I am eight weeks into deliberately reducing rather than stopping, and the appetite change came back faster than the weight did.
So the question, as narrowly as I can put it: whether extending the interval works as well as reducing the dose, since they are not the same intervention pharmacologically.
Happy to be told the question itself is wrong.
This one has a reasonably settled answer, so here it is. One third of STEP 4 participants held most of their loss without the drug, and nobody has convincingly characterised who they are. That subgroup is the most interesting unanswered question in the field and it is routinely flattened into the two-thirds headline.
Dr.GastroMayo said:One third of STEP 4 participants held most of their loss without the drug, and nobody has convincingly characterised who they are.
Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.
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Browse GL BiochemInsuranceTom said:I am eight weeks into deliberately reducing rather than stopping, and the appetite change came back faster than the weight did.
Can confirm the pattern InsuranceTom describes. Extending the interval and reducing the dose are pharmacologically different. Reducing the dose lowers the whole exposure curve evenly; extending the interval keeps the peak and drops the trough. Since the appetite effect tracks the trough, interval extension tends to give you good days and bad days rather than a uniformly smaller effect, which most people find harder to live with.
If somebody has the primary source to hand I would rather cite it than paraphrase it.
From the other side of the consultation, briefly.
Pregnancy after maintenance dosing weight loss: stopped GLP-1 medication 5 months before TTC as recommended. Was terrified of regaining weight during pregnancy.
Worked closely with my OB and MFM. Gained 28 lbs during pregnancy (within recommended range). Baby is healthy. The metabolic improvements from pre-pregnancy weight loss gave both of us a healthier pregnancy.
If you're planning pregnancy, discuss the medication discontinuation timeline with your OB. GLP-1 agonists are NOT safe during pregnancy.