so there's been a lot of research on dieting and losing weight, etc., and one of the things that has been found is that your body has a "set" point weight wise that it will try REALLY hard to return you to. If you lose weight, your body will slow its metabolism until you return to that weight. If you gain weight, your body will rev up metabolism. That's why you might gain 10 lbs over Christmas and then lose it in January without purposefully trying to lose weight. (this is all in the short term, ofc, as people do tend to naturally gain weight as they age).
This seems to imply that semaglutide would need to be taken forever. However, there seems to be an important caveat: you *can* reset your set point, it just takes a long time at the new weight. When most people go on diets and lose weight, they end up regaining the new weight quite quickly after they "end" their diet, so they don't have a chance to reset their set point.
Speaking from personal experience, I had kind of an accidental natural experiment with this: I once lost 40 lbs over the course of a year and a half, where I began with a very strict low carb diet that very very slowly trailed off to a normal diet, mostly because I got progressively more tired of being on the low carb diet. So by the time I had gotten back to my normal diet, I had been losing weight for a long time. I ended up regaining 10 lbs of the weight, but no more, and am still ~30 lbs below my peak even today (5 years later). I noticed that my own "set point" seemed to reset: when I would overindulge during the holidays and the like, I would often lose the weight the next month without really trying. All of this to say that I do think patients will have to take semaglutide for a while, but not necessarily forever. The brilliant thing about the drug is that it essentially just works like extra strength willpower. If someone takes the drug for a while, loses weight, and their body eventually resets to a new set point, and they themselves eventually get used to their new level of calories/diet, I expect that they could then come off the drug. Personally, that's my plan for ~20 years from now: I don't qualify for the drug at the moment (BMI of around 25-26, so overweight very slightly) and I probably won't ever, but I expect it will become far more available and affordable in the future to the point where even just overweight people are taking it.
so there's been a lot of research on dieting and losing weight, etc., and one of the things that has been found is that your body has a "set" point weight wise that it will try REALLY hard to return you to. If you lose weight, your body will slow its metabolism until you return to that weight. If you gain weight, your body will rev up metabolism. That's why you might gain 10 lbs over Christmas and then lose it in January without purposefully trying to lose weight. (this is all in the short term, ofc, as people do tend to naturally gain weight as they age).
This seems to imply that semaglutide would need to be taken forever. However, there seems to be an important caveat: you *can* reset your set point, it just takes a long time at the new weight. When most people go on diets and lose weight, they end up regaining the new weight quite quickly after they "end" their diet, so they don't have a chance to reset their set point.
Speaking from personal experience, I had kind of an accidental natural experiment with this: I once lost 40 lbs over the course of a year and a half, where I began with a very strict low carb diet that very very slowly trailed off to a normal diet, mostly because I got progressively more tired of being on the low carb diet. So by the time I had gotten back to my normal diet, I had been losing weight for a long time. I ended up regaining 10 lbs of the weight, but no more, and am still ~30 lbs below my peak even today (5 years later). I noticed that my own "set point" seemed to reset: when I would overindulge during the holidays and the like, I would often lose the weight the next month without really trying. All of this to say that I do think patients will have to take semaglutide for a while, but not necessarily forever. The brilliant thing about the drug is that it essentially just works like extra strength willpower. If someone takes the drug for a while, loses weight, and their body eventually resets to a new set point, and they themselves eventually get used to their new level of calories/diet, I expect that they could then come off the drug. Personally, that's my plan for ~20 years from now: I don't qualify for the drug at the moment (BMI of around 25-26, so overweight very slightly) and I probably won't ever, but I expect it will become far more available and affordable in the future to the point where even just overweight people are taking it.