You've Reached Your Goal Weight. So Now What?
I remember ‘back in the day’ when I started in General Practice, the medication we were using for weight management was only to be prescribed for three months. Enough to give people a ‘kick start’.
After three months the guidelines dictated that we stop.
I know that for so many people there was the feeling of being left stranded. Or a feeling akin to ‘drug seeking’ when trying to renew their prescription. Or feelings of shame when the weight loss achieved was just regained.
Weight Set Point
We now know a lot more about the body’s regulation of weight. And we know how the body fights weight loss.
This is why time and again individuals experience yo-yo weight regain after significant weight loss.
And this is not the fault of the individual.
But it does mean that if you are using a medication to counteract your body driving weight regain, there may be weight regain when we stop.
So does this mean you need to take the medication forever?
Think of it like high blood pressure… or high cholesterol… or asthma… or diabetes…
Many people who start taking medications for chronic conditions, like high blood pressure, need to keep taking the medications for life.
But some people may eventually be able to stop those medications and the underlying condition remains controlled.
Weight is similar.
So Who Can Stop?
That's the million dollar question!
What we do know is that, to give you the best chance of stopping successfully without weight regain, there are some things that we can help you to do…
#1 Work on Habits
Just like training wheels on a bike, use the medication to help you to undo problematic habits.
It is easy when you are on medication to let the medication drive your changes. By just increasing the dose until you don’t feel hungry and just eating less you will lose weight. But when the medication is stopped, you will likely just eat more. And you will find you are back where you started.
A better plan is to concentrate on the changes you want to make and use the medication to help you make them.
The difference is subtle. But one (may) allow you to reduce/stop the dose, and one will likely lead to a greater reliance on the medication.
Work on a healthy diet with combinations of foods to manage hunger and fullness. Work on tendency to binge eat, to comfort eat, to stress eat. Add in regular exercise. Work on getting good sleep.
Know what you are changing, how you are changing it and why.
We will aim to tailor the dose to the point where this is (relatively) easy to do.
Over time, these changes just become what you do. Ie: habits.
#2 Build Muscle
I know - I do go on about this. But it is the only way to increase your basal metabolic rate (the energy you burn at rest)
#3 Don’t Stop Without A Plan
You can absolutely stop at any time. But reach out to make a plan.
What are we going to do to minimise the risk of weight regain?
What do we do if your weight starts going up?
#4 Don’t be Ashamed!
The biggest takeaway!
If you do regain weight after stopping a weight management medication this is not your fault! You may just need medication support for longer.
In Summary…
Medication can be used for the long term if needed
Any suggestions of using it for a quick fix, or brief kick start should be questioned.
To give yourself the best chance of not needing lifelong medication, get some support to change habits - diet, exercise, psychology and sleep.
If you do choose to stop, and do regain weight - reach out! This is not a personal failure, this is just information we can use to better tailor the help your need next time!
