In "setpoint theory" there's an additional hunger drive based on whether you are below or above a given level of adiposity - your "setpoint". This is often given as an explanation for why people can't keep weight off, and is the sort of thing you'd need to posit to explain why people on GLP-1 inhibitors can't as easily get to lower levels of adiposity.
1) How is your energy/stamina following the 35% loss
2) Have you done any dexascans/bodyspecs to measure your lean mass percentage before and after your loss
3) Did you take any steps to reduce the muscle loss?
4) with 35% loss, what BMI are you at?
The other wild thing is general health improvement - all of my bloodwork has gone from questionable to better than standard - closer to ideal values than I would ever expect. Liver values, cholesterol, lipids, blood pressure, everything. I expected them to improve but not to the degree that they have, my LDL has gone down by 60%. Actuarial tables say it's given me another ~10 years of probable lifespan, and even more if you think in healthspan.
1) Amazing, like being a decade and a half younger
2) Not before, planning one in the next couple months, but I use skinfold and impedance and they say I've dropped from about 48% to ~20% as I've dropped from 272 to 186, lean mass seems maybe 5kg lower than I started with? Less lean mass loss than I expected.
3) Weight bearing exercise and medium-high protein intake (>80g/d)
4) Per above, starting BMI 37.9 -> ending BMI 25.9
1) amazing, I can actually do things now. I didn’t realize how much I was resting and just not doing anything around the house. I managed to do my work with stimulants but that’s about it.
2) I did a scan and am currently around 110% for with 100% being the baseline for the average male my age, for my muscle mass. I did lose more muscle mass in the 230-210 loss than most of the previous, but I think that’s because I couldn’t ride my bike everywhere as it’s winter time. I had to chug protein shakes while losing weight and do physical therapy for a few body parts, especially my hip and my shoulders as they were easy to hurt. Going to the gym regularly solved this long term.
3) I guess I answered question 2
4) I’m now 27.1 BMI, although my percent body fat is only 18.9%, so I’m not concerned about the number since I have access to a body scanner and can see I’m fine. My visceral fat levels have dropped below concerning levels, which is great.
I also sleep way better, and the heartburn I thought was just a part of life went from “literally every day” to “once or twice a year, and only if I do something I shouldn’t have”.
I was also way more aggressive about just going to the dose and hit 15mg in April of 2025, and have stayed there. I might go for another 10 pounds mostly out of vanity.
2. I have not. Considered it, but locally the scans are expensive and I could not convince myself what I'd do differently if I knew the numbers. My goals would stay the same.
3. I lift weights, but there's no way around it, losing a lot of weight means caloric deficit and I have definitely lost some mass. I'm trying to establish a slight caloric surplus now combined with a heavier focus on lifting-for-growth to see if I can claw back some of what I've lost. I got big enough at my largest (and I am just over 50 years old, which does not help) that now I have a little bit of loose skin on my belly, thighs, and upper arms ... I'm hoping that if I can regain some muscle that I can alleviate much of that. Otherwise I'll get a surgeon to do it.
4. Currently at 25.2. Could lose some more, but happy enough where I'm at and my test results are spectacular now, so I am no longer targeting further weight loss. I still weigh myself but I am now refocusing my definition for success in how I look and feel.
I feel this, too. I was on Prilosec indefinitely, gastroenterologist said I have a mild hiatal hernia and that I'll probably be stuck on PPIs forever. But after losing a lot of weight, I was able to switch to occasional Pepcid instead, with Prilosec temporarily if I get tolerant to the Pepcid. The hernia won't heal itself, but taking the pressure off has really reduced the GERD symptoms.