Two years off GLPs! Still a successful GLPGrad.
Hi fellow Grads and soon-to-be Grads. Last year I made an AMA (check it out here) on my first anniversary as a GLPGrad. I thought some of you might like to read more about the struggles I’ve had to get through during these couple years so I decided to make this post. You’re also going to read about the strategies and solutions I’ve implemented to navigate this med-less journey. So grab your favorite low-calorie drink and snack, this is going to be a loooong one!
First off, a few pointers about me:
- Before starting to lose weight, I had been a life-long obese person.
- I’m not sure what my heaviest weight was, but I was for sure above 136 kg / 300 lb
- Before GLPs, I had tried multiple diets/regimes to try to lose weight with no success.
- I was prescribed a GLP because of my Type 2 Diabetes diagnosis.
- I was on a GLP for 1 year and a half
- My max Semaglutide dose was 0.5mg
- I have not had a goal weight ever
- I quitted cold turkey
Last year I graphed my weight progress - so I thought you’d appreciate an up to date graph.
I think the graph it’s pretty self-explanatory, but in any case, here are the main data points:
- Heaviest Weight: 136 kg / 300 lbs (Approximate)
- GLP Start Weight: 119.5 kg / 263 lbs
- Graduation Weight: 97.5 kg / 220 lbs (End of GLP use)
- 1st Grad Anniv. Weight: 85 kg / 187 lbs
- Lowest Weight: 79.5 kg / 175 lbs
- Current Weight: 81 kg / 178 lbs
As you can see, my weight has finally stabilized within 2kg / 5lbs - in other words - I’ve reached maintenance weight. This was not on purpose though as I’m still actively trying to lose more weight. More on that later. From this point forward, I’ll tackle some of the most common questions / topics that people have asked me and that are frequently asked in this subreddit. I’ll try not to go too deep into any of them - I could talk about weight loss for hours - but feel free to ask away for more details about anything in the comment section.
"How did you do it?"
There is no short answer to this. In a nutshell, I’ve done what most people in this sub will recommend you to do: I’ve adopted lifestyle changes that allow me to get off the meds without weight regain. That's not the whole story though. Most of the lifestyle changes that I do now, I was also doing before coming off. But as you can see on the graph, two months after quitting I was on an upward trend to regain. At that moment in time I tried the last resort I had not implemented yet; I started counting calories. Nowadays, I attribute most of GLPGrad success to this practice alone, but that’s also not the whole story either. So even though there was a clear before-and-after counting calories, I don’t think that’s any different than any other lifestyle change. To me, counting calories is only one more of the changes I had to do to my lifestyle. In my case, I could not have done this without counting. To this day, I still think the key to becoming a successful grad is to adopt lifestyle changes while you’re on the med so you can maintain your weight when you get off. But I also think that most of us, ex-obese people, will have to resort to counting calories in order to become successful grads.
"What’s your exercise routine?"
Ah - the million dollar question. See when people think about weight loss and maintenance, exercise is probably the very first thing that pops into people's mind. In reality, what you do for exercise is not that important for weight loss. It’s almost irrelevant. That’s a hot take - I know - but it’s one that is backed by science and my own experience as well. Long story short, weight loss / maintenance is all about Calories In Calories Out. At the end of the day, exercise accounts for a minor percentage of our calorie expenditure, making exercise not as important as other factors. Watch these couple videos: Video Link 1, Video Link 2; if you’re confused by this concept.
Alright Curiousbato, we get it, exercise is not the end-all be-all of weight loss. But what do YOU do? Well I mostly do strength training. I currently do a 4-day upper/lower split of around 50min each day. Don’t let fitness influencers foul you. You don’t need to spend a lot of time at the gym or do fancy routines to build muscle, making sure you go to failure with proper form is much more important. I also try to walk at least 10k steps every day and have at least one hardcore cardio session a week of about 30min. That could be swimming, running or whatever I’m in the mood for. On top of that, I’m very active for leisure; I play pickleball regularly and go out for hikes. So yeah, I live an active lifestyle.
So what do I recommend for weight loss?... WALKING!! Don’t get me wrong, by all means please do strength training and cardio but don’t approach these two with weight loss in mind but rather with an approach of improving your overall health. Both strength and cardio training are incredibly beneficial as we age. As for walking; Walk as much as you possibly can. I’m not talking about doing 10k on a single brisk walk session. If you really want to get serious about weight loss, accumulate 20k steps (or more) throughout the day. Yes, get into those brisk walking sessions but also walk instead of taking your car everywhere, stroll through the park for fun, take walk breaks when at work, do your groceries at the store instead of ordering online, make walking for anything and everything part of your daily routine. The more steps you do of LIGHT walking the better. This is - by far - the greatest tip I can give you. Walking is so effective that it almost feels like cheating. There is no other exercise that will make you burn more calories while keeping your hunger/cravings so low. If you want to make your walk extra spicy you can do a slight incline on your treadmill or wear a weighted vest to burn extra calories.
If you already walk a lot and/or can not spend a whole lot of time walking everyday, I’d say the second best thing for weight loss would be circuit training, crossfit or any kind of training that combines strength and cardio. These kinds of workouts are not the best at either (making muscle or training your cardio resistance) but are good in the sense of calories burned per minute. That said, it’s hard to find good classes/instructors and it’s easy to get injured. So be careful with this one.
All that said, any exercise - literally any - is better than nothing. When it comes to weight loss every little thing adds up and helps. So my last advice in this regard is for you to find something you actually enjoy doing. Whatever you can commit and stick to. Doesn’t really matter if it’s the best exercise for weight loss.
"What’s your diet?"
If the exercise question was the million dollar one - this one has to be worth at least one billion. If exercise is almost irrelevant for weight loss, diet has to be on the completely opposite side of the spectrum. This is where the money is. Diet IS the end-all be-all of weight management. So what do I do? I count calories. By this point you might feel like I’m a very hard proponent of counting calories for weight loss, and that is true. It has worked great for me. You’ll read more about this below. “Ok, we get it. You count calories, but what do you actually eat?” - you might be asking - and the answer to that is: literally whatever I want. Don’t get me wrong, I do have diet strategies and preferences but I don’t follow any hard diet or regimen like Keto, Intermittent Fasting, Carnivore, One-Meal-A-Day, etc.
On a regular basis I eat fruits, all kinds of dairy, cereals, all kinds of meat, beans, legumes, all kinds of bread and a long etcetera. I also eat burgers, pizza, ice cream, fries, take out food or whatever I please. That’s the beauty of the calorie counting approach; I can have anything as long as it's within my calorie budget. Now, one thing is for sure; I mostly eat whole foods that I make myself. I’d say that - on a weekly basis - I cook 70% of what I eat with the remaining percentage being either “healthy” processed food (protein bars/chips, etc.) and/or take out food.
I do prioritize protein but only because I’m a Type 2 Diabetic in remission. That means that I’m not able to eat as many carbs as regular people. I also have a history of high cholesterol and triglycerides, and because of that, I try to not over do fats. As a result, protein ended up being the thing that I can eat “as much as I want”. Right now, I’m eating anywhere from 180 to 230 grams of protein a day. That comes to be around 2.2g of protein per kilo on average. Not extremely high, but still high. Again, not really doing it on purpose and I also don’t care if I don’t get to my protein goal. I’ve had days with less than 100g.
In short, I think you could describe my diet as a Mediterranean whole-foods based diet during the week and delicious junk food on the weekends.
>“Perfectly balanced, as all things should be”
- Thanos
I do want to get away from ultra-processed food as sometimes I find myself relying way too much on protein bars, low-calorie products and A LOT of zero calorie soda. This is mainly because of overall health reasons but not for weight-loss reasons. Again, for weight loss it doesn’t really matter what you eat as long as you’re within your calorie budget.
One strategy that I use every single day is volume eating. I firmly believe that my life-long obesity destroyed my satiation triggers. I could literally eat a large pizza on my own in a single sitting. Not even exaggerating, I’ve done this in the past. So as you might suspect, when I stopped using GLPs food noise and satiation were a major issue I had to solve. Volume eating is a huge tool for me. Again, won’t go into much detail here, find more info about this below!
"Why and how did you stop?"
I’ve been asked this question many times. Basically I didn’t have a good reason to stop other than to see if I could do it on my own. Point blank. One big thing to note though is that I didn’t actually stop because I wanted to become a “GLPGrad” but rather to become a Type 2 Diabetic in remission. Back when I was debating myself whether to stop or not there was no GLPGrad subreddit but there were multiple diabetes forums/subs that had people that had become T2D in remission. So to me, weight maintenance was more of a secondary goal as keeping my A1C (sugar levels) down was my main concern. My endocrinologist didn’t think the same though.
See, to my endo, keeping me on semaglutide was more about keeping my weight off rather than my sugars low. So when I brought the idea to the table, she didn’t approve. At that moment in time in my T2D journey, Ozempic was the only med I was taking for my blood sugars which were very low for a T2D (4.7%). For those of you who might not be familiar with A1C numbers, people should stay below 5.5% to be considered healthy individuals. So I figured I could get away without the med, as I thought I had some leeway for my A1C to creep up a little.
I kept pushing the idea but my endo never liked it. I’m not sure how many studies were published at the time but she was probably aware that the odds were against me. I don’t blame her. I was told this was a life-long medication many times but after bringing this same discussion so many times, she ended up agreeing to at least try it out for some time. And so I did. On my own and into the darkness.
'I stopped cold turkey, as my endo didn’t give any advice on this. Food noise didn’t kick until probably 3 or 4 weeks after. And like many others report, it came back hard. I did not experience any side effects on or off the meds. The rest is history. You already know my weight has been great but I’m also very happy to report that, two years later, my A1C is still within the 4.9% and 5.2% range (which is very good!). I’ve also managed to become a little more sensitive to insulin which means that I can eat a lot more carbs than regular T2D people. Which is awesome.
Calorie counting
You may be tired of me mentioning calories but - to me - counting them has been the greatest tool in my journey. So yeah, I won’t stop recommending it. I’m not saying that it will work for every single person, that it’s easy or even that it’s 100% healthy. Heck, I’ll be the first to say that if you’re not careful, calorie counting could trigger EDs. But what I am saying is that if you’re planning to come off GLPs or already struggling to maintain your weight, counting calories should be a tool that you should heavily consider.
Most people are not good at naturally maintaining their weight. The reason why goes beyond individualistic reasons; mental health, quality food access, habits, ignorance, lifestyle, etc. So I’d dare to say that if most people are not good at naturally maintaining their weight, ex-obese soon-to-be GLPGrads will have it 100 times harder. So why give a shot to the tool that is known to be THE most effective for weight management? I’m not here to convince anybody but If you do want to start counting, there are two things you have to be aware of: tracking your food intake and calculating your calorie expenditure (a.k.a TDEE). Those are two very different things and most people that dive into calorie counting fail at one or the other. You might have a very accurate TDEE calculation but you’re failing at correctly tracking your food, a lot of people forget to track the oil they cook with for example. You might also be very diligent at tracking your food but have a poor TDEE calculation. Both of these things will make you inevitably fail. So what’s the best way to approach both of these things?
In my opinion, the only answer is the MacroFactor app. I’m in no way, shape or form affiliated with MF. I wish I was. It’s just simply the best tool there is for this. You can do it without the app, that’s for sure. You can go many ways about tackling these two things but using a single app to do both is - to me - the ideal way to do it. The deal about MF is that it re-calculates your TDEE every week. TDEE re-calculations are a really big deal as your TDEE number will change over time. Constantly. See image below if you’d like to see some TDEE gore:
That right there is my TDEE over time. As you can see, my TDEE has crashed down as I’ve lost weight. It has gone up momentarily due to different reasons but it has trended downwards overtime. So as the TDEE number changes, your food intake shall follow suit. Sticking to the same calorie number will make you inevitably plateau. This is why people plateau in their weight loss journeys. They might be doing everything right, eating the same thing everyday and exercising harder than ever. But at some point, your body catches up. Your body becomes better at burning less calories while doing the same stuff. That’s called Metabolic Adaptation. And it’s a b#$ch. It gets us all. At that point the only thing to do is to eat less calories, and that’s why MF shines above the rest. Because, again, it calculates your TDEE every week. By being aware of this number you can continue losing, slow your loss rate or even gain weight. All to your command.
Food noise, Volume Eating and the Hunger Wars
I still remember the first time I stopped hearing all that noise… food noise. I couldn’t believe myself. Back in the day, I could go a whole day without thinking, worrying or even eating food. Eating became a thing I had to do instead of something I needed to do. I remember thinking; is this how everybody feels? Is this how it is supposed to be? When I was debating myself whether to stop the shots or not I knew that food noise and hunger would be the thing to fight against. So I came up with a strategy.
Initial strategy
Before stopping, I knew there were some foods that I could eat freely - as instructed by my dietitian. So a few days before stopping I packed my fridge with obnoxious amounts of celery and cucumber. The idea was simple; I can’t be hungry if I’m full all day. And so I did. I drank water and ate celery and cucumber all day long. Did it work? Yes, for a short period (see weight graph black line). See, this is what I didn’t understand at that time - food noise and weight loss are two totally different battles. Feeling satiated should be part of your food noise strategy, but winning the food noise battle doesn’t mean you’ll win the GLPGrad war.
Second strategy: Volume Eating
When I started counting calories, one of the things that surprised me the most was how calorie dense some foods are. Yes, I was eating maybe 4 cucumbers a day making myself feel full but that wouldn’t matter as I’d have a toast with 200 calories of peanut butter on it - which sounds like a lot but that’s only like one spoonful. So now I had two issues to solve: one was feeling satiated and the other was to make my food as low calorie as possible. The solution? Volume eating. I simply can not recommend this enough. You’ll actually see me comment these two words all the time in this subreddit. If you have no idea what this is, it’s basically focusing on making your meals as LARGE in size as possible. It sounds counter intuitive, how can a large meal be low in calories? Well, there’s a whole world of recipes and “tricks” you can do to make that possible; you can bake stuff to increase volume (google baked cottage cheese recipes), you can add air or water to stuff you wouldn’t normally (google fluffy jell-o) or you can just add veggies to anything, literally anything. This last one is key as veggies are low in calories and high in fiber, so it’s a win-win. I’d highly recommend you going over to r/Volumeeating for meal ideas.
Satiation Triggers
If you ask the internet how to feel satiated, half of the internet will yell at you “EAT FIBER!” while the remaining half would yell “EAT MORE PROTEIN”. How could I be struggling if I eat double the amount of the recommended protein and fiber intake? I should not be hungry! - Well, it turns out that not every person responds the same to the same nutrients. For some, fiber and protein might be the key to their satiation. For me it wasn’t. So for me, I had solved one piece of the puzzle with volume eating but the other piece that I simply didn’t see coming was fat. It has been in front of me this whole time! Turns out, having moderate amounts of fat with my meals would make a huge difference in how that meal would satiate me. No kidding, I discovered this with overnight oats. Lol. I made probably 10 different recipes of overnight oats. I’d play with the milk, oat, protein quantities just to find myself being hungry the following morning. One day I decided to add a spoon of peanut butter and… voilà. Everything changed. So, this is all to say: try different things. Play with your fiber, protein and fat numbers and make note of what works best.
Hunger Suppression
This one topic has become very popular, especially in the supplement side of things. Berberine, metformin, etc. I do not recommend taking anything as far as hunger suppression goes but I will concede that research seems to suggest that some of these supplements/meds might slightly work for some people. So make of that what you will. From my perspective, I can confirm that at least caffeine does work on me. One more thing I discovered is that exercising does something on my body that results in hunger suppression as well. I’m not sure how it works but I basically stop feeling hungry when I do intense cardio. Other than that, I’m afraid to tell you that most of those hunger suppression supplements and hacks that you see on the internet probably won’t work for most people. GLPs are the only real deal - for now.
What are you planning on doing now?
I actually want to continue losing. At this point, going 5kg / 10 lbs lower would be the difference between seeing my abs or not. So, in terms of “wanting” - yes! - I’d love to continue losing BUT it has become much much harder to do it. As of now, my current TDEE is 2300 calories, per MacroFactor calculations. This is very low for someone like me, an active 6ft man in his 30s with an average muscle mass and a healthy fat mass.
Losing weight would mean to stick to 1800 calories a day. Which I have done multiple times this year. But not consistently. This is why my weight has stabilized and why my weight stays within the same 2 kg / 5 lbs window. Sometimes I’m able to stick to 1800 a day - which makes me lose weight. Some other times I can only manage to stay on maintenance calories - which makes me not lose or gain. And some other days I go over - which makes me gain. This makes me go up and down within 2kg / 5 lbs.
With my current lifestyle, exercise routine and diet, it would be VERY hard for me to continue losing. Yes, I could walk 30k instead of my usual 10k and I could choose to only eat prepped meals instead of having dinner out with friends once a week. But for the first time in my weight loss journey I must say that I’m getting tired. If my calorie goal was closer to 2700 (like it was when I first went off the shots) it would be so much easier. Sticking to 1800 calories with the appetite of a 300lbs man it’s not easy. Sometimes I’m able to do it and sometimes I’m not. And that’s just the reality of being an ex-obese GLPGrad. It is what it is.
So for the time being, I’ll continue to TRY to stick to my 1800 calorie goal but if I fail miserably one day because I want delicious pizza… it won’t matter. It could not care less if I don’t get to my calorie goal any given day. Don’t get me wrong, I’m not saying I’ll let loose but I’m ok with not losing for weeks/months at a time. I guess what I’m saying is: I don’t mind if my weight stays as is or if I lose very slowly.
For the time being, and maybe for the rest of my life, body composition and mental health are my main priority.
Thank you!
Last thing I want to touch on is your support! Seeing your post, commenting on them and being part of this community has also made me keep going, so I want to thank you for being part of my journey as well. I hope I can be of help. My inbox is always open for all my GLPGrad comrades!
TLDR: I’ve continued losing weight 2 years after stopping GLPs. In this post, I explain the things that have work - and what has not - to achieve this.