four months ago, I wrote about losing 40 pounds on mounjaro and wondered how I would do without the drug. It’s been an odyssey of binges, diets and exercise, but I’ve kept the weight off.
My food cravings came back at first with a whimper, then with a bang. I noticed them about three weeks after I took my last dose of a blockbuster medicine that helped me lose 40 pounds with shocking ease.
During the five months that I took mounjaro, I had experienced what felt like freedom. My usual internal greek chorus of a thousand voices, always telling me to eat, had been silent. French fries, doughnuts and frosted flakes no longer called to me. Then, I stopped taking the drug, a common choice for those using medicines like mounjaro or ozempic to lose weight. Cost was a primary factor; I was paying $1,000 a month myself because most insurance generally covers the drugs only for their primary use, combating diabetes. And despite the weight loss, I felt ambivalent about the idea of relying on the pharmaceutical help for life, as the drug makers recommend.
Then came the challenges of the next four months: a roulette wheel of binges, diets, exercise regimens and mental and emotional battles with myself over will power, self-image and motivation. It was remarkably like the struggles of overeating without taking a wonder drug first, though with one important difference: that wonder drug had given me the gift of a 40-pound head start, to either seize upon or squander.
In my case, there was a surprise revelation to process as well. After I published an essay in the wall street journal in january about my weight-loss experience, my mother disclosed to me that she had been taking ozempic, then mounjaro, herself for more than a year. She lost just about as much weight as I did, but as the milestone of her 80th birthday approached, she sought to lose more—“I wanted to feel well,” she told me—so she opted to raise her dose, despite the daily bouts of nausea and gastric discomfort that followed.
She recounted for me her own experience with a lifetime of battling obesity, starting from her senior year in high school when she lost 15 pounds for graduation photos. Over the decades, she turned to one crash diet after another and seesawed in weight more than a dozen times. In her later years, she has endured almost constant pain from a variety of conditions, all made worse by her weight. Lately, she has also been racked with guilt over feelings of having passed such issues and struggles along to me, whether by nature or nurture. “I should have protected you from that,” she said.
As we talked, we bonded over the difficult duality of being overweight or obese: often, you wish that you didn’t care and pledge that you can love yourself as you are. But then you start to wonder: could I change?
Something like that has motivated the millions taking mounjaro, ozempic and similar drugs purely for weight loss. As the drugs’ popularity has surged, a number of clinical studies have shown that those who stop taking them can regain the lost pounds at a rapid clip. That has led drug manufacturers eli lilly and novo nordisk to recommend that patients stay on the medicines, perhaps for life. But most people are quitting: a recent analysis of thousands of insurance claims found that only a third of individuals who started such drugs for weight-loss were still taking them after a year.
‘my mother disclosed to me that she had been taking ozempic, then mounjaro, herself for more than a year. “I wanted to feel well,” she told me.’ photo: brandi flowers
Some people do get sustained benefits. In a study by epic research, more than half of participants either maintained their weight, or had lost more, a year after stopping the medicines; one in five had even doubled their weight loss. I was determined to be one of the success stories and to figure out what to do to keep the drug’s effects from fading.
‘since I was at the lowest weight I had seen in years, I decided to try out a new look. For years, I had imagined that a new style and wardrobe would complete my pygmalion story.’
When I stopped the mounjaro, tortilla chips and salsa were the first “bad” food I wanted again. I only ate a handful at first, a minor dalliance. But within a few weeks, the dam started to break. After eating a normal-size salad for lunch while at work, I started feeling hungry about an hour later. I avoided snacking, but the cravings only grew. By dinner, I felt famished and ate to excess as soon as I got home: not one but two plates of spaghetti, which I chased down with another round of chips and salsa. It was a familiar, and crushing, pattern. Within two months I gained back 5 pounds and wondered: is this, already, when the music dies?
There was one clear bright spot: I had been liberated from an addiction to sugar, a miracle that has brought tremendous joy and relief. Since ending my course of mounjaro, I still can’t finish a doughnut. And because I no longer want sugar on everything I eat (I used to put it on strawberries—or even already sugar-laced breakfast cereal), a lot of naturally sweet food is wonderful again. (even so, I also adopted a sugar substitute, allulose, which helped reduce nighttime hunger pangs—it occurs naturally in foods such as figs and has about 70% of the sweetness of regular sugar.)
With my sweet tooth defanged, I started to research what I could do to feel more full—-to essentially replicate the effect of the medicine. Thus began what felt like an obsession with high-protein foods. In some scientific studies, diets higher in protein have been shown to help eaters feel full. They also complement weightlifting or resistance training, which research has shown can help reduce the risk of regaining weight after a period of dramatic weight-loss. After consulting with a friend and personal trainer, I set a high target of 150 grams of protein a day, above normal u.S. Government recommendations but in a range aimed at people on resistance training trying to retain muscle mass.
At first, it worked. The more protein I had, the less hungry I felt. It offered a respite from the voices. I ramped up my exercise to about 12 hours a week, half of it in the weight room, and started eating meat and cheese like a heavyweight champ. Steak and eggs in the morning, buffalo chicken and rice for lunch and brisket for dinner. I replaced chips and salsa with jicama and high-protein cottage cheese. It felt like I had beef jerky and peanuts or cashews all day long, and when I wasn’t eating those I was dousing one thing after another in protein powder.
Eventually, I got meat fatigue: it got harder and harder to eat that second or third helping of dried, barbecue-flavored korean pork. I started looking to fiber, which also helps increase satiety. Avocados, blueberries and certain other fruits and vegetables were a much-needed respite from protein, and ultimately I reduced my protein goal by half and instead tried to keep the calories lower—a little under 1,800 a day.
So far, the hard work has been successful. I lost back the 5 pounds, and I’m still at roughly my post-mounjaro weight. Recently, I began training to summit mount whitney, california’s tallest peak, which will require even more exercise and may lead to even more weight loss, if the past is a benchmark.
Even so, I’m staying cautious. I didn’t get rid of my too-big clothes until just last week—a ritual that always fills serial dieters like me with a peculiar combination of excitement and dread. The dread comes from the question: how long will it be before any new and lovely clothes I buy won’t fit anymore? Still, since I was at the lowest weight I had seen in years, I decided to try out a new look. I emulated former apple designer jony ive by shaving my head and trimming my beard down to stubble and by adopting fitted t-shirts. My kids were unimpressed. I had to admit they weren’t wrong. For years, I had imagined that a new style and wardrobe would complete my pygmalion story. But there I was being teased mercilessly by my 13-year-old son. I’m letting the hair grow back now.
Overall, I found myself feeling more conflicted about my gaunter self. Having pined to be thin for so long, once it became somewhat routine, I was surprised to be a little underwhelmed.
My feeling reminded me of a great scene from “lonesome dove,” the pulitzer prize-winning novel by larry mcmurtry. I remember gus, an old texas ranger played by robert duvall in the tv miniseries, comforting a paramour who can’t let go of her dream of being a “fancy lady” in san francisco. “life in san francisco is still just life,” gus says in the book. “if you want one thing too much it’s likely to be a disappointment.” he urges her, instead, “to learn to like all the everyday things,” like a soft bed or a glass of buttermilk.
Life as a thin person trying to stay that way, it turns out, is like that—still just life. The same struggles, the same need to enjoy the little things to compensate. The pygmalion story goes on.
