If you take ozempic for weight loss but choose to continue eating like shit then it isn’t the drug’s fault.

That's not how it works. Ozempic simply opresses the hunger feeling, therefor helping you lose weight. Problem is that still existing, but empty/depleted fat cells basically scream "we are hungry", so as soon as you get off Ozempic, you basically can't stop eating until you regained at least the former state. That was - for me - the reason not to start on Ozempic, it's like the "bounce back" effect after a diet, but on steroids. That current research has found other issues (heart problems, ocular nerve damages) just enforced my rejection (I was offered this on a free prescription base).

I think most medications are meant to be accompanied with permanent lifestyle changes where possible. No, you should not take this drug “forever”.

That is a very idealistic view, at least on some medication. With Ozempic, this is basically impossible due to the circumstances written above, with other medications it is simply due to the fact that no "lifestyle changes" can change e.g. genetic defects.

You completely ignored the “permanent lifestyle change” aspect. It doesn’t matter whether the person in need of weight loss does it via diet and exercise or via diet and ozempic, the diet/lifestyle that they got themselves fat on has to change.

You’re basically blaming the drug for the person’s inability to psychologically deal with diet. That isn’t what the drug does. No, you don’t need to eat back to your old weight, that’s the part where permanent change to diet comes in.

I already stated a caveat for conditions that may be outside the user’s control, so don’t use that as an excuse for all users. Yet again, the doctor and patient have to discuss the risks. I’m done here.

You’re basically blaming the drug for the person’s inability to psychologically deal with diet.

No, I don't. I'm just stating facts on how the human body works. With extreme willpower you might be able to counter this for a time, yes. But it will be a serious uphill battle, and the messenger chemicals from the depleted fat cells do not just stop because you will them to. You will just have to live in a state of perpetual raving hunger then. The few who can successfully overcome this for a significant time are rare, indeed.

I’m down 100lbs and been chilling there for a a while actually. (I do bulk/cut cycles of around 30lbs for bodybuilding so my total weight loss fluctuates from like 120lbs to 90lbs depending on how that’s going. Just for disclosure)

But I’ve heard a few people mention this idea that “fat cells stick around forever” and “send hunger signals to fill you back up”. Do we have a scientific source for this?

My other thing with it is like, that’s not the reason someone gets fat the first time right? Because the idea is your fat cells start multiplying after a certain weight? So regardless it still seems important to address that first cause and not repeat it

But for me personally I just haven’t really experienced it at all lol. I’ve found that actually the type of food I eat makes me hungry and more likely to go off track. Like any fast food, most prepackaged snacks and prepared meals from the grocery store.

Like I could eat an 800cal pint of ice cream then have dinner 45 minutes later. But 200 calories of frozen grapes and I’m like, stuffed lol. Or I’ve also noticed if I have a doughnut in the morning (work offers them) I’m hungry all day, but eggs cheese oats and yogurt leave me satisfied to the point where I’m not hungry at all when I get home, and eat just because I know I need the nutrition from dinner.

Anyway sorry for rambling, really I’m just curious to get to the bottom of the “depleted fat cell” thing. I had never heard of it the entire time I was losing weight/maintaining then all of the sudden I’m hearing it pop up in lots of places, even lemmy now

Fat Tissue Growth and Development in Humans - PubMed

Lipid storage and release from fat cells in adipose tissue are key factors in the regulation of the energy balance. During infancy and adolescence, adipose tissue is growing by a combination of increase in fat cell size (to a lesser extent) and (above all) the number of these cells. In adults, fat c …

PubMed (pubmed.ncbi.nlm.nih.gov)

In adults, fat cell number is constant over time in spite of a large turnover (about 10% of the fat cells per year) when body weight is stable. A decrease in body weight only changes fat cell size (becoming smaller), whereas an increase in body weight causes elevation of both fat cell size and number in adults.

403

(pmc.ncbi.nlm.nih.gov)

This one's not as easy for me to quote.

Basically the gist of the whole idea is that your body maintains the level of fat cells pretty steadily as an adult. When you gain or lose weight the cells just grow or shrink, but they can only grow so big before you need new cells to store more energy and your body will build them. Each of the fat cells have a part to play in signaling that you're in a deficit and need to consume more calories (when we didn't have such calorie dense foods readily available this was probably correct most of the time). So, if you have 2 or 3 times the number of fat cells then you "should" that's increasing the signaling you receive to eat, making it harder not to (simplifying that a lot). In normal maintenance, your body still maintains that turnover pretty steadily so it generally doesn't go away.

I’ve read the first study already, it doesn’t comment at all on the hunger signaling aspect.

The second study is just proposing this as a mechanism which may account for weight regain. They spin off pretty quickly into a more matter-of-fact tone while presenting the hypothesis itself, but at the moment it remains speculation. I obviously haven’t had the time to click through to every reference in there, but so far the links I have checked similarly lead to speculation.

Basically I think it’s somewhat dishonest to present this hypothesis as a statement of fact. I feel like the inevitable result of this mischaracterization will cause people to not even try. Why bother if something is probably impossible, or only one in a million could do it?

Thank you for linking it however, and I will be very interested to know if Professor MacLean verifies the concept. Of note, in the conclusion they propose that environmental and behavioral interventions will be important for combatting this effect, if it does turn out to be true

You're right the second article probably doesn't support the hunger bit enough. As i understand it, the hunger signaling is largely an absence of leptin, which is a hormone that regulates appetite. The increase in fat cells from obesity leads to more leptin production and then leptin resistance, so it's less effective. When you diet and lose the weight the fat cells aren't producing as much leptin and you're resistant to what they are producing so you're comparatively hungrier than you may have been if you stayed at a healthier weight. I believe the leptin sensitivity can recover and be improved through other ways but I'm not an expert.

403

(pmc.ncbi.nlm.nih.gov)

Thank you again for the link, but it seems like you’re just reiterating the hypothesis without any supporting evidence? We have a proposed mechanistic explanation for the phenomena that requires further study. My point of contention is that it should be presented as such, and not as a granted fact

Maybe my sources aren't great, I use kagi nowadays over Google and they have an academic filter (like Google scholar). That's all I used to find the few things I linked.

It's well established that your fat cell count is relatively stable as an adult and that as you gain significant weight that your body creates more fat cells to store this energy. It's known that the number of cells stay relatively stable even after losing weight, they just shrink. It's also known that leptin, or lack there of, affects your hunger. These things specifically are well documented. Other points of what I shared, and the overall impact may be, still hypothetical.

I'm not going to keep looking for and reading articles because I'm not finding what you're looking for and that's all good. I don't want to act like I'm an expert, I'm just a nerd reading things on the internet.

That's not to say, though, that this fat cell count is the end all be all and it's impossible to lose weight because you've already gained too much — your own situation is proof of that. It's just added context, not a barrier. Highly satiating foods like what you've mentioned, grapes over ice cream, eggs oats and yogurt over donuts, these make a much bigger impact on your overall hunger. I feel it too, I'm overweight and working on losing it, and if i snack on something like chips, it almost feels like it does nothing for me. That's why all the weight loss advice mentions high protein and High fiber foods.

Gotcha, yeah and thanks once again for the discussion. What I’m looking for basically is just evidence for the claim posted above us, specifically that “it is a fact that weight loss results in lifelong ravenous hunger due to fat cell signaling”

Scientists all the time come out with reviews and proposals that ultimately fizzle out without supporting evidence. So before I am able to believe any specific claims I need to see that it’s an actual scientific finding rather than just something tentative that has caught headlines (like I said, it happens all the time).

Since you like reading studies in general, for your own amusement I would suggest investigating the claim “cooking rice with coconut oil, then leaving it in the fridge overnight, will reduce the calories absorbed by your body by half!”

It’s a total and blatant piece of misinformation based on a chain of bad news reports made about a study that claimed something totally different, and was subsequently never confirmed. Yet I have met people in real life who swore by the method (even though they struggled to lose weight regardless of this supposed calorie cutting “hack”).

The weight loss space in general is totally flooded with this type of misinfo which is why I get so particular about it. Thank you again!

I'll bite. I'm on it for what some people here would consider "recreational" purposes (weight loss). However, I have polycystic ovaries and have had extreme difficulty losing weight in other ways. Essentially the only way I can lose weight is doing a pretty severe calorie deficit, which is really hard to do and essentially means I am starving all the time. Ozempic has helped me curb that perpetual feeling of hunger, and besides diarrhea (which I already had often anyway), it hasn't caused me that many side effects.

Essentially PCOS causes a craving for carbs and sugar. It's hard to fill that hole, but there are other ways to supplement the things that my body is not creating which make me crave those things. While I'm on ozempic (I don't plan on using it long-term) I'm also working to make changes to my diet to make sure I'm getting those things I was missing (B12, chromium picolante, some other stuff with scientific names).

And I know people think it's just "lazy", which it is for some people, but I struggle to lose weight even with exercise and calorie deficits. Ozempic has helped me lose some, but not as drastic as other people.

I have friends who are on waygovy (the same drug as ozempic but specifically targeted at weight loss) and they've had more side effects than me, but they are significantly bigger, have less healthy lifestyles and are I believe on a much higher dose than me. They've lost a ton of weight though.

My ex is on one of those for blood sugar. She’s not losing weight but she said it made a significant difference controlling her blood sugar.

On the other hand her Dad is also on one of those for blood sugar but he’s never hungry and forgets to eat for days so has lost too much weight. It’s to the point where the doctor said anything he wants, load him up on chips and ice cream if necessary to get him back to a healthy weight

Because weight gain is from not having enough vitamins or a correct balance of vitamins. Taking fat soluble vitamins (esp E&K1&coq10) made me lose weight and exercise more without trying.

Im like 190lbs and have high blood sugar. I see guys twice my size eating cheeseburgers and they don’t get it. Doctor told me it’s generic for me, but it doesn’t help that I smoke weed and eat all my kids cereal at 1am

You might want to consider keto or low carb. It will help with your blood sugar.

Essentially PCOS causes a craving for carbs and sugar

There is a good amount of literature documenting PCOS being a downstream effect of metabolic syndrome. Metabolic syndrome is caused by carbs and sugar. The addiction and cravings are real, but the order is reversed.

I'm sorry, but what? Weight gain is most primarily the result of calorie surplus, with genetics playing a major role as well. Telling people to take random vitamins, especially when you don't know the full story of their dietary and micronutrient status is just completely inappropriate and unhelpful.

empty/depleted fat cells basically scream “we are hungry”, so as soon as you get off Ozempic, you basically can’t stop eating until you regained at least the former state.

I don't think that is quite right. If people on Ozempic use the opportunity to adapt to a low carbohydrate diet, when they come off the drugs they won't be suffering from the save sugar craving addiction cycle.

Fat cells don't scream "we are hungry" they scream "we are full" that is what leptin signaling is for, but carbohydrate addiction is a much stronger signal for many people.

What I’m looking for basically is just evidence for the claim posted above us, specifically that “it is a fact that weight loss results in lifelong ravenous hunger due to fat cell signaling”

In my reading the the literature there is nothing to support this "fat cells make you hungry" theory.

At best there is an association between fat people and fat cell population, but given hyperplasia is more common in people of european descent its not a causal connection. Plus this theory doesn't account for fat people from hypertrophic populations (asians).

That's such a simplistic look at weight gain lol. Wanting food is caused by neurochemicals in your body first before you even eat a bite. Eg Prader-Willis patients gain weight because they have excess ghrellin which makes them super hungry. (It's obvious they do not have Prader-Willis).

Vitamins are over the counter. We are supposed to eat them every day. Doctors literally ask you if you eat a balanced diet as their first screening question because they are supposed to fix vitamin deficiencies first before treating anything else (lol as if they do that). I think adults, who walk by these same vitamins every day at the store and see ads for them, can read a vague internet comment that they know is a stranger, and know if they should talk to their doctor about their health conditions etc or not. I think they can decide for themselves if they want to try a vitamin regimen, that again, is over the counter and has recommended daily intakes by nutritionists so your body can function.

Further, there is no overdose range for vitamin k, as in, we haven't found an upper limit where it'll kill you, although if deficient in vitamin e, then blood clots can happen. COQ10 is likewise very safe.
https://pubmed.ncbi.nlm.nih.gov/19096117/

Vitamin E is pretty safe unless you macrodose it every day for a while, and even then, as long as you've got vitamin k (and in some weightlifters do vitamin C) on board it shouldn't be an issue. And again, I never said to macrodose or gave any dose, so why the shaming and policing?

Last, most overweight people are eating a lot of animal products that contain retinol type vitamin a instead of beta carotene type vitamin a found in plants. Because of the way retinol works, you HAVE to absorb it. To deal with the extra retinol, you need vitamin e and vitamin k, so you start craving fats. Then often people want meat and cheese or a pasta with meat, lasagna, pizza, etc, (which btw I eat too and I eat meat) and yeah they get some vitamin k in that, but not enough vitamin e to deal with the retinol. Which then causes stuff like eczema, allergies, pink irritated skin, dry skin, headache, high blood pressure, nausea, diarrhea - the stuff on the accutane side effects list.

So the craving continues and feeds itself. I used to be hungry AFTER I ATE and wished I could eat more, and that's not uncommon in people who eat caloric excess - because they actually DO need to eat something else.

If you take vitamin e, it treats vitamin a overdose symptoms relating to the skin sloughing off and heightened immune system issues. But also vitamin e should be given with vitamin k since vitamin k is relatively benign anyway and helps produce osteocalcin which helps people exercise and want to move/feel good moving.