> Dr Adam Collins, an expert in nutrition at the University of Surrey, says the way the jabs work in the brain and body might explain why weight regain is amplified once you stop taking them. They mimic a natural hormone called GLP-1, which regulates hunger. "Artificially providing GLP-1 levels several times higher than normal over a long period may cause you to produce less of your own natural GLP-1, and may also make you less sensitive to its effects. "That's not a problem when taking the drugs, but as soon as you withdraw this GLP-1 'fix', appetite is no longer kept in check and overeating is far more likely."

If that is true, and it makes mechanistic sense if I think about opiod withdrawals for example, then it is a problem regardless. If you have a stronger hunger impulse then before AND a lower body weight and thus TDEE, I can imagine that it would be pretty tough mentally to maintain your weight, even if you count your calories.

It's amazing that this isn't common sense to most people.

I foresee the overwhelming majority of people on these drugs regaining everything (and maybe even going beyond their original weight), because, just like traditional dieting, they don't actually change their lifestyle. They're just giving their system a shock, which when it goes back into fat storing mode will overcompensate due to the shock of the loss.

The nihilist in me doesn't believe that many people are truly capable of massive lifestyle change. Once you've lived a certain way for 20 or 30 years, any change beyond that is just a fleeting thing. Yo-yo weight loss and gain just proves that. It only becomes a real lifestyle change after many years.

Somewhere in this thread someone mentioned eating a tub of ice cream at night, if anything, all that sugar is going to fuck your system up beyond what any drug can repair.

I agree, I fast regularly and I’m fit for most of the year but comes the holidays and I don’t restrict myself which causes issues comes January, I have to train myself to regulate my appetite Ava hunger. It takes a bit and it goes back to normal by February and March but it takes some work.

My wife, age 60, has battled her weight her whole life, and my son-in-law is currently taking one of the GLP-1 drugs. When I listen to them discuss all this, the one thing that stands out to me is "The drug quiets the voices in my head about food." If there are sweets in the house, for instance, my wife can possibly resist eating them, but she cannot stop thinking about them. For them, and I think for many people, it's not just a matter of hunger but hunger and learned behaviors. My wife can tell you how those voices were activated by her mother when she was a child. It's really complicated.

If there are sweets in the house, I may eat more than I would like, but I don't really have those voices, and after being married to my wife for 40 years, I can't pretend to even understand what her thoughts are about food. I can get a brownie from the kitchen, eat it and forget about them until I come back into the kitchen again. I suspect you also don't have those voices.

(For reference, I've never been particularly overweight, but twice in my life my weight crept up, and I managed to lose and keep off for years 10-25 pounds through diet changes alone; yes, my weight did eventually creep up, but I think the number of years before that happened would qualify medically as a successful weight loss)

To get back to this discussion, my son-in-law has lost 50 pounds since he started taking the GLP-1 drug, but he has also changed his diet and he exercises regularly. He was trying to do those things with mixed success in terms of weight loss before he started taking the drug, so I would say he would probably stand a higher chance of keeping the weight off if he were to stop the drug, but his doctor talks about him always being on a low maintenance dose.

The other option which people seem to shy away from is to simply embrace the act of feast and famine. I'll regularly go through binges, colloquially known as "Christmas" and "Summer", and to be honest I don't sweat about it. Either the fire is on and we're all celebrating with family and friends with a beer and a roast dinner, or the sun is out and we're having BBQ and cocktails doing the same.

If you can master the skill of dietary control, and go a month or two with really spartan fasting routine between celebration periods, life becomes a lot less stressful. I always enjoy watching Paddy Pimblett (UFC fighter well known for radical weight transformations:https://www.bbc.com/sport/mixed-martial-arts/62135535) bounce between weights, but always get in shape before a fight. It's a skill that only gets easier with practice.

Yeah, rather than eating pizza and being unable to finish the incredibly delicious high calorie food you probably want to just eat quinoa and salmon bowl or equivalent healthy food.

What does this even mean? GLP-1s modify the reward center of the brain which significantly quells cravings and makes foods much less rewarding when they are consumed. If pizza becomes just as rewarding as a quinoa and salmon bowl the you're less likely to eat the pizza.

You can gain weight on a healthy diet too though!