Weight would only be regained if you start eating more, no? I would think that would be hard to do if you've already seen what appropriate portions are.
You seem to have a fundamental misunderstanding of what GLP-1 agonists help with. In simple terms, they make you less hungry. If you stop the drugs, it's not surprising you go back to being hungry. It would be a miracle drug if you didn't.
People, on average, eat until they're no longer hungry. Problem is, there's only a loose relationship between your caloric needs and your hunger response. That's how you end up with underweight people who are trying to put on muscle saying they can't possibly eat any more and still can't put on weight, while having overweight people who eat twice as much as that guy and have to actively choose not eat more. Both people can make a conscious choice to disobey their signals, just like how you can choose to hold your hand to a hot stove. But it takes a lot of energy to keep up that willpower. Effective weightloss drugs solve that problem, by treating the actual problem: the hunger.
I don't misunderstand. I understand they stop you from feeling as hungry. That is why it is even more perplexing. Eating until you are no longer hungry isn't how most people eat I'd say. Most people eat a given quantity of food. A plate of food. A bowl of soup. An entree with the provided side perhaps. People don't generally order food, eat it, and order more food. Maybe they do I guess, but I haven't seen it personally. I mean I think a lot of people could shove a dozen hotdogs down their gullet if they wanted to, but that reaction isn't a typical expectation. Plus once you've seen normal portions, surely you'd realize when you are going beyond those.
Speed of eating might also be an underrated factor in all this. Stretching out ones meals and slowing down the pace might lead to satiety triggers coming before the meal is done, whereas if one scarfs down the plate before that signal happens, well, one already scarfed down the plate and might be working into the next before those signals hit. This meta analysis suggests this is a possibility (1).
It's possible that your internal hunger mechanism is different from other people's. In my experience, hunger leads me to eat, and I stop eating when I feel full. Perhaps I will go back for seconds if I am eating at home, or, if I am eating at a restaurant, I will likely not eat everything on my plate (giant US portions).
> I would think that would be hard to do if you've already seen what appropriate portions are.
This would be true if not knowing what an appropriate portion size is was the one thing keeping most people from losing weight. If that was the case, traditional dieting would have a far better track record with long term weight loss.
People notoriously don't know what an appropriate portion size is. Usually those failed diets come from failing to appreciate the quantity of calories coming in. Those sugary drinks and snacks add up fast. I've seen it among people I know. I might drink water, they opt to drink 250 calories. Does that make them feel any full? Probably not, its merely sugar water, but it accounts for calories and can kill diets. We order a 750 calorie entree and they get a refill. We walk away from the same meal but one of us had almost twice as many calories.
Nope, the body will adjust to regain it no matter what.
Australia's health organization did a meta study on people who had bariatric surgery. They found that every single one regained 70% of their original weight after five years, even though they were physically incapable of eating the way they did before.
This happened to my grandmother, she had a bypass in the 2000s, lost over a hundred pounds, and then regained it again and was back to her original weight when she passed in 2022. The woman couldn't eat more than 4 ounces per meal without throwing up.
I lost 40 pounds in 2017 from gastritis. I kept it off for three years, and then regained 50 pounds despite starting ozempic.
Except if your body is unnaturally screaming at you to eat more. The obesity epidemic is not caused by ignorance or lack of willpower. It's natural differences in how people's bodies work compounded by modernity's changes to physical activity levels and diet.
People do learn to fast and deal with those signals. Once you are aware of what they are it probably gets easier. I've fasted before, by choice and via circumstance in less fortunate times in my life. Is it uncomfortable? Sure. But it is no punch in the face. It is something you can learn to push aside and handle the task. One can learn to go to sleep hungry, sadly.
And you mention exercise, that is an excellent point. Hunter gatherers might forage for 8 miles a day, while many peoples daily walking effort can be measured in a few dozen feet. Our bodies are built to be used. It is no surprise that when they are not, systems designed for a certain baseline load are no longer functioning as intended.
People, on average, eat until they're no longer hungry. Problem is, there's only a loose relationship between your caloric needs and your hunger response. That's how you end up with underweight people who are trying to put on muscle saying they can't possibly eat any more and still can't put on weight, while having overweight people who eat twice as much as that guy and have to actively choose not eat more. Both people can make a conscious choice to disobey their signals, just like how you can choose to hold your hand to a hot stove. But it takes a lot of energy to keep up that willpower. Effective weightloss drugs solve that problem, by treating the actual problem: the hunger.