On weight loss medication.
Jul. 9th, 2025 08:53 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
lnrI wrote this on Bluesky last week, but wanted to save it in slightly longer form
On obesity and weight loss and medication
As a well off, educated, active person, who likes food including healthy things, but still has a lifelong struggle with my weight I do find even the best intentioned discussions around obesity hard. I'm currently heading towards a healthy weight/waist size using Wegovy, but that's a short term aid. What happens when I stop taking it? The advice from my practitioners is that obviously unless I keep up enough healthy changes I will gain weight, and I know that. But I don't know *how*. How to not eat when I'm hungry. How to never want to eat the foods that other normal people eat. I can book in some one-to-one sessions with a dietician and psychologist when I'm closer to trying to maintain my weight, but I honestly don't know how much it will help.
The first time I lost a big chunk of weight I was *sure* I wasn't going to be one of those people who gain it all back again. But I found it so so hard to stay where I wanted to be that eventually I couldn't face trying any more. I do wonder if in future a very low dose of GLP1 agonists or similar will be a long term maintenance option for people like me. Its not an option now. When I hit a BMI of 23.5, or reach 2 years of taking them, I'll be cut off. Then we get to see what realistic help is available at that point. I don't want to have to battle my weight forever, and right now it's not a battle. But how do you even prepare for that?
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Date: 2025-07-09 03:55 pm (UTC)My hope is that if you've already lost a lot of weight, some set point mechanisms may adjust to your new weight and diet, and *not* fight you if you keep eating similarly.
But I don't know what's actually likely. My speculation is that when people sustain weight loss, they've usually found an adjustment where they're "normally" hungry approaching meal times, but not continually hungry the way people can be when they're actively calorie restricting, and that people usually can't sustain a diet if their body is constantly demanding more.
But I know it varies massively between people. Have you heard any anecdotal reports from people who have transitioned off the drug?
My experience has been that I have managed a sustained period of weight loss a couple of times, but only when I was sufficiently non-depressed, and when I focused on doing exercise and eating more healthy foods, and naturally found I had less appetite for everything else. I speculate that some people have a metabolism like that always (or until they reach 30), and some people never do, and maybe I'm in the range where my mental health makes the difference between healthier habits and less healthy habits winning out. But that's *really* unfounded...