Not sure where to go

I'd say the weight comes back if the person eats too much again and has not learned anything while using ozempic and similar things.

Here's my question about ozempic. I tested very high for diabetes and was offered Ozempic, even insulin, but I told the PA that I wanted to try it with just diet and exercise. So 190 days and 50 lbs less (after low carb dieting) later I am testing at or close to normal blood sugar in the morning most days. I probably still need a couple of months to get my A1C in a normal range. I don't really understand why the need for Ozempic, if diet can reverse T2. Is it necessary to go on a life long medication when you can't really eat carbs anyway, if you are T2? Is it so you can eat carbs? I don't think I have a normal insulin response at this point (maybe after another six months to get my A1c back to normal) but is it really worth it, and more healthy, to go the ozempic route?

Think about how AI works, assuming you have some inkling of that. Essentially, it reads kazillions of web pages, and draws conclusions from that. The Google one appears to be somewhat coded to prefer certain authoritative sites, but that seems to include some sites that may have biases. Right now, IMO, the web is more dominated by enthusiasm for these drugs than by cautions, in the sense that they're saying it's a miracle drug and people can/should rely on it forever, mostly.

I ran a similar Google search myself, and sampled the links the AI recommended as their source. The sites are much more nuanced in what they say than the AI summary.

That nuance includes talking about things that I hope people here on MFP already know: Overwhelmingly, most diets fail, most people regain, people who make permanent lifestyle changes are more likely to succeed, etc.

The articles say those things around the issue of quitting Ozempic, just like lots of us here would say them about any weight loss method, especially a fast weight loss method that never includes learning how to live reasonably happily long term on reduced calories. I'm not going to go into the details that the sites discuss, but the AI summary completely lacks that dimension, as far as I can read.

What I strongly suspect we'll find is that using the drug as a "lose weight fast then go back to normal" strategy (including going off the drug in the "normal") is going to work just about as well as that works for every other method of weight loss: Mostly fail, long term.

From reading experiences of people here, I feel like the drugs potentially do have a little bit of physiological magic for at least some people, using the term "magic" pretty loosely. That reduction in appetite, "food noise", etc. - maybe even feeling sick when overeating - seems quite powerful for overcoming what are quite possibly individual hormonal issues. Can lifestyle change eventually reach a point where those helpful factors recede into the background, even when people cease taking the drugs? I'm not sure we know that yet, in a mass-numbers sense. I'm not even sure how long it might take to get such results, because with any weight loss method, so few people actually permanently change behavior patterns.

I'm pretty sure, though, that if people using the drug rely only on the appetite/cravings reduction, and don't take other steps toward revamping lifestyle, then go off the drug, they're very likely to regain . . . just like any other temporary weight loss intervention.

There is regain following MOST types of dietary intervention, including drug therapy, surgery, exercise, diet, or diet and exercise.

I've heard of some silly people around here going on about long term management, taking the long view, not only considering immediate weight loss results but setting up building blocks, making silly statements such as "the biggest predictor of length of future weight maintenance is… the length of maintenance to date", going on about setting up a layered or "onion" defense to weight regain by supporting the lifestyle changes that have been gradually build during the time of weight loss, going on about more silly things such as having at least a five year post weight loss time horizon in mind and setting up reasonable goals and worrying more about the process than the immediate results… if only these silly people were totally wrong…

The AI answers, in part, depend on the questions.

Semaglutide vs. Non-Drug Interventions

• Semaglutide:
  After discontinuation, patients regain ~66% of lost weight within 1 year (e.g., 11.6 percentage points regained after initial 17.3% loss)12. This rapid rebound aligns with metabolic adaptations like increased appetite and reduced energy expenditure3.
  • Example: A 17.3% weight loss with semaglutide drops to a net 5.6% loss after 1 year off the drug1.
• Non-drug interventions (diets/lifestyle):
  Meta-analyses show >50% of lost weight is regained within 2 years, and >80% by 5 years3. The regain rate is slower than semaglutide but still significant, driven by similar metabolic adaptations3.
  • Key difference: Non-drug methods lack pharmacological appetite suppression, making sustained lifestyle changes critical23.
    
    Semaglutide vs. Bariatric Surgery
• Bariatric surgery:
  Weight regain is slower but still occurs. Studies report:
  • 7% total body weight regain over 10 years on average6.
  • 8.2–23.8% of maximum lost weight regained, depending on surgery type and follow-up duration7.
  • Significant regain (≥25% from nadir) in 53% of patients by 6 years post-surgery6.
• Semaglutide post-surgery:
  Used as an adjunct, semaglutide reduces regain. Patients with weight recurrence after surgery lost 10.3% of body weight over 6 months when treated with semaglutide4.
  
  Key Factors Driving Regain
• Metabolic adaptation:
  All interventions face reduced energy expenditure and increased hunger after weight loss. For semaglutide, withdrawal abruptly removes GLP-1-mediated appetite suppression23.
• Behavioral adherence:
  Surgery enforces dietary restrictions physically, whereas semaglutide and non-drug methods rely on conscious effort36.
• Timeframe:
  • Semaglutide: Rapid regain (months).
  • Surgery: Gradual regain (years).
  • Non-drug: Intermediate (1–5 years).
    Percent Regain Comparison

Semaglutide discontinuation leads to faster and more pronounced weight regain compared to bariatric surgery but aligns with non-drug interventions in underlying metabolic drivers. Surgery offers the most durable results, though adjunct therapies like semaglutide can mitigate post-surgical regain.

All methods underscore obesity as a chronic condition requiring long-term management347.

It is now just about 124 months since I decided to take more control of my health and weight. I still log daily other than the 10 to 15 days a year I am travelling on vacation. This "non logging" is new, during the past 60 months or so ;-) I still evaluate my "departure" / "fake deficit" between what my Fitbit believes is my caloric expenditure, what my logging indicates as my caloric intake and what my weight trend change indicates is the reality! :) This evaluation is not based on a week or two or even three. I usually consider one year, six month, and three month trends. I still engage. And I still manage.

And I'm still at normal weight after having spent the better part of the "first" 30 years of my adult life in the obese range. Sure. There WAS a blip during the past 124 months where I sat in the BMI 25 to 26 range for a good year. Still maximum regain to date has been of the order of 15% of total loss because of steps taken to slow down the cycles of loss and regain. Because obesity IS a chronic condition requiring long-term management ;-)

Since we are playing with AI's, other interesting questions give other interesting answers. To anyone wondering I confirm that in the end I did chose non-surgical (self)intervention even though my BMI was in the 45 range before I started.

I love the "dietary and behavioral support" concept that is seen in many studies when comparing outcomes. Reminds me a bit of "wonderful weight loss results if you take blah blah*** Note: *** Our big promises are valid only if you take blah blah in conjunction with an appropriate diet and exercise intervention.

In a "do-it-yourself" environment such as with most of us using MFP… we sort of have to provide the ongoing dietary and behavioral support to ourselves by ourselves!

Here is some more "generic" AI info when prompted appropriately!

I will note that myself, and many other people anecdotally on MFP, have experienced some form of type-2 remission or improvement with weight loss and exercise, so not sure how rare rare is or whether it is rare because of subsequent regains for example.

Some of the references used in the AI discussion below are:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7773341/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8427732/
https://pmc.ncbi.nlm.nih.gov/articles/PMC5764193/

Of course I would urge people to do their own research. AI's are getting there… but they are NOT quite there yet.

Non-drug dietary interventions and bariatric surgery comparison based on outcomes and side effects:

Weight Loss Results

Side Effects and Risks

1. Efficacy:
   • Bariatric surgery produces 3–5× greater weight loss than dietary interventions, with superior metabolic benefits (e.g., diabetes remission)16.
   • Dietary methods are less effective long-term but safer for mild obesity24.
2. Durability:
   • Surgery maintains >50% excess weight loss at 10 years vs. ~5% total loss with diets14.
   • Both approaches face regain, but surgical regain is slower and less severe14.
3. Risk-Benefit Trade-off:
   • Surgery suits patients with severe obesity (BMI ≥40) or comorbidities, despite higher complication risks35.
   • Dietary interventions are preferable for lower-risk individuals prioritizing non-invasive options24.

NB: the above is the AI conclusion, not my own. Thank you for reading ;-)

All we know so far by easy searches is that there is a higher initial loss and higher initial regain for "most" people in the really fast time-frame. Same as saying that keto loses weight fast (and regains it fast when going off keto) by only considering the amount of glycogen manipulation. You have to equalize for protein intake and exercise and look at several months down the road.

So far I, personally, do not see compelling evidence of being any worse in terms of results. Which doesn't make it great either. One suggestion was tapering with additional support and intervention. In any case: self diet and exercise does remain less expensive to implement ;-)

But, a common mistake, in my opinion is the belief that maintenance is entirely based on voluntary "mindset". You have a whole interplay of internal physical and mental and environmental factors that come into play. What one decides is THEIR mindset TODAY doesn't always play out when the rest of life happens to them. Just like teens are not always in full control of their emotional responses.

So interesting...

A few random thoughts.

• Easy to talk options, harder to actually choose an approach, then start and do it
• Any of the options is likely better than nothing.
• Emotional tolerance is important for deciding. If you can't tolerate the idea of the choice, choose something you are willing to try - personally, the risks of surgery or drugs doesn't appeal to me, so I am better able to try self-intervention with food and movement.

We are unique and can be in the 5% - of any of the paths.

• It was noted that for some approaches, most has significant regain and 5% manage to not regain.
• I think that is similar to quit smoking for the hard cases, 5% make it.
• Somewhere read that for the 'super-obese, bmi 60+, maybe only 1% keep the weight off post- bariatric surgery, the rest regain over a number of years.
• All of the fails and stats can be a barrier de-motivation to even try...
• So instead, have the goal to shoot for the 5% who do make it,
• Be willing to keep trying and adjusting. Shoot for the moon with it.

So, I would agree that the time that is better is better than nothing.

Personally, have a lifelong yoyo pattern - which means there was some time better than nothing - and more trying ahead... whether it's losing or maintaing...

The statistical liklihood of failure will NOT be a reason for me NOT to even try. I have to choose to try... If I don't even choose to try, well then... whatever, sometimes we just don't, sometimes we just talk about it.

But, when we have an urge to try, then we should... and trying is always better than nothing… stopping before I do that circle again ;)

As far as the doctor, yes they may know better on their plan, their plan with 10000 steps a day, 30-60 minutes of cardio a day and 30-60 min of strength exercises from day 1 is not practical or could I do it. Those are GREAT goals to get to, but there is no way I could TODAY. I am at 2500 steps a day and took a flight of stairs at work.

there was a lady here a few years back who was very similar to you.

She set a goal of walking to the end of her driveway and back every day.

Then she added the neighbor’s mail box.

Then she increased to a phone pole, and then another. It took a while but I remember her joy when she accomplished a mile.

Small goals are way better than no goals

I see you there, and I see you being of the ones who says “I started taking the stairs at work instead of the elevator and stairs don’t get me out of breath any more!”

I sincerely hope you see you there! 😘