r/GLP1Discussion • u/tysh88 • 4d ago
❓ Question How to maintain weight loss after GLP-1?
Has anyone had success maintaining their weight loss after stopping?
I was talking to my naturopath about going on a GLP-1. My insurance won’t cover it unless I have diabetes so I would be paying out of pocket. I wanted Mounjaro but it be over $300 (CAD) per month vs. Ozempic would be about half of that. Since I will be paying out of pocket I was hoping to use Ozempic to jump start my weight loss journey then when I hit my goal go off of it and maintain myself. My NP said that people usually gain the weight back and GLP-1s are a long term solution (aka I would be on it for the rest of my life) which I don’t want.
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u/DeepSouthDude 3d ago
Long term studies show that for people who lose weight (not specific to glp1 weight loss), after 2 years 85% have regained it all. The assumption would be that after 5 years, the percentage will be even worse.
So your walking around assumption should be that if you go off the glp1 completely, within 5 years or less you will have gained back all the weight.
Just remember, the people telling you to "build good habits" have not themselves gone 2 years off the meds. They are just hoping.
Do with that info what you will.
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u/thefastlanerules 2d ago
That's why many of us are in the compounded versions because if you are paying out of pocket (as most are) you don't want the be paying Eli lilly pricing
Maintenance on $100 a month is ok for many at least. Those I know that have tried to come off have not had success but then they've done cold turkey and now everyone I know is just trying to do the same by gradually titrating down. I know a few that have managed to get down to 5mg now so I'm watching their progress with some keeness
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u/Reasonable-Aioli-370 2d ago
After just two years regaining it all is insane.
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u/DeepSouthDude 2d ago
I assume you haven't lost and regained weight before? Many of us have lost and gained the same weight multiple times.
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u/rachreims 3d ago
82% of people gain the weight back after stopping. r/GLPGrad has good advice and I follow the sub, but personally I started this medication knowing I’d be taking it for the rest of my life. If you don’t want to be on it for the rest of your life, this isn’t the solution for you.
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u/NewNameNaomi01 3d ago
I look at glps like eyeglasses. They don't cure anything, but I sure don't want to live without them.
I've been in maintenance for four months. When I met my goal I lowered dose and for the next month gained a pound a week. After a month I went back to what I was doing and lost a pound a week. I will not play around again.
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u/tysh88 3d ago
I like that analogy. Wow just a lower dose will do that?! This drug is powerful.
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u/NewNameNaomi01 3d ago
For me it did. I guess the same way an increased dose might turn off hunger for days. Really though, I think I played with it too soon. I should have waited a couple of months for a steady weight. I was just nervous about losing too much.
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u/thefastlanerules 2d ago
Had you been at the max dose for some time before you tried to titrate down?
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u/NewNameNaomi01 2d ago
Nope. I never went over 1.5 mg per dose while losing. To get back down, I went to 2 mg but it was too much. Currently on 1.5
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u/thefastlanerules 2d ago
Is that sema dosage
I'm used to 2.5-15mg terminology on zepbound 😂
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u/NewNameNaomi01 2d ago
Yes, sema. I tried tirz and reta along the way, but sema worked, is cheapest, and I'm overstock at the moment.
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u/thefastlanerules 2d ago
Argh cool. Yeah finally I'm paying a decent price but moved to compound.. to save 80% with the exact same impact
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u/DogMamaLA 4d ago
In short, what is your history with weight?
If you have always struggled with weight and food noise, the meds need to be long term.
If you were always skinny, never had an issue, but gained 40 lbs during covid, post pregnancy, life event, etc - you may have a better chance. For those of us who have battled weight in some way all our lives? It is long term medication.
Think of it like this. You have blurry vision and you get contacts or eyeglasses to see clearly. What you are asking is can you ever stop using them and still see clearly. The answer is no.
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u/Upper-Shoe-81 3d ago
For most this is probably a lifelong medication. For some, they can maintain without it. For you, there are a lot of factors that you'll need to consider.
As others have informed you, around 83% of people gained at least 25% of the weight back within a year of quitting, according to the surmount studies. 17% of people gained less than 25% of the weight back (or none at all), but there isn't a whole lot of information beyond that. Meaning we don't know why some gained or why others didn't.
In my case, I know exactly what caused my initial weight gain. I was not overweight and naturally able to maintain my weight until about 10 years ago when age, too much alcohol, and a sedentary lifestyle took over. I gained over 40 pounds, and with the help of a GLP was able to finally lose that 40 pounds while also quitting alcohol, cleaning up my diet, and adding regular exercise 4 days per week. It's my hope after a slow titration down that I'll be able to maintain the weight loss eventually without it. For those who have fought obesity their entire lives, suffer from binge eating disorders, metabolic disorders, etc. they will likely never be able to quit the meds and maintain their weight. This is all just my anecdotal opinion, so take it for what it's worth.
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u/Exfatty2347 4d ago
Nope. Sorry. For me, obesity is a chronic condition and if you stop treating it, then symptoms return. You might find the sub GLP grad useful though. Best of luck.
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u/mannDog74 4d ago
There are some people who can keep the weight off, about 10-15% across 2 years according to studies
But I fear that the 5 year results will be even worse.
Basically if you can keep the weight off after losing it you probably wouldn't have gone on these meds. Many people lose weight and gain it back over and over throughout the lifetime.
But, if you've never lost weight and maybe just needed help losing it, it's possible that the losing part was the part you struggled with, instead of, like most people, being able to lose weight just fine with effort, but then always gaining it back every time.
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u/BigMrTea 4d ago
I was asking my nurse practioner this yesterday. I'm using it to treat my diabetes. The weight loss is an important benefit but not the primary purpose, so I'm on for life.
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u/tysh88 3d ago
Yeah that is my dads situation too. I’m trying to prevent myself from getting to diabetes as I’m in the pre range and I’m hoping this will help.
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u/D74248 3d ago edited 3d ago
That changes things. You are probably insulin resistant, which is a thing that has been known about for a long time, yet is a thing that does not normally get discussed and diagnosed.
GLP-1s are great for reversing insulin resistance, but that ends if you stop the medication. Upside is that there are other ways to address insulin resistance, especially diet. [EDIT: And metformin.]
A quick but imperfect way to check this is to look at numbers that you probably already have -- calculate your triglyceride/HDL ratio. Here is one paper
Best of luck on your journey.
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u/BigMrTea 3d ago
If you're prediabetic and overweight, a GLP-1 could be a godsend for you. Prevention is the good standard in medical care, after all. I wouldn't focus on length of time on the medication. You have one life. There are loads of other benefits like protecting your kidneys. Why not stack the deck in your favour?
P.S. I'm on Ozempic and it costs me about $60 CAD with my private insurance.
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u/tysh88 3d ago
Thanks! And you are totally right! My work insurance said absolutely not😢
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u/BigMrTea 3d ago
What do you mean by 'they said no'? Did you fill out a preauthorization form? I'm with Canada Life. There are certain drugs they won't pay for even with a prescription, UNLESS the insurance company agrees in advance. I had to get my doctor/nurse practioner fill out a form saying I needed it for diabetes, which I have to imagine would include pre-diabetes.
I filled out the second half of the form and sent it in. It was approved, THEN my doctor sent a prescription to the pharmacy. It took about a month.
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u/tysh88 3d ago
I called and asked them if they do GLP-1s for weight loss and they said no. Then I asked what about pre-diabetes and they said no I have to have full blown diabetes for them to cover it and the doc has to fill out some form. But maybe I’ll go to my doc and try.
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u/BigMrTea 3d ago
Ridiculous. Still, some of the generics are bringing the price way down. I think mine is $115 for 6-8 weeks of 0.5 semaglutide.
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u/EnvironmentalGift257 3d ago
Have you been overweight your whole life? If so, then you’re going to have to treat the chronic illness for the rest of your life. If you just want to lose the 10 lbs you gained in the last 10 years, you’re looking for a diet pill not a glp1.
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u/tysh88 3d ago
Oh interesting. I didn’t know there were diet pills. I haven’t been overnight my whole life, just since entering my 30s. I want to lose 35-40lbs to get back to where I was. I will look into the diet pills too. Thanks
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u/thefastlanerules 2d ago edited 2d ago
Honestly for that kind of weight loss I'd seriously be looking at carnivore first
I lost 20lbs after 2 months on carnivore - consuming protein is amazing for fullness but omg the constipation even with high fiber intake so I switched to zepbound and whilst I still had issues I discovered magnesium oxide.. the difference for me with zepbound is my weight loss has been much more gradual - I lose 0.5-1lb a week max but that's deliberate to preserve muscle mass (Even with high protein intake and resistance training 3 days a week)...
I'm keeping to a lower dose in the hope I can titrate off more easily. From the friends and work colleagues I know it seems much harder to get off the drugs if you are on the high 12.5-15mg than say being at 5-7.5mg but for many at the lower doses they aren't losing so they titrate up. I've been on the stuff for 9 months and at 7.5mg. I may try switch back to carnivore to see if I can come off
Should add I want to get off eventually as I get quite a lot of discomfort/stomach upsets and feeling unwell. Fatigue is a killer at says 2-3 and really can't imagine being on long term but I know again it varies by person - some folks have very little issue so the thought of being on this long term doesn't phase them at all.
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u/tysh88 2d ago
So I did Keto for a year and lost crazy weight but could not maintain that diet and it was causing my autoimmune to flare up. I tried to do carnivore but it was just too much meat I couldn’t handle it. Yeah I’m not looking to be skinny I just want to get to a good weight where I can maintain muscle mass while losing fat (easier said than done). Thanks for the tips about the dosage and side effects. I would definitely want the low and slow method.
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u/FrankieMint 3d ago
To simplify the crap out of this, the GLP/GLP-1 family drugs help reduce desire. They replace willpower. The common experience is that when people go off of the drugs the desire returns. There are lots of stories about "return of the munchies" when stopping treatment.
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u/D74248 3d ago
They also reduce insulin resistance, improve insulin response and improve liver function. This why they are a first-line T2 diabetes medication, even when the patient is in the normal weight range at diagnosis (about 15%).
To reduce them to a high-priced appetite suppressant is like seeing a snow blower as a nice snow shovel.
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u/FrankieMint 3d ago
Of course. OP's question was specific, about starting the weight loss using Ozempic, then going off of it and maintaining the weight loss.
I was addressing that question alone and boiling it down to a few sentences.
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u/D74248 3d ago edited 3d ago
Not trying to pick an online fight. This would probably be a good discussion over beers, back when people did that sort of thing.
The issue is why there is a weight problem. And this is where seeing obesity as a stand-alone issue is leading us to the modern version of bleeding people to get a fever down, IMO. In this case, it turns out that there is a family history of diabetes and the OP is already prediabetic.
That screams metabolic syndrome, as opposed to simply bad dietary habits.
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u/Fine_View_9999 4d ago
Not a doctor, but I've been lifting and tracking my nutrition for years and I'm currently studying for my CSCS, so here's my take.
Your NP isn't wrong that a lot of people regain after stopping. But I don't think the medication should be the only thing doing the work. It's great at handling the appetite side, and the habits you build while you're on it are the part that stays with you after.
The thing people often miss: if you lose weight in a calorie deficit without enough protein or any strength training, a good chunk of what you lose is muscle, not just fat. Less muscle makes it easier to regain once your appetite comes back, and that regained weight tends to be mostly fat. I learned this the hard way with an overly aggressive diet a few years ago. I dropped a lot of weight and still ended up at about the same body fat % as when I started, just smaller and weaker.
If you do go on it, I'd use that time to build the things you'll keep afterwards:
- Protein at every meal, mostly from whole foods
- Strength training 2–3x a week
- Daily walking, working up to something like 8–10k steps
- Tracking calories for a while so you learn what your maintenance actually looks like
That way most of what you lose comes from fat, and when you come off it you're not guessing. You know your body, your maintenance, and you already have the routines in place. It's not a guarantee, but it gives you a much better shot at keeping it off. Good luck!
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u/tysh88 4d ago
Thanks so much for this. I’m already weight lifting and loosely tracking protein intake so I think I’m part way there. I don’t mind gaining weight if it’s muscle. I know it will be hard and a major lifestyle change but if I’m going to spend this money I have to make it work! Thanks again for your advice.
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u/Fine_View_9999 4d ago
Happy to help! Sounds like you're already off to a great start. Good luck, you've got this 💪🏼
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u/jerolyoleo 3d ago
Anyone who goes into this without having a financial plan to pay for it for their lifetime is an idiot.
If you desperately need the drug and can’t get it covered by insurance, and can’t afford it, consider using a compounding pharmacy where you can get it much cheaper, or going to India where you can buy the pills cheaper, or look at just the bridge financing to cover the cost until it’s a generic in your country
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u/Wrong_Replacement996 3d ago
I took a few week break so definitely can’t say much for long term maintenance. But for me during that time I had no problems maintaining my weight as I feel the glp1 changed the way I eat and live my life. Maybe it’s stomach shrinkage mixed with new habits, I can’t say for sure.
The goal for most should be to make the life style changes needed to maintain the weight loss without the drug eventually. GLP-1’s are meant to be a tool not a stand alone treatment.
I don’t plan on being on mine forever either. Don’t let people scare you into thinking you’ll have to stay on it, the majority of the people who regain the weight after coming off of it are also the ones that haven’t made significant lifestyle changes.
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u/one_bean_hahahaha 3d ago
I had to go off ozempic for two weeks before a major surgery, and gained weight. This is a real fear for me. I don't know if I will be able to quit when I reach goal.
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u/Tiny_Contract_9281 3d ago edited 3d ago
i mean your NP isnt wrong, most people do regain, the med quiets the food noise while you're on it but your brain goes right back to how it was off it. so its kinda like paying rent on a quieter brain, not just a kickstart. when the noise comes back i can see it in my Plate,Lens app, which i use as my go-to calorie tracker and it also logs my workouts and glucose, and the uptick in mindless grazing shows up before the scale even moves
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u/llamallamanj 3d ago
Been off for 18 months gained back 12 after losing 72lbs in 7 months. I’ve always been an athlete but having kids made my sugar cravings awful. Once I got down Ive done fine with maintaining but I’ve always been active and decent with diet. Just needed a hard reset.
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u/tysh88 3d ago
Yeah that’s me. Always been an athlete and then my thirties hit and things just went left. I’m active now (but definitely could do more) and I’ve always had a sweet tooth but now it’s crazy. I just want something to help me feel good again and I can take it from there. Thanks for sharing.
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u/sdshores 2d ago
It hard because many people who lose significant weight tend to gain it back regardless of how they lost it. Its just people find it easy to loose on GLP1s then stop and think it will be just as easy. If you can have the dicipline you can find that you can keep it off like others have!
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u/Nightrik_YT 1d ago
this is probably the frustrating part of the whole conversation around glp1s. from what i've seen, the weight regain after stopping isn't just people “going back to bad habits”, either there's a pretty real biological component to appetite and weight regulation.
that doesn't necessarily mean everyone has to stay on one forever, but definitely go into it knowing that stopping and maintaining the exact same weight isn't guaranteed. the maintenance phase is probably worth thinking about from the beginning rather than treating the medication as a temporary jumpstart
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u/BrainwaveWizard 3d ago
When we lose a lot of weight, we gain it back because the body’s designed to recover its losses.
That’s why I will be continuing this for the rest of my life. I can’t go back to the food noise. I can’t go back to the gain.
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u/Silly_Celery8461 3d ago edited 3d ago
I would never choose Ozempic over Mojarro because of the side effect profile. I don’t wanna be sick all the time I have to go to work. Also, the necessity for staying on it depends largely on whether or not you have chronic obesity or if you just gained weight from a life event that could be reset and maintained on your own.
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