A year after I stopped taking a weight-loss drug, I’ve lost nine more kilos
I’m one of the millions of people trying to keep the weight off without taking expensive drugs like Mounjaro for life. It wasn’t easy, but I found ways.
Recently, I caught myself being weird about food again. I was trying to get a colleague to eat some sriracha-flavoured edamame beans. “They’re sooooo good, and the macros on these are ridiculous,” I told him, going on in a similar vein to explain how they pack in 11 grams of protein and four grams of fibre in just 117 calories. “Superfood of superfoods,” I concluded triumphantly.
He smirked with an amused sort of scepticism. This kind of thing happens to me a lot now. I smiled back, feeling almost as if I were looking at myself in the mirror in the recent past, back when I didn’t get too excited about roasted edamame beans. That was before I shed 18kg with the help of a weight-loss drug — and then, even more surprisingly, lost another 9kg after going off it.
Just over a year ago, I finished a five-month course of taking a GLP-1 medication purely to reduce my weight from 105.7kg – setting up a formidable challenge of how to keep all of the weight off without it, as studies show only 20 per cent of patients or fewer do.
The companies who make Mounjaro and others in the GLP-1 family use phrases such as “long-term” and “chronic treatment” to describe their recommended use for obesity; many clinicians see them as lifelong drugs, and in the US people with diabetes can be covered by insurance indefinitely.
But the rising millions of people taking them for weight loss, unless they are officially classified as obese and have additional health issues, generally pay retail prices of up to $US1000 a month as I did for Mounjaro. That’s why I stopped after five months and tried a variety of ways, some of them admittedly extreme, to keep my new body in its slimmer shape.
Medical professionals and US insurance benefits administrators have started avidly searching for effective off-ramps for people on GLP-1s. That is partly because once patients reach their target weight with the drug’s help, they might be able to dispense with the weekly self-injections and any uncomfortable side effects.
It’s also because the popularity of the expensive drugs threatens to bankrupt some US insurance providers if too many people never go off the medications. Public providers including the University of Michigan health system and the UK’s prescription-drug regulator have limited coverage to two years.
An effective post-GLP-1 strategy could save billions of dollars in healthcare costs and offer millions more overweight people affordable access to the medications and their powerful effects. While many studies are under way about additional uses for the medicines, such as possibly helping to curb alcohol and drug use, there isn’t yet a clear picture about the potential effectiveness of off-ramps and short-term use. Meanwhile, an industry of influencers has plunged into the vacuum, hawking various unproven programs and products — many of them reminiscent of fad diets and methods that GLP-1 drugs are meant to replace.
When I went off Mounjaro in January of 2024, weighing 87kg, that was the landscape I had to navigate. I found waiting for me a torrent of conflicting information about nutrition and exercise. I heard the siren songs of what I like to call “The Alphaverse,” a group of influencers whose dogmatic advice is never very far away from a product they happen to be selling — be it ice-bath makers, protein bars, supplement stacks or red-lens eyewear.
While I ultimately found some Alphaverse advice to work surprisingly well, the best success for me came with the basics, after plenty of wrong turns. Ultimately, using a combination of rigorous exercise and a structured nutrition plan with expert coaching, I lost the additional 18kg and experienced a metabolic transformation.
My first mistake in stopping the medicine was that I didn’t wean myself off it more slowly. I stopped cold turkey, and my hunger pangs and food noise came back with a vengeance. Some doctors and researchers have begun to recommend stopping more gradually, as well as taking appetite suppressants like phentermine to ease the transition. This has helped reduce weight regain in some patients.
My second mistake was not having a structured nutrition plan at the ready. The medicine had helped winnow my bad habits down to a number I could actually manage, from perhaps 25 or 30 entrenched eating behaviours (really!) down to more like five or six (I still can’t shake my addiction to impulsive runs to the 7-Eleven, for example). But even a few bad habits – when they meet with what feels like insatiable hunger – can do a lot of damage.
After a few months, I found a highly structured nutrition program, one with expert coaching that focused on a low-carb diet. While the transition was difficult, it eventually helped me bring my cravings under control.
Virta Health, a start-up I turned to for a few months, has users test their blood daily. The results, which measure glucose levels and another indicator of dietary compliance, are beamed through an app to a nutrition coach. Being aware that someone was watching – and would know if I had cheated – was immensely helpful as I sought to improve my nutrition and manage hunger.
Without wading into the nutrition wars over the keto or Atkins or Mediterranean diet or any other, I’ve found that I have generally been far less hungry when I’ve eaten more protein, fibre and healthy fats. Meanwhile, drastically limiting carbohydrates has had another benefit: forcing me to eat more vegetables. Gobs and gobs of them.
One of those bad habits that remained after taking the medicine was that I never really brought anything more than salad kits and cucumbers into my diet. I still found broccoli, celery, spinach, onions, brussels sprouts and most other vegetables largely unappealing.
But when it’s pretty much all you can eat other than meat and protein shakes, you can adapt really fast. An essential piece of the nutrition puzzle – one I had been loath to deploy – finally became an integral part of my diet. I learned to roast broccoli and stir-fry green beans like a champ. I would even catch myself salivating about a snack of celery and cream cheese. Celery, of all things!
Of course, I still eat unhealthy food on occasion, from pizza to ice cream, but the portions are smaller (one slice or scoop instead of two) and almost always come with a sizeable helping of vegetables. My long history of dieting has taught me that a permanent hiatus from food that I love is unsustainable.
After supposing my weight loss had plateaued at 18kg, I lost the next 4.5kg through my diet, along with fibre supplementation before some meals and the glucose monitor to keep tabs on my body’s responses to certain foods.
The next 4.5kg came off as I began to ramp up my exercise. Eventually, I reached a point where I needed to maintain my weight and stop losing pounds. I had to increase my carbohydrates and count calories to make sure I had enough fuel for workouts.
Now, possibilities in my life that seemed like pipe dreams have become … real. Without the monkey on my back of what had long felt like a permanent, intractable failure in trying to lose weight, I have been free to try just about anything, whether food, exercise or sport.
About a decade ago, in a moment of frenzied goal-setting meant to inspire me to lose weight, I wrote down a list of items that I thought could add up to my fitness true north: Run a 7-minute mile, do 10 pull-ups, beat my personal best 10K time from when I was 14, bench-press my body weight.
Sadly, over nearly 10 years, I didn’t come close to any of these goals. But once I was around 22kg lighter, I made a surprising discovery: I was already pretty close to reaching all of them. I still remember how it felt to finish a 10K in San Francisco in about 52 minutes — four minutes faster than the pace I ran when I was 14. I hadn’t actually trained much at all. It just happened.
These kinds of experiences led me toward an excited question: What else can my new body do? Eager to find out, I hit the streets, and the weight room, and the gym, and the mountains with ferocity. Each surprising discovery produced a new euphoria.
One such moment came last year on Mount Whitney. Facing a menacing storm cloud heading toward the summit, we decided to stop our ascent just 800 feet from the top. But before we headed down, I gathered my breath — what little there was at 13,600 feet — and started to take a parting jog up the trail. I thought I would almost certainly have to stop after just a minute or so, but I was able to keep going for about five minutes at that altitude before turning around to rejoin my group. As my heart raced, I blew a kiss to the mountain and promised to come back, a moment of sheer joy and glory on a journey I never thought I would be able to make.
Of course, not everything has been perfect. There was no beach body waiting for me at the terminus of gravity’s rainbow. It’s a fairly common, if disappointing, effect for people who drop a large percentage of their body weight quickly: The mirror exposes a bit of turkey neck due to the slack from my newly skeletal face, flaps of cellulite-scarred skin around my thighs; and a midsection that at times resembles a deflated bouncy house.
But that’s far from the end of the world. Right? Instead of ruminating on all the parts of life that I felt were off-limits, due to my size and sense of despair over it, I have dipped my toes into the water of all the living I haven’t done. Let’s try it has sort of become a mantra, in food, nutrition and a whole host of other things.
Bradley Olson is a technology editor in The Wall Street Journal’s San Francisco bureau.
The Wall Street Journal
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