Incretin-based therapies (such as Wegovy and Mounjaro) are a group of medications that work by targeting specific areas in your digestive system triggering a series of metabolic processes that help regulate your appetite and improve your body's ability to use insulin effectively. One of the key effects of these drugs is that they slow down the rate at which your stomach empties after a meal. This delay in emptying makes you feel fuller for longer, leading to reduced hunger and ultimately lower calorie intake.

However, it's important to note that these appetite-suppressing effects are temporary and will wear off once you stop taking the medication. So, while incretin-based therapies can be a helpful tool for weight management, their effects will reverse when the treatment stops.

Obesity and overweight are now thought of as long-term medical conditions, much like diabetes or hypertension; so the evidence is starting to suggest that they should be treated in the same way over a long period of time period

In other words, weight gain after stopping incretin-based therapy may occur in the same way that blood pressure may increase if a person stops antihypertensive tablets.

As we highlight in our article on the 'set point theory', evidence suggests that our bodies have a predetermined weight range that they naturally aim to maintain. When we start to lose weight and fall below this range, it triggers a series of responses that make it more challenging to sustain weight loss over the long term. In simple terms, it suggests that the body will put the brakes on when we lose weight beyond that range, in order to protect its fat stores which are there for emergencies!

However, during your time at Roczen you will have not only been taking your medication, but also establishing powerful new habits and making meaningful changes to your lifestyle. As our Psychologist, Dr Alves says, ‘repetition rewires the brain’, and the more you have been making these healthy choices, the more that this way of living will have become your new normal. Whilst you will likely notice an increase in appetite when you stop the medication, if you continue to implement all the tools you have learned at Roczen, you will be in a good position to maintain your results as best as possible.

Here are a few tips that, when followed diligently, can empower you to control weight regain after stopping the medication:

• Follow the general principles of the Roczen programme, maintaining the 16-hour fast and following a relatively low-carbohydrate diet, prioritising good-quality protein, fibre, and nutrient-rich foods.
• Keep active: 150 minutes weekly of a combination of moderate to vigorous activity will help to maintain your weight and overall health.
• Make good quality sleep a priority: ensure you are getting enough sleep and follow good sleeping hygiene habits.
• Keep up with fluid intake aiming for at least 2 to 2.5 litres of water or non-caffeinated drinks.
• Practi, paying attention and enjoying the present moment while eating.
• Reflect on changes to your appetite and food intake. You will likely feel hungrier so use the Hunger Scale and Food Diary regularly as additional tools.
• Be kind to yourself and acknowledge that some weight gain is normal and expected.
• Reach out to your Roczen network. Your clinicians, mentors, and fellow group members are here to support you.

Finally, once you have decided to stop the medication, ideally discuss with your clinician the option of doing it gradually so that you can practice the tips above progressively.

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