Consideration: There is no "stopping" these meds.

[randompersonrandom]

So it's my understanding that these meds, if you opt to use them, are a "forever" thing. It looks awfully well-studied that if you use sema or tirzep and prolly reta when the studies get that far, you lose a bunch a weight, hooray you're healthy, and then you stop....then you are probably going to start slowly regaining "a lot" to "all and more" of that weight back over the course of a year; and there's no indication I saw that at the end of that year, your body goes "all right buddy, I tried my best, but I see you really don't want to do this so we can stop gaining weight now." Maybe you'll be in the exceptional minority posting on reddit "I lost it all six years ago, stopped the med, and haven't gained an ounce!" But you probably won't be.

Roughly 1/3 of my office is on some kind of glp1, either sema or tirz. The ones who are very near goal weight talk about how excited they are to be done and get off the meds, or that they only have X weeks of the meds to go. And of course the insurance companies who cover these meds stop when you're not obese anymore, because "all better!"

This seems pants-on-head insane to me. Far as I know, glp1 drugs mostly make it so that you can stand to eat the amount that would put you at a healthy weight. Remove that, and you lose that ability, and regain. The studies seem to support that.

But it feels like everybody's walking around saying with a straight face that that's not true, and blinking twice at me when I say "No, I'm never coming off these drugs. This is a lifelong med." I'm starting to feel like I'M the crazy one here.

Would welcome perspectives.

 

[latviantower]

Until and unless I were to develop medullary thyroid cancer (and recent studies say no increased risk from glp1’s unless you are predisposed to that particular disease), I will never stop. Not only losing nearly 100 pounds, my labs are freaking PERFECT now and I’m off all other meds - we’re talking six different BP meds over 25 years, 3 different statins. Yes, the hypertension and elevated cholesterol probably resolved in large part due to weight loss, but without tirz this wouldn’t haven’t happened. And the FBS from 123 to 84 and A1C from 6.7 to 5.0 - yes, again the weight loss probably took me from prediabetic to disgustingly normal, but I thank God every day for GLP’s. With supplies, my 60 mg of tirz per month is less than $20. I challenge anyone to find a better value in today’s health care!!!

 

[AndyPanda]

All drugs stop working when you don’t take them. Exercise stops working when you lose motivation. Dieting stops working when you start pigging out. You lose gains when you stop taking steroids. Hell, even people who have bariatric surgery gain weight back long term. If anyone thinks they can just stop taking these meds and keep the weight off without lifestyle changes, they are probably delusional. It’s pretty objective.

 

[Morbius]

My anecdotal experience is nearly everyone who discusses it says "I'm a lifer." It seems like about half of us are experiencing benefits beyond weight loss too, like losing other cravings or reduced inflammation.

As I always say, maintenance is THE question and there is no good answer yet.

Assuming I do not develop any kind of side effects, I anticipate that I am going to be on this stuff for the long term because my stomach is clearly not well calibrated to the size of my ass. I hope someone figures out a proper evidence-based maintenance protocol.

 

[MsGizmo]

So it's my understanding that these meds, if you opt to use them, are a "forever" thing. It looks awfully well-studied that if you use sema or tirzep and prolly reta when the studies get that far, you lose a bunch a weight, hooray you're healthy, and then you stop....then you are probably going to start slowly regaining "a lot" to "all and more" of that weight back over the course of a year; and there's no indication I saw that at the end of that year, your body goes "all right buddy, I tried my best, but I see you really don't want to do this so we can stop gaining weight now." Maybe you'll be in the exceptional minority posting on reddit "I lost it all six years ago, stopped the med, and haven't gained an ounce!" But you probably won't be.

Roughly 1/3 of my office is on some kind of glp1, either sema or tirz. The ones who are very near goal weight talk about how excited they are to be done and get off the meds, or that they only have X weeks of the meds to go. And of course the insurance companies who cover these meds stop when you're not obese anymore, because "all better!"

This seems pants-on-head insane to me. Far as I know, glp1 drugs mostly make it so that you can stand to eat the amount that would put you at a healthy weight. Remove that, and you lose that ability, and regain. The studies seem to support that.

But it feels like everybody's walking around saying with a straight face that that's not true, and blinking twice at me when I say "No, I'm never coming off these drugs. This is a lifelong med." I'm starting to feel like I'M the crazy one here.

Would welcome perspectives.

I'm ok with taking it for the rest of my life. Plenty of medical conditions require taking something forever. Why would this be any different? I do hope that I won't need large doses of it forever .. but if I do ... meh.

 

[cheaperseeker]

Every diet I have ever been on was like "it's not a fad diet, it's changing your lifestyle!" Well, once I hit goal the old habits would creep back in because during the whole diet I was so fucking hungry all the time, thus making the "lifestyle change" unsustainable. The only way I'm ever getting off these meds is if they make one that somehow teaches my body to produce the right hormones on its own.

 

[HumanusExMachina]

Once I started to understand what peptides were fixing (filling in? replacing?) in my cells, I realized I was in it for the long haul.

 

[littledragon25]

I will stay on Tirz or some form of GLP1 for as long as my body stays healthy enough to allow it. I will likely titrate down to the lowest dose possible to allow maintenance, rather than the high dose I am on, but I can't see me coming off it.

So I either need a much bigger freezer for stockpiling grey for the next 40 years or I hope that legit sources' prices come down significantly once out of patent protection.

 

[desinr-gal]

I'll stay on them as long as possible. I went out sat night with friends to dinner and a show. The contrast to how different the experience was hit me. I was happy just being there. No craving a drink, then the next drink.. No craving food, I just drank water and ate some soybeans. They had ordered a pile of fried food and soybeans.. But it didnt matter. We went to the show, and I remembered all the times before I'd head straight to the bar for a drink before hand. It was surreal looking back at that like it was another life I lead.
I am free!
well mostly..

 

[Jfrick11]

Before even starting this class of "medications".... I think it's crucial people really understand what they are and I'm not convinced doctors are doing the best job of explaining.
Specifically....
GLP-1 is a hormone naturally produced in the gut that helps regulate blood sugar, insulin secretion, and appetite. It plays a major role in how full you feel after eating and how efficiently your body uses glucose.

Over time, many people become what could be considered “GLP-1 deficient” — not in the medical sense of a lab-diagnosed deficiency, but functionally. Years of processed food consumption, blood sugar spikes and crashes, crash diets, stress, poor sleep, and metabolic strain can all blunt GLP-1 signaling. In other words, the body stops responding the way it should. Appetite control, insulin sensitivity, and energy balance all start to misfire.

This is one reason why GLP-1–based medications can feel like a “reset.” They mimic that natural hormone and restore the signals that tell your body when it’s had enough to eat, improve glucose regulation, and reduce inflammation over time. For many people, it’s the first time they’ve experienced real metabolic balance in years.

There’s growing conversation around microdosing GLP-1s — using very low doses long-term to maintain the benefits without the stronger side effects or ongoing weight loss. The idea isn’t to stay in a calorie deficit forever, but to support healthy metabolism and appetite regulation for the long run.

Some people may choose to stay on a maintenance dose indefinitely, especially if they have a history of obesity, insulin resistance, or metabolic dysfunction. Others may taper down once they’ve rebuilt healthier habits and their body has re-learned proper hunger and fullness cues. There’s no one-size-fits-all answer; it depends on genetics, goals, and how much the medication has helped to correct underlying imbalances.

 

[randompersonrandom]

Before even starting this class of "medications".... I think it's crucial people really understand what they are and I'm not convinced doctors are doing the best job of explaining.
Specifically....
GLP-1 is a hormone naturally produced in the gut that helps regulate blood sugar, insulin secretion, and appetite. It plays a major role in how full you feel after eating and how efficiently your body uses glucose.

Over time, many people become what could be considered “GLP-1 deficient” — not in the medical sense of a lab-diagnosed deficiency, but functionally. Years of processed food consumption, blood sugar spikes and crashes, crash diets, stress, poor sleep, and metabolic strain can all blunt GLP-1 signaling. In other words, the body stops responding the way it should. Appetite control, insulin sensitivity, and energy balance all start to misfire.

This is one reason why GLP-1–based medications can feel like a “reset.” They mimic that natural hormone and restore the signals that tell your body when it’s had enough to eat, improve glucose regulation, and reduce inflammation over time. For many people, it’s the first time they’ve experienced real metabolic balance in years.

There’s growing conversation around microdosing GLP-1s — using very low doses long-term to maintain the benefits without the stronger side effects or ongoing weight loss. The idea isn’t to stay in a calorie deficit forever, but to support healthy metabolism and appetite regulation for the long run.

Some people may choose to stay on a maintenance dose indefinitely, especially if they have a history of obesity, insulin resistance, or metabolic dysfunction. Others may taper down once they’ve rebuilt healthier habits and their body has re-learned proper hunger and fullness cues. There’s no one-size-fits-all answer; it depends on genetics, goals, and how much the medication has helped to correct underlying imbalances.

I'm curious about why you put "medications" in quotes. I promise I'm not asking in bad faith; I go back and forth on whether to refer to them as a "medication" or a "drug," except when someone who hasn't heard that I'm on them congratulates me on my weight loss and asks how I'm doing it. I ALWAYS happily exclaim "I'M ON DRUGS!" before discussing further cause that's amusing, but beyond that, I can't decide which word is appropriate in like normal conversation.

 

[Jfrick11]

I'm curious about why you put "medications" in quotes. I promise I'm not asking in bad faith; I go back and forth on whether to refer to them as a "medication" or a "drug," except when someone who hasn't heard that I'm on them congratulates me on my weight loss and asks how I'm doing it. I ALWAYS happily exclaim "I'M ON DRUGS!" before discussing further cause that's amusing, but beyond that, I can't decide which word is appropriate in like normal conversation.

It's a good question and yes they're technically considered meds.... It's just that they’re quite different from most medications in how they work and how people experience them, so it deosnt seem like medication is exactly the right word.

Here's why. They’re biomimetic, meaning they imitate a hormone your body already produces — so rather than forcing a single reaction (like a stimulant or appetite suppressant), they restore a signal that’s supposed to be there.

They impact multiple systems — blood sugar regulation, digestion speed, inflammation, even brain signaling related to reward and cravings. Again this is because they're channels and are present all over the body.

They can be used short-term or long-term. Some people use them for a therapeutic reset, others stay on a low or “micro” maintenance dose indefinitely, more like ongoing hormonal support than a classic medication cycle.

So yes — they are absolutely medications in the clinical sense, but functionally they act more like metabolic regulators or hormone analogs than typical drugs.

 

[HumanusExMachina]

They’re biomimetic, meaning they imitate a hormone your body already produces — so rather than forcing a single reaction (like a stimulant or appetite suppressant), they restore a signal that’s supposed to be there.

This is exactly why I also tend to not refer to peptides as "medicine" or "drugs".

Thanks for putting together such a clear explanation of what I've been trying to put into words for a couple of days.

 

[randompersonrandom]

I'll stay on them as long as possible. I went out sat night with friends to dinner and a show. The contrast to how different the experience was hit me. I was happy just being there. No craving a drink, then the next drink.. No craving food, I just drank water and ate some soybeans. They had ordered a pile of fried food and soybeans.. But it didnt matter. We went to the show, and I remembered all the times before I'd head straight to the bar for a drink before hand. It was surreal looking back at that like it was another life I lead.
I am free!
well mostly..

It's a good question and yes they're technically considered meds.... It's just that they’re quite different from most medications in how they work and how people experience them, so it deosnt seem like medication is exactly the right word.

Here's why. They’re biomimetic, meaning they imitate a hormone your body already produces — so rather than forcing a single reaction (like a stimulant or appetite suppressant), they restore a signal that’s supposed to be there.

They impact multiple systems — blood sugar regulation, digestion speed, inflammation, even brain signaling related to reward and cravings. Again this is because they're channels and are present all over the body.

They can be used short-term or long-term. Some people use them for a therapeutic reset, others stay on a low or “micro” maintenance dose indefinitely, more like ongoing hormonal support than a classic medication cycle.

So yes — they are absolutely medications in the clinical sense, but functionally they act more like metabolic regulators or hormone analogs than typical drugs.

Thanks! I appreciate your work in explaining that, and it's something I'm glad to have to consider.