“Aren’t you done losing weight yet?” “How much more weight do you want to lose. You’re skinny already.” “Does your doctor know how thin you are?”
I’ve had these questions asked of me several times, always by people who know me. No stranger has said anything remotely like that since I still weigh 224 pounds. My BMI is 43.3, technically “morbidly obese.” 30 is the beginning of just being obese. Do people expect me to believe I am too skinny at 224 pounds? Many, if not most, people start their health gain/weight loss journeys at less than 224 pounds. Some, far less. And people think I am done at this weight?
Are people saying similar things to you, too? Does it annoy you as much as it does me? Sure, comparatively, we might look really small and thin, but the reality is I (we?) are not. Yet.
“What Is Your Goal Weight?”
After the ‘You’re too small” situation, the next question I get from friends, strangers, journalists, and doctors is “What is your goal weight?”
They all seem baffled that I do not have a goal weight. I have goal labs. Most of those are much better. Besides my HbA1c (which is 5.1) being in the non-diabetic range now, I still have work to do. And I have only been on Mounjaro (aka tirzepatide, a glucagon-like peptide 1 [GLP-1] combined with a glucose-dependent insulinotropic polypeptide [GIP] for four and a half months.
My standard answer to “Aren’t you done losing weight yet?” or “What is your goal weight?” is “Ask me at 72 and 88 weeks.” Why those specific numbers? Because the Eli Lilly‘s research on Mounjaro has studied tirzepatide through those weeks. I’ve been on the medication for 22 weeks. Many more to go before I meet the threshold of knowing my final weight.
The two major Mounjaro Trials, the Surmount and Surmount-4 Trials give us the most information at this point. The Surmount Trial measures the results of Mounjaro up to 15mg (which I am on) through 72 weeks while the Surmount-4 Trial (also with Mounjaro) goes through 88 weeks.
Mounjaro Stats Up to 88 Weeks
Novo Nordisk has their studies for Wegovy, the weight loss side of Ozempic, both GLP-1s going to 68 weeks. These studies are called the STEP Trials. If you’re on Wegovy, you have the right to tell people to ask you at 68 weeks what your goal or final weight will be.
The Wegovy Stats up to 68 Weeks
This is why I tell people to wait until I am at those specific week markers. We don’t know exactly yet when weight loss stops after those study number of weeks. We who are on the medications are in a fishbowl being watched to see how we do.
My weight loss has slowed over the year to about 10 pounds a month. Looking at the graphs, you can see this is a normal course of the medication. Will I eventually have a permanent plateau? I do not doubt I will at all. If I do get to a place where I feel I don’t want or need to improve my labs or lose more weight, I know the endocrinologist will merely lower my dose of Mounjaro.
“Why Not Stop the Medications?”
There is ample evidence already that shows how fast people regain the weight when they go off the meds. Diabetes and Obesity are chronic conditions, ones that do not go away even when corrected with medication. When someone takes blood pressure medication and it becomes normal, when they quit taking them, it reverts right back to the high blood pressure. Medications do not always cure. I will be on psych medications for the rest of my life. My Bipolar Disorder 1 is a chronic condition in my body. Same with diabetes. If I wasn’t on Mounjaro, I would have to go back to taking insulin several times a day. Forever. And high blood pressure meds. And medications for my kidneys. And I would have Fatty Liver Disease again. And I would regain all the fat I have lost inside my body that can be seen with an MRI.
Would I rather take one shot once a week or go back to all that I just wrote above. There’s absolutely no question which I would choose.
GLP-1s Are Not a Diet to Go On and Off Of!
There is so much misunderstood about the process of taking GLP-1 and GLP-1/GIP agonists because everything is brand new. I am sure it will take years for the rhythm of the process to become more common knowledge. But even health gain/weight loss surgeries like the Roux en Y Gastric Bypass, which have been around for 50 years, are terribly misunderstood. Unless someone seeks out information, the rumors and guesses abound.
Of course a permanent plateau, an invisible finish line, is going to happen and that’s great! I look forward to it. Then I begin maintenance. My life will continue just as it is now. Eating tons of protein, drinking buckets of water, walking miles a day, and smiling the whole time. I’m having a blast being mobile and healthier.
I hope you are, too!
all photos by Barb Herrera