this post was submitted on 30 Jun 2025
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Allow me to echo a common bit of advice. Any weight loss you do must be accompanied by an overall diet and lifestyle change in order to be permanent. Weight loss treatments and drugs are fine if you are using them with medical supervision (sounds like you are) as a way to kick start this transition in diet and lifestyle for a more healthy and manageable future for maintaining your weight and governing your health. But that lifestyle and diet change is key. Don't squander your chance to get on the right tract to start taking control of your health. Make the changes. Stick to them and you'll see success.
You should know that some evidence suggests weight loss via GLP1 drugs might be stable e.g. https://www.nature.com/articles/s41591-024-02996-7 while some contradicts this. The overall picture of long term weight loss is extremely bleak: https://pmc.ncbi.nlm.nih.gov/articles/PMC5764193/
Lifestyle changes aren't really a more sustainable intervention than anything else. For a lot of people it seems like losing weight = feel hungry for the rest of your life and commit to calorie counting forever.
I had a colleague tell me that GLP-1s inhibit individual fat cell (adipocyte) growth, but can ultimately lead to adipocyte proliferation, especially if lifestyle modifications aren't made, and that this is a major factor in rebound weight gain. Can't speak to the veracity myself and am having trouble interpreting the literature off-hand.
This sort of detail is well beyond my level of expertise. All I know is that at this point they appear to work about as well as anything else and be a lot more comfortable that hardcore calorie counting and denial for a lot of people, with usually tolerable side effects. Some evidence suggests long term success and some suggests that they're just like everything else. As far as I know there is no data yet on whether it is safe to spend a lifetime going on and off them as one would expect to end up doing with any diet regime; which would be relevant if they have about average long term results.
Below Lydmila linked a combo therapy which seems to have interesting results, so that's exciting.