Good-Heart6425
GLP-1 Apprentice
Opinion | I No Longer Think GLP-1s Are the Answer
The drugs 'work' but may be working against us long-term
www.medpagetoday.com
adverse effects of stopping GLP medications, as evidence suggests risks are associated with Weight cycling
- Thread starter Good-Heart6425
- Start date
www.medpagetoday.com
I hate to say it... I agree. After being on sema, and stacking others, I had to stop for 8 weeks as I had scheduled surgeries.. one that got pushed back two weeks. I had stopped a few other times but for only a week or two due to surgeries and colonoscopies.Opinion | I No Longer Think GLP-1s Are the Answer
The drugs 'work' but may be working against us long-term
I was at my absolute lowest since I started this peptide journey. The noise came back full force. I was ravenous. I ate like I had not in 4 years. The holidays and having junk in the house has not helped. Thankfully I have only gained about 7 lbs but... I absolutely hate this. I "thought" I had my shit in check. I eat healthy, walk a lot, do some strength training.. but I don't deprive myself when I want something sweet.. I just eat a "normal" portion. Now? Once I start eating junk I just want more...
I have restarted what I was taking but low and slow. I do not want to get sick because I am eating like an asshole. I still think they are the answer but I am convinced I will be pinning something until the day I die...
Mr.Tired
Recently Joined
Thanks for sharing. It's good to hear other perspectives, but I don't find this guy particularly persuasive.
He cites is own personal anecdotal evidence and a study from several years ago that had been superceded by more recent and comprehensive research. This isnt to say that people don't come off of glps and gain back all their weight. That obviously happens, and I am sure it is unbelievably frustrating for those folks. But he asserts that as the norm, and it doesn't look like that is factually correct.
He cites is own personal anecdotal evidence and a study from several years ago that had been superceded by more recent and comprehensive research. This isnt to say that people don't come off of glps and gain back all their weight. That obviously happens, and I am sure it is unbelievably frustrating for those folks. But he asserts that as the norm, and it doesn't look like that is factually correct.
Attachments
Was that doctor truly unaware of the muscle loss concerns prior to January of 2025 (date of the article)? And he also failed to understand that pharma viewed these drugs as a subscription plan rather than a cure? I'm not big on hurling insults around, but perhaps if he's been this hopelessly naive in the past, he should recognize his shortcomings and let others with better critical thinking skills author the contrarian articles of this sort. LOL
The article raises valid concerns. If one were paying full retail price ($1000+ per month in prior years), I can see where it might feel like extortion to have to keep paying that to maintain a stalled out weight loss and avoid regain, but I suspect many here aren't too worried about the financial aspect. The muscle-loss concerns are rather controversial as well with different studies showing different results in regards to body composition results and that likely varying across different formulations.
I think those who view GLP1's as first-line weight loss methods (while failing to address underlying food addiction issues or investigate their own relationship with food) may be disappointed, but like any other tool, these drugs have strong use cases for many people.
The article raises valid concerns. If one were paying full retail price ($1000+ per month in prior years), I can see where it might feel like extortion to have to keep paying that to maintain a stalled out weight loss and avoid regain, but I suspect many here aren't too worried about the financial aspect. The muscle-loss concerns are rather controversial as well with different studies showing different results in regards to body composition results and that likely varying across different formulations.
I think those who view GLP1's as first-line weight loss methods (while failing to address underlying food addiction issues or investigate their own relationship with food) may be disappointed, but like any other tool, these drugs have strong use cases for many people.
byefatlicia
GLP-1 Enthusiast
My big takeaway from this article is that name brand prices aren't realistic for the long term for the average person.
Grey is the way. I may never stop and I'm okay with that.
Grey is the way. I may never stop and I'm okay with that.
cygnus
GLP-1 Apprentice
Stopping an exercise also comes with the risk of losing the positive benefits associated with exercise. Stopping a nutrition plan (drug aided or not) comes with the risk of worsening outcomes. Cutting back on sleep hygiene comes with risks associated with worsened sleep...
The GLPs and whatever drugs come next are incredible tools in the toolbox; sensationalist articles always seem to want to create a strawman fallacy of them being all-or-nothing in order to knock them down.
Until something better than reta comes along, I'll be pinning once a week. If the GGG III ends up being an oral reta analog that comes close and is easy to use in maintenance, cool. If something like some crazy GLP/GIP/Glucacon/Myostation/Activin/IGF mega awesome med comes along with minimal side effects, then yeah, I'm checking that out.
The GLPs and whatever drugs come next are incredible tools in the toolbox; sensationalist articles always seem to want to create a strawman fallacy of them being all-or-nothing in order to knock them down.
Until something better than reta comes along, I'll be pinning once a week. If the GGG III ends up being an oral reta analog that comes close and is easy to use in maintenance, cool. If something like some crazy GLP/GIP/Glucacon/Myostation/Activin/IGF mega awesome med comes along with minimal side effects, then yeah, I'm checking that out.
Grogu
GLP-1 Apprentice
All types of issues with the article, but I guess for me, I always thought that long-term use of a glp-1 was going to be required. In my mind, glp-1 medications treat an underlying metabolic disease and none of the glp-1s are cure for that disease. For me, I think if I stopped taking the medication, I would fully expect my symptoms (ravenous hunger, weight, joint pain, etc.) to return with a raging vengance. And even this go around with weight loss I've done nutrition counseling, cognitive behavioral therapy, and adjusted my behaviors, I honestly don't think that's going to "cure" bad physiology.
cygnus
GLP-1 Apprentice
Blood pressure meds, cholesterol meds, blood sugar control meds are also long-term use. Reta offers the potential ability for many to just consolidate that into a singular med.
CNCCurrency
GLP-1 Apprentice
I read recently that cholesterol meds, ie statins reduce glp1 efficacy.
cygnus
GLP-1 Apprentice
What I was referring to is the tri-agonist GLPs showed drastic improvements across triglycerides, blood pressure, blood sugar and A1C, in addition to the actual weight loss. Those types of meds tend to be "for life" until something drastic changes...reta offers that drastic change.
The contraindications as I understood had to do more on the other direction, where GLP-1 agonism slows digestion and thus oral meds aren't absorbed on schedule.
The contraindications as I understood had to do more on the other direction, where GLP-1 agonism slows digestion and thus oral meds aren't absorbed on schedule.
cookieguggleman
GLP-1 Apprentice
As much as I am benefiting from these drugs, I could never do it without overeaters anonymous. I have been in that program for 16 years, and it changed my life. Even before the drugs, food noise was hugely diminished, and I had been at a stable weight for 14 years. Never perfect and it required constant spiritual work, but it changed my life. I started taking GLP because of menopause and an auto immune disorder that made my metabolism come to a screeching halt. I think most people who try to stop who had chronic issues with food addiction will definitely have trouble keeping the weight off.
Statins were found to significantly decrease naturally occurring GLP-1 levels (in addition to previously having been found to increase diabetes risk and increase plaque calcification). Not sure how that would affect GLP-1RA efficacy, unless you're saying they'd make it harder for someone to maintain a weight loss after going off GLP1 drugs.
Laidbackleo87
Recently Joined
I'm no expert but I do think it's good to hear out constructive criticism when it's presented, in a world of echo chambers that are designed to keep us happily filled with whatever information the algorithm can get and keep our attention with it's good to read something even if we may not agree with it. There's no doubt critical thinking has taken a hit due to said echo chambers.
tiddiesandnunchuck
GLP-1 Apprentice
The article is only true because users don't make the lifestyle change required, ie: work out and consume enough protein. These two are non-negotiables, whether you take GLP's or not.
Grogu
GLP-1 Apprentice
Same for me. The drugs are truly amazing, but by this past summer after I had lost about 70 pounds, I was thinking that this is great, but why is this time going to be any different than all the other times I've lost a ton of weight just to regain it. Just by chance, my new pcp referred me to a nutritionist. I was like, okay, I'll give it a try. While working with the nutritionist we realized I had some messed up eating behaviors and I realized that I needed a psychotherapist. I found a therapist and she's been amazing and that has truly been life altering. I'll have to look into OA as a path forward.
lessthanhalf
GLP-1 Apprentice
This is just in relation to the image under this statement, not the comment itself.
When people stop glp medications, as is the case for all other weight loss interventions except surgery ( and even then regain after a few years is common ) , people will tend to gradually regain the weight lost. A tiny percentage will keep weight off long term <5%. Most will eventually return to a weight close to their starting weight. This has been found in hundreds to thousands of papers over decades.
I have come across this very poor piece of research before and made a comment on it on this forum. This information is bad because it looks like real research when it is not and is misleading to most people who see it. It shows that people are equally likely to lose more weight than regain weight after stopping semaglutide. This is simply wrong and totally at odds with every other published paper about glp medications.
The results they present may well be genuine but are very obviously suffering from poor data analysis, maybe the ones who lost weight switched to tirzepatide for example. The fact that they present information that is opposite to established understanding of this issue without any comment on this or attempt to explain their findings is indicative of research that would not be publishable in any peer reviewed journal. I did not have a huge amount of success finding out more about epic research other than finding the article it came from.
I believe the evidence is quite strong that people who wish to maintain the weight loss achieved with glp medications will need to stay on them long term to maintain that weight loss. I have no problem with anyone trying different approaches, and it is a bit less applicable to people who are only mildly overweight or have only been overweight for a short period of time .
I really could not disagree more with the doctor who wrote the article this post is about, almost every comment on the article itself disagreed with it . Being unhappy with a therapy that stops working after you stop taking it is fairly silly, the vast majority of medical treatments work this way, and essentially all that relate to hormonal or metabolic issues apart from a few rare problems that can be cured by surgery. The main reason apart from nausea that people stop these medications is their cost and unreliable and inconsistent and changing insurance coverage, which are political/economic problems not a fault with the drug.
CNCCurrency
GLP-1 Apprentice
I misread it, thanks
I will also say that, as an early post menopausal woman, had I not done bloodwork and got my hormones in check I couldn't even start losing weight. We added Oz after I had already dropped a few pounds and stalled for a bit. Thyroid issues came up about a year ago and once I got those in check (lowest dosage of T3 and T4) I broke another stall. Everything needs to be working together... GLPs are not just a quick fix to everything. Just MY experience over the last 4 years.
I have always approached GLP-1s as a treatment, and not a cure. I intend to stay on some version of them for life. That might explain my completely irrational desire to hoard multiple years' worth. I'm never going off. I'm never going back. I just can't.
ThatNextGril
GLP-1 Apprentice
I've come to this same conclusion. When I think of how freeing it's been to have no food noise for the 2.5 years I've been on glp (was sema, now tirz) I can't imagine going back. It actually scares me to think of having to live that life again. It's not the "eat better, exercise, sleep quality" part of it - I got that nailed - it's the actual, physical manifestation of food noise, that constant thought of eating all day long, that was like torture now that I look back. I almost cry for reals when I think of not having a glp to keep that at bay. I've got about 3 years of tirz stocked up, along with some reta if I go that route, but I seriously want to keep adding to the tirz pile as I'm so worried that years down the road I won't have access.
MsGizmo
GLP-1 Enthusiast
When I took my very first dose I was already planning on taking it long term, even without a full fledged plan on how to pay for it beyond the first year. Fortunately I learned about the grey market after the first 2 months. I have no intention of ever stopping. I do have a medical procedure scheduled in February and I will most likely have to take a 2 week break .. I am not looking forward to it.
Two weeks wasn't bad. I have done that a few times. You will still have some of your dosage in your body. My situation was not by choice.. trust me. Back a few years ago everyone spoke about "resets".. stopping a few months and restarting to stop a stall. I never subscribed to that theory.
cookieguggleman
GLP-1 Apprentice
But their efficacy fades with time. So staying on them for life won’t necessarily work.
Grogu
GLP-1 Apprentice
I'm not sure if there is enough data to support the statement that the efficacy of glp-1 medications fades with time. The medications just haven't been used that long for weight management.
But this article from earlier this year reports long-term usage of tirzepatide and the results suggest that at least at 3 years that study participants were able to maintain their weight loss while staying on the dosage of tirzepatide assigned at randomization.
Tirzepatide for Obesity Treatment and Diabetes Prevention - PubMed
Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. (Funded by Eli Lilly; SURMOUNT-1 ClinicalTrials.gov number, NCT04184622.).
pubmed.ncbi.nlm.nih.gov
The increase at week 176 through 193 is off-treatment.
The flatening of the weight loss line at week 85 and the line staying flat, suggests to me that weight loss is pretty durable while on treatment. So, at least at 3 years there is no loss of efficacy. The flat line is beautiful to me and really exciting.
cookieguggleman
GLP-1 Apprentice
Three years isn’t long term at all.I'm not sure if there is enough data to support the statement that the efficacy of glp-1 medications fades with time. The medications just haven't been used that long for weight management.
But this article from earlier this year reports long-term usage of tirzepatide and the results suggest that at least at 3 years that study participants were able to maintain their weight loss while staying on the dosage of tirzepatide assigned at randomization.
Tirzepatide for Obesity Treatment and Diabetes Prevention - PubMed
Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. (Funded by Eli Lilly; SURMOUNT-1 ClinicalTrials.gov number, NCT04184622.).
The increase at week 176 through 193 is off-treatment.
The flatening of the weight loss line at week 85 and the line staying flat, suggests to me that weight loss is pretty durable while on treatment. So, at least at 3 years there is no loss of efficacy. The flat line is beautiful to me and really exciting.
View attachment 12213
If the efficacy doesn’t wear off, then why do we have to increase dosage?
Grogu
GLP-1 Apprentice
I hear you—but given my own history of losing 100+ pounds several times and not keeping it off anywhere close to three years, holding steady at my current weight for that long would feel like a godsend. I’m not claiming we have lifetime data; I actually said we don’t have enough time-on-drug to make sweeping “long-term” declarations. What we can say is that the best evidence so far suggests weight loss can be durable while on treatment out to about three years, which is a meaningful real-world benchmark. And on dosing, increases don’t prove “wear-off”—a lot of that is titration to therapeutic levels plus individual variability. Many people at 5 mg simply aren’t at an effective dose yet, which is very different from the medication losing efficacy.
MsGizmo
GLP-1 Enthusiast
I think it has to do with continued weight loss. Like taking 2mg of substance x will get you down 50 pounds but you will need to increase your dose to lose another 10 pounds.
For example My husband is a diabetic at a healthy weight, be both took semaglutide. I lost weight but he didn't.
This is my second new years on my 18 month GLP1 journey. I came off a months long stall with mounjaro. Went grey in 2025 and commenced Reta in September.
Three months on Reta, now at 7mg and I’ve dropped 14lbs. Hardly melting away. That’s because the smaller doses of Reta didn’t work for me and 6mg is where weight loss started happening again. As many here suggested and I am delighted with it.
Until…. I hit another stall. This is my third week of staying the same and I increased to 7mg. I was not prepared for how I’d feel hitting a 3 week stall not knowing when or if it will ending, how much that’s challenged my feelings about the journey ahead, and while I know it’s the long game I still have 50lbs to lose. It hits me right in the hope. Hard. Because even then I will still be classed by BMI as obese.
In this stall… I know something is up in my body, I feel it. I have pcos, a metabolic disorder, and I know from the appearance of odd symptoms something is out of whack in my hormones (erm hello 👋 is that you perimenopause 👀?). Make sense it would affect all my systems. But it will pass.
Long way of saying …. I think I know I will be on some form of this long term and I feel good and reassured about my 2 years of peptide freezer supplies.
I knew I would probably have to keep taking it to feel normal and keep the weight stable: I have accepted now there is something wrong with me that cannot be cured and will worsen again without helping myself using this treatment, combined with diet and ongoing exercise for health and self care.
Sending 💜love to @Laxfinity because as bad as I’m feeling, I’d be really depressed if I put 7lbs back on over the festive when it took me 7 dang months to lose it. Reading your story I thank you for sharing it because I feel for you! You will drop it again. Onwards we go!
Three months on Reta, now at 7mg and I’ve dropped 14lbs. Hardly melting away. That’s because the smaller doses of Reta didn’t work for me and 6mg is where weight loss started happening again. As many here suggested and I am delighted with it.
Until…. I hit another stall. This is my third week of staying the same and I increased to 7mg. I was not prepared for how I’d feel hitting a 3 week stall not knowing when or if it will ending, how much that’s challenged my feelings about the journey ahead, and while I know it’s the long game I still have 50lbs to lose. It hits me right in the hope. Hard. Because even then I will still be classed by BMI as obese.
In this stall… I know something is up in my body, I feel it. I have pcos, a metabolic disorder, and I know from the appearance of odd symptoms something is out of whack in my hormones (erm hello 👋 is that you perimenopause 👀?). Make sense it would affect all my systems. But it will pass.
Long way of saying …. I think I know I will be on some form of this long term and I feel good and reassured about my 2 years of peptide freezer supplies.
I knew I would probably have to keep taking it to feel normal and keep the weight stable: I have accepted now there is something wrong with me that cannot be cured and will worsen again without helping myself using this treatment, combined with diet and ongoing exercise for health and self care.
Sending 💜love to @Laxfinity because as bad as I’m feeling, I’d be really depressed if I put 7lbs back on over the festive when it took me 7 dang months to lose it. Reading your story I thank you for sharing it because I feel for you! You will drop it again. Onwards we go!
seems like you only have to increase when you hit certain weight "stalls" not because it no longer works anymore. At least that's what I experienced. Like If I wanted to stay at 200 lbs I would have stayed on a smaller dose of Tirz. I kept going Until I Hit around 155 to 160. I haven't tried it out but I bet if i went higher I would lose more. Even though I still feel over 200lbs at times looking in the mirror is a reality check that I'm at a good size. Kinda do want to try it though but I feel that might be a dark road...
Trending Topics
Members Online
- WhirlpoolBathWater
- AdjLindley
- ribbit
- mendelevium
- Cashoes
- CNCCurrency
- mraajr
- Hvac9021
- mozz79
- HooberBloober
- Lyophilized
- New2ton
- twindance
- Lanceito54
- Mantheunknown
- zexze
- FireMoon
- Schism
- WBS Tiffany
- goco85
- hardtaildawn
- Mr.Tired
- Chacha1488
- Bds405
- Roadrunner
- juGGaKNot
- Aao318
- Twowheelr2
- GeraltRedhammer
- Joonchie
- MaxieChi
- GTmuggs
- Asher13
- Oreopteris
- jobrien
- Kayakgrl
- jordekorn
- Azaye1
- Chopper
- jl2000
- Smr_rpm