

So yes — they are absolutely medications in the clinical sense, but functionally they act more like metabolic regulators or hormone analogs than typical drugs.

If any nosy person insists on knowing how you achieved your High School body, just tell them you found some amino acids that are helping you tremendously with lots of things including weight, inflammation, heart/liver/kidney health and overall well-being.

Peptides = 2 - 50 amino acids

Proteins = 50+ amino acids (Note: this is an arbitrary distinction, not a scientific or medical one).

Alternatively, you could just tell them that you're taking something not quite as complicated as protein although protein isn't a bad idea either. How much sense would it make to never consume protein again?

GLPs are no more drugs than protein is a "drug" or "medication." Google it.

 

[mlke6]

I don't ever, ever want to go back to food in the way I was before Sema/tirz. After my first month of Sema when I started I knew it was a lifetime med and started Hoarding as I got the money and haven't really stopped since.

My hunger is back like before but not really. I do crave food at maintenance and I do have emotional issues where I just go crazy sometimes and it feels like before, but it's not. I get full. It's not an all day, all week binge. I end up "sick" of eating and my mind wonders on.

So many other benefits as well.

I feel the people in your office will change once they go off. I wonder if they are just seeing theses meds as a temporary tool like aspirin or something. LIke not really reading on them. How can you not want to try and learn more though when you first start and actually feel satisfied on a meal for the first time in your entire remembered history. I freaking cried.

 

[exploitedworkerbee]

oh yeah, don't get me wrong--nobody's being mean or judgy or scoldy about it. It's just that everyone I know in real life who is on it (which is just a HUGE amount of people, because they all come and tell me about it since I'm public about being on it) is acting like when you finish losing the weight, you can just stop and it's fine. Insurance companies are ALSO acting like that, because they stop covering when you get below the threshold. And I know almost nobody I'm talking to is genuinely stupid. I don't understand why it's not a known thing that no man, this is like ADHD meds; you don't just stop taking them because you feel much more focused and are cured.

Sorry for my terse phrasing, I didn’t mean that directed at you. Just generally, there is a widespread notion that glp1s are bad because they are probably a lifelong deal for many if not most. I don’t see why that is a big deal to so many people. Life is full of commitments, no reason a daily med that keeps you lean and healthy shouldn’t be one of ‘em.

 

[randompersonrandom]

If any nosy person insists on knowing how you achieved your High School body, just tell them you found some amino acids that

Alternatively, you could just tell them that you're taking something not quite as complicated as protein

Oh no, though anyone whose situation is more complicated than mine is welcome to. My stuff (minus the grey part) is right out there on FB. I don't talk to judgy people, and I'm over the moon to get what feels like proof that it was never a moral failing and now it's over. I want EVERYONE to know.

I don’t see why that is a big deal to so many people. Life is full of commitments, no reason a daily med that keeps you lean and healthy shouldn’t be one of ‘em.

I'm starting to suspect the answer might be "money." Like, they've accepted that this means five hundred dollars a month (so many of them don't even know about compound), and know that's just not doable for a decade or more until generic comes. Or they're still in "being fat is a moral failing and after I'm a thin person, I'll be able to act right and eat less" thoughts. Either way, it's likely to hurt their hearts so much when they go off and say "all done" and I wish whoever's job it was to make that clear to people was working harder to make that understood.

 

[Stets]

I'll be titrating down over the course of a couple of months until I can come off completely. I'll be continuing my habit of daily weigh ins, daily cardio, and weightlifting 4-5 days per week. I was doing all of this before going on Reta, and I was losing weight fine without it, but I've had essentially zero cravings while on Reta. It has definitely been easier to lose these last few pounds than it would have been without.

If I gain a bit of weight back, I'm fine with that. I want to try to put on some muscle over the winter anyway, and with my current level of hunger being basically zero that would be impossible. If I need to go back on Reta in the spring to lean out again, I'm fine with that.

 

[Captj]

Unless you can control all the things that made you obese (psychological issues, caloric surplus eating, age) you have to accept these are lifelong drugs no different than blood pressure medication. You have a disease process that these drugs keep controlled. Why would you stop taking them????

Exactly! My husband likes to say there are ways to do this without taking shots, but he doesn’t get it. He’s never been overweight or had issues with food so he doesn’t understand why this is a long term thing and not just a “jump start”. We definitely agree to disagree and I do what I have to do and for the most part he’s supportive of my weight loss and my working out.

 

[deleted.user.18]

Yeah… IDK about continuously for life… but when you see yourself slacking off in the kitchen or at the gym and you want a little support to drop 10lbs while you get back on track, maybe. I cannot really speak until I hit my goal weight and start trying to maintain.

 

[littledragon25]

I'll be titrating down over the course of a couple of months until I can come off completely. I'll be continuing my habit of daily weigh ins, daily cardio, and weightlifting 4-5 days per week. I was doing all of this before going on Reta, and I was losing weight fine without it, but I've had essentially zero cravings while on Reta. It has definitely been easier to lose these last few pounds than it would have been without.

If I gain a bit of weight back, I'm fine with that. I want to try to put on some muscle over the winter anyway, and with my current level of hunger being basically zero that would be impossible. If I need to go back on Reta in the spring to lean out again, I'm fine with that.

See, this is where I think there is a difference in the 2 types of people taking GLP1s. There are the people who sound like they were fit and healthy before and just used it to get really shredded (which you sound like you fit here, as you have lots of healthy lifestyle habits anyway which you were able to stick to without the reta) and the people who were obese and struggled with controlling their intake before the meds.

Group 1 will be able to stop the meds. Group 2 will struggle if they do.

 

[lessthanhalf]

I think it depends a bit on why you are taking it, if you are 5 to 10 kilos overweight or don't have a long term problem with obesity, then maintaining a good diet might work, without having to stay on glp's long term. Exercise is definitely good for you but there is not a lot of evidence it makes much difference to weight. It also would depend on how old you are and if you have other health problems. Any of hypertension, diabetes, pre diabetes, high cholesterol, heart disease, kidney disease, arthritis etc are good reasons to stay on it because they improve long term outcomes.

Assuming you have severe obesity or a lifelong problem, there is zero doubt that staying on them long term is a good idea. Losing weight is not the hard part, keeping it off is. In all the research I have read, with the exception of bariatric surgery 90 to 95% of people who lose significant amounts of weight through diet and exercise, put all or most of it back on over the next few years, even with expert help from multidisciplinary teams. And if you lose weight with glp's and then stop them the research says the same. Nearly everyone will gradually put the weight back on. Unfortunately self control is not an infinite resource, if you are having to consciously control how much you are eating with mental effort, it wears out eventually in nearly everyone no matter how much you don't want it to. There are not yet any very long term studies on glp's, I think 60 months is the longest , but they all show that if you stay on the dose that worked, then the weight loss is maintained.

A lot of people on here think that maintenance can be done with lower doses than were used to lose the weight, and that may apply if the weight loss was not massive or was still falling at a decent rate when you got to your target weight, but otherwise the maintenance dose is likely to be the dose that got you there. All the research on weight loss maintenance with glp's is at the final dose not at lower doses. The biggest problem with them for a lot of people like me, who are or were very overweight, is they are not quite effective enough yet, the best result being low 20% range from reta, and a lot of people want to lose more than that resulting in the experiments with multiple glps or other peptides. The drug companies seem to be looking into this as well, quite intensively, from what I have read, but apart from cagrisema, and a few early phase 1 and 2 trials, there are no results yet. But even 20% loss if you are 30 or 40 % overweight is still enough to make a huge difference to long term health consequences. And staying on glp's reduces the risks of most of the most common and serious health problems - cancers, heart disease, probably dementia and lots of others.

 

[desinr-gal]

Oh no, though anyone whose situation is more complicated than mine is welcome to. My stuff (minus the grey part) is right out there on FB. I don't talk to judgy people, and I'm over the moon to get what feels like proof that it was never a moral failing and now it's over. I want EVERYONE to know.

I'm starting to suspect the answer might be "money." Like, they've accepted that this means five hundred dollars a month (so many of them don't even know about compound), and know that's just not doable for a decade or more until generic comes. Or they're still in "being fat is a moral failing and after I'm a thin person, I'll be able to act right and eat less" thoughts. Either way, it's likely to hurt their hearts so much when they go off and say "all done" and I wish whoever's job it was to make that clear to people was working harder to make that understood.

Yes Money! If it were available and covered by insurance like my Levothyroxine, no one would be stopping. IMHO It is cruel and so greedy of EL to charge what they do.

 

[brownb56]

For me the only real alternative I saw was having a doc slice up and rearrange my guts. And dealing with the lifelong consequences with that and no guarantee of long term success.

I've struggled all my life and needed some kind of help. Watched a bunch of my family go through gastric by-pass. Know quite a few others. And only very few of them were successful. And dealt with issues such as vitamin deficiency. Getting to be standard now that people are put on glp meds a year or two after by-pass to help them maintain weight.

People are on all kinds of other meds for the rest of their lives. I see no reason this should be looked at differently. I'd rather be on a glp that I take once a week. Rather than blood pressure, diabetes or pain meds that are taken daily.

 

[psycho_driver]

A couple of factors here.

When a person puts on weight their fat cells inflate with stored energy up to a point, then when they get to a certain size they're like "Oy! Enough of that!" and they split into two half-full fat cells. Rinse and repeat, over and over, as a person gets more overweight.

When we lose weight the fat cells do not disappear. They shrink. When they shrink they start grumbling to your brain via chemical signalling that they're starving. As we lose more weight we have more grumbling fat cells, and your brain starts to think "maybe I really am starving" and it tries to trick you into eating caloric-dense foods to re-inflate your poor starving fat cells. Thus why people generally need to titrate doses up as they lose weight to continue to achieve comparable appetite control.

Fat cells have an average lifespan of 8-10 years. If we can keep them in a starved state until the end of their lifespan they might just go away instead of the body replacing them as it would normally try to do. Therefore the need to remain on a GLP-1 might decrease over a long period of time as fat cells finally disappear.

The second factor is insulin resistance. Being overweight tends to mean you have at least some level of insulin resistance. If you're pre-diabetic or diabetic then you definitely have a good amount of insulin resistance. Insulin resistance plays all kinds of havoc on your metabolic processes. GLP-1s work magic when it comes to glucose metabolism and insulin sensitivity. If you can lose down to a healthy weight and maintain a healthy diet for a long period of time it's believed most people can reverse insulin resistance. Probably the younger and healthier you are combined with how long you can maintain a healthy balanced diet will determine how fast and far you can reverse insulin resistance. This would also be a long-term process but over time might allow for GLP-1 maintenance doses to slowly decrease.

 

[MsGizmo]

For me the only real alternative I saw was having a doc slice up and rearrange my guts. And dealing with the lifelong consequences with that and no guarantee of long term success.

I've struggled all my life and needed some kind of help. Watched a bunch of my family go through gastric by-pass. Know quite a few others. And only very few of them were successful. And dealt with issues such as vitamin deficiency. Getting to be standard now that people are put on glp meds a year or two after by-pass to help them maintain weight.

People are on all kinds of other meds for the rest of their lives. I see no reason this should be looked at differently. I'd rather be on a glp that I take once a week. Rather than blood pressure, diabetes or pain meds that are taken daily.

I've had the vertical sleeve surgery .. and that often doesn't work long term either. If only GLP1s existed back then.

 

[MsGizmo]

A couple of factors here.

When a person puts on weight their fat cells inflate with stored energy up to a point, then when they get to a certain size they're like "Oy! Enough of that!" and they split into two half-full fat cells. Rinse and repeat, over and over, as a person gets more overweight.

When we lose weight the fat cells do not disappear. They shrink. When they shrink they start grumbling to your brain via chemical signalling that they're starving. As we lose more weight we have more grumbling fat cells, and your brain starts to think "maybe I really am starving" and it tries to trick you into eating caloric-dense foods to re-inflate your poor starving fat cells. Thus why people generally need to titrate doses up as they lose weight to continue to achieve comparable appetite control.

Fat cells have an average lifespan of 8-10 years. If we can keep them in a starved state until the end of their lifespan they might just go away instead of the body replacing them as it would normally try to do. Therefore the need to remain on a GLP-1 might decrease over a long period of time as fat cells finally disappear.

The second factor is insulin resistance. Being overweight tends to mean you have at least some level of insulin resistance. If you're pre-diabetic or diabetic then you definitely have a good amount of insulin resistance. Insulin resistance plays all kinds of havoc on your metabolic processes. GLP-1s work magic when it comes to glucose metabolism and insulin sensitivity. If you can lose down to a healthy weight and maintain a healthy diet for a long period of time it's believed most people can reverse insulin resistance. Probably the younger and healthier you are combined with how long you can maintain a healthy balanced diet will determine how fast and far you can reverse insulin resistance. This would also be a long-term process but over time might allow for GLP-1 maintenance doses to slowly decrease.

Hmm ... so what I get from that is we need to have an 8 year supply tucked away in our freezers.

 

[mlke6]

Hmm ... so what I get from that is we need to have an 8 year supply tucked away in our freezers.

Of each favorite. Just in case you want to switch around every few months

 

[50ShadesGreyMarket]

I just did my first pin of 1mg of triz and I am worried because I have never done anything like this before and hope I don't regret it. I don't think even though I just started if this is something that I want to do long term. The shot was easy but it's kind of irritated. I did use an alcohol wipe before it was administered. Thank God it's only one time per week and I hope that I notice a lessening of food noise very quickly LOL I don't know how you guys can see the numbers and lines on those syringes. I bought the .3 cc sryinge and I had a hard time seeing it. I brought a 1 mg syringe home from work and it was even worse....

Long before I started on GLP’s I’ve been pinning so many peptides that I’d lose track if it weren’t for the excel sheets. I pin NAD+ almost daily and cycle GLOW 5 days a week for 2-3 months at a time in addition to 10-15 other peptides I take anywhere from twice a week to once a month. I’m not overweight by any means so there’s not a whole lot of space to chose from on my abdomen.

My first pin was the hardest, I had to come up with a breathing technique so I didn’t tense up and I use a small light against my flesh to make sure I avoid larger capillaries/veins. One trick is to use 31g/8mm needles, pinch and poke fast on the exhale. I started watching in a mirror once I was comfortable, then stopped even looking at it during the poke. I gently lessen my grip on the pinched skin/fat and let it go flat while I slowly inject. I also dilute NAD+ a lot more with bac and it doesn’t burn anymore. There’s a lot of tricks you will learn over time, most importantly have all your supplies together to maintain sterility and comfort.

 

[hexagonal]

So it's my understanding that these meds, if you opt to use them, are a "forever" thing. It looks awfully well-studied that if you use sema or tirzep and prolly reta when the studies get that far, you lose a bunch a weight, hooray you're healthy, and then you stop....then you are probably going to start slowly regaining "a lot" to "all and more" of that weight back over the course of a year; and there's no indication I saw that at the end of that year, your body goes "all right buddy, I tried my best, but I see you really don't want to do this so we can stop gaining weight now." Maybe you'll be in the exceptional minority posting on reddit "I lost it all six years ago, stopped the med, and haven't gained an ounce!" But you probably won't be.

Roughly 1/3 of my office is on some kind of glp1, either sema or tirz. The ones who are very near goal weight talk about how excited they are to be done and get off the meds, or that they only have X weeks of the meds to go. And of course the insurance companies who cover these meds stop when you're not obese anymore, because "all better!"

This seems pants-on-head insane to me. Far as I know, glp1 drugs mostly make it so that you can stand to eat the amount that would put you at a healthy weight. Remove that, and you lose that ability, and regain. The studies seem to support that.

But it feels like everybody's walking around saying with a straight face that that's not true, and blinking twice at me when I say "No, I'm never coming off these drugs. This is a lifelong med." I'm starting to feel like I'M the crazy one here.

Would welcome perspectives.

It depends on a whole lot.

I've totally changed my lifestyle while on tirz and then reta. I doubt that even if I dropped off I'd ever get back to where I was. It's just a lot harder to put on all that fat when you've changed your source of food from Uber Eats twice a day to prepackaged healthier food from the local supermarket, going from totally sedentary to lifting 5 times a week and some additional cardio, etc.

But I'm also likely staying on low-dose for forever. Just too much evidence of other health benefits even outside of the weight loss.

But I do also think that most people don't make these massive lifestyle changes and will likely need to continue indefinitely. And that's fine! Far better than the alternative.