If you’re one of the hundreds of thousands now taking weight-loss jabs and are happily watching the numbers tumble on your bathroom scales, it can be seductively easy to think you’ll never be fat again.
I’ve lost nearly 2st on Mounjaro, taking me from 13st to a few pounds off 11st (I’m 5ft 7in), and I’m beyond delighted to be in the ‘healthy’ BMI category for the first time in decades. I love how the GLP-1 medication subdues my appetite and silences the food noise. It still seems miraculous to be able to say ‘no’ to cakes, desserts and biscuits (with not the slightest tinge of regret or temptation) and to push away a plate of half-eaten food at the first sign of feeling full.
I’m off all other medication (blood pressure tablets, steroid nasal spray for sleep apnoea and pain relief for arthritic joints) and feeling fitter and looking better now at 60 than I did at 40. I don’t remember the last time I was this happy in my skin.
But I’m dreading the arrival at my target weight – 11st – because I don’t want this journey to end. Honestly? I’m terrified of the hunger and the food noise returning, of slipping back into my old eating habits – scarfing family packs of salt and vinegar crisps, wine and peanuts in front of the TV, thick layers of butter on bread – and piling on the pounds once more.
Like many lifelong dieters, I lived with the perpetual disappointment and self-recrimination that comes when you find yourself with your head in the fridge late at night, or staring at the bottom of an empty ice cream carton. For the six months I’ve been taking the jabs, that nagging voice has been silent and I feel so calm without it.
I am well aware that studies show most people using GLP-1 medication regain much of their lost weight after they stop taking them. And, like me, most jabbers harbour a secret terror of losing control and getting fat when their drug regime ends.
Susan Jebb, professor of diet and population health at University of Oxford, is one of many experts who warns: ‘These drugs are very effective at helping you lose weight, but when you stop them, weight regain is much faster than [after stopping conventional] diets. Either people really have to accept this as a treatment for life, or we in science need to think really hard how to support people when they stop the drug.’
The tricky truth is you can’t just squeeze out the last drops from your final syringe and hope for the best. When those clever chemicals leave your body, your appetite and food noise will inevitably reappear with a vengeance, bringing the urge to eat the cakes, biscuits, pizza and burgers you’ve been so smugly avoiding.
Louise Atkinson lost 2st while using Mounjaro weight-loss jabs. Now she is ‘reverse dieting’
You need a plan.
You could rely on old-fashioned willpower to keep you on protein shakes and salads, but take away the magic of GLP-1s and it’s super-tough. Obesity experts repeatedly say that dieting is hard, but weight maintenance is harder.
Fortunately there is a scientifically proven path to ease you back into real-world eating habits and help you maintain your new-found slenderness that I’m keen to try.
The key lies in a trick used by body builders called ‘reverse dieting’, which they use to slowly readjust after being on special diets before a competition. The principle apparently works for coming off jabs too, allowing you to get back to normal meals without the risk of regaining fat. Here’s how…
FIRE UP YOUR SLUGGISH METABOLISM
The main reason so many people pile back the weight after a protracted period of dieting is – infuriatingly – because our bodies become remarkably efficient at sucking the most out of the tiny morsels we’ve been feeding it.
This can mean that eating half as much as you used to eat pre-diet could be enough to tip you back into weight gain.
When you seriously restrict your food intake, your bodily functions slow down and your basal metabolic rate (BMR) – the amount of energy you need when at rest – drops too.
It’s called metabolic adaptation – the body cleverly adjusts to the lack of food by burning fewer calories – and it explains why dieters often feel cold and why jabbers might notice a drop in general energy levels. Studies show that dieters even fidget less.
The big problem is, if you go straight back to eating normal portion sizes, snacks and treats while your body is in this state, there’s a strong chance you’ll rapidly gain weight. But if done correctly, reverse
dieting can flip that metabolic adaptation, allowing you to eat proper non-diet quantities of food without regaining weight.
LEARN FROM PRO BODY BUILDERS
When they are preparing for a Mr Universe-style competition, bodybuilders typically ‘bulk’ by eating far more food than their body needs and training very hard so all that food energy is pumped into creating maximum muscle.
Then, in the weeks before their big reveal, they’ll go on a strict diet (the ‘cut’) to strip their body of fat so their newly pumped muscles can be impressively displayed on the day. They know that this strict diet phase will make their metabolic rate slow right down, and if they jump straight back to normal eating patterns when the competition is over the extra calories will just pile on as body fat.
So, instead, they switch to a process of reverse dieting to nudge their BMR back up to normal.
Quite simply, reverse dieting means reintroducing foods in a slow, controlled way, helping you restore hormonal balance and energy levels so your body gradually readjusts to happily burning more calories again.
Get this right when you’re coming off GLP-1 jabs, and the best news of all is that your calorific sweet spot – the number of calories you need to maintain weight loss – will end up higher than it was when you stopped taking the medication.
‘You could think of it as giving your body time to catch up, especially if you’re rebuilding muscle in the gym and rebalancing hunger signals,’ says registered nutritionist Rob Hobson, who is the author of Unprocess Your Life.
‘It’s not a magic fix, but it’s a smart, structured way to transition out of a calorie deficit.
‘This approach can help prevent rebound eating, support your metabolism, and reduce the mental pressure around going back to a normal non-jab way of life.’
Louise before she started using fat jabs. Now she is around 11st
HOW TO START REVERSE DIETING
Body builders are familiar with the intense discipline required to go through the ‘cut’ and then a process of reverse dieting afterwards, but weight-loss experts say you can make the process easier by planning for this phase in advance.
Dr Claire Madigan, a senior lecturer in the School of Sport, Exercise and Health Sciences at Loughborough University, tells me that people who are most successful at maintaining weight loss are those who used their original diet plan to form healthy new habits (in terms of portion size, limiting treats, snacking less, reducing alcohol consumption and exercising regularly).
‘Ingrained habit is much less likely to be affected by temptation and inevitable fluctuations in motivation,’ she points out.
This means taking advantage of the appetite suppression provided by the jabs to instigate good, healthy-eating habits which you can rely on afterwards. On a healthy jab regime you should be reducing your intake of highly processed foods, getting into a rhythm of three small meals a day, or introducing a bit of intermittent fasting and skipping breakfast. Then, as you get close to your weight-loss goal, follow the jab manufacturer’s instructions to start to slowly reduce your dose to the point where you can come off completely.
Now you are ready to start reverse dieting.
Body builders will tell you the key to success is patience – you need to increase your food intake very slowly and resist all temptation of a post-diet blow out.
First, calculate your baseline daily calorie intake – the amount of calories you eat each day when you arrive at your target weight. Just write down everything that passes your lips and use a tracking app to add up the calories.
For me, that’s around 1,200 calories. Then, on the first day without the jabs, add an extra 50-100 calories to that total, and repeat each day for a week.
So for me, that means sticking to a daily total of 1,250 or 1,300 calories per day. It is only a very small increment – just one apple or a tablespoon of peanut butter on top of what you were eating when you were losing weight.
The following week you can add another 50-100 calories.
As your BMR gradually rises, so will your energy levels, which become a little more active generally without even noticing, burning more calories naturally in the process.
KEEP TRACK OF YOUR PROGRESS
Studies show that jumping on the scales on a regular basis helps keep you on track, and many people find a tracking app (such as MyFitnessPal) useful.
The TeamRH app (teamrhfitness.com) has a specialised GLP-1 Reverse Diet programme which guides you through the process, albeit for £7.99 per month.
No matter how tempted you might be to allocate your extra calories to chocolate (one 10g square is around 54 calories) it is important to make these extra calories count nutritionally.
Hobson recommends focusing on reintroducing nutrient-dense foods that provide essential vitamins and minerals while supporting your metabolism and overall health. He says the extra calories you take on board should be in the form of protein (extra eggs, a larger portion of chicken) and fibre (salad, vegetables and pulses).
Healthy food tends to be lower in calories, so you can eat more, and hopefully feel fuller to dampen down the return of hunger and cut the risk of sugar-chasing cravings that come with the return of food noise.
As the process continues, he suggests introducing small quantities of healthy complex carbohydrates (wholegrain seeded bread and crackers, sweet potatoes, bananas, butternut squash, brown rice) and also healthy fats (avocado, smoked salmon, nuts and seeds).
Research suggests that the time the body needs to ‘recover’ from dieting might be roughly proportional to the amount of time you spent dieting.
So if you were on the jabs for six months, as I have been, you might need to give your metabolism six months to adjust – nudging your calorie intake up by 50-100 calories a day in weekly increments.
This means after one month of reverse dieting I will have added 200-400 calories to my daily total, which then becomes a more manageable 1,400-1,600. After three months I should be able to maintain my new slender figure on 1,800-2,400 calories a day.
Everyone reacts differently. And the word in the body building world is the older you are, the more difficult and slower the process is.
It’s clearly not easy, and this highly structured rules-based method of returning to normal eating might not suit everyone, but it gives useful parameters within which to work and guidelines to help you stand up to the food noise.
Regular exercise – and particularly strength training – is also an important part of the reverse dieting process, because the activity and muscle-building will help to boost your metabolism, allowing you to eat more without gaining fat.
‘Consistency is more important than intensity,’ says Dr Madigan.
Research suggests you should try to get at least 250 minutes of exercise each week to maintain weight loss. And a study published last year by Dr Madigan and her team found those more likely to stick with exercise were those who ‘found it enjoyable, prioritised it, and integrated it into their daily routine’.
EATING A BIT LESS – FOR EVER
Even though reverse dieting can slowly nudge your BMR back up from the ‘must protect this body from starvation’ rates, it can drop when you are on the jabs.
Dr Madigan points out that when I reach my new post-diet equilibrium, staying slim means I will never be able to return to the portion sizes or eating habits that caused me to gain weight in the first place. ‘You will have to accept that you can never eat like you used to,’ she says.
She explains that my body is smaller now, so simply needs less fuel to function.
So if you’ve successfully lost 20 per cent of your body weight, the portion of spaghetti bolognese that you routinely serve yourself for dinner will have to be at least 20 per cent smaller to keep in line with your body’s new fuel requirements. Indeed, if you were steadily gaining weight before the diet, your old pasta bowl was probably far too large and you’ll need to get used to eating even less, perhaps two-thirds the size of your old portion (for ever!) if you don’t want to see the weight creeping back on.
Nutrition experts at the University of Colorado have calculated that a weight loss of 2.5st creates an energy gap of approximately 320 calories a day. This means to maintain your newfound slenderness, you’d need to eat 320 calories a day less than you did before you lost weight – indefinitely.
As long as you are prepared to apply some effort and focus, it should be possible to maintain your cherished new body shape without having to rely on an endless jab prescription – and the health gains will certainly be worth it.
‘Coming off GLP-1 medication is not a return to square one,’ says Hobson, ‘It’s the next phase of your journey.’
But I might keep an emergency Mounjaro pen in my fridge for a sly boost once in a while – just in case.
