[bedast]

The biggest problem using these drugs for weight loss is they need to be used as part of a program that also includes making lifestyle changes. If you don't push the changes and just do things to your limits, when you stop the drug, your unchanged habits make you gain the weight back.

This is one of the biggest things people with obesity struggle with. This is seen as a miracle cure for obesity because it doesn't require work, just a weekly injection and watch the weight melt off. But making lifestyle changes (changing eating habits, increasing activity, etc) is the most reliable way to make this a permanent fix.

But that's putting the patient to work and they don't want that.

[treis]

That's just not really true. People tend to gain weight and stabilize. It's not like they suddenly get will power. Most everyone has a weight they will end up at if they eat to satiation. These drugs lower that weight.

Of course will power and environment changes can keep you at a lower weight but it's a constant struggle against your body.

[cameronh90]

I take Wegovy for obesity, and it completely changes my behaviour. I don't often think about food any more, and when I do, I am quite happy preparing a small amount of healthy food. Not only that, I have more energy so I maintain a far more active lifestyle.

Given that I can go for months without those "bad habits", but if I stop taking it they come back, I think they're more than habits. Habits break if you stop doing them for a while, these compulsions don't. Until I took this drug, I didn't know what it was like to be able to not constantly think about food and being hungry. I've been overweight for nearly my entire life since I was a breastfeeding baby, and this is the first time in my life that I don't feel like I'm being held hostage to my hunger.

I have lost weight and maintained a healthy weight for periods of time, but I'm just hungry the whole time and eventually the hunger starts beating my willpower.

For what it's worth I also have problems with anxiety. Similarly I tried years of therapy/mediation/mindfulness/etc. to get rid of my anxiety but it never went away until I took sertraline. Now, I live a pretty much anxiety-free life as long as I take a pill a day.

[LazyMans]

One of the dramatic effects I’ve noticed is I finally know what being truly hungry feels like. I can differentiate between appetite and hunger. I used to think it was odd how people would turn down food when it’s offered to them. Either my hunger cues were so strong, or my lack of self control has made me absolutely unable to restrict my intake long enough to reduce my weight in a meaningful way. This drug is essentially turning down my hunger drive and now I get it when someone turns down food offered to them. It’s also given me control over what I eat since I don’t have those wild hunger pangs telling me to eat way too much or to eat the wrong thing. Feeling hungry was like this “emergency” that I had to resolve as quickly as possible.

I probably need to see a therapist that can help with my eating habits, and this has highlighted that for me.

[cameronh90]

The thing is that, at least as far as we know, these drugs don't have any direct effect on the brain. Any effect they have is apparently from adjusting hormone levels and possibly some metabolic effects.

It's also interesting that they were designed to treat diabetes then we also discovered they reduce hunger. My guess is that we may have assumed the cause-effect relationship is more straightforward than it actually is.

I also want to see what happens if we take the people who criticise us for relying on a drug instead of willpower/mental conditioning, then give them a drug that does the opposite of these ones. My guess is they'll overeat and get fat. Much like animals do in animal studies. Ignoring your body constantly telling you to eat is almost impossibly hard over the long term.

Humans have a tendency to assume that we have much more free will than any kind of scientific evidence tends to show.

[bedast]

In my experience, if you're going to use GLP-1 RA for weight loss, it needs to be part of a larger program of changes, including lifestyle changes. That you have to lead the charge on. The people that say losing weight on these means you gotta take it for the rest of your life, they're wrong. It eventually stops having that effect on you. It certainly makes the process of changing things a lot easier, and it buys you a lot of time to adopt those changes. But if you don't put in the mental work and reshape your lifestyle to this new body, you're going to have a bad time later regardless of if you're still on it or not.

I've taken various GLP-1 RA over a decade for glycemic management (I'm on Mounjaro now). They still work great for this. But I have to do the work to maintain my body, now.