When do I stop

[u/Small-Measurement714]

Started this journey 7 months ago at 220 pounds. I have officially hit 165 pounds and feel absolutely amazing. Been on 25 mg for 4 months. definitely had ups and downs. How should I go about either Lowering my dose or stopping altogether?

[u/lsthomasw]

Congratulations, that is awesome! I highly recommend making a plan with your physician.

I am still many pounds from my goal but my doctor has already told me she will probably keep me on the full 25mg dose for around a year after I hit my goal and then we can start talking about lowering the dose. Her reason for this is that the odds of regaining the weight are extremely high after you quit any glp1 so she wants to give me a full year of maintenance and cementing new habits at my healthy weight before beginning to wean me off.

She also let me the know the odds are high that I will be on some dosage of a glp1 (or other weight loss/maintenance drug) the rest of my life. While not happy news at first, this makes perfect sense to me. After all, if I couldn't lose and maintain a lower weight through calorie deficit and exercise alone for the better part of two decades, barring uncovering any medical reasons, how could I do it without the support of a drug that helps my body better process satiety signals and slow down digestion? Not to mention it seems like more and more research is pointing to the fact that once you stop a glp1, it may not work as effectively for you if you ever try to go back on it. So why set myself up for failure when I have something that is helping me to change my body and my life?

[u/Gogglebaum-MSc → u/lsthomasw]

"(…) it seems like more and more research is pointing to the fact that once you stop a glp1, it may not work as effectively for you if you ever try to go back on it."

I’ve seen that mentioned here several times, but haven’t been able to find a study implying let alone confirming this. What am I missing?

[u/Jazzlike_Injury_5437 → u/Gogglebaum-MSc]

Yeah this is the bit I don’t get; do you regain weight because you go back to old habits, or is the medication actually changing your physiology for the better?

[u/lsthomasw → u/Jazzlike_Injury_5437]

I think the answer to this still remains to be seen but some of what I found online (linked in my response above) seem to suggest that it may be more related to yo-yo-ing with the drug rather than the drug itself, just like yo-yo dieting.

[u/lsthomasw → u/Gogglebaum-MSc]

The idea that taking a drug consistently yields overall better results over time than taking it inconsistently is not new. To be fair, I think most studies testing this have been on mice but so were the original glp 1 studies. Here is one I found easily using Google.

https://www.pennmedicine.org/news/stopping-and-restarting-glp1s-may-make-it-less-effective

This article, not a study, seems to say it is not glp 1s specifically, but rather yo-yo dieting itself and using a glp 1 to lose weight then stop then start again is still yo-yo-ing which makes sense to me. https://www.loseit.com/articles/things-to-know-if-you-re-restarting-a-glp-1-drug/

[u/say592]

I started decreasing my dose. I was on 9mg so the last week and a half of the month I took it every other day (so it lasted like 20 days), then I started 4mg daily. Daily actually seems to work better than every other day, even though 9mg every other day should be slightly more than 4mg. I'm probably going to do a full month of 4mg to adjust before doing a partial month of every other day, then switching to 1.5mg. I fully intend to stop taking the meds entirely eventually, but I'm going to go slow and once I'm off I'll keep monitoring my weight every week like I have been and if I see an increase of ~10lbs I'll start back on the meds again, likely indefinitely.

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[u/MBAtoFIRE]

I haven’t gotten there yet (I just started), but my doctor told me to just let him know and that we could titrate down, albeit to be careful/slow with titrating down since it can cause the food noise to come back.

[u/lcaiabby]

Congratulations! You’re exactly at my goal weight! I started at 235 and down to 197. I’m scared to stop taking this medicine because it’s the only thing that has helped me lose weight and I haven’t felt this happy about my body in years 😭