How do you lose weight without using up all your willpower?

[EscapeVelocity2020]

With as strong as these GLP-1 medications are, and how they advise a slow ramp up and ramp down, I'd be nervous about this strategy of dilution.  I now receive 2ml of 2.5mg/ml (months 3 - 6).  I spent 1 month at 0.25mg and will now stay at 0.5mg for months 3 and 4 by personal choice, which effectively doubles how long my supply will last.  What would give me pause about your 'cost saving strategies' would be having to deal with an overdose.  These medications can last 5 - 7 weeks on average in the body and side effects include nausea, fatigue, low blood sugar, constipation, dizziness... 

[TheAnonOne]

You can get compounded tirzepatide for 300-400/mo. I am also looking into just buying it from the source as a raw powder. I know at least one supplier will sell 10x 10mg vials for $450. That's quite a lot of this drug, especially if your under the 10mg dosage. Looking at $22.50 a week for the 5mg level ($90ish per month).

Access will expand over time, and quite a few companies have a version in the works. Prices won't stay this elevated for long, even at the "name brand" level.


Weight Update while I am typing: Only half way through W4, so it's really W3.5 right now. Hit 246. Down another 2.4lbs so far. Final weigh in isn't for another 4-5 days for W4 or Month1.

Yeah I've been reading about that a bit.  The world of peptides (mainly sourced from China) has me a bit cautious.  What I think I will do instead (and others are doing) is to buy the Eli 15mg pens at the cash price (w/ or w/o coupon) and then reconstitute/dilute down to the dose I need, using BAC water. 

Using the new coupon, and taking a 5mg dose, that makes a 15mg pen Rx $1051-$500=$551.  Then you can get 3 months of drug, for 183/mo.  And no worry about purity/origin.  If you are on 2.5mg does, its 6 months per 15mg fill. 

I assume come June, they will either offer a new coupon, or the obesity indication will be approved and a new brand drug will be launched, along with a new coupon.  For those first few months, they coupon will have to be attractive since no insurance company will have it on their formulary yet. 

Day 10 for me on 2.5mg dose, -8.9lbs.  No "food noise".  Have been eating very healthy.  Exercising daily.  No temptation to "binge".   RBG / BP are all improving.
Planning to stay on 2.5mg - 5mg for as long as I can.  Buying a used lifefitness elliptical today :)

Buying raw peptides ranges from sketchy to pretty safe.

• Directly from china? sketchy (but $45 for 10mg)
• Directly from some places like arctic peptides? very safe ($110-130 for 10mg)
• Getting an RX from an online doctor and having the script sent to a compound pharmacy like ACA? Extremely safe, and already in liquid form. This is what I am doing for now. ($300-400 for 10mg)
• Mounjoro name brand ($1000+/mo for all levels)

[mm1970]

I tend to mindlessly snack. if there are baked goods in the house I demolish them. I'm not paying attention to what goes in my mouth and making considered choices; I'm choosing what is convenient. And because convenience is such a big driver for me, going through the extremely INconvenient MFP process just never happens no matter how I try lol

But much like my spending, I do need to create that similar pause moment with food, to step back and see my patterns that are both working and not working, and are or are not going in a direction I want. I KNOW more nutritionally satisfying foods would make me feel better and more full, but in the moment, food is just food and I'm alleviating an urgent need and quieting the pangs. But food isn't just food; its a tradeoff and I think I need to be more conveniently and quickly reminded of what I'm trading.

What has been working for me (SLOWLY, and mostly- this past weekend of being in a hotel room / car for hours on end) ...

I let myself have the treats.  But I plan ahead each day, choose what the treat is going to be, and look forward to it.  If I'm going to eat banana bread, I know at 9 am that it's going to be my afternoon treat.

I also spend about 5 minutes every morning planning out my meals for the day - so that I know I'm getting enough protein and produce.

[jrhampt]

Interesting to see all the diabetic meds in this thread...I went on 1000 mg daily dose extended release version of metformin in mid-February (this is a much, MUCH less expensive diabetic drug that also has much less dramatic weight loss effects) and have lost 7-8 pounds since then.  Prior to that I had unusually gained 10 pounds over a short period of time between the holidays and covid, and I was already doing all the usual things (IF, daily exercise weights + cardio, reasonable diet with calorie deficit) but they were having absolutely zero effect which was also highly unusual.  I suspected some combo of covid after effects (known to increase risk of becoming diabetic), hormonal changes associated with perimenopause, or temporary reduction of weight training following a car accident.  Whatever the cause, metformin is a very safe, cheap drug with multiple benefits that lots of the longevity people are on for reasons other than weight loss.  My only side effect was minor constipation for the first week or so; I am quite satisfied with the results. 

[wenchsenior]

Interesting to see all the diabetic meds in this thread...I went on 1000 mg daily dose extended release version of metformin in mid-February (this is a much, MUCH less expensive diabetic drug that also has much less dramatic weight loss effects) and have lost 7-8 pounds since then.  Prior to that I had unusually gained 10 pounds over a short period of time between the holidays and covid, and I was already doing all the usual things (IF, daily exercise weights + cardio, reasonable diet with calorie deficit) but they were having absolutely zero effect which was also highly unusual.  I suspected some combo of covid after effects (known to increase risk of becoming diabetic), hormonal changes associated with perimenopause, or temporary reduction of weight training following a car accident.  Whatever the cause, metformin is a very safe, cheap drug with multiple benefits that lots of the longevity people are on for reasons other than weight loss.  My only side effect was minor constipation for the first week or so; I am quite satisfied with the results.

Yeah, I would say Metformin is frequently viewed as a wonder drug in the polycystic ovary syndrome community (assuming the people have a doctor that understands PCOS well enough to think to try it, which shockingly many do not).

[Prairie Gal]

PTF

[Cassie]

Unless I was very obese I wouldn’t use metformin or any other diabetes drug to lose weight. They all have side affects.

[TheAnonOne]

Unless I was very obese I wouldn’t use metformin or any other diabetes drug to lose weight. They all have side affects.

GLP-1 drug side effects are only about as bad as most diets cause. Tiredness, sometimes upset stomach/constipation.

[EscapeVelocity2020]

Unless I was very obese I wouldn’t use metformin or any other diabetes drug to lose weight. They all have side affects.

Everyone is entitled to their own opinions, but there is a whole body of research about the benefits of a calorie restricted diet.  The more informed I am about the tradeoffs, the better my decisions can be.  https://www.nia.nih.gov/news/calorie-restriction-may-benefit-healthy-adults-under-50

[Cassie]

I just prefer to both lose weight and maintain by calorie counting and exercise. I lost 50lbs 3 years ago and have had no problems maintaining. In the past I did this for 20 years until my beta blocker slowed down my metabolism and I basically gave up and ate whatever I wanted. Then 3 years ago older fat people were dying due to covid and I became motivated to change. Since I have been successful in the past maintaining for decades without drugs I am sure that I can do it now.

[Nangirl17]

I also find it takes a lot of energy to count calories, so I do 2 things to mitigate that:

1) First thing in the morning, I plan out what I'm going to eat for the entire day. I put it in my calorie tracker and everything (I use Noom). Then it is easy to just follow the plan instead of thinking all day about what to eat/avoid. If I don't do this, I fail every time - I just don't have the energy or willpower!

2) I have a lot of routine foods that I eat - oatmeal with fruit in the morning, peppers/dip or apples/yogurt for mid aft snack, etc. 

[Prairie Gal]

I just prefer to both lose weight and maintain by calorie counting and exercise. I lost 50lbs 3 years ago and have had no problems maintaining. In the past I did this for 20 years until my beta blocker slowed down my metabolism and I basically gave up and ate whatever I wanted. Then 3 years ago older fat people were dying due to covid and I became motivated to change. Since I have been successful in the past maintaining for decades without drugs I am sure that I can do it now.

That's great that you are able to maintain your weight loss. Seriously great. The vast majority of people are not able to do that. People with obesity often have hormonal or other problems that prevent this. The new GLP1 agonist drugs help correct this. They are only indicated for people with a BMI over 30, or 27 with co-morbidities. Doctors and scientists are only beginning to understand obesity. It is not as simple as calories in, calories out. Not by a long shot.

[jim555]

Sorry, it is all about calories.  Pure math problem.

[dividendman]

Sorry, it is all about calories.  Pure math problem.

Yes, calories in < calories out will reduce weight. But it can also be true that some people are hungrier than others, ghrelin and other "hunger" hormones are more active in heavier people. This causes them to consume more calories. Obviously they can still lose weight by consuming fewer calories and/or burning more.

[EscapeVelocity2020]

Sorry, it is all about calories.  Pure math problem.

Obesity solved!  You really should write a book LOL

[TheAnonOne]

Update:

6 weeks on Tirzepatide. 4 weeks at 2.5mg, 2 weeks at 5.0mg.

260->243
Down 17.2lbs and 1 entire pant size.


Basically magic.

[Kris]

Update:

6 weeks on Tirzepatide. 4 weeks at 2.5mg, 2 weeks at 5.0mg.

260->243
Down 17.2lbs and 1 entire pant size.


Basically magic.

What happens when you’re done losing weight? Do you have to keep takin* it, or do you stop?

[TheAnonOne]

Update:

6 weeks on Tirzepatide. 4 weeks at 2.5mg, 2 weeks at 5.0mg.

260->243
Down 17.2lbs and 1 entire pant size.


Basically magic.

What happens when you’re done losing weight? Do you have to keep takin* it, or do you stop?

It's a bit personal, given that I could get down to around 200lbs as a 6ft stocky male, I have some time to think about it.

First and foremost, I have never been under 220 as an adult, struggled to ever really be under 230 and since 2019, struggled to be under 250.


The data says the following:
70% of folks will regain most of their lost weight but still remain under their max.
30% of folks will maintain their new body weight.

Those are actually extremely superior results to dieting, which has something like 95% fail rate.


For me personally:
This will take 6-12 months, maybe longer. My eating habits are being altered, perhaps permanently. I will likely need to occasionally revisit the medication at much lower concentrations and/or go on a lower dosage with longer times between.

For me, obesity, even if I was never uber-fat, has much more side effects and costs than this medication ever could have, in lifestyle, health, and yes, just how I look. These are easily sourced for cheap through off-market methods now as well.


Ultimately, time will tell, but I would gladly take this for the rest of my life if it could maintain my health, and weight.

[EscapeVelocity2020]

Just for an additional datapoint with Semaglutide, I was at 0.25 mg/week my first month (0.1 mL), then 0.5 mg and now should be 1 mg (0.4 mL).  I lost around 10 lb my first 4 - 6 weeks and another 5 lb after another 4 weeks.  I have decided to remain at 0.5 mg/week, although instructions are to go to 1.7 mg.  Honestly, the constipation aspect and feeling nauseous at the end of vigorous exercise have me concerned to increase the dose further.  I am maintaining my current weight, or maybe still dropping a little, so I am extremely happy.  100% agree with your comments that it is 'like magic', even when I was going hardcore on diet and exercise, it was never this easy to maintain my current weight and resist snacking / sweets.  Because I am being mailed the 1.7 mg dosage, DW might join me - she has been asking a lot of questions and noticing the change. 

[TheAnonOne]

Just for an additional datapoint with Semaglutide, I was at 0.25 mg/week my first month (0.1 mL), then 0.5 mg and now should be 1 mg (0.4 mL).  I lost around 10 lb my first 4 - 6 weeks and another 5 lb after another 4 weeks.  I have decided to remain at 0.5 mg/week, although instructions are to go to 1.7 mg.  Honestly, the constipation aspect and feeling nauseous at the end of vigorous exercise have me concerned to increase the dose further.  I am maintaining my current weight, or maybe still dropping a little, so I am extremely happy.  100% agree with your comments that it is 'like magic', even when I was going hardcore on diet and exercise, it was never this easy to maintain my current weight and resist snacking / sweets.  Because I am being mailed the 1.7 mg dosage, DW might join me - she has been asking a lot of questions and noticing the change.

That's awesome. Consider Tirzepatide if you can, it's really broken quite a few "walls" from folks on Semi. It's more $$$, it's got a bit of a shortage going on, but it is objectively better, much less side effects, more loss.

[bryan995]

Week 4 for me on Mounjaro (Tirzepatide).  Week 3 for my wife.  We are both still taking the 2.5mg.  Absolutely amazing drug.  I am down 15 lbs, wife is down 11 lbs. Appetite suppression has been unreal. 
RGB is back to normal.  BP is normal.  Mental clarity, energy, everything has improved.  Maybe its all psychosomatic, but who cares? :)

Plan is to continue on the lowest possible dose for as long as it is still effective.  No desire to ramp monthly towards the 15mg. (though I am ramping my fills/buys - already have some 15mg and splitting doses via sterile handling.. this drives the cost very low)

Have been paying the $523/mo for the pharma pens per fill, with no plans to pursue compounding.  Given how (both my wife and I ) are responding we are OK to continue spending the ~$1200/mo or even the ~$2400/mo after the coupon ends in June.
Insurance is refusing to cover, as one would expect in the USofA.  I need to develop full blown diabetes first, preventing the onset of a chronic disease does not count...

We've already accumulated 6 boxes ahead of the pending June coupon-pocalypse.  Never thought we would spend >$3500 on a medicine in <2 months, but here we are.

So far, no symptoms (nausa, GI etc).  Wife has had some mild nausea that has now subsided. 
I have also experienced incredibly high energy, so much so that I now find myself 'wanting' to work-out for 45-60 mins per day.  what?

Given our experience and countless others that have been using these drugs (facebook/reddit), we've now invested just about $50k of our rothIRA into $LLY. 
The obesity indication approval is coming soon - this is going to be a total game changer for many years to come.

[bryan995]

Just for an additional datapoint with Semaglutide, I was at 0.25 mg/week my first month (0.1 mL), then 0.5 mg and now should be 1 mg (0.4 mL).  I lost around 10 lb my first 4 - 6 weeks and another 5 lb after another 4 weeks.  I have decided to remain at 0.5 mg/week, although instructions are to go to 1.7 mg.  Honestly, the constipation aspect and feeling nauseous at the end of vigorous exercise have me concerned to increase the dose further.  I am maintaining my current weight, or maybe still dropping a little, so I am extremely happy.  100% agree with your comments that it is 'like magic', even when I was going hardcore on diet and exercise, it was never this easy to maintain my current weight and resist snacking / sweets.  Because I am being mailed the 1.7 mg dosage, DW might join me - she has been asking a lot of questions and noticing the change.

These are wegovy pens or ozempic?  It is unfortunate that you cannot click-dose on the wegovy pens.  If it were ozempic, self dosing / metering is incredibly easy.  Buying the 8mg pens would be the most cost effective.  Then all you need to buy are more disposable needles heads.  You could split the 8mg pen into 16 x 0.5mg doses.  Which given that nova only recommends for the pen to be used for 56 days after the first dose, splitting it between two people would solve that problem.  Each using a different sterile needle cap each time.

It really is like magic, as crazy as that sounds.  Lots of studies now looking at GLP-1s effect on various other diseases / disorders (alcoholism, parkinsons etc).  Lots to come here.

[TheAnonOne]

Week 4 for me on Mounjaro (Tirzepatide).  Week 3 for my side.  We are both still taking the 2.5mg.  Absolutely amazing drug.  I am down 15 lbs, wife is down 11 lbs. Appetite suppression has been unreal. 
RGB is back to normal.  BP is normal.  Mental clarity, energy, everything has improved.  Maybe its all psychosomatic, but who cares? :)

Plan is to continue on the lowest possible dose for as long as it is still effective.  No desire to ramp monthly towards the 15mg. (though I am ramping my fills/buys - already have some 15mg and splitting doses via sterile handling.. this drives the cost very low)

Have been paying the $523/mo for the pharma pens per fill.  Do not plan to pursue compounding.  Given how (both my wife and I ) are responding we are OK to continue spending the ~$1200/mo or even the ~$2400/mo after the coupon ends in June.
Insurance is refusing to cover, as one would expect in the USofA.  I need to develop full blown diabetes first, preventing the onset of a chronic disease does not count...

We've already accumulated 6 boxes ahead of the pending June coupon-pocalypse.  Never thought we would spend >$3500 on a medicine in <2 months, but here we are.

So far, no symptoms (nausa, GI etc).  Wife has had some mild nausea that has now subsided. 
I have also experienced incredibly high energy, so much so that I now find myself 'wanting' to work-out for 45-60 mins per day.  what?

Given our experience and countless others that have been using these drugs (facebook/reddit), we've now invested just about $50k of our rothIRA into $LLY. 
The obesity indication approval is coming soon - this is going to be a total game changer for many years to come.

I've considered just buying the 15mg pens and dosing them appropriately to have "name brand" and also some reasonable costs.

That said, you need an actual prescription first, and I never bothered going to the doctor. I signed up with a telehealth and had the crap ordered within a few hours online.

I've since ordered the powdered peptides directly from an international manufacturer that has a decent reputation online, but that option is probably a bit too sketchy for most. That said 10mg only costs $45. I'll report back if/when I actually use it. Still going with the telehealth compounded version for now, but wanted a supply for the coupon wave that's coming.

[EscapeVelocity2020]

These are wegovy pens or ozempic?  It is unfortunate that you cannot click-dose on the wegovy pens.  If it were ozempic, self dosing / metering is incredibly easy.  Buying the 8mg pens woudl be the most cost effective.  Then all you need to buy are mode screw on needles. 

It really is like magic, as crazy as that sounds.  Lots of studies now looking at GLP-1s effect on various other diseases / disorders (alcoholism, parkinsons etc).  Lots to come here.

I receive 3 x 1 mL vials of Semaglutide and 10 subcutaneous needles per month currently, definitely prefer this over the prefilled pens.  I can see this medication becoming normalized for people who can afford it, along the lines of getting Botox…

[bryan995]

Week 4 for me on Mounjaro (Tirzepatide).  Week 3 for my side.  We are both still taking the 2.5mg.  Absolutely amazing drug.  I am down 15 lbs, wife is down 11 lbs. Appetite suppression has been unreal. 
RGB is back to normal.  BP is normal.  Mental clarity, energy, everything has improved.  Maybe its all psychosomatic, but who cares? :)

Plan is to continue on the lowest possible dose for as long as it is still effective.  No desire to ramp monthly towards the 15mg. (though I am ramping my fills/buys - already have some 15mg and splitting doses via sterile handling.. this drives the cost very low)

Have been paying the $523/mo for the pharma pens per fill.  Do not plan to pursue compounding.  Given how (both my wife and I ) are responding we are OK to continue spending the ~$1200/mo or even the ~$2400/mo after the coupon ends in June.
Insurance is refusing to cover, as one would expect in the USofA.  I need to develop full blown diabetes first, preventing the onset of a chronic disease does not count...

We've already accumulated 6 boxes ahead of the pending June coupon-pocalypse.  Never thought we would spend >$3500 on a medicine in <2 months, but here we are.

So far, no symptoms (nausa, GI etc).  Wife has had some mild nausea that has now subsided. 
I have also experienced incredibly high energy, so much so that I now find myself 'wanting' to work-out for 45-60 mins per day.  what?

Given our experience and countless others that have been using these drugs (facebook/reddit), we've now invested just about $50k of our rothIRA into $LLY. 
The obesity indication approval is coming soon - this is going to be a total game changer for many years to come.

I've considered just buying the 15mg pens and dosing them appropriately to have "name brand" and also some reasonable costs.

That said, you need an actual prescription first, and I never bothered going to the doctor. I signed up with a telehealth and had the crap ordered within a few hours online.

I've since ordered the powdered peptides directly from an international manufacturer that has a decent reputation online, but that option is probably a bit too sketchy for most. That said 10mg only costs $45. I'll report back if/when I actually use it. Still going with the telehealth compounded version for now, but wanted a supply for the coupon wave that's coming.

Yeah I can understand that. It’s just too sketch for me. If I can stay on 2.5mg or 5mg, then a 15mg box bought now at $523, turns into either $87 or $174 / month.  That’s good enough for me for pharma/FDA QC and oversight.

Plus when dosing yourself you don’t need to go in the normal 2.5, 5, 7.5, 10, 12.5, 15 increments. I’ve seen quite a few start even lower (0.5) and titrate up much more slowly as their body adjusts. Not something the average person should do. 

Plan is to have 6+ boxes of 15mg before June :) 

Agreed with the telehealth. That’s how I ramped up the Rx to 15 so quickly .. wild times.

[bryan995]

These are wegovy pens or ozempic?  It is unfortunate that you cannot click-dose on the wegovy pens.  If it were ozempic, self dosing / metering is incredibly easy.  Buying the 8mg pens woudl be the most cost effective.  Then all you need to buy are mode screw on needles. 

It really is like magic, as crazy as that sounds.  Lots of studies now looking at GLP-1s effect on various other diseases / disorders (alcoholism, parkinsons etc).  Lots to come here.

I receive 3 x 1 mL vials of Semaglutide and 10 subcutaneous needles per month currently, definitely prefer this over the prefilled pens.  I can see this medication becoming normalized for people who can afford it, along the lines of getting Botox…

Absolutely. This many even start to replace many expensive cosmetic procedures. And is arguably far better for both the longevity and health of your body.

Side benefit of this is that we’ve saved almost the full monthly cost of the drug via a reduction in food and occasional dining out spend. #winwin?

[Lalalauren]

Have you heard of the magical buffet? It's called eating a whole food plant based diet.

You can eat all you want, not count calories, and still lose weight.

The way it works is that you eat nutrient dense, low calorie food.

I would recommend reading the Pleasure Trap book (or How Not to Die). Watch Game Changers, Forks over Knives (or other WFPB documentaries).

Happy to give tips/recommendations, but you need to know that it's essentially eating minimally processed food that does not contain any animal products. Once you get what is good to eat, it's very easy to follow.

FIBER is the magical ingredient (naturally in your food, not from supplements).

Must supplement b12 - nonnegotiable!

[Omy]

Veganism is not a magical panacea. There's a fair amount of work involved in eating correctly to avoid serious deficiencies. It can also cause weight gain since it's more challenging to get protein and easier to eat too many carbs. My exH suffered from severe B12 deficiency and gained weight when he became a vegan.

That being said, I'm also skeptical of using drugs to regulate hunger and prefer to make lifestyle changes to correct unhealthy habits.

[Lalalauren]

Thanks, Omy for calling out b12 - I just modified to call out the need for b12 supplements.

I’m not saying that a vegan diet is the magic bullet, I’m trying to point out that a whole food plant based diet is. Vegan diets can easily be very processed, oil heavy, and therefore calorie heavy diets.

WFPB diets are generally very nutrient dense, low calorie, and fiber rich diets.

That’s not to say you can’t game the WFPB diet as well. If you eat blended cashew sauce as a soup for every meal, you probably will gain weight. But I’m guessing that’s an unlikely choice and that the participant would explore eating at least a small variety of foods.

Hope this helps clarify. My intention isn’t to plug Veganism, but instead to use language that people may be familiar with to describe a less familiar topic (WFPB eating).

[bryan995]

No such thing as a magic bullet. 

Everyone's genetics are different, and different folks will respond to different things.  This is why disease exists.  This is why medicine exists.

Great that a whole food plant based diet works for you, but it does not work for most (over the long term).

[Lalalauren]

No such thing as a magic bullet. 

Everyone's genetics are different, and different folks will respond to different things.  This is why disease exists.  This is why medicine exists.

Great that a whole food plant based diet works for you, but it does not work for most (over the long term).

Okay, I’ll rephrase to say: “a WFPB diet could be”.

My original post was not saying that it is a magical bullet, but called it a magical buffet. I acknowledge I did say it “is” in response to Omy’s post contrasting it to veganism, but again it wasn’t my original intention.

Check out epigenetics and the study of how gene expression can change based off diet.

[eav]

Currently doing the following (have lost 10 lbs since March 9th with the goal of 10-15 more) Female/29 y/o 5'7"

Use the Lose It! app for calorie counting on the Flexible Weekender budget.
M-Th Calories are 1400
Fr-Sun Calories are 1600
*More days than not I am ~200 under budget for the day due to tracking exercise in the app.

Coffee 8a with creamer ; Breakfast 10-11a ; Lunch 2p ; Dinner 6p
Weekend budget allows for a snack/one alcoholic beverage

At Home Workout Schedule Cycle
Day 1: 20 min floor Pilates to warmup followed by 40 minutes weight lifting (20 lower/20 upper, dumbbells/kettlebells only using Caroline Girvan on YouTube)
Day 2: 30 min Tabata style HIIT (Caroline Girvan on YouTube)
Day 3: No workout
Repeat! I am an avid gardener April-October so that adds to my activity as well as long walks. 

Could I do more to lose weight faster? Probably. Am I willing to suck the joy out of life? No.

[Cassie]

30 years ago medication for weight loss sometimes lead to illness and death. I know a couple of people that this happened to. Hopefully the new drugs are better but not worth it for me.

[EscapeVelocity2020]

30 years ago medication for weight loss sometimes lead to illness and death. I know a couple of people that this happened to. Hopefully the new drugs are better but not worth it for me.

Yeah, I remember the whole Fen-Phen debacle (or various other amphetamines and stimulants) - https://en.wikipedia.org/wiki/Fenfluramine/phentermine

I have never taken any other weight loss pill or medication, but the fact that GLP-1 was initially designed for diabetes care and only later discovered had the side effect of weight loss was reassuring.  I also would stop taking it if it had any psychoactive effects (speeding up resting heart rate, making me agitated, overheating, etc.).  All I have noticed thus far is that it curbs hunger and suppresses appetite, but in a very subtle way.  I still get hungry, but not as often and feel full sooner.  I have even experimented in eating a bit more sugar in my diet and did not gain weight!  It's like it used to be in my 20's and 30's...

Not trying to change any hearts and minds by posting all this, just want put my experience out there.  I had no problems maintaining a healthy weight from my teens until my mid-40's through a reasonable amount of exercise and a reasonable diet, losing weight when I put my mind to it and being relaxed about it otherwise.  At some point in my 40's, my diet got increasingly restrictive (no added sugars, more plant based, no snacking, IF...) and my exercise got increasingly intense (fewer rest days, more variety) and I was still gaining weight.  I was diagnosed with an underactive thyroid and put on a synthetic hormone for that, which helped my weight and mood a bit, but again my weight has been creeping up over the years and now I am getting more injuries.

If there is a tool which helps me maintain my ability to lead a healthy lifestyle like I used to - augmenting reasonable diet and exercise, then I am open minded to try it.  I will also be open minded to wean myself off if I am experiencing negative effects or get negative results from my annual physical.  I am also continuing to educate myself on any new information (and secretly hoping Huberman will put out an update to this podcast soon). 

[bryan995]

https://podcasts.apple.com/us/podcast/zoe-science-nutrition/id1611216298?i=1000606583568

https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

https://www.nejm.org/doi/full/10.1056/NEJMoa2107519

https://youtu.be/eUgh0uSEkr4

[TheAnonOne]

30 years ago medication for weight loss sometimes lead to illness and death. I know a couple of people that this happened to. Hopefully the new drugs are better but not worth it for me.

Yeah, I remember the whole Fen-Phen debacle (or various other amphetamines and stimulants) - https://en.wikipedia.org/wiki/Fenfluramine/phentermine

I have never taken any other weight loss pill or medication, but the fact that GLP-1 was initially designed for diabetes care and only later discovered had the side effect of weight loss was reassuring.  I also would stop taking it if it had any psychoactive effects (speeding up resting heart rate, making me agitated, overheating, etc.).  All I have noticed thus far is that it curbs hunger and suppresses appetite, but in a very subtle way.  I still get hungry, but not as often and feel full sooner.  I have even experimented in eating a bit more sugar in my diet and did not gain weight!  It's like it used to be in my 20's and 30's...

Not trying to change any hearts and minds by posting all this, just want put my experience out there.  I had no problems maintaining a healthy weight from my teens until my mid-40's through a reasonable amount of exercise and a reasonable diet, losing weight when I put my mind to it and being relaxed about it otherwise.  At some point in my 40's, my diet got increasingly restrictive (no added sugars, more plant based, no snacking, IF...) and my exercise got increasingly intense (fewer rest days, more variety) and I was still gaining weight.  I was diagnosed with an underactive thyroid and put on a synthetic hormone for that, which helped my weight and mood a bit, but again my weight has been creeping up over the years and now I am getting more injuries.

If there is a tool which helps me maintain my ability to lead a healthy lifestyle like I used to - augmenting reasonable diet and exercise, then I am open minded to try it.  I will also be open minded to wean myself off if I am experiencing negative effects or get negative results from my annual physical.  I am also continuing to educate myself on any new information (and secretly hoping Huberman will put out an update to this podcast soon).

This is nothing like weight loss drugs of the past. GLP-1 drugs have been around for 15-20 years already, and they are insanely effective, with realistically no bad side effects beyond some GI tract items.

Personally, I don't even see a reason why someone who wants to lose "that last 10 lbs" couldn't use these.

The dreamer side of me thinks these could mostly end the worst of diabetes(the worlds most expensive sickness), and cure most obesity. . . and remember, there are more in the pipeline that are significantly more effective at weight loss coming in the next 1-3 years.

[Cassie]

I know a few people with diabetes that have had bad side affects from these drugs.

[StarBright]

The thing that I find most compelling about the ozempics, etc is how people describe feeling unburdened by thoughts of food.

I spend a disproportionate amount of my life thinking about, planning, and preparing food and scheduling exercise (and have for several years now).

I find myself expending rather constant effort to keep all my bloodwork just inside of "normal" ranges and my BMI close enough. Which is good I suppose, but it is a constant, my numbers are still not where my doc wants them to be, and twice a year or so they tell me to just work a little harder to get my numbers better.

A pill or injection sounds so restful! I 100% understand the appeal.   

[bryan995]

The thing that I find most compelling about the ozempics, etc is how people describe feeling unburdened by thoughts of food.

I spend a disproportionate amount of my life thinking about, planning, and preparing food and scheduling exercise (and have for several years now).

I find myself expending rather constant effort to keep all my bloodwork just inside of "normal" ranges and my BMI close enough. Which is good I suppose, but it is a constant, my numbers are still not where my doc wants them to be, and twice a year or so they tell me to just work a little harder to get my numbers better.

A pill or injection sounds so restful! I 100% understand the appeal.   

To me, that is the primary MOA.  Second to the feeling of satiety after a very small amount of food.

On these GLP-1s, you don't even give food thoughts a chance to enter your brain. Not even for a minute.  Reddit/Facebook calls it "food noise"  And it absolutely silences it.  Your brain is left to focus on other, more interesting things.
Some are reporting anti-depressant like effects, due to the feeling of near constant satiety and less anxiousness/worry around planning the next meal.

The "food noise" effect started within 24 hours of the first injection and lasted for ~5-6 days for me.  Day 7 you take your next injection and it repeats.
I had been trying to intermittent-fast for a few weeks, was hard to make it to 2pm most days.  Now, its trivial.  GLP-1 + IF is quite the combo. 

Big pharma has 10+ of these drugs in the pipeline.  They are currently on gen-2.  Gen-3 is under clinical trial (retatrutide, triple agonist), and gen-4 and gen-5 are in research. 

This is not going away anytime soon :)

The comments re. knowing someone with a side-effect are not helpful.  This is what clinical studies are for. 

[mm1970]

I think knowing the side effects is useful information, and allows people to factor that in.

My cousin was on Ozempic, and her side effects were bad, so she had to go off of it.  And she was really sad about it.

--
My main concern is that it's become this way to promote vanity.  Like, yay, we'll never have to see fat people anymore - just when it seemed like we were going body positive/ fighting against weight discrimination.

I have ZERO problems with people using it as a solution to obesity.  The Hollywood folks using it to get super skinny though...ugh.

[zolotiyeruki]

(didn't have time to read the whole thread, so I apologize if this is a duplicate) A while back, my brother shared this article with me.  The short version of it that to develop a good habit, or break a bad one, you have to recognize the four steps of a habit: trigger, desire, execution, and reward. To break a bad habit, you have to disrupt one of those four steps. To establish a good one, you have to establish those four steps.

https://jamesclear.com/three-steps-habit-change

[zolotiyeruki]

I have a sister who likes to say "you lose weight in the kitchen, not at the gym."

[GuitarStv]

I'm going to sound like a heretic, but I don't think that trying to do loads of cardio is a particularly good weight loss plan. You get HUNGRY! It is fantastic for your health, but burning 600 calories with an hour long-run makes it really, really easy to wolf down 600 calories of food.

Like many of the above, I eat a lot of protein, vegetables and enough fruit to satisfy my sweet tooth. I find calorie counting to be a real test of willpower, so I've made some changes to remove temptation instead. I don't have any sugar or flour in the house, so I can't whip up an after-dinner cake (not joking - this was a regular occurrence), and I don't keep highly processed foods other than condiments and protein powder in the house. Adding a scoop of plain protein powder to my breakfast oatmeal makes it much more satiating. I do still eat junk if I'm away from the house, but in smaller servings than I'd eat at home.

Once you've adjusted to the dietary changes - that's the time to add the cardio.

Depends on the cardio you do.  A 4.5 hour 160k bike ride will kill about 4000 calories for me.  And when done, I'm too tired to even eat much.

I agree though, get your diet in order first - then exercise.  But exercise with a solid and achievable performance goal you can work towards rather than a target weight.  It's much more motivating and gratifying when you get there.

[wenchsenior]

I have a sister who likes to say "you lose weight in the kitchen, not at the gym."

So true.

[RetireOrDieTrying]

I have a sister who likes to say "you lose weight in the kitchen, not at the gym."

Your sister is spot-on, at least in my personal experience.

Down ~40 lb. since 18-Feb, mainly just changing my kitchen habits.

[Metalcat]

Whenever people ask me about exercise vs diet for weight loss I always ask them "do you plan to stop exercising when you've hit your target weight?"

Exercise because you have to not to frickin' die. Don't worry about what it does for your weight because your exercise needs don't change based on your weight. It's just not relevant.

Exercise however you need to exercise to not decay into a sad, hunched over, brittle fucking mess.

If you want to lose weight, then figure out how to run a consistent caloric deficit, whatever that means for your body.

For me, I can eat substantially more calories and still run a deficit if I do intermittent fasting. I've logged meticulously and found that I can eat about 20% more and lose if I'm a BMI around 23. But that's only because I damaged my metabolism with years of weightloss, illness, and inactivity. The intermittent fasting only brings me closer to my old metabolic rate, it's not magic, it just makes me feel a hell of a lot less lethargic.

That's just me though. I'm sharing that example not to tell people what they should do, but as an example of how running a deficit is particular to the individual.

But yeah, you need to figure that out for yourself.

Exercise though? If you want the latter half of your life not to suck donkey balls, then just do it.

[Cassie]

A few days ago the newer diabetes drugs were all over the evening national news because of the weight loss. They did say that once people quit taking them the weight comes back. Much better to develop an exercise and eating plan that you can stick to without a lot of effort.

[GuitarStv]

Exercise because you have to not to frickin' die it's a powerful antidepressant and mood elevator, it helps you look good naked, it helps with confidence, has been shown to improve your mental acuity, burns some calories, and because (if you find the right activity) it's really fun.

I fixed that for you.  :P

[Metalcat]

Exercise because you have to not to frickin' die it's a powerful antidepressant and mood elevator, it helps you look good naked, it helps with confidence, has been shown to improve your mental acuity, burns some calories, and because (if you find the right activity) it's really fun.

I fixed that for you.  :P

I mean, those are all great bonuses, but the not fucking dying one take precedence for me.

Or better yet I should say not dying a slow, painful death as you rot over your latter half of your life as every system crumbles under the weight of your neglect.

Better?

Can you tell I've treated A LOT of seniors?

[EscapeVelocity2020]

A few days ago the newer diabetes drugs were all over the evening national news because of the weight loss. They did say that once people quit taking them the weight comes back. Much better to develop an exercise and eating plan that you can stick to without a lot of effort.

Doesn't have to be a false dilemma.  I've had an exercise and eating plan that worked for decades.  As you get older, it's harder to ramp up exercise and you can only cut out gluten, dairy, sugar, and limit carbs so much...

I thought I would never lose weight below 200 lbs, other than temporarily with extraordinary effort like my final week training and running a half marathon or using 48 hour fasts... got me below 200 but was unsustainable to keep me there for a full month.  I have now been below 200 lbs for over a month and I have a 'normal' life - eating smaller portions while enjoying more variety, exercising in a more realistic, sustainable regimen like walking/hiking, swimming, biking.  I basically *had* to run or get my heart rate over 160 every day in order to stay below 200 lbs prior to Semaglutide. 

I'm not out to get super skinny or attractive, I just want to feel energetic and reduce damage to my joints so I can continue an active lifestyle as long as possible.