kartikeya
Explorer
When it comes to taking an aggressive route with weight loss, one of my biggest fears stems from what happened to my mom: she had weight loss surgery, and as a result, her gallbladder was destroyed.
Aggression in GLP-Fueled Weight Loss
- Thread starter kartikeya
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kartikeya
Explorer
Staying on a GLP-1 for life isn't something I really want, particularly since I'm in my 20s, so I know I'll have to keep an eye on the habits I used to have. That said, maintenance isn't where I usually get stuck — what trips me up is staying disciplined when the food noise kicks in during a deficit. Every pound I put on showed up after I wrecked my knee (I used to run before that), and my hope is that a short-term GLP run (8-12 months) can act as a systemic reset, and if I keep moving and track my macros, I'll manage some body recomposition and land around 200 pounds.
kartikeya
Explorer
Nice work on what you've achieved up to now!
I've seen the same thing when people go the "natural way". When losing weight doesn't come easily to you, every single decision has to be oriented toward that goal. This is a really useful anecdote.
woundcarping
Explorer
Sounds like the deck is stacked against you, though I still wish you the best in what you're pursuing—a few individuals actually drop additional pounds once they come off treatment.
A modest retrospective analysis examined whether dosing less often (once every 2 weeks) worked well, and by and large it did. As for Surmount-Maintain, that trial compared staying on the highest dose tolerated, stepping down to 5mg each week, and quitting altogether.
Here's an AI-generated summary of the data from that trial on people who stopped therapy:
My overall target is a 160lb drop, and I'm still a long way from it. The starting point was 386lbs; right now I'm at 345lbs. Since I began, only 66 days have passed, so I realize the pace is extremely quick. Eating has been good, and I've had no side effects at all — bowel movements are great, I get 7hrs of sleep each night, and there is absolutely no food noise. The standard schedule was followed: 4wks at 2.5mg, then 4wks at 5mg. I chose to skip 7.5mg since I felt no hunger whatsoever and saw no reason to move up. A switch to 6.25mg did happen, but the only reason was that I'm still using the same vial from the start, now 66 days old, so some potency loss must be expected.
My gallbladder worries me, though there's no gut pain or cramping. Daily intake includes 200g of protein plus fresh raw veggies and fruits. Magnesium and collagen protein are part of my routine alongside whey isolate, and I exercise through swimming and resistance training. Weight training gets added starting tomorrow.
What I'm thinking about using is Ursodiol, to safeguard my gallbladder. To reach my goal weight of 220lbs, I still have 120lbs to lose. I'm a 55yr old male, 6'3".
Ursodiol’s role in the gallbladder
A hydrophilic bile acid, Ursodiol lowers cholesterol saturation in bile, encourages gallbladder emptying, and is able to dissolve cholesterol gallstones. Its mechanism involves changing bile composition and stimulating gallbladder contraction.
Has anyone tried it?
My gallbladder worries me, though there's no gut pain or cramping. Daily intake includes 200g of protein plus fresh raw veggies and fruits. Magnesium and collagen protein are part of my routine alongside whey isolate, and I exercise through swimming and resistance training. Weight training gets added starting tomorrow.
What I'm thinking about using is Ursodiol, to safeguard my gallbladder. To reach my goal weight of 220lbs, I still have 120lbs to lose. I'm a 55yr old male, 6'3".
Ursodiol’s role in the gallbladder
A hydrophilic bile acid, Ursodiol lowers cholesterol saturation in bile, encourages gallbladder emptying, and is able to dissolve cholesterol gallstones. Its mechanism involves changing bile composition and stimulating gallbladder contraction.
Has anyone tried it?
lastresort
Explorer
Has lipo 360 ever crossed your mind?
woundcarping
Explorer
Also keep in mind an easy way to help with fat consumption so the gallbladder keeps emptying, which lowers the likelihood of stones developing.
woundcarping
Explorer
When I was counting macros, I never went below 50g of fat per day. Fat is fat.
birdwhacker
Explorer
Is diet, habits, and lifestyle change factored into any of these studies? Or is the typical setup just handing the drug to some random guy, pushing the dose up until he can't stand it, and then pulling him off in a few different ways?
Honestly, the finding that most people put some weight back on barely registers with me as meaningful information.
If there's truly no route off a GLP without regaining a huge chunk of the weight, that would suggest the GLP is wreaking havoc on the body, and I'm not convinced of that. You drop the weight, rework your habits, build some muscle, add exercise mimetics and metabolic enhancers to keep the fat cells quiet, taper the dose however makes sense for you, and get off it. Whether that takes months or years.
If that genuinely can't be done, then GLPs amount to nothing more than a party trick and a lifelong prescription for the chronically obese.
birdwhacker
Explorer
Yeah, olive oil does amazing things in my case. Based on what some random guy's doctor said—he seemed like he knew what he was doing—you should get no less than 25g of fat in at breakfast, and it's best if that meal lands within 45 minutes of getting up. I take a swig of vinegar too, to get things moving, and TUDCA is non-negotiable for me as well.
The simplest method for me seems to be a can of beans with olive oil poured over it. My gallbladder improved enormously from that, going from attacks every day to just the odd bit of discomfort, along with TUDCA and chanca piedra and reducing my reta dose.
Here I have to disagree as well. Drinking bacon grease or beef runnings is not something I'd recommend. Fatty pork and beef both irritated my gallbladder a lot, which I figure is down to too much cholesterol, whereas seed oils didn't.
Omega 3's also have some clinical indication when it comes to treating gallbladder issues, though I won't act like I know the research well.
rokowho
Explorer
My dose stayed the same, yet my body reacted far more strongly than most. In under 10 months, I dropped over 60 pounds. When you've spent years fighting your weight, putting the brakes on that momentum feels almost impossible. Still, looking back, I regret not easing off the pace — the final 20 pounds left my skin visibly loose.
lessthanhalf
Explorer
Sustained obesity or diabetes management is basically the purpose these drugs were created for. To me, the real strength lies not in starting the weight loss but in keeping it off over time — almost every obese individual has shed and then regained significant amounts at some point, so dropping the pounds is not the toughest hurdle; staying at a lower weight is.
Research spanning thousands of studies and many decades demonstrates that, broadly speaking, people are terrible at keeping weight off, with just a tiny fraction — perhaps around 5% — managing to shed a large amount and hold onto that loss long term. For smaller losses, say 10% or less, or over briefer periods, the figures look somewhat better, yet most folks taking these medications, including those here, are aiming to drop more than 10%, aside from a handful of bodybuilders or people doing it for cosmetic or lifestyle reasons. To my knowledge, no other treatment offers even passable long term maintenance of weight loss beyond 10%, other than GLP drugs or bariatric surgery.
If you can build lasting habits around improved eating and regular exercise, keeping the weight off is achievable. The issue isn't that this approach fails — it's that very few people ever truly pull it off. And the explanation seems clear: if you were already skilled at diet and exercise, you wouldn't have needed to lose weight in the first place; if you weren't and became obese, then altering those patterns and sticking with the change is genuinely difficult.
The notion that needing to remain on these drugs means they're wreaking havoc on your body is simply wrong. Many long term medications that are proven to lower health risks — like statins, blood pressure drugs, or diabetes treatments — only function while you continue taking them to correct a metabolic system that isn't working properly, and GLP's operate the same way. No existing therapy addresses the root cause of obesity, and honestly, scientists don't fully understand how weight is regulated in normal or obese individuals, much less how to fix it permanently. Far from causing harm over time, GLP's are arguably the closest thing to a genuine longevity medication that actually works — with far stronger evidence than any supplement — cutting the risk of numerous health issues, including the most common and serious ones tied to aging, cancer, and cardiovascular disease. The verdict is still out on dementia.
"run some exercise mimetics and metabolic enhancers to help keep the fat cells inactive, lower the dose in whatever way you see fit, and come off. Over years or months."
The trouble here is that right now, no treatments are proven to genuinely accomplish this. Some show promise in mice or rats, but a large share of that research fails to translate to humans. Thus far, the only non toxic drugs demonstrated to sustain long term weight loss in people are GLP's. Overall, I haven't seen solid evidence even on this forum that any of the other peptides significantly affect weight.
woundcarping
Explorer
Trying to account for what people eat, their routines, and how they live just isn't realistic. A number of trials included some lifestyle guidance while treatment was ongoing and afterward. Sure, that's an exaggeration, but to get into those trials, people had to fit particular requirements tied to the outcomes the studies were built to measure.
80% putting back on 25% or more of what they'd lost looks like a data point. The typical regain sitting at roughly 2/3 of the weight lost is another practical data point. The 4% who kept shedding weight after they stopped is maybe the data point that interests me most.
So basically the same as old-school dieting and working out... which tends to produce a 5-10% average weight loss, occasionally 12-15% under intensive programs, and leaves people on average 3-5% lighter 5 years down the line? One big gap is that peptides tend to yield a noticeably larger average weight loss, and the typical regain usually levels off near 75% in the admittedly less mature data.
More exaggeration, and not what I put forward... but fine, achieving and holding onto surgical-level weight loss through a weekly injection is one hell of an effective party trick. Diet and exercise can definitely keep the weight off too, provided you never stop doing whatever made you lose it.
Everybody prefers to believe they aren't average; that they're somehow an exception, a rebel against the trends; but odds are, all of us, on average, land closer to average than to unique.
Comparing your troubled gallbladder to one that's asymptomatic and presumably healthy strikes me as unfair.
You mention 25g of fat to kick off the day; that's under two tablespoons of grease... not something I'd call appetizing, but it matches 3-4 slices of the bacon I eat with no problem. A plain Chick-fil-a chicken biscuit carries 23g of fat, or about the same as a Wendy's Jr Bacon Cheese Burger.
Gallbladder dumping is triggered mainly by the fat in a meal (or certain proteins) reaching the small intestine via CCK, no matter how much cholesterol is in it.
kartikeya
Explorer
It's striking that steering clear of the most severe weight-loss side effects mostly comes down to doing what you were taught in health class about eating well — that is, keep your macros in balance, watch your nutrient intake, and skip foods with no nutritional value.
kartikeya
Explorer
On r/GLPgrads you'll find plenty of accounts from people who took that exact route, and reading them is part of why I want to try this myself. In places like the US, where poor eating and weight-related habits get a kind of quiet approval, it makes sense that most people would put a lot of the weight back on unless they change the way they live day to day. Think of crash diets: they can take weight off fast, yet the pounds come back easily since nothing healthy got built into the routine along the way.
kartikeya
Explorer
I take issue with describing what comes after reaching your goal weight as simply carrying on with "...what you did to lose the weight". That framing is already a simplification, yet weight management really breaks down into 3 distinct modes: loss, gain, and maintenance. Each mode places different demands on a person. Once someone reaches their goal weight and wants to stay there, repeating the same loss-oriented behaviors wouldn't be logical. From what I understand, the best path would be to recalculate a calorie target using your updated resting metabolic rate and activity level.
Keep in mind that ordinary people can accomplish remarkable things, and transforming your life for the better doesn't require an iron will.
kartikeya
Explorer
The point here isn't really that you should remain on a GLP indefinitely. Rather, it's that you ought to be careful and deliberate if you're planning to stop using them. The difficulty of altering your habits doesn't justify skipping those changes.
birdwhacker
Explorer
A lot of the best products come out of being built for something else entirely.
Sorry, but this proves what I was saying. Staying on a statin or blood pressure drug forever isn't right either — doing that is foolish unless, like we already covered, you simply can't get at the underlying problems.
For the most part, high blood pressure and bad cholesterol can be fixed completely. With a GLP, you can basically take care of 3 birds in one shot because of what it does for lipids.
That's insane. The treatment is calorie counting and keeping your mind and body in shape so you don't fall apart. It's just an unlucky fact that some people can't pay for treatment, some can't stick with it, and some aren't lucky enough to get it or respond to it.
On the praise for GLPs, sure, they're good drugs and for some folks they look like no cost at all. But we shouldn't treat lifetime use as a default or a must just because a lot of people fail at staying healthy.
No proof is needed, the same way intent during a drug's development isn't needed. Results are what count.
Some will go on to live meaningful lives at a normal weight after the GLPs, and luckily that drug class will keep getting better, and will be there if they slip up.
Right. Totally unrealistic for a weight loss drug trial to teach people to track macros and log exercise. How foolish of me.
Getting to my goal weight and then putting back 25% of the loss is something I'd be thrilled to live with.
"It seems unfair to compare your diet as an obese person with a healthy person. Why should they bother eating vegetables or watching their calories?"
"It seems unfair to compare your regimine as a person with a failing liver to someone with a healthy liver. Why should they avoid alcohol and take glyNAC?"
I think I get why you're so eager to stay on a GLP for life.
Sorry, but this proves what I was saying. Staying on a statin or blood pressure drug forever isn't right either — doing that is foolish unless, like we already covered, you simply can't get at the underlying problems.
For the most part, high blood pressure and bad cholesterol can be fixed completely. With a GLP, you can basically take care of 3 birds in one shot because of what it does for lipids.
That's insane. The treatment is calorie counting and keeping your mind and body in shape so you don't fall apart. It's just an unlucky fact that some people can't pay for treatment, some can't stick with it, and some aren't lucky enough to get it or respond to it.
On the praise for GLPs, sure, they're good drugs and for some folks they look like no cost at all. But we shouldn't treat lifetime use as a default or a must just because a lot of people fail at staying healthy.
No proof is needed, the same way intent during a drug's development isn't needed. Results are what count.
Some will go on to live meaningful lives at a normal weight after the GLPs, and luckily that drug class will keep getting better, and will be there if they slip up.
Right. Totally unrealistic for a weight loss drug trial to teach people to track macros and log exercise. How foolish of me.
Getting to my goal weight and then putting back 25% of the loss is something I'd be thrilled to live with.
"It seems unfair to compare your diet as an obese person with a healthy person. Why should they bother eating vegetables or watching their calories?"
"It seems unfair to compare your regimine as a person with a failing liver to someone with a healthy liver. Why should they avoid alcohol and take glyNAC?"
I think I get why you're so eager to stay on a GLP for life.