If purely used as an appetite suppressant, then of course people will put the weight back on as soon as they regain their appetite.
People get lulled into a false sense of security that their diet is fine because they're losing weight! But it isn't.
However the jabs work well if you use the time to "retrain" your appetite, diet, and tastebuds. Then you keep the weight off because you no longer crave processed, high calorie, or junk foods.
I think the problem is in the marketing of these medications. They're not slimming jabs, they're appetite suppressors. If you never fix the appetite you will need to go back to suppressing it!
> Dr Adam Collins, an expert in nutrition at the University of Surrey, says the way the jabs work in the brain and body might explain why weight regain is amplified once you stop taking them.
They mimic a natural hormone called GLP-1, which regulates hunger.
"Artificially providing GLP-1 levels several times higher than normal over a long period may cause you to produce less of your own natural GLP-1, and may also make you less sensitive to its effects.
"That's not a problem when taking the drugs, but as soon as you withdraw this GLP-1 'fix', appetite is no longer kept in check and overeating is far more likely."
If that is true, and it makes mechanistic sense if I think about opiod withdrawals for example, then it is a problem regardless. If you have a stronger hunger impulse then before AND a lower body weight and thus TDEE, I can imagine that it would be pretty tough mentally to maintain your weight, even if you count your calories.
I agree, I fast regularly and I’m fit for most of the year but comes the holidays and I don’t restrict myself which causes issues comes January, I have to train myself to regulate my appetite Ava hunger. It takes a bit and it goes back to normal by February and March but it takes some work.
My wife, age 60, has battled her weight her whole life, and my son-in-law is currently taking one of the GLP-1 drugs. When I listen to them discuss all this, the one thing that stands out to me is "The drug quiets the voices in my head about food." If there are sweets in the house, for instance, my wife can possibly resist eating them, but she cannot stop thinking about them. For them, and I think for many people, it's not just a matter of hunger but hunger and learned behaviors. My wife can tell you how those voices were activated by her mother when she was a child. It's really complicated.
If there are sweets in the house, I may eat more than I would like, but I don't really have those voices, and after being married to my wife for 40 years, I can't pretend to even understand what her thoughts are about food. I can get a brownie from the kitchen, eat it and forget about them until I come back into the kitchen again. I suspect you also don't have those voices.
(For reference, I've never been particularly overweight, but twice in my life my weight crept up, and I managed to lose and keep off for years 10-25 pounds through diet changes alone; yes, my weight did eventually creep up, but I think the number of years before that happened would qualify medically as a successful weight loss)
To get back to this discussion, my son-in-law has lost 50 pounds since he started taking the GLP-1 drug, but he has also changed his diet and he exercises regularly. He was trying to do those things with mixed success in terms of weight loss before he started taking the drug, so I would say he would probably stand a higher chance of keeping the weight off if he were to stop the drug, but his doctor talks about him always being on a low maintenance dose.
The other option which people seem to shy away from is to simply embrace the act of feast and famine. I'll regularly go through binges, colloquially known as "Christmas" and "Summer", and to be honest I don't sweat about it. Either the fire is on and we're all celebrating with family and friends with a beer and a roast dinner, or the sun is out and we're having BBQ and cocktails doing the same.
If you can master the skill of dietary control, and go a month or two with really spartan fasting routine between celebration periods, life becomes a lot less stressful. I always enjoy watching Paddy Pimblett (UFC fighter well known for radical weight transformations:https://www.bbc.com/sport/mixed-martial-arts/62135535) bounce between weights, but always get in shape before a fight. It's a skill that only gets easier with practice.
Yeah, rather than eating pizza and being unable to finish the incredibly delicious high calorie food you probably want to just eat quinoa and salmon bowl or equivalent healthy food.
What does this even mean? GLP-1s modify the reward center of the brain which significantly quells cravings and makes foods much less rewarding when they are consumed. If pizza becomes just as rewarding as a quinoa and salmon bowl the you're less likely to eat the pizza.
It's amazing that this isn't common sense to most people.
I foresee the overwhelming majority of people on these drugs regaining everything (and maybe even going beyond their original weight), because, just like traditional dieting, they don't actually change their lifestyle. They're just giving their system a shock, which when it goes back into fat storing mode will overcompensate due to the shock of the loss.
The nihilist in me doesn't believe that many people are truly capable of massive lifestyle change. Once you've lived a certain way for 20 or 30 years, any change beyond that is just a fleeting thing. Yo-yo weight loss and gain just proves that. It only becomes a real lifestyle change after many years.
Somewhere in this thread someone mentioned eating a tub of ice cream at night, if anything, all that sugar is going to fuck your system up beyond what any drug can repair.
One thing that seems missing from a lot of these comparisons is the base rate of success for dieting itself.
Most people who “start a diet” never meaningfully lose weight in the first place, or lose a small amount and plateau quickly. The cohort of “dieters who regain weight” is already heavily filtered toward the minority who were unusually successful at dieting to begin with. That selection bias matters a lot when you then compare regain rates.
GLP-1s change that denominator. A much larger fraction of people who start the intervention actually lose substantial weight. So even if regain after stopping is faster conditional on having lost weight, the overall success rate (people who lose and keep off a clinically meaningful amount) may still be higher than dieting alone.
In other words: “people who regain weight after stopping GLP-1s” vs “people who regain weight after dieting” ignores the much larger group of dieters who never lost anything to regain. From a population perspective, that’s a pretty important omission.
You are the third person to mention that the cohort is "dieters who regain weight".
Reading the article and its referenced study, I thought the cohort was "all who were included in the non-placebo group of the RCT" and that the average was taken over all such subjects.
I've tried, can't find any evidence to the contrary. I am wrong and missing some key claim in the study? I would appreciate if you could support your claim.
> Weight regain data are expressed as weight change from baseline (pre-intervention) or difference in weight change from baseline between intervention and control for randomised controlled trials. When analysing and presenting data from all studies, we used weight change from single arm trials, observational studies, and the intervention groups from randomised controlled trials. When analysing data from randomised controlled trials only, we calculated the difference in weight change between the intervention and control groups at the end of the intervention and at each available time point after the end of the intervention. When studies had multiple intervention arms, we treated each arm as a separate arm and divided the number in the comparator by the number of intervention arms to avoid duplicative counting.19
> The results at year eight are heartening. Eight years later and 50.3 percent of the intensive lifestyle intervention group and 35.7 percent of the usual care group were maintaining losses of ≥5 percent, while 26.9 percent of the intensive group and 17.2 percent of the usual care group were maintaining losses of ≥10 percent.
The idea of "heartening" by an obesity doctor was that half of people lost a largely imperceptible amount of weight.
This was considered success at the time.
For comparison, to be on the edge of normal weight from the edge of obese is a 16% reduction.
I was concerned about this too. Gemini informed me that the researchers "found that even when comparing people who had lost the same amount of weight, the rate of regain was significantly faster in the drug group (GLP-1s) than in the diet group (approximately 0.3 kg/month faster)."
Also, both groups contained those who didn't lose weight. They did not omit dieters who failed to lose weight or those who weren't "super responders."
Contrast this with taking the headline as fact without further scrutinizing it, which happens often. Or, look at the other posts here that are assuming that the cohort was restricted to only those who lost weight.
In an informal conversational context such as a forum, we don't expect every commentator to spend 20 minutes reading through the research. Yet we now have tools that allow us to do just that in less than a minute. It was not long ago that we'd be justified to feel skeptical of these tools, but they've gotten to the point where we'd be justified to believe them in many contexts. I believed it in this case, and this was the right time spent/scrutinization tradeoff for me. You're free to prove the claim wrong. If it was wrong, then I'd agree that it would be good to see where it was wrong.
Probably many people are using the tools and then "covering" before posting. That would be posting it as "fact". That's not what I did, as I made the reader aware of the source of the information and allowed them to judge it for what it was worth. I would argue that it's actually more transparent and authentic to admit from where exactly you're getting the information. It's not like the stakes are that high: the information is public, and anyone can check it. Hacker News understandably might be comparably late to this norm, as its users have a better understanding of the tech and things like how often they hallucinate. But I believe this is the way the wind is blowing.
I'm not sure exactly what you're asking. What I meant was that, for example, before you might've needed to track down where to find the underlying research paper, then read through the paper to find the relevant section. That might've taken 20 minutes for a task like this one. Now you can set an LLM on it, and get a concise answer in less than a minute.
The few doctors I've seen react to these news all seem to share the same opinion, which is: Duh, if you're prescribed GLP-1 for a medical reason, you're expected to keep taking it basically for life, it's the safe way to proceed. It's not a diet pill.
I'll second this, the medical opinion that I've seen is "You should take the drug as prescribed, if you tolerate it well it's safe to take indefinitely".
Now this does get a bit more complex when you consider the nontrivial financial cost to someone without insurance or who's insurance does not cover their intended use.
And the problem with that is what, exactly? These drugs not only optimize weight, but make it easier to avoid all sorts of useless dopamine spam activities. People report drinking a lot less on them too
I read the OP's observation to be "they need to take it for life - and not treat it as a short term fix" but people talk about it as a short term fix.
Some medication, like Tylenol, is short term. You take it for a headache, and then move on. Other medication, like Adderall, you take for life. Everyday, you take it to manage ADD.
OP is arguing that appetite suppressor are a "take everyday for life, and stop talking about it as though it is a short term fix"
---
For my part, I know 3 people on appetite suppressors. 1 person lost a lot of weight, and then stopped recently - it is too soon to know if she "relapsed". 1 person lost a lot and will "stop taking it in 2 months". 1 person recently started taking it.
In my experience, people do talk about it like a short term fix. Should they take it for life? I'm not equipped to have an opinion just yet.
I'm about to start taking it, with plans for it to only be temporary.
I used to be fit and healthy, but then some things happened, and now I need a jumpstart to get to a lower weight to where I can resume doing physical activities and resume a healthy diet and lifestyle.
I think it’s an awareness problem as much as anything. Folks going on these medications aren’t aware it may well be a lifelong commitment. And particularly in the US any lifetime medication comes with financial implications.
"people who come off statins have higher cholesterol levels than people who lowered cholesterol with diet and exercise."
That's obviously stupid, so why are we treating GLP-1s differently?
I also hear people say things like "GLP-1s shouldn't exist because you'll gain weight when you go off them" which is as nonsensical (to me) as saying "you shouldn't exercise because the benefits of exercise will stop if you don't continue exercising."
It's only GLP-1s that have this "moralizing" associated with them.
"people who come off vaccinations still don't get sick, compared to those who continue taking vaccines"
You have a strong bias towards thinking GLP-1 behaves like a statin rather than a personality altering drug (or a vaccine, or nicotine patches.) Please provide a basis for this bias.
We're not treating GLP-1 different because it's a different thing. We're treating it differently, because we don't know if it's an analogous thing without this type of study.
But the article isn't saying it's surprising that you gain weight when you stop the treatment, the surprise is how fast you regain it compared to other treatments.
The conclusion isn't at all obvious so there's no "duh" moment. Why would you gain back the weight that much faster if you lost it with this pill vs. that pill?
I lost 40 lbs with Ozempic and kept almost all of it off a year after stopping the drug. The little I have gained is almost certainly been muscle. But I have had to pay attention to what I eat. Nothing crazy. I don’t count calories, but I can’t house pints of ice cream in the middle of the night anymore.
My wife has been similar. She came off, gained a small amount of weight, but her diet has stabilized to a much healthier norm than before. I would argue that she's healthier now than just before she stopped, because she is eating enough to have energy for exercise/activity.
Similarly, people get their weight back after liposuction, or after stopping the diet, as the article posits.
This boils down to the fact that the weight, and its quality (fat vs muscle) is a function of habits.
Given the number of studies that show the complexity of factors that influence the weight, from neuroscience and psychology to studies of metabolism, it is a wishful thinking to have an injection or a pill alone as a long-lasting solution.
Other studies [0] report that people end up under their starting weight
It seems this meta-analysis estimate the average amount regained this week and then projected that forward - but that doesn't quite match what is reported [0]? Does anyone know more about this?
Dieting forces you focus the actual problem which could be lack of cooking skills, poor shopping choices, lack of accurate information, lack of available healthy foods, poor lifestyle choices or much more.
Ozempic/Wegovy and the like while they have their place, are simply useful tools in the hands of doctors. They are not a magic bean that will cure over eating but they are being marketed and discussed as that.
There are almost no short cuts in this world of losing weight but there are extremely worthwhile trade off’s.
> They are not a magic bean that will cure over eating but they are being marketed and discussed as that.
Where and by whom? I keep seeing this claim but every ad I see mentions diet and exercise. The subreddits for these drugs are all full of people talking about diet and exercise.
Sure they mention diet and exercise in the same way gambling or alcohol ads recommend being “responsible”, or how TikTok talks about their automatic screen limiting time functionality, which they love to promote but internally know does nothing.
I’m not sure where the goalposts are in this discussion. My doctor assigned me a dietitian. My insurance company assigned me 12 weekly modules that cover diet, exercise, mental health and cooking before they would pay for it. The ads I see on the subway for Ro have the words “with diet and exercise” in bold letters on them.
So I just don’t know what to make of this “magic beans” deception claim.
It’s starting to feel like a certain group of people, for reasons I can’t discern, are desperate for some kind of “gotcha.”
I've switched to a low carb diet this year and have cut out just about all processed foods. I am considering getting a GLP1 injection privately in the near future. I'm hopeful that when I do get down to my target weight, my diet will remain changed, my habits will have improved and I'll be putting my new mobility to some use.
I don't plan on going cold turkey, I'll taper off the dose slowly and see what happens.
It matches my intuition. Long term change requires skill acquisition. What foods contain more calories than people realize? What foods are more satiating? What kind of portion sizes for each food will keep me from eating a surplus? How much snacking is too much? How does the amount of oil in the foods I eat change the equation? What does the non-drug-augmented sensation of stomach fullness tell me about when I should stop eating? Can I eat more slowly and stop at the right time? The list goes on.
From personal experience alone these drugs feel fairly easy to start and stop taking. So taking them every third or fourth month (or similar) would seem like a straight-forward option, unless I'm missing something.
This isn’t surprising, but I have trouble taking anyone seriously when they use the term “jabs”. I’m rather shocked it’s in the headline of a BBC article.
Interesting. I’m so used to only hearing it from people about to rant about vaccine mandates, which has given it quite the negative connotation (for me) on this side of the pond.
While "jab" is used almost universally across UK print and broadcast media to describe an injection, it's interesting to note the choice of accompanying adjective.
The Sun, The Telegraph, Daily Mail and The Times love to use "fat jab".
The BBC, The Guardian and The Mirror seem to prefer "slimming jab" or "weight-loss jab".
It is just the usual vice vs. virtue approach to things where 'the right' tends to point at vices which are in need of curtailing while 'the left' points at the virtue in those turning away from such vices. This also relates closely to 'the right' tending to voice support for punishing those who commit vices in some way while 'the left' voices support for rewarding those who turn away from committing them. Deeper down it points down to the preference for personal agency and responsibility on 'the right' versus collective responsibility and a related lack of personal agency on 'the left'.
Sometimes it is not malicious language. There's a trend in modern journalism towards colloquial, imprecise language that in itself is a reaction to decreasing reading abilities and vocabulary in the general population, as we are now in the descending slope of the Flynn's effect curve.
Also, a journalist nowadays is evaluated as a professional basically by the amount of pageviews he can harvest. There's a strong incentive towards clickbait language.
English pedant and RP speaker here. Jabs is a colloquialism in British English, but the BBC website is riddled with grammatical and vocabulary errors daily and rarely rises above a secondary (high school) reading level.
The meta-analysis that is being referenced in the paper included only randomized controlled trials for body-weight management programs. I don't see why you think the weight loss/regain being compared is excluding those who weren't successful rather than averaged over all participants.
I read the study to the best of my abilities, and I see nothing that would support your claim.
Yea, there is quite a lot of survivorship bias in this comparison. "People who succeeded at controlling hunger and improving diet" vs "People who stopped taking their medicine". It is very unsurprising.
Where do you see that they are comparing "people who succeeded" in the study?
I'm not the best at reading medical studies, but it seems to me like they are taking averages over all subjects in the randomized controlled trials, not just "successful" subjects.
I'm currently on my second extended period of GLP1 agonist unavailability (country-wide). The one I have been using is dulaglutide which is much less potent than the newer ones (it's the only one legally imported here) but being cut off still sucks. However, it's far from the only medication I'm on and not even close to the worst one to be cut off from or the first one I've had issues getting. It's just part of life in the third world at this point.
I found it very disturbing how heavily these were marketed as miracle drugs that would "bankrupt fast food". Seems like another instance of create a problem ("food" industry) and sell a recurring "solution" (big pharma).
> The stories about bankrupting the fast food industry were from journalists looking for sensational stories to write, not from the marketers.
Those are not necessarily disconnected. Marketers pitch stories, they fund studies they know will show X outcome, etc etc, which are picked up by journalists.
I mean it isn't a conspiracy. People love food that makes them fat cuz it's fucking tasty. But being fat is cosmetically unappealing, is socially stigmatized, makes it hard to do things, and is bad for your overall health. All of this, the drugs, the fat burning "cures," diet culture, surgery, all of it going back to time immemorial is trying to resolve this inherent conflict:
* Shitty food is fucking delicious.
* For whatever reasons an individual cites, being fat is undesirable.
And... you can't. At least not with today's technology. But people hate that answer and so there's huge money in figuring out how to make it so people can eat like fatasses without being fatasses.
And... same. I'd fucking love that, I just don't expect it coming anytime soon.
I have understood that mechanism these drugs actual work with is making fatasses not eat like fatasses. While possibly continuing to eat what fatasses do, but less of it and less often.
No that's basically what they do, AFAIK. Seems to something with the rewards center of the brain since it also seems at least somewhat effective in treating addiction too.
It heavily depends on how the jabs are used.
If purely used as an appetite suppressant, then of course people will put the weight back on as soon as they regain their appetite.
People get lulled into a false sense of security that their diet is fine because they're losing weight! But it isn't.
However the jabs work well if you use the time to "retrain" your appetite, diet, and tastebuds. Then you keep the weight off because you no longer crave processed, high calorie, or junk foods.
I think the problem is in the marketing of these medications. They're not slimming jabs, they're appetite suppressors. If you never fix the appetite you will need to go back to suppressing it!
> Dr Adam Collins, an expert in nutrition at the University of Surrey, says the way the jabs work in the brain and body might explain why weight regain is amplified once you stop taking them. They mimic a natural hormone called GLP-1, which regulates hunger. "Artificially providing GLP-1 levels several times higher than normal over a long period may cause you to produce less of your own natural GLP-1, and may also make you less sensitive to its effects. "That's not a problem when taking the drugs, but as soon as you withdraw this GLP-1 'fix', appetite is no longer kept in check and overeating is far more likely."
If that is true, and it makes mechanistic sense if I think about opiod withdrawals for example, then it is a problem regardless. If you have a stronger hunger impulse then before AND a lower body weight and thus TDEE, I can imagine that it would be pretty tough mentally to maintain your weight, even if you count your calories.
I agree, I fast regularly and I’m fit for most of the year but comes the holidays and I don’t restrict myself which causes issues comes January, I have to train myself to regulate my appetite Ava hunger. It takes a bit and it goes back to normal by February and March but it takes some work.
My wife, age 60, has battled her weight her whole life, and my son-in-law is currently taking one of the GLP-1 drugs. When I listen to them discuss all this, the one thing that stands out to me is "The drug quiets the voices in my head about food." If there are sweets in the house, for instance, my wife can possibly resist eating them, but she cannot stop thinking about them. For them, and I think for many people, it's not just a matter of hunger but hunger and learned behaviors. My wife can tell you how those voices were activated by her mother when she was a child. It's really complicated.
If there are sweets in the house, I may eat more than I would like, but I don't really have those voices, and after being married to my wife for 40 years, I can't pretend to even understand what her thoughts are about food. I can get a brownie from the kitchen, eat it and forget about them until I come back into the kitchen again. I suspect you also don't have those voices.
(For reference, I've never been particularly overweight, but twice in my life my weight crept up, and I managed to lose and keep off for years 10-25 pounds through diet changes alone; yes, my weight did eventually creep up, but I think the number of years before that happened would qualify medically as a successful weight loss)
To get back to this discussion, my son-in-law has lost 50 pounds since he started taking the GLP-1 drug, but he has also changed his diet and he exercises regularly. He was trying to do those things with mixed success in terms of weight loss before he started taking the drug, so I would say he would probably stand a higher chance of keeping the weight off if he were to stop the drug, but his doctor talks about him always being on a low maintenance dose.
The other option which people seem to shy away from is to simply embrace the act of feast and famine. I'll regularly go through binges, colloquially known as "Christmas" and "Summer", and to be honest I don't sweat about it. Either the fire is on and we're all celebrating with family and friends with a beer and a roast dinner, or the sun is out and we're having BBQ and cocktails doing the same.
If you can master the skill of dietary control, and go a month or two with really spartan fasting routine between celebration periods, life becomes a lot less stressful. I always enjoy watching Paddy Pimblett (UFC fighter well known for radical weight transformations:https://www.bbc.com/sport/mixed-martial-arts/62135535) bounce between weights, but always get in shape before a fight. It's a skill that only gets easier with practice.
Yeah, rather than eating pizza and being unable to finish the incredibly delicious high calorie food you probably want to just eat quinoa and salmon bowl or equivalent healthy food.
What does this even mean? GLP-1s modify the reward center of the brain which significantly quells cravings and makes foods much less rewarding when they are consumed. If pizza becomes just as rewarding as a quinoa and salmon bowl the you're less likely to eat the pizza.
You can gain weight on a healthy diet too though!
It's amazing that this isn't common sense to most people.
I foresee the overwhelming majority of people on these drugs regaining everything (and maybe even going beyond their original weight), because, just like traditional dieting, they don't actually change their lifestyle. They're just giving their system a shock, which when it goes back into fat storing mode will overcompensate due to the shock of the loss.
The nihilist in me doesn't believe that many people are truly capable of massive lifestyle change. Once you've lived a certain way for 20 or 30 years, any change beyond that is just a fleeting thing. Yo-yo weight loss and gain just proves that. It only becomes a real lifestyle change after many years.
Somewhere in this thread someone mentioned eating a tub of ice cream at night, if anything, all that sugar is going to fuck your system up beyond what any drug can repair.
One thing that seems missing from a lot of these comparisons is the base rate of success for dieting itself.
Most people who “start a diet” never meaningfully lose weight in the first place, or lose a small amount and plateau quickly. The cohort of “dieters who regain weight” is already heavily filtered toward the minority who were unusually successful at dieting to begin with. That selection bias matters a lot when you then compare regain rates.
GLP-1s change that denominator. A much larger fraction of people who start the intervention actually lose substantial weight. So even if regain after stopping is faster conditional on having lost weight, the overall success rate (people who lose and keep off a clinically meaningful amount) may still be higher than dieting alone.
In other words: “people who regain weight after stopping GLP-1s” vs “people who regain weight after dieting” ignores the much larger group of dieters who never lost anything to regain. From a population perspective, that’s a pretty important omission.
You are the third person to mention that the cohort is "dieters who regain weight".
Reading the article and its referenced study, I thought the cohort was "all who were included in the non-placebo group of the RCT" and that the average was taken over all such subjects.
I've tried, can't find any evidence to the contrary. I am wrong and missing some key claim in the study? I would appreciate if you could support your claim.
You're right.
> Weight regain data are expressed as weight change from baseline (pre-intervention) or difference in weight change from baseline between intervention and control for randomised controlled trials. When analysing and presenting data from all studies, we used weight change from single arm trials, observational studies, and the intervention groups from randomised controlled trials. When analysing data from randomised controlled trials only, we calculated the difference in weight change between the intervention and control groups at the end of the intervention and at each available time point after the end of the intervention. When studies had multiple intervention arms, we treated each arm as a separate arm and divided the number in the comparator by the number of intervention arms to avoid duplicative counting.19
https://www.bmj.com/content/392/bmj-2025-085304
If you look back at the pre-Ozempic era, you had articles like this:
https://www.vox.com/2016/5/10/11649210/biggest-loser-weight-...
> The results at year eight are heartening. Eight years later and 50.3 percent of the intensive lifestyle intervention group and 35.7 percent of the usual care group were maintaining losses of ≥5 percent, while 26.9 percent of the intensive group and 17.2 percent of the usual care group were maintaining losses of ≥10 percent.
The idea of "heartening" by an obesity doctor was that half of people lost a largely imperceptible amount of weight.
This was considered success at the time.
For comparison, to be on the edge of normal weight from the edge of obese is a 16% reduction.
It's because taking a drug requires zero willpower
I was concerned about this too. Gemini informed me that the researchers "found that even when comparing people who had lost the same amount of weight, the rate of regain was significantly faster in the drug group (GLP-1s) than in the diet group (approximately 0.3 kg/month faster)."
Also, both groups contained those who didn't lose weight. They did not omit dieters who failed to lose weight or those who weren't "super responders."
I apologize in advance for the tone of my response.
>Gemini informed me...
Phrases like this are essentially, "I asked an LLM to interpret this and I didn't bother verifying it's accuracy, but I will now post it as fact."
Contrast this with taking the headline as fact without further scrutinizing it, which happens often. Or, look at the other posts here that are assuming that the cohort was restricted to only those who lost weight.
In an informal conversational context such as a forum, we don't expect every commentator to spend 20 minutes reading through the research. Yet we now have tools that allow us to do just that in less than a minute. It was not long ago that we'd be justified to feel skeptical of these tools, but they've gotten to the point where we'd be justified to believe them in many contexts. I believed it in this case, and this was the right time spent/scrutinization tradeoff for me. You're free to prove the claim wrong. If it was wrong, then I'd agree that it would be good to see where it was wrong.
Probably many people are using the tools and then "covering" before posting. That would be posting it as "fact". That's not what I did, as I made the reader aware of the source of the information and allowed them to judge it for what it was worth. I would argue that it's actually more transparent and authentic to admit from where exactly you're getting the information. It's not like the stakes are that high: the information is public, and anyone can check it. Hacker News understandably might be comparably late to this norm, as its users have a better understanding of the tech and things like how often they hallucinate. But I believe this is the way the wind is blowing.
>Yet we now have tools that allow us to do just that in less than a minute.
With this tool, you read in under one minute what would've taken you 20 minutes before?
I'm not sure exactly what you're asking. What I meant was that, for example, before you might've needed to track down where to find the underlying research paper, then read through the paper to find the relevant section. That might've taken 20 minutes for a task like this one. Now you can set an LLM on it, and get a concise answer in less than a minute.
The few doctors I've seen react to these news all seem to share the same opinion, which is: Duh, if you're prescribed GLP-1 for a medical reason, you're expected to keep taking it basically for life, it's the safe way to proceed. It's not a diet pill.
I'll second this, the medical opinion that I've seen is "You should take the drug as prescribed, if you tolerate it well it's safe to take indefinitely".
Now this does get a bit more complex when you consider the nontrivial financial cost to someone without insurance or who's insurance does not cover their intended use.
And the problem with that is what, exactly? These drugs not only optimize weight, but make it easier to avoid all sorts of useless dopamine spam activities. People report drinking a lot less on them too
>And the problem with that is what, exactly?
I read the OP's observation to be "they need to take it for life - and not treat it as a short term fix" but people talk about it as a short term fix.
Some medication, like Tylenol, is short term. You take it for a headache, and then move on. Other medication, like Adderall, you take for life. Everyday, you take it to manage ADD.
OP is arguing that appetite suppressor are a "take everyday for life, and stop talking about it as though it is a short term fix"
--- For my part, I know 3 people on appetite suppressors. 1 person lost a lot of weight, and then stopped recently - it is too soon to know if she "relapsed". 1 person lost a lot and will "stop taking it in 2 months". 1 person recently started taking it.
In my experience, people do talk about it like a short term fix. Should they take it for life? I'm not equipped to have an opinion just yet.
I'm about to start taking it, with plans for it to only be temporary.
I used to be fit and healthy, but then some things happened, and now I need a jumpstart to get to a lower weight to where I can resume doing physical activities and resume a healthy diet and lifestyle.
I think it’s an awareness problem as much as anything. Folks going on these medications aren’t aware it may well be a lifelong commitment. And particularly in the US any lifetime medication comes with financial implications.
Exactly. Chronic conditions require chronic management.
Imagine if the headline was
"people who come off statins have higher cholesterol levels than people who lowered cholesterol with diet and exercise."
That's obviously stupid, so why are we treating GLP-1s differently?
I also hear people say things like "GLP-1s shouldn't exist because you'll gain weight when you go off them" which is as nonsensical (to me) as saying "you shouldn't exercise because the benefits of exercise will stop if you don't continue exercising."
It's only GLP-1s that have this "moralizing" associated with them.
Or:
"people who come off vaccinations still don't get sick, compared to those who continue taking vaccines"
You have a strong bias towards thinking GLP-1 behaves like a statin rather than a personality altering drug (or a vaccine, or nicotine patches.) Please provide a basis for this bias.
We're not treating GLP-1 different because it's a different thing. We're treating it differently, because we don't know if it's an analogous thing without this type of study.
But the article isn't saying it's surprising that you gain weight when you stop the treatment, the surprise is how fast you regain it compared to other treatments.
The conclusion isn't at all obvious so there's no "duh" moment. Why would you gain back the weight that much faster if you lost it with this pill vs. that pill?
I lost 40 lbs with Ozempic and kept almost all of it off a year after stopping the drug. The little I have gained is almost certainly been muscle. But I have had to pay attention to what I eat. Nothing crazy. I don’t count calories, but I can’t house pints of ice cream in the middle of the night anymore.
My wife has been similar. She came off, gained a small amount of weight, but her diet has stabilized to a much healthier norm than before. I would argue that she's healthier now than just before she stopped, because she is eating enough to have energy for exercise/activity.
Similarly, people get their weight back after liposuction, or after stopping the diet, as the article posits.
This boils down to the fact that the weight, and its quality (fat vs muscle) is a function of habits.
Given the number of studies that show the complexity of factors that influence the weight, from neuroscience and psychology to studies of metabolism, it is a wishful thinking to have an injection or a pill alone as a long-lasting solution.
Other studies [0] report that people end up under their starting weight
It seems this meta-analysis estimate the average amount regained this week and then projected that forward - but that doesn't quite match what is reported [0]? Does anyone know more about this?
[0] https://glp1.guide/content/do-people-regain-all-the-weight-l...
I just came off Zepbound for a month and gained a lot of weight.
It wasn’t like I didn’t know what I was doing though. I was enjoying food again in a way that Zepbound meaningfully repressed.
So it’s not like the drug scammed me, I just wanted to eat more again naturally
Dieting forces you focus the actual problem which could be lack of cooking skills, poor shopping choices, lack of accurate information, lack of available healthy foods, poor lifestyle choices or much more.
Ozempic/Wegovy and the like while they have their place, are simply useful tools in the hands of doctors. They are not a magic bean that will cure over eating but they are being marketed and discussed as that.
There are almost no short cuts in this world of losing weight but there are extremely worthwhile trade off’s.
> They are not a magic bean that will cure over eating but they are being marketed and discussed as that.
Where and by whom? I keep seeing this claim but every ad I see mentions diet and exercise. The subreddits for these drugs are all full of people talking about diet and exercise.
Sure they mention diet and exercise in the same way gambling or alcohol ads recommend being “responsible”, or how TikTok talks about their automatic screen limiting time functionality, which they love to promote but internally know does nothing.
I’m not sure where the goalposts are in this discussion. My doctor assigned me a dietitian. My insurance company assigned me 12 weekly modules that cover diet, exercise, mental health and cooking before they would pay for it. The ads I see on the subway for Ro have the words “with diet and exercise” in bold letters on them.
So I just don’t know what to make of this “magic beans” deception claim.
It’s starting to feel like a certain group of people, for reasons I can’t discern, are desperate for some kind of “gotcha.”
> They are not a magic bean that will cure over eating
All evidence points to them being very effective in reducing food intake. That’s how they work.
The fact that users return to their previous eating habits when discontinued is not surprising at all.
> They are not a magic bean that will cure over eating but they are being marketed and discussed as that.
Well in a way they kind of are (at least more so than any previous pharmaceutical approach), but only as long as you take them.
>but only as long as you take them.
This is why these drugs are a treatment, not a cure.
I've switched to a low carb diet this year and have cut out just about all processed foods. I am considering getting a GLP1 injection privately in the near future. I'm hopeful that when I do get down to my target weight, my diet will remain changed, my habits will have improved and I'll be putting my new mobility to some use.
I don't plan on going cold turkey, I'll taper off the dose slowly and see what happens.
Here is the study: https://pmc.ncbi.nlm.nih.gov/articles/PMC12776922/
It matches my intuition. Long term change requires skill acquisition. What foods contain more calories than people realize? What foods are more satiating? What kind of portion sizes for each food will keep me from eating a surplus? How much snacking is too much? How does the amount of oil in the foods I eat change the equation? What does the non-drug-augmented sensation of stomach fullness tell me about when I should stop eating? Can I eat more slowly and stop at the right time? The list goes on.
From personal experience alone these drugs feel fairly easy to start and stop taking. So taking them every third or fourth month (or similar) would seem like a straight-forward option, unless I'm missing something.
This isn’t surprising, but I have trouble taking anyone seriously when they use the term “jabs”. I’m rather shocked it’s in the headline of a BBC article.
Jabs is basically the British equivalent of the American term shots.
Yes. Queens English countries it's the phrase used (New Zealand - that's what we use).
Interesting. I’m so used to only hearing it from people about to rant about vaccine mandates, which has given it quite the negative connotation (for me) on this side of the pond.
While "jab" is used almost universally across UK print and broadcast media to describe an injection, it's interesting to note the choice of accompanying adjective.
The Sun, The Telegraph, Daily Mail and The Times love to use "fat jab".
The BBC, The Guardian and The Mirror seem to prefer "slimming jab" or "weight-loss jab".
There's a lot to digest in those choices.
It is just the usual vice vs. virtue approach to things where 'the right' tends to point at vices which are in need of curtailing while 'the left' points at the virtue in those turning away from such vices. This also relates closely to 'the right' tending to voice support for punishing those who commit vices in some way while 'the left' voices support for rewarding those who turn away from committing them. Deeper down it points down to the preference for personal agency and responsibility on 'the right' versus collective responsibility and a related lack of personal agency on 'the left'.
> 'the right' tending to voice support for punishing those who commit vices
the right spends a lot of time defending a corrupt pedophile ordering invasions and murders, isn't it curious?
Sometimes it is not malicious language. There's a trend in modern journalism towards colloquial, imprecise language that in itself is a reaction to decreasing reading abilities and vocabulary in the general population, as we are now in the descending slope of the Flynn's effect curve.
Also, a journalist nowadays is evaluated as a professional basically by the amount of pageviews he can harvest. There's a strong incentive towards clickbait language.
in this case they’re just British mate
English pedant and RP speaker here. Jabs is a colloquialism in British English, but the BBC website is riddled with grammatical and vocabulary errors daily and rarely rises above a secondary (high school) reading level.
If this was a US-based journalist I’d agree, but the term doesn’t carry the same connotations for the BBC’s home audience
If it had been BBC Scotland you might have seen "jags" instead.
Isn't "jab" just another word for "an injection" not only "a vaccine"?
In the UK, yes.
I had to think about what a “slimming jab” would be. Interesting terminology for weight-loss injections.
This is obviously because the people who successfully lose weight via dieting are more capable of internalized diet control.
The meta-analysis that is being referenced in the paper included only randomized controlled trials for body-weight management programs. I don't see why you think the weight loss/regain being compared is excluding those who weren't successful rather than averaged over all participants.
I read the study to the best of my abilities, and I see nothing that would support your claim.
Yea, there is quite a lot of survivorship bias in this comparison. "People who succeeded at controlling hunger and improving diet" vs "People who stopped taking their medicine". It is very unsurprising.
Where do you see that they are comparing "people who succeeded" in the study?
I'm not the best at reading medical studies, but it seems to me like they are taking averages over all subjects in the randomized controlled trials, not just "successful" subjects.
It's good to make people aware of that. At the same time, people who come off insulin get blood sugar problems fairly quickly too.
I think, barred some horrible, long term side-effects, we need to accept that people will be staying on those drugs for a long time.
What if increasing global instability renders them sporadically unavailable for certain markets?
Then I guess those people will sporadically gain weight
Then they will regain (some of) the weight, most likely?
In that scenario I'd be more concerned with food insecurity rather than the drugs that make me eat less.
I'm currently on my second extended period of GLP1 agonist unavailability (country-wide). The one I have been using is dulaglutide which is much less potent than the newer ones (it's the only one legally imported here) but being cut off still sucks. However, it's far from the only medication I'm on and not even close to the worst one to be cut off from or the first one I've had issues getting. It's just part of life in the third world at this point.
They’ll have to deal with that, I guess? What’s your point? That’s how everything works.
> At the same time, people who come off insulin get blood sugar problems fairly quickly too.
Yep, within hours for a type 1 diabetic, followed quickly by death within a few days to weeks
God I hate my disease, haha
I found it very disturbing how heavily these were marketed as miracle drugs that would "bankrupt fast food". Seems like another instance of create a problem ("food" industry) and sell a recurring "solution" (big pharma).
That would be really bad marketing. When's the last time you bought something because it'd bankrupt fast food?
They aren’t marketed as bankrupting fast food. They’re marketed as weight loss drugs, which is honest and accurate.
The stories about bankrupting the fast food industry were from journalists looking for sensational stories to write, not from the marketers.
> Seems like another instance of create a problem ("food" industry) and sell a recurring "solution" (big pharma).
There is no conspiracy between the food industry and pharmaceutical companies. They’re all just selling products that people demand.
> The stories about bankrupting the fast food industry were from journalists looking for sensational stories to write, not from the marketers.
Those are not necessarily disconnected. Marketers pitch stories, they fund studies they know will show X outcome, etc etc, which are picked up by journalists.
Do you have any evidence of this happening, like a link to the studies you’re talking about? Or is this just speculation?
I mean it isn't a conspiracy. People love food that makes them fat cuz it's fucking tasty. But being fat is cosmetically unappealing, is socially stigmatized, makes it hard to do things, and is bad for your overall health. All of this, the drugs, the fat burning "cures," diet culture, surgery, all of it going back to time immemorial is trying to resolve this inherent conflict:
* Shitty food is fucking delicious.
* For whatever reasons an individual cites, being fat is undesirable.
And... you can't. At least not with today's technology. But people hate that answer and so there's huge money in figuring out how to make it so people can eat like fatasses without being fatasses.
And... same. I'd fucking love that, I just don't expect it coming anytime soon.
I have understood that mechanism these drugs actual work with is making fatasses not eat like fatasses. While possibly continuing to eat what fatasses do, but less of it and less often.
Though I might have misunderstood.
No that's basically what they do, AFAIK. Seems to something with the rewards center of the brain since it also seems at least somewhat effective in treating addiction too.