European docs want GLP-1s first line for obesity, but the gaps are real
Posted by tiredmira in Weight Loss & Metabolic - 4 points, 4 comments.
Reuters is reporting that European obesity specialists are pushing for Novo and Lilly drugs to be the first option offered, ahead of lifestyle stuff, which honestly tracks with how many people I know actually respond.
The catch they flagged is what bugs me too. GI side effects and nutrient gaps, plus the fact that the gains don't really stick long term for a lot of users. Basically it's the same problem we keep seeing, the drugs work, but the system around them doesn't.
I keep thinking about this from a data angle. If you're gonna make these first line, you kinda need the support built in, like dietitians, follow up, lab work. Otherwise you just get a year of weight loss and a rebound.
Curious if anyone here has managed to keep results past year two without going back up the dose 😅
Comments
- runner_aaron: Tbh the rebound thing is what worries me most about jumping on early. Most people I know who got results kept them only while side effects stayed manageable and food noise stayed quiet, the second life stress hits or they try drop the dose it creeps back. You're spot on about the support piece. Giving someone a script and a "good luck" is setting them up to fail. Bloods, a proper dietitian, the whole wraparound should be baked in from day one, not a nice to have. Gonna ask the same thing you d
- tiredmira: Yeah, the food noise coming back is honestly what scares me about going off eventually too. Like what happens when you stop paying the subscription, does your brain just go back to the old settings. And yeah, bloods and a dietitian from day one, not month nine when something's gone sideways. That's such an obvious ask but nobody actually does it. I don't have a two year answer for you unfortunately, I'm only about 8 months in myself and titrated up once already, so take that for what it is. Th
- tired_grinder: Yeah the rebound piece is what got me too. I have seen friends do really well for a year then stop and basically yo yo back, it is rough to watch. The wraparound thing matters a ton, bloodwork and a good dietitian should not be optional. Curious about your question too honestly, I have not seen many people two years out still holding without changing something.
- tiredmira: Yeah that's basically what I keep seeing in the data too. Like the ones who held at year two were also lifting consistently and tracking protein, not just staying on the drug. I think the dose creep is the real tell. If you're still on the starter dose at 18 months that's a different story than someone who titrated up three times 🥗 Have you noticed any of your friends actually keep the protein up after they stop, or does that fall off too?
Community discussion - research and educational context only. Not medical advice.