Muscle for Life with Mike Matthews - A Science-Backed Guide to the Most Popular Weight Loss Drugs

Episode Date: November 1, 2023

The market is flooded with claims of miracle weight loss pills and injections.  But which of these medications hold up under scrutiny?  In this episode, Mike discusses the science behind 7 prominent weight loss drugs, providing clarity on their effectiveness, potential side effects, and more. Timestamps: (0:00) - Please leave a review of the show wherever you listen to podcasts and make sure to subscribe! (0:40) - What Are Weight Loss Drugs, How Do They Work, and Why Are They Popular? (6:57) - What Is Orlistat and How Is It Used? (9:54) - How Effective Is Orlistat in Aiding Weight Loss? (12:32) - What Should You Know About Semaglutide? (14:41) - Are There Any Risks or Concerns with Using Semaglutide? (17:35) - Our Biggest Sale of the Year! Save 50% during our Black Friday Sale! https://buylegion.com/ (19:47) - How Does Phentermine Work for Weight Loss? (24:05) - What Is Plenity and What Benefits Does It Offer? (27:56) - What Are the Potential Side Effects of Plenity? (28:21) - How Does Liraglutide Function in Weight Loss? (30:34) - What Are the Side Effects and Risks of Liraglutide? (30:53) - What Is Naltrexone Bupropion and How Is It Used? (32:07) - Are There Side Effects or Risks with Naltrexone/Bupropion? (33:56) - How Does Tirzepatide Aid in Weight Loss? (35:27) - If I Stop Taking Weight Loss Medications, Will I Regain the Lost Weight? Mentioned on the Show: Our Biggest Sale of the Year Is Here! Save 50% during our Black Friday Sale. Go to https://buylegion.com/ and use coupon code MUSCLE to get double reward points!

Hello and welcome to Muscle for Life. Thank you for joining me today. I'm your host, Mike Matthews, and in this episode, I'm going to talk about seven popular weight loss drugs. And yes, it is going to include semaglutide, one that is probably the most popular currently, but I'm going to talk about six others as well and help you understand how they work, how well they work, potential side effects, and ultimately whether you should consider using any of these drugs or if you should just stick to the old eat less, move more, and stay patient. Okay, so before I get into the seven specific drugs I'm going to talk about today, I want to make a few comments on these types of drugs. So they work in various ways. Some of them help you

feel fuller sooner, so feel fuller on less food, on fewer calories. Others curb your appetite for food or curb your desire to eat large amounts of food or certain types of food. And that can help with cravings and other drugs. They make it harder for your body to absorb calories, particularly calories from fat in the food that you eat. Now, these drugs are designed to help people who are overweight or obese and have a lot of weight to lose. And therefore, doctors usually will only prescribe them if you are an adult with a BMI of weight to lose. And therefore, doctors usually will only prescribe them if you are an adult with a BMI of 30 or greater. So that's quite overweight or a BMI of 27 or greater. So moderately overweight, plus some sort of weight related health problem like high

blood pressure or type two diabetes. That said, many people who are not in either of those buckets get their hands on these drugs and want to use them to go from, let's say, fit to really fit or really fit to shredded. And that's one of the reasons I wanted to record this episode. I'm not trying to play doctor here, but I would like to inform as many of my listeners as I can about these drugs so they can think with the bigger picture if they are considering using any of them or maybe are currently using any of them and probably shouldn't be and so forth. Now, one of the most important things that you should know about these drugs is they cannot replace diet and exercise as an effective way to lose fat, especially to lose a large amount of fat and to keep it off. Most of the research I am going to share with you on these drugs in this episode shows that weight loss drugs are only effective when combined with physical activity and or healthy eating habits. So if you are thinking about

trying any of these drugs as a substitute for cleaning up your diet, for example, or following a meal plan, or at least loosely tracking your calories or macros, it's probably not going to work out. And the same thing goes for trying to use a weight loss drug to get around exercising. So some people are willing to restrict their calories. They're willing to do what's required on the diet side of the equation, but they really don't want to train. They're not willing to do even a couple of hours of strength training per week. They're not willing to do any cardio workouts. And they think maybe that they can take one of these drugs instead of the

exercise and that that can replace at least the calories that they would burn or the fat they would lose from the additional calories that they would burn through the workout. So instead of doing that, they think, well, maybe I can just take one of these drugs and thereby accelerate the results of my diet. And yes, that's true to a point. You can probably accelerate weight loss that way. But let's remember that the goal when you say you want to lose weight, it's not just to lose weight, it's to lose fat and not muscle. And if you're like many people, you don't just want to maintain the muscle you have. You actually would like to gain muscle during your weight loss phase if possible, especially if you're somebody who hasn't done much strength training. And so you have maybe a normal amount of muscle, which isn't very much,

or you have even less than that. And so then what can happen during a fat loss phase with no exercise, especially no strength training, is you can lose a lot of fat. You can lose a lot of weight. You can maybe lose even more fat and more weight with one of these drugs I'm going to talk about rather than without. However, you also will lose a fair amount of muscle. And if you do things very incorrectly, like heavily restricting calories and eating very little protein, you can lose a lot of muscle and that can leave you looking skinny fat. That's often how people end up skinny fat. Extended periods of dieting, sometimes extreme dieting, no strength training, very little protein, and they get their weight way down. They lose a lot of fat, but they also lose a lot of muscle. And the resulting look is

maybe better than overweight or obese, but not what they were going for, not fit and healthy and toned. Instead, there is still a layer of fat covering all muscle definition. Sometimes there are larger fat deposits, like in men, for example, they might still have a bit of a belly. They don't really have any abdominal definition. In women, it can be a bit more fat than they would like in their hips and thighs and butt, that area, at least in younger women. And then in older women, that fat distribution pattern shifts upward to a more male-like pattern. So as women get older, they will tend to, and this is just hormonally driven, they will tend to store more body fat in the abdominal region. And so you can have a skinny fat woman who doesn't look explicitly overweight, but who

lacks muscle definition in her arms and in her legs and also has a bit of a belly. And so if you are currently using any of these drugs or thinking about using any of these drugs, and if you go through with using any of these drugs, please don't try to use a drug to replace the fundamentals of proper diet and proper training. In a way, these drugs can be seen as supplemental to the diet and the exercise, just as natural fat loss supplements would be supplemental at best. And yes, as you will learn, these drugs work better than natural supplements, which is usually the case, but they still should be viewed as a supplement, not as a pillar of your weight loss program. Okay, let's talk first about the drug Orlistat, which is a prescription pill marketed under the name or brand name Xenical.

You can also buy it as an over-the-counter drug, and that brand name is Alli. And the difference is Alli is a smaller dose of Orlistat than Xenical. It's half the dose. So Alli is 60 milligrams, Xenical 120. And both versions, of course, work the same way because they are the same drug. And that is by preventing your body from absorbing fat that you eat. And of course, then absorbing calories in fat that you eat. And that can be significant because one gram of fat contains about nine calories, whereas one gram of carbohydrate contains about four calories, one gram of protein, about four calories. Also, the calories from fat are efficiently stored as body fat, very efficiently. Whereas the calories from carbohydrate are not efficiently stored as body fat, something

that many people don't know. Research shows that it actually takes a large and sustained calorie surplus from carbs to meaningfully contribute directly to fat gain. Now, it doesn't mean that you can't gain fat by overeating carbs. Ultimately, if you overeat calories consistently, you will gain body fat, but your body does process macronutrients differently. It processes protein, carbohydrate, and fat differently. And in the context of directly turning into body fat, dietary fat is the most fattening, so to speak. Carbohydrate is the second most fattening and protein is the third most fattening in that your body essentially cannot turn protein into dietary fat directly.

And so Orlistat's mechanism is pretty straightforward. If you absorb fewer of the calories from the dietary fat that you eat, you have a better chance of being in a calorie deficit or achieving a calorie deficit consistently enough and significantly enough to produce meaningful fat loss. But you'll notice that this mechanism does not directly induce fat loss. You can still screw it up by just eating too many calories from protein, from carbs, even from fat, because Olistat is not going to block all of the calories that you are getting from fat.

It's just going to block some of them. And specifically, research shows that it can block about 30% of the fat that you are getting from fat. It's just going to block some of them. And specifically, research shows that it can block about 30% of the fat that you eat. So 30% of the calories approximately from dietary fat will not be absorbed. You'll just poop them out instead. And it does that by inhibiting the action of enzymes that are in the digestive tract that break down dietary fats into smaller molecules that the body can use. So by blocking the enzymes, your body can't use the dietary fat and it just gets eliminated as useless waste, basically. Now, that sounds good enough if you're trying to lose fat, but practically speaking, does Orlistat work? Well, studies show that, yes, it does work. It

can work for aiding weight loss as well as weight loss maintenance. For example, a meta-analysis that was conducted by scientists at the University of Alberta found that on average, people who took Allie, so this is the 60 milligram, the over-the-counter version, people who took those pills and exercised regularly and followed a calorie-controlled diet. Important details going back to what I was saying earlier. They lost about three kilograms more than the people who just exercised, dieted and took placebo pills. Now, something worth noting is these were long trials, durations of one to several years. So an additional seven pounds or so of fat loss over the course of

a year even is nothing to celebrate per se. And those rather modest results are not surprising, right? Considering how Orlistat works. Again, it's going to block about 30% of the calories, the absorption of about 30% of the calories from the dietary fat that you're eating, which can be significant enough to enhance fat loss, but it is not going to be significant enough to drive an additional, let's say, pound of fat loss per week. I mean, if you just think about how much dietary fat you're eating on an average day and you calculate the calories, so take the grams, multiply that by nine approximate calories. And if your daily calorie deficit were increased by about 30% of that number, that is helpful, but not revolutionary. And so ultimately then your success is going to depend on your consistency

with your diet, hitting your calories, hitting your macros close enough, often enough, doing your workouts and so forth. Now, as for side effects, research shows that the most common side effects of orlistat are related to poop like oily stools, fecal urgency, increased bowel movements. And you can find some rather harrowing stories online, particularly of the fecal urgency type, where the need to go to the bathroom comes on fast and hard. And if you are not able to literally run to the toilet, you might have a disaster.

Now, that's not to say that you will shit yourself if you use Orlistat, but many people have or have come close. So you should just know that it's possible. Okay, let's move on to the next drug, the drug du jour semaglutide. So this is Ozempic, Wagovi, Ribelsis. And this is an injectable drug that is used to help people manage obesity, help with type 2 diabetes. And it works by mimicking the action of a hormone called glucagon-like peptide 1, GLP-1. And this is a hormone that regulates insulin secretion in the body. And when you introduce a lot of GLP-1 or a lot of a drug that mimics GLP-1's actions in the body, it suppresses appetite. And that, of course, then just helps you eat fewer calories and lose weight. And studies show that semaglutide does indeed enhance weight loss, especially when coupled

with a weight loss diet and regular exercise. For example, in one 68-week study that was conducted by scientists at the University of Liverpool, the researchers found that people who took semaglutide plus did a lifestyle intervention, diet exercise, lost quite a bit more weight than people who did the lifestyle intervention plus no semaglutide. So it was about 34 pounds lost versus just six pounds lost in the placebo group. And with that additional weight loss came better waistline measurements, obviously better blood pressure, blood sugar levels, cholesterol, inflammation levels, all things that go down as you lose weight. So to be clear there, it's not accurate to say that semaglutide will directly

reduce your blood pressure, your blood sugar, your cholesterol, your inflammation levels. But it is accurate to say if you are overweight or very overweight and you lose weight, that is going to do those things. And research shows that if you lose weight with the help of semaglutide, you will still experience those benefits. And if we look at results in several other studies, we see that semaglutide appears to be about as effective as bariatric surgery at boosting weight loss and at improving health as a consequence of aiding weight loss. And that is impressive.

And that's, of course, the main reason why semaglutide is so popular right now. However, many people who are promoting this drug are not talking about side effects and risks. So most people who take semaglutide will experience gastrointestinal issues, and that can include nausea, vomiting, stomach pain, diarrhea, constipation, although research shows that those types of side effects do seem to diminish with continued use. And as for risks, many experts believe that the risks are minimal, but some research has linked semaglutide use with an increased risk of thyroid cancer, pancreatitis, diabetic retinopathy, and gallbladder disease. What's more, using semaglutide can increase your risk of losing muscle because if you respond to it like most people, it makes

eating undesirable. Really, I have a couple of friends who tried it to lose some weight. They didn't need to. They were in the fit category, at least one of them, fit tried it to lose some weight. They didn't need to. They were in the fit category, at least one of them fit, wanting to get super fit. Well, super lean and not wanting to follow a meal plan or be consistent with his training and just wanting to try to magic bullet it with some aglutide. And it completely turned his appetite off. He didn't track calories, but in talking with him to get a sense of what his food journal might look like, he was probably between 500 and 1000 calories on many days. And most of those calories were carbs and fat. And so, yeah, he lost fat, but he also lost a fair amount of muscle. At the end of his little personal experiment,

he looked leaner, but he also looked smaller. And ironically, he didn't even look that much more defined because the fat loss was offset by the muscle loss. And ironically, in his case, the semaglutide actually put him in the hospital. And it was after he was drinking alcohol for several days in a row, which you're not supposed to do if you are using semaglutide. So after four days of drinking mild to moderate amounts of alcohol while on the drug, he had to go to the hospital. Now, I don't say those things to try to warn you off the drug completely, but you should

understand there are side effects. There are potential risks, there are unknowns. And so in my opinion, if you are relatively fit and you just want to lose a bit of body fat, you want to get a bit leaner, you want to get beach ready and you know how to do it, you've done it before, you have a fairly healthy relationship with food, just stick to the meal plan, stick to the tracking of calories and macros if you prefer to do it that way. Be consistent, get in the gym, do your workouts, stay patient, leave semaglutide out. If you like what I'm doing here on the podcast and elsewhere, and if you want to help

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and save big. That's builegion.com. And save big. Okay, the next drug on my list is Phentermine, which is a weight loss pill used for short-term weight loss with overweight and obese people. It's sold under a couple of brand names, Adipex P, Lamyra. And as for how it it works scientists are not quite sure actually they don't fully understand the mechanisms by which phentermine curbs appetite they just know that it curbs appetite the most plausible theory though is that it elevates the concentration of norepinephrine serotonin and dopamine in your brain and when these neurotransmitter levels rise, hunger typically falls. And less hunger means you generally eat less, means it's easier to stick to your diet,

which means it's easier to maintain that calorie deficit that drives weight loss. And as for efficacy, most research shows that phentermine does work. It does increase weight loss. On average, people taking phentermine for three to six months lose about three to seven percent of their body weight. So if you weigh 200 pounds, you could expect to lose maybe 10 to 14 pounds within six months. That said, that's also assuming that you know what you're doing with your diet and ideally you are including some exercise in your regimen. So those research results need to be understood through that lens. It's not as simple as take the drug and you're just going to lose 10 to 14, 15 pounds in your first six months. No, it means

that if you know how to set up a meal plan and you know how to stick to it fairly well, and you know how to stick to a decent exercise regimen, you may be able to get better results by adding phentermine because it's going to help you stick to your diet. It's going to help with dietary adherence. Now, that also means that if you are the type of person who doesn't usually have an issue with dietary adherence, if you are pretty good about hitting your calories consistently, you are not consistently overeating, you are not having crazy cheat meals or cheat days, then phentermine probably doesn't have that much to offer to you. And that would go for some aglutide as well. Orlistat may be able to help a little bit because you're able to take that adherence to your calories and macros

and get a little bit more out of it because now you're just absorbing fewer of those calories that you are consistently eating. But any drug or any supplement that primarily works by helping you manage hunger and manage cravings is only going to help you better stick to your diet. So if you're already really good at sticking to a diet, adding one of those drugs is not going to do much of anything. Now, something else you should know about phentermine is research shows that the effectiveness differs between individuals and it also diminishes over time. And so doctors usually recommend that people who are not seeing much of a change in their body composition after three months of taking Phentermine to just stop. And if you are looking into Phentermine in particular, you are probably also going to come across another drug that it is often paired with, Topiramate. And this is a drug

that's primarily used to treat seizures, but it also further suppresses appetite. And so research shows when you combine Topiramate with phentermine, you get even more appetite reduction. So for example, there was a 2021 meta-analysis that showed that people taking phentermine and tapiramate lost an average of about 17 pounds more than the people who were taking a placebo. And this was the result of analyzing various different trials with these drugs of varying durations. But the bottom line is people lost quite a bit more weight than taking a placebo when they took these two drugs together. And the same study also found that the more of the drugs that people took, the more weight they generally lost because the appetite reduction effects were stronger.

lost because the appetite reduction effects were stronger. Now, as for side effects of Phentiramine, the commonly reported ones are dry mouth, insomnia, dizziness, palpitations, flushing, fatigue, and constipation. And people respond to drugs differently. Some people experience no side effects whatsoever. Some people experience multiple and heavy side effects. All right, the next drug on the list is Planety, which is unlike the ones that I've discussed so far because it's not absorbed into the bloodstream. Instead, it functions in the stomach and the small intestine. And here's how it works. So these pills contain hydrogel particles made from cellulose and citric

acid. And you ingest the pills, the particles rapidly absorb water in your stomach, they expand, and then that makes you feel full. Many people don't know that food volume is more filling than calories, meaning a larger but lower calorie meal is generally going to be more filling than a smaller, higher calorie meal. And that's been shown in at least a few studies that I've seen, by the way, where researchers manipulated the volume and the calories of meals and found that when volume went up, satiety went up, even if calories went down. In one study, for example, researchers were using hamburger-based meals and using, if I remember correctly, using vegetables like tomato and lettuce to increase the volume of the hamburger meal that was eaten, but not significantly

increasing the calories of it. And in another study, there were smoothies that were being made with and without a fair amount of air being whipped into them. And so you had in one smoothie, let's just say 500 calories, and you had maybe 500 milliliters of volume, just making those numbers up, just keeping it simple. And then in another smoothie, you had maybe 400 or even 300 calories, but 750 milliliters because of air being whipped into the smoothie ingredients. And researchers found that the 750 milliliter smoothie, in the case of my made up numbers, was more filling, even though it had significantly fewer calories. And so anyway, coming back to Plenity, we have these little hydrogel particles. They expand in your stomach and then that can create a sensation

of fullness. So you would take them following a meal usually, and they would make you feel fuller longer, and then you would poop them out. Now, as for efficacy, evidence suggests that coupling Planety with a calorie-controlled diet and regular exercise can indeed facilitate more weight loss than just diet and exercise alone. For example, in a 24-week study that was published in the journal Obesity and funded by Planety's creator, which should be noted. That doesn't automatically mean it's bad research, but it should be noted. That is generally a red flag. So I'm just letting you know. But in this study, researchers found that people who supplemented with Planety shed an average of about 6.4% of their starting weight compared to about 4.4% in the placebo group. So pretty significant improvement there, about a 50%

improvement in weight loss. And additionally, in this study, about 60% of the people who took Planety lost about 5% of their weight, with 27% losing at least 10% of their initial weight. And 10% of initial weight in 24 weeks is quite good, especially when you look at average results among, let's say, normal dieters, people who don't understand many of the things you probably understand. And supporting that is the fact that researchers found about 42% of the participants taking the placebo pills lost 5% of their starting body weight, again, compared to 60% of the people who took Plenity, and about 15% shed 10% or more, compared to 27% of the Plenity supplementers.

Now, as for side effects, the most common side effects include gastrointestinal issues, as you could imagine. Bloating, gas, changes in bowel are the most common ones. However, because Planeti is not absorbed into the bloodstream, it is generally well-tolerated, and it doesn't have the potential systemic side effects that are common with other weight loss medications that do absorb into your bloodstream. Okay, next on the list is loraglitide, which is also sold under the brand names Saxenda and Victoza. And as you've probably guessed, loraglitide is similar to semaglitide. Loraglitide is an injectable drug. It's for managing weight, type 2 diabetes. And

like semaglitide, it is a GLP-1 receptor agonist. So it stimulates that GLP-1 receptor. And we recall that GLP-1 is a hormone that influences insulin secretion. And when we have large amounts of GLP-1 in our body, it suppresses appetite. So in the case of loraglitide, it has a similar effect when you're injecting this in your body as if you were injecting GLP-1. Now, it's not GLP-1, but because it has similar effects in the body, it can reduce appetite. And studies show that when it is used in conjunction with a calorie-controlled diet and regular exercise, and you hear me using that phrase again and again in this podcast for good reason,

those are the key components to weight loss. You have to know how to control your calories, maintain that calorie deficit, and regular exercise helps with that. And regular strength training in particular helps with improving body composition, making sure you don't lose a bunch of muscle while you are losing a bunch of fat. We want to get rid of the fat, not the muscle. And so anyway, studies show that loraglitide can assist overweight and obese people in losing weight and preventing weight regain. So for example, in a study that was published in JAMA, scientists found that people who followed a weight loss diet and exercise regimen and took loraglitide tended to lose between 5% to 6% of their body weight compared to about

2% of body weight in the case of people who took a placebo. What's more, up to 54% of people taking loraglitide lost at least 5% of their body weight compared to about 21% of people taking a placebo and up to about 25% of people taking the drug lost at least 10% of their body weight in the trials that were analyzed compared to just about 7% of people taking a placebo. So pretty significant results. Now, as for side effects and risks, research shows that loraglitide may increase your risk of pancreatitis and gallbladder and biliary disease. And it may also increase heart rate and cause gastrointestinal symptoms. Common ones are nausea, vomiting, constipation, and diarrhea. And the next drug on my list is naltrexone bupropion, also known as Contrave.

I'm just going to call it that to keep it simpler. And Contrave is a weight loss pill that contains two active compounds, the two that I mentioned, naltrexone, which is an opioid generally used to treat alcohol addiction and bupropion, which is a type of antidepressant. And as for mechanisms, researchers don't fully understand yet how Contrave works, but they believe that it affects the brain's reward system and that this can then help you control your food intake and avoid food cravings and overeating. And as for efficacy, studies show that combining a weight loss diet and an effective exercise regimen with Contrave can enhance weight loss and can do so above and beyond what you can get out of just diet and exercise alone. So for example, according to a review by scientists at

Boston University School of Medicine and Boston Medical Center, people who followed a calorie controlled diet exercise regularly and took Contrave for a year, lost an average of about 11 to 22 pounds. Now, as for side effects and risks, they include increased heart rate and blood pressure, nausea, constipation, headache, vomiting, dizziness, and insomnia. And that's a pretty standard list of side effects for those types of drugs. But I think the antidepressant should be given special consideration because of the amount of research that has come out in the last 10, especially the last five years on those types of drugs, psychotropic drugs of all kinds, showing that they are likely more dangerous than we've been led to believe. For example, research has come out in the last

year or so showing that the phrase chemical imbalance has been really nothing more than a marketing mantra, that in reality, there is no scientific basis for a chemical imbalance causing depression. Now, for a long time, though, doctors would say it, medical textbooks would say it, pharmaceutical advertisements would say it. And the message was very simple and very effective. Oh, you're depressed. Well, that's because there is a chemical imbalance in your brain. And so you just have to take this drug here that will fix the chemical imbalance and you will no longer be depressed. Well, it turns out they were wrong. Depression is not caused by a chemical imbalance

and so therefore cannot be corrected or cured by taking drugs that are supposed to resolve the imbalance. You can take drugs that make you feel better for a time. That you can do. You can use street drugs. Cocaine will do that for you. But you wouldn't say that cocaine is curing your depression. And so anyway, my point is with something like bupropion, I would be extra cautious. I personally would never choose that drug. If I had to choose one on the list, it would not be that one. Okay, let's move on to the final drug I want to discuss today, which is terzepatide, also known as Munjaro. That's the brand name. This is also an injectable medication. And like the other atides we have discussed, like loraglitide, semaglitide, terzepatide is a drug that mimics the effects of both GLP-1, which you learned about, and another hormone that has

similar effects in the body called glucose-dependent insulinotropic polypeptide. That's a mouthful, and that's why it's also just referred to as GIP. And so, like our other two attide drugs, terzepatide works by reducing appetite. And early research has shown promising results for this drug. For example, in one study published in the New England Journal of Medicine, dieters took either a small, moderate, or large dose of terzepatide or a placebo once per week for 72 weeks. And at the end of the study, the people who took the small dose of terzepatide lost an average of about 15% of their body weight.

People who took a moderate dose lost about 20%. And people who took the large dose lost about 21% of their body weight. And if we look at the placebo group, they lost about 3% of their body weight. So for some people, this drug can certainly help a lot. Now, as for side effects, it's similar to the two other attide drugs. Gastrointestinal disturbances are most common. Nausea, diarrhea, constipation.

But so far, it seems to be fairly well tolerated. Okay, so those are the seven drugs I wanted to discuss with you today. And to wrap up, I want to answer briefly a question that many people have asked me in relation to these different types of weight loss drugs, and that is, will I just regain some or all of the weight that I lose when I come off the drug? And yes, that can happen. And research shows that that can the right lifestyle habits, if you haven't used the drug as a means rather than an end, a means to getting used to eating well, getting used to exercising, getting results, creating that positive feedback loop, maybe improving your relationship with food and making some pretty big dietary changes.

If you haven't done those things, what is going to happen when your appetite returns to normal? Yes, you guessed it. Then you have the rebound. You have the post diet weight regain period that happens to many people who yo-yo diet and people who crash diet. They can somehow, some way force themselves to starve for a period and they can lose a bunch of weight, lose a bunch of fat, unfortunately lose a bunch of muscle. And then when they can no longer starve, they gorge themselves and often regain all of the weight that they've lost and even gain more. Many people, unfortunately, when we look at their body composition over time

and we look at their dietary practices, especially if they are the yo-yo type of dieter, their body fatness is slowly increasing over time and their total amount of lean mass is decreasing. And so that is exactly what can happen with any of these drugs that I have mentioned in today's podcast if they are not used properly. And using them properly, again, is using them in conjunction with effective dieting and effective training and hardwiring those habits. So when you come off of the drug, you may gain some weight back because your appetite may still be a bit outsized. But research shows that if you've done a good job addressing your lifestyle and you have firmly established the right habits in the kitchen, in the gym, then you can lose a ton of

weight and you can keep it all off. Well, I hope you liked this episode. I hope you found it helpful. And if you did, subscribe to the show because it makes sure that you don't miss new episodes. And it also helps me because it increases the rankings of the show a little bit, which of course then makes it a little bit more easily found by other people who may like it just as much as you. And if you didn't like something about this episode or about the show in general, or if you have ideas or suggestions or just feedback to share, shoot me an email, mike at muscleforlife.com, muscleforlife.com, and let me know what I could do better or just what your thoughts are about

maybe what you'd like to see me do in the future. I read everything myself. I'm always looking for new ideas and constructive feedback. So thanks again for listening to this episode and I hope to hear from you soon.