Jonathan Meyers, a digital strategist at an environmental nonprofit, has faced decades of fluctuating weight, despite trying various diets such as Keto, high-protein, low-fat, and calorie-restrictive regimens. "I’ve had success, up and down, but I always regain the weight," Meyers states. His experience mirrors that of many individuals battling obesity, a chronic condition requiring more than lifestyle changes alone.

Recently, Meyers experienced significant weight loss using Zepbound, a new GLP-1 agonist drug, shedding 35 pounds and appreciating the reduced hunger. The absence of "food noise," or the constant urge to eat, allowed him to eat less and move more. However, the drug's limited availability has posed a challenge. Meyers has gone to great lengths, including having family in Maine ship the medication to his home in Kensington, Maryland. Despite these efforts, Zepbound remains hard to find.

GLP-1 agonists, like Zepbound, Wegovy, and Mounjaro, have been effective for many in achieving sustained weight loss. However, the benefits often diminish once the medication is discontinued, due to factors such as cost, side effects, or supply shortages. Research supports Meyers' concerns: a study indicated that patients regained two-thirds of the weight lost within a year of stopping treatment. Another analysis revealed only 17% maintained 80% of their weight loss after discontinuing the drug. Dr. Eduardo Grunvald, director of the weight-management program at the University of California San Diego, asserts that most patients relapse once they stop the medication, reflecting the chronic nature of obesity.

The social media hype around these medications can also mislead patients, warns Dr. Rekha Kumar, an endocrinologist and former medical director of the American Board of Obesity Medicine. Misconceptions about short-term use for cosmetic weight loss contrast with the intended purpose of treating obesity as a disease. Kumar emphasizes that the biological and genetic factors influencing weight regain make it unlikely for most people to maintain weight loss without continued pharmacological support.

Public perception of these drugs is mixed. A KFF poll found that only 14% of people remained interested in treatment after learning about the potential for weight regain. Nevertheless, drug manufacturers are pursuing longer-acting maintenance drugs to address this issue. For those needing to transition off GLP-1 agonists due to medical reasons, such as surgery or pregnancy, personalized plans with healthcare providers are essential. Dr. Natalie Muth, a pediatrician and obesity specialist, highlights the emotional and behavioral challenges patients face during such transitions.

Meyers has encountered these challenges firsthand. Without the medication, he resorts to strict dietary measures, tracking every bite and limiting his intake to 1,000 calories a day, leaving him "just absolutely starving all the time." Recently, he opted to purchase similar drugs from a compound pharmacy in Florida, despite potential risks. After two weeks, he reported mixed results, experiencing both dyspepsia and increased hunger.

Despite uncertainties about supply, cost, and long-term effects, Meyers remains committed to using these medications. "To me, if I have GI problems for the rest of my life, but I don't have a heart attack or don't have all the other things associated with obesity, it's fine," he says, reflecting the complex trade-offs many patients must navigate in their quest for effective weight management.

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