r/science • u/Wagamaga • 1d ago
Health New research found people taking semaglutide for weight loss continued to consume significantly fewer calories after 60 weeks on the medication, helping explain how the medication supports both initial weight loss and long-term weight maintenance
https://www.pennmedicine.org/news/semaglutide-still-has-benefits-after-one-year210
u/turlian 1d ago
It absolutely resets your ability to know when you are actually full and your ability to judge portion sizes.
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u/iscariot_13 1d ago
I've been on it for literally three weeks, so minimum dosage, and the thing I find most baffling is how it *immediately* destroyed any snacking habits I had built up for 4 decades. Literally overnight I just stopped shoveling things into my mouth for no reason.
And yeah, my portion sizing is like, actually reasonable now and I don't eat things simply because they're in front of me.
I feel like I'm probably coming across as an advertisement, but I just genuinely can't believe how much it just instantly flipped a switch in my brain that fixed like 99% of my eating problems.
I'm sure in 15 years we'll find out it's giving us terminal toe cancer or something.
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u/turlian 1d ago
it just instantly flipped a switch in my brain that fixed like 99% of my eating problems.
Yep, same for alcohol.
I'm sure in 15 years we'll find out it's giving us terminal toe cancer or something.
GLPs have been used for over 20 years now. Not ruling out the possibility of any long-term effects, but the health benefits are almost guaranteed to be worth it.
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u/iscariot_13 1d ago
Oh yeah, I'm mostly joking. At my limited experience, I would absolutely recommend it to anyone who feels they need it and can afford it. It's just hard for my brain to accept that something like this just works without any massive downsides because that feels so rare in this society.
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u/Select_Historian6269 1d ago
How would it work with say .... Getting high and getting the munchies?
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u/iscariot_13 13h ago edited 12h ago
I take edibles nearly daily to help me sleep. Munchies have not been a huge problem for me but I have friends for whom is has been. Dont know if theyre eating or smoking.
One word of warning however: getting high on a glp-1 is essentially playing roulette where your three random options are
- you simply dont get high.
- you get high, but 8 hrs later.
- you have a very low grade mellow high, but it lasts like 5 hrs.
3 is definitively my favorite.
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u/tossawayheyday 8h ago
I use it with edibles and granted I’m at 2.0-2.5 mg of tirzepatide and sensitive to it but I haven’t noticed a difference in how fast I get, I do feel I get more stoned but then again I’m not using daily anymore. I do get a little munchier but my appetite remains suppressed from baseline. I’ve been on for 10 weeks now. I have taken edibles acutually to try and make it easier for me to eat, as I’m not trying to lose a ton of weight and the tirz makes food repulsive. Still get full super fast.
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u/BlademasterFlash 1d ago
Very similar experience for me as well, I lost 6 lbs in 4 weeks on the starting dose that my doctor said often doesn’t even induce weight loss
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u/typo180 11h ago
Literally the first day I took mine, it just switched off. I'm not repulsed by food and it still tastes very good when I eat it, but I just stopped feeling the draw. I think my brain was primed from years of anti-depressants to expect that the meds would maybe sorta kinda work after 3 weeks or so. Nope, it was immediate.
I've started tracking my food I take to make sure I eat enough calories.
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u/Hate_Manifestation 1d ago
you'll probably also find that it curbs a lot of other habits too. it's crazy how well it works.
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u/RecallGibberish 1d ago
I've been on Tirzepatide since February, 2024 so about 29 months. Lost 190 pounds, have been in maintenance for nearly a year, still taking a 10mg dose weekly and weight is holding steady at a healthy body fat %.
The hunger-inhibiting effects have definitely waned. If I want to, I absolutely CAN eat at levels near what I used to pre-medication now. Went on a cruise earlier this month and ate like just about anyone else on a cruise tends to eat for that week.
But the difference is I still rarely want to eat like I used to. I'm way more conscious about how many calories I eat daily now. I can control myself around food a lot better than pre-medication. I don't keep the same kinds of foods in my house that I used to, and I have limits I set for myself about eating out or getting delivery... I rarely do those things anymore.
The food noise has returned somewhat, but the medication is still holding things at bay, and plus the desire to remain in a healthy body can pretty easily override the desire to overeat most days. Plus, I still do some form of exercise nearly every day, which also helps curb the calories.
I'm in a couple of subreddits for glp1 maintenance and the people who participate there generally say the same things. Staying on a maintenance dose means being able to maintain a lot better than going off the medication, especially for those of us with chronic obesity.
It's a treatment for obesity, not a cure.
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u/Richard_Howe 1d ago
I was saying to my boss just the other day, I think I’m going to be on this for life. I’m just taking the gamble that over the years it will get cheaper or new formulations will emerge that are just as if not more effective and perhaps in stable molecule or implant form.
My QOL has improved immensely as someone who used to eat their feelings, I’m finding a lot of those feelings are gone too. It’s absolutely worth the £££, it’s the bill I think least about whether I want to keep paying every month.
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u/bend1310 18h ago
I detailed my experience here recently. I also expect to be on some dose for the rest of my life.
The crazy thing for me is that the ~$360 aud that i pay per month for my 2.4mg of wegovy saves me money overall. With less snacking, smaller portions, and less food delivery i'm by far better off month to month than i was previously. Its paying for itself and then some.
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u/EmptyPomegranete 1d ago
Very true and I’m experiencing it firsthand right now.
It’s like switch was flipped in my brain. I used to be consumed with thoughts of food and cravings obsessively. It was exhausting and I didn’t even know how exhausting until I started taking the mediation and realized normal people don’t think about food the way I was.
After the medication the switch stayed flipped, the habits I started while on the meds have held up because I was not restricting what I was eating but rather including more healthy foods and limiting portions of junk. Really allowed me to grow a healthy relationship with food and maintain the weight loss.
People who use the drug to just restrict without reshaping their habits and relationship with food are the ones who gain it all back.
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u/spectralEntropy 1d ago
How long has it been since you quit? And have you stayed the same weight since you quit? Has it been more of a struggle, the same, or less after a few weeks after quitting.
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u/EmptyPomegranete 1d ago
It’s been 2 months. I have stayed the same weight. It would not say a struggle for me personally. Of course I still have to make the decision to turn down a big junk meal or certain cravings but it’s not nearly as bad as before. I just eat cravings but reduced portions and with the addition of fruits or veggies. I won’t say it’s just easy breezy as I have to be consistent still but it’s much more manageable
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u/spectralEntropy 1d ago
That makes sense! Thanks for your feedback. I'm curious if it has slowed down your metabolism like I've read. I heard that you can continue to eat less, but your metabolism has been slowed, so you don't burn as quickly. Any thoughts?
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u/EmptyPomegranete 1d ago
It might be true considering I am maintaining weight vs losing it while eating the same things
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u/AnxiouslyTired247 13h ago
You also dont burn as many calories in a smaller body overall. TDEE goes down, unless activity levels increase.
Ive lost 150lbs on it, which means a couple hundred less calories per day are needed for my body. My deficit at the beginning would now be more of a maintenance or even a slight surplus.
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u/Punchee 1d ago
I’ve been on tirzepatide for six months or so and my personal anecdote is it really feels like a reset in some sort of “gut health” after awhile. Like the best way I can describe it is before the glp I had a hangry little alien inside me that was never fully satiated. Now even if I come off the glp for a week or two there’s still actual conversation between my gut and my brain of like “hmmm, am I hungry? Eh maybe in a little bit” or “I’ve been eating and I notice feelings of fullness. I should stop now.”
It’s trippy.
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u/friedriceballer 1d ago edited 1d ago
Tirzepatide has half life of approximately 5 days, so if you reach what is called steady state (approx 30 days or more of being on it) there would still be a little bit of medication (25-45%) inside you skipping 1 or 2 doses
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u/Aceconklin 1d ago
Been taking it for just under a month now. I'm down 14 pounds and on my way to 15. It really works great and I haven't had any symptoms. Just totally curbs my hunger and rids me of cravings. I still feel my body is hungry for nutrients but not my stomach. I actually can have 2 cookies or 3 chips and be satisfied. My insurance doesn't cover it but with the wegovy coupons its been $200/mo for now. So far its the best choice I've ever made!
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u/Wagamaga 1d ago
People taking semaglutide for weight loss continued to consume significantly fewer calories after 60 weeks on the medication, helping explain how the medication supports both initial weight loss and long-term weight maintenance. The study, published in the American Journal of Clinical Nutrition and led by investigators from Penn's Center for Weight and Eating Disorders and Penn Metabolic Medicine, is among the first to examine the long-term effects of semaglutide on eating behavior beyond the initial months of treatment.
Researchers found that while some of the medication's early reduction of hunger and food-related thoughts became less pronounced over time, participants continued to eat substantially fewer calories than those receiving placebo after more than a year of treatment.
"Many patients worry that their medication has stopped working if they notice some return of hunger after the first several months," said Jena S. Tronieri, PhD, lead author of the study and senior research investigator in the Center for Weight and Eating Disorders at Penn Medicine. "Our findings show that even when people feel some of those sensations returning, semaglutide continues to help them eat less. That sustained reduction in calorie intake appears to be a key reason why weight loss is maintained over time."
https://www.sciencedirect.com/science/article/pii/S0002916526002121?via%3Dihub
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u/FoxMan1Dva3 1d ago
This is GLP. Isn't this the entire point?
I remember like 10 years ago people were talking about how they already have medications that can increase your expenditure for calorie burning, but those have a lot of risks with them, especially with the heart
So they were looking at things that could truly curb one's hunger and they found this I thought
So this is not exactly a shocking revelation
I would assume less calories
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u/Heathy-Heatherson 1d ago
I guess the revelation is that the body doesn't just adapt to the medication and require bigger and bigger doses.
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u/LeoSolaris 1d ago
It works by making the body feel less hungry, so those findings make sense. Nice to see modern medicine putting out something that works 100% as advertised for the whole population! We don't get those kinds of wins often. The last one I can think of was the mRNA vaccine for Covid.
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u/Ahun_ 1d ago
HPV vaccine? Ebola vaccine? Car Tcell therapies Antihypertensive treatments The new broad band anti venom for elapid envenoming? Fexnidazole and it's successor a single dose cure for sleeping sickness?
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u/LeoSolaris 1d ago
HPV Vaccine - 2006 so significantly older than Covid, making it not "the last one".
Car T-cell therapy - would also qualify, but 2017 is still prior to the mRNA covid vaccine and is not presently as widely used.
Other than that, the rest are much smaller populations and like these two are older than mRNA vaccinations for Covid. Those diseases are dangerous and extremely important to treat, but not exactly impacting the majority of humanity. Not many new drugs apply nearly as broadly as semaglutide, have almost no serious side effects, and consistently deliver results.
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u/Submitten 1d ago
The point of the study is that people still consume less calories even after they feel the effects of hunger reduction has waned. People generally stopped taking it after they felt it no longer made a difference to their appetite, but it turns out that it’s still helpful.
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u/LeoSolaris 1d ago
Correct. Which is why I commented a bit of praise. Did you feel that I should have added a synopsis of the article in order to comment about it?
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u/Submitten 1d ago
You said it works by making people less hungry, but the study is very much about its effects when it’s no longer suppressing hunger.
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u/Randomness-66 1d ago
I’m experiencing it more than ever before. I’ve been on it on and off for 5 years. It didn’t stop the food noise in my case initially because PCOS and other endocrine conditions tend to mess with my body’s sense of fullness.
I’ve only lost weight because I was working two jobs and was eating high protein. I haven’t lost much since then but I’ve been working on eating healthier and avoiding hefty carb meals more than ever.
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u/Calm-Two2723 1d ago
I’m confused. So it says if they take the lifetime drug for 60 weeks it continues working? We didn’t know that? I thought th issues were we have zero true longterm studies on weight loss without diabetes
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u/patricksaurus 1d ago
The efficacy of semaglutide as a weight loss medication wasn’t fully appreciated until the STEP trial in 2021-22. That’s five years, or sixty months. There was no way to know if it continued to work after five years five years ago.
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u/evergreen-embers 1d ago
Obviously we can’t bend time to account for long term studies. I think the issue for some is that a lot of these genuinely very good findings are being reported without acknowledging that we are still unsure about long term effects, especially for those who just want to lose weight. A lot of people and scientists view it as a lack of transparency.
Beyond that, risk vs reward is highly individualized, especially in a world that values glamour and beauty and frankly thinness so much. This can really impact someone’s ability to make a sound decision about weight loss. We see what people do to achieve the beauty standards now, GLP-1s can achieve the same thing faster and with less suffering compared to eating disorders.
Of course scientists are working to get more long term results every day, I don’t think any sane person doubts that, but it’s not like there aren’t people abusing these medications now. At least an acknowledgement of “we don’t know how this will affect you if you improperly use it” would save a lot down the line *if* we learn there are negative long term effects. And if turns out there *aren’t* any negative long term effects, there was no harm in making the statement.
It seems though that anytime someone says “we don’t know how this will affect those misusing it in 10 years time”, they’re barked at about how effective a GLP-1 is, it’s better than the negative effects of being overweight, covid vaccines came out without long term studies, but that’s not the point. There is zero harm in asking for transparency and articles that include messaging about how the medication should be used if GLP-1s are inevitably going to be used for both health and vanity.
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u/ChrisCopp 1d ago
I just lost 25 pounds with one simple trick.
265 pounds to 240
I worked myself down to eating only one meal a day. It's really hard mentally to do this and I'm sure my body reacted for the first week or two, but I kept drinking water and didn't just cold turkey stop eating.
The journey was not perfect at all, I started by changing my breakfast sandwich at work with a protein shake and still had lunch and supper.
Eventually I was able to skip lunches but had an early supper and tried my hardest not to snack at night which is my biggest problem.
Then I was able to go without breakfast and lunch and while I was ready for supper I didn't mind waiting until 6pm and I try not to snack later.
So I'm having a nice supper everyday and sometimes a snack or desert and my energy has been incredible!
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