> most people who succeed at significant weight loss while taking GLP-1 drugs regain most or all of the weight within a couple years if they stop taking the drugs.
Anecdata: I've gone from 260lb down to a minimum of 198ish, up to maybe 230, back down to 193, long slow climb up to 270 and now on a GLP-1 I'm under 230 and definitely look fat, but in the right light you can see my quad separation. The only people I know who've lost the kind of weight I've lost and kept it off (like a 5' man going from 250lb down to 145) went from logging every bite in My Fitness Pal (or similar) to keeping the log running in their head of what they're eating all day every day. Diabetics sometimes say they're making their prefrontal cortex do the work of their pancreas. That feels relatable.
So IDK if there's a weight loss solution that works that you don't have to do in perpetuity. "Eat less" yeah sure, but how? Magic Danish Gila monster potion that makes you want to eat less, or recording everything you eat and using that to tell yourself you're more full than you feel?
I managed some fairly significant weight loss and kept it off kind of by accident.
I was 326 lb when I took the physical that my college required incoming first year students to take. It slowly crept up over the years and by my mid 50s was generally in the 420-440 lb range. I had been diagnosed with type 2 diabetes about 10 years before that but responded spectacularly well to cheap diabetes drugs like metformin and Glucotrol. Same for cholesterol--it has been very high but Lipitor brought it down to normal. If you had showed my blood work to a doctor with no other information than my age and sex they would have not found any sign of anything wrong.
But then A1C started going up again, despite steady weight and no diet changes. I decided to try to lower carbs to see if that would help. Most low carb diets aim for a very low amount of carbs which require a lot of work to achieve (especially if like me at the time you don't mostly cook at home), so I decided to just try lower the percent of calories that came from carbs rather than worry about the absolute amount.
I picked 40% because (1) that is lower that average and definitely lower than what I was consuming, and (2) it is real easy to track (more on that below).
I was just trying to see if this change in balance would affect blood sugar and wasn't actually trying to lower calories. So rather than do things like give up most bread like many of the low carb diets require, I got the carb calorie percent down by adding non-carbs. For example if my normal ham and cheese sandwich with low calorie mayo was 60% calories from carbs, I'd switch that to regular mayo and/or double meat and/or double cheese. That would add a couple hundred or so calories which would lower the percent from carbs. The grams of carbs wouldn't change.
Two things happened then. First, my blood sugar did start going down. Second, and unexpectedly, I started losing weight. I had been keeping a simple food log for years at that point and it revealed that I in fact was consuming less calories.
Apparently what was going on is that things like the double meat double cheese regular mayo sandwich were keeping me satisfied longer, so I naturally snacked less, and naturally started eating smaller portions.
In two years I was down to 280 lb, and completely off diabetes and cholesterol. (I'd always had high blood pressure, and going from 420-440 lb to 280 lb had no effect whatsoever on that).
Over the next maybe 18 months it crept up to 320-325 lb (so basically my high school weight) and it has been steady in that range ever since (6 or 7 years so far).
I said earlier that 40% is easy to track. That's because 1 g of carbs has ~4 calories. That means all you have to do is look at the nutrition label and if numerically calories/10 <= carb grams the thing is not over 40% calories from carbs. (You can subtract grams of fiber from the carb grams).
For a meal with multiple items, say a fast food burger and fast food fries and a diet soda you could total the calories and total the carbs and do the calculation on that, but an easier way is to do the burger and fries separately and add the over/under amounts together.
For example let's say you are contemplating a Burger King Whopper (670 calories, 51 carbs) and large fries (440 calories 59 carbs). For the burger calculate 670/10-51=16, and for the fries 440/10-59=-16. 16 + -16 = 0, and your burger and fries together is 40% calories from carbs.
It is also fairly easy to keep a running net for the day, so just remember that say at breakfast you came out say at -8 because you decided to treat yourself to a donut for desert. Then at lunch you could change that Whopper to a Whopper with Cheese (770 calories 53 carbs) which is +24 instead of +16, nicely cancelling out your breakfast donut as far as carb balance goes.
> I had been keeping a simple food log for years at that point
> It is also fairly easy to keep a running net for the day
Right, so there it is: whatever you did to get to a calorie deficit you need to keep doing to be calorie neutral. If it's take a GLP-1 then that works. If it's using pen and paper or an app or even vibes-based reckoning to track everything you eat, then it's that. Regardless it just doesn't seem like a valid criticism of any given weight loss strategy when I have yet to hear of one that doesn't have that feature
Anecdata: I've gone from 260lb down to a minimum of 198ish, up to maybe 230, back down to 193, long slow climb up to 270 and now on a GLP-1 I'm under 230 and definitely look fat, but in the right light you can see my quad separation. The only people I know who've lost the kind of weight I've lost and kept it off (like a 5' man going from 250lb down to 145) went from logging every bite in My Fitness Pal (or similar) to keeping the log running in their head of what they're eating all day every day. Diabetics sometimes say they're making their prefrontal cortex do the work of their pancreas. That feels relatable.
So IDK if there's a weight loss solution that works that you don't have to do in perpetuity. "Eat less" yeah sure, but how? Magic Danish Gila monster potion that makes you want to eat less, or recording everything you eat and using that to tell yourself you're more full than you feel?