I've Reached My Goal Weight - Now What?
One of the most asked questions from our clients, and rightly so, is “What happens once I have lost the weight that I want to lose?” It is a good question to be thinking about from the beginning. As you proceed through the weight reduction journey with the help of Semaglutide or Tirzepatide there are many experiences and habits you can learn before you get to your goal weight to help sustain the healthy weight you want to achieve. If you choose to stop the medication there is a potential for weight gain for several reasons and there are ways to help prevent this.
This article explores the science behind weight regain after stopping Tirzepatide and Semaglutide, investigates the evidence and equips you with strategies for long-term success
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The Science
- Tirzepatide and Semaglutide work by mimicking the effects of incretin hormones, GLP-1 and GIP, which stimulate insulin secretion, increase satiety and slow down stomach emptying.
- Essentially, these medications trick your body into feeling fuller for longer, promoting a calorie deficit – the key to weight loss.
- However, when you stop taking them, these hormonal effects wear off, potentially leading to increased hunger and a return to old eating patterns.
- But don’t worry. It is not inevitable, and options are discussed below.
Clinical Trials Paint a Clear Picture: Weight Regain is a Reality
The STEP 1 trial extension provides a sobering illustration. Participants who lost weight on semaglutide regained two-thirds of it within a year of stopping the medication. Similarly, a study on Tirzepatide documented substantial weight regain after discontinuation. These findings highlight the importance of understanding weight maintenance after losing weight on Tirzepatide and Semaglutide. One thing to consider however, was that these trials did NOT have any kind of post-treatment management incorporated in them. Study subjects were taken off the medications cold turkey and without specific weight counseling.
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Understanding the Why Behind the Weight Regain:
Several factors contribute to weight rebound after stopping these medications:
- Hormonal Rebound: As mentioned earlier, these medications alter hormones that regulate appetite. Discontinuing them disrupts this control mechanism, potentially leading to increased hunger and decreased satiety.
- Lifestyle Challenges: Building and maintaining healthy habits like diet and exercise can be challenging. Without the medication’s support, reverting to old eating patterns or neglecting physical activity can accelerate weight regain [8]. It’s like trying to bike uphill – the medication provides a boost, but without continued pedaling (healthy habits), you’ll roll back down.
- Metabolic Adaptations: The body is an incredibly adaptive machine. In response to weight loss, it can slow down metabolism, a process known as metabolic adaptation. This means you burn fewer calories at rest, making it harder to maintain weight loss without continued calorie restriction. Think of it as the body trying to conserve energy after a perceived period of scarcity (weight loss).
Strategies for Long-Term Success: Beyond Medication
While some weight regain is a possible scenario, it’s not inevitable. By focusing on the following strategies, you can significantly increase your chances of lasting weight loss:
Embrace Lifestyle Changes:
- Diet and exercise are the cornerstones of weight management, and the key to long-term success lies in developing sustainable healthy habits you can maintain even after stopping the medication.
Ideas That Work
- Portion Control: Focus on mindful eating practices. Use smaller plates, chew your food thoroughly, and pay attention to your body’s hunger and fullness cues. Learn from the medication. You don’t need to eat as much as you think.
- Balanced Meals: Include on your plate a colorful variety of fruits, vegetables, and whole grains. These foods are packed with nutrients and fiber, which keep you feeling full for longer.
- Healthy Fats and Protein: Don’t shy away from healthy fats like those found in avocados, nuts, and olive oil, or lean protein sources like fish, chicken, and beans. These nutrients promote satiety and support muscle mass, which can help boost metabolism.
- Hunger Pains: Once you are off the meds the hunger sensations will return. They may feel stronger than before because you have not had them for a while and they are new to your body and mind. One option is to eat a SMALL health snack. Take only a bite or two. Another option is to “walk away”. Distract yourself by going on a walk or do something other than think about your hunger.
- Rewards: Many of us use food as a reward. Our culture says we should reward ourselves and our children with a delicious sweet or a night out at a restaurant. Perhaps we should look for other reward options. Why not have a family game night or walk together. How about rewarding yourself with a nice new outfit for your new healthy you? But maybe we should get away from food as our default reward?
Medication assisted maintenance and taper
There are several ways we offer that use Semaglutide or Tirzepatide to help maintain your health and weight goals.
- Overshoot your goal: Some weight gain is expected for many of the reasons we have covered. So we recommend shooting for a few pounds extra weight loss beyond your goal. This will give you a little “cushion” to work with during the maintenance and taper.
- The Taper: We don’t just recommend stopping your medication completely. We offer a gradual dose reduction catered to your needs. Initially, we recommend reducing your dose to about half of your maximum required dose during your weight reduction. Then we monitor how your cravings are and continue to taper as needed.
- Stop Trial: At a certain point when you are feeling comfortable with your weight reduction and tapered down to a low dose it is reasonable to see how you do without the medication. We hope if you focus on your new habits, portion control and just a healthy new lifestyle, you will be able to maintain the new health you have achieved.
- Pulse Dosing: But, if your weight begins to sneak up on you we are always available to restart the meds that have worked for you to give you that little boost to get back to where you feel the healthiest. Remember, The GLP-1 class of drugs were designed and have been used for long term use and glucose control. Being on them for longer periods of time have been proven to be safe and effective.
Weight ReductionMD is here to help you achieve your best health.
Weight ReductionMD is here to help you achieve your best health and that includes a catered maintenance program once you have accomplished your goals. In this way you can confidently begin our program knowing we will be there to celebrate your healthy accomplishments and help you sustain them.