Relationships: When To Stick It Out & When To Call It Quits
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Like A Ship Loves An Anchor?
Today’s article may seem a little bit of a downer to start with, but don’t worry, it picks up again too. Simply put, we’ve written before about many of the good parts of relationships, e.g:
Only One Kind Of Relationship Promotes Longevity This Much!
…but what if that’s not what we have?
Note: if you have a very happy, secure, fulfilling, joyous relationship, then, great! Or if you’re single and happy, then, also great! Hopefully you will still find today’s feature of use if you find yourself advising a friend or family member one day. So without further ado, let’s get to it…
You may be familiar with the “sunk cost fallacy”; if not: it’s what happens when a person or group has already invested into a given thing, such that even though the thing is not going at all the way they hoped, they now want to continue trying to make that thing work, lest their previous investment be lost. But the truth is: if it’s not going to work, then the initial investment is already lost, and pouring out extra won’t help—it’ll just lose more.
That “investment” in a given thing could be money, time, energy, or (often the case) a combination of the above.
In the field of romance, the “sunk cost fallacy” keeps a lot of bad relationships going for longer than perhaps they should, and looking back (perhaps after a short adjustment period), the newly-single person says “why did I let that go on?” and vows to not make the same mistake again.
But that prompts the question: how can we know when it’s right to “keep working on it, because relationships do involve work”, as perfectly reasonable relationship advice often goes, and when it’s right to call it quits?
Should I stay or should I go?
Some questions for you (or perhaps a friend you might find yourself advising) to consider:
- What qualities do you consider the most important for a partner to have—and does your partner have them?
- If you described the worst of your relationship to a close friend, would that friend feel bad for you?
- Do you miss your partner when they’re away, or are you glad of the break? When they return, are they still glad to see you?
- If you weren’t already in this relationship, would you seek to enter it now? (This takes away sunk cost and allows a more neutral assessment)
- Do you feel completely safe with your partner (emotionally as well as physically), or must you tread carefully to avoid conflict?
- If your partner decided tomorrow that they didn’t want to be with you anymore and left, would that be just a heartbreak, or an exciting beginning of a new chapter in your life?
- What things would you generally consider dealbreakers in a relationship—and has your partner done any of them?
The last one can be surprising, by the way. We often see or hear of other people’s adverse relationship situations and think “I would never allow…” yet when we are in a relationship and in love, there’s a good chance that we might indeed allow—or rather, excuse, overlook, and forgive.
And, patience and forgiveness certainly aren’t inherently bad traits to have—it’s just good to deploy them consciously, and not merely be a doormat.
Either way, reflect (or advise your friend/family member to reflect, as applicable) on the “score” from the above questions.
- If the score is good, then maybe it really is just a rough patch, and the tools we link at the top and bottom of this article might help.
- If the score is bad, the relationship is bad, and no amount of historic love or miles clocked up together will change that. Sometimes it’s not even anyone’s fault; sometimes a relationship just ran its course, and now it’s time to accept that and turn to a new chapter.
“At my age…”
As we get older, it’s easy for that sunk cost fallacy to loom large. Inertia is heavy, the mutual entanglement of lives is far-reaching, and we might not feel we have the same energy for dating that we did when we were younger.
And there may sometimes be a statistical argument for “sticking it out” at least for a while, depending on where we are in the relationship, per this study (with 165,039 participants aged 20–76), which found:
❝Results on mean levels indicated that relationship satisfaction decreased from age 20 to 40, reached a low point at age 40, then increased until age 65, and plateaued in late adulthood.
As regards the metric of relationship duration, relationship satisfaction decreased during the first 10 years of the relationship, reached a low point at 10 years, increased until 20 years, and then decreased again.❞
Source: Development of Relationship Satisfaction Across the Life Span: A Systematic Review and Meta-Analysis
And yet, when it comes to prospects for a new relationship…
- If our remaining life is growing shorter, then it’s definitely too short to spend in an unhappy relationship
- Maybe we really won’t find romance again… And maybe that’s ok, if w’re comfortable making our peace with that and finding joy in the rest of life (this widowed writer (hi, it’s me) plans to remain single now by preference, and her life is very full of purpose and beauty and joy and yes, even love—for family, friends, etc, plus the memory of my wonderful late beloved)
- Nevertheless, the simple fact is: many people do find what they go on to describe as their best relationship yet, late in life ← this study is with a small sample size, but in this case, even anecdotal evidence seems sufficient to make the claim reasonable; probably you personally know someone who has done so. If they can, so can you, if you so wish.
- Adding on to that last point… Later life relationships can also offer numerous significant advantages unique to such (albeit some different challenges too—but with the right person, those challenges are just a fun thing to tackle together). See for example:
An exploratory investigation into dating among later‐life women
And about those later-life relationships that do work? They look like this:
this one looks like the title says it all, but it really doesn’t, and it’s very much worth at least reading the abstract, if not the entire paper—because it talks a lot about the characteristics that make for happy or unhappy relationships, and the effect that those things have on people. It really is very good, and quite an easy read.
See again: Healthy Relationship, Healthy Life
Take care!
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Boundary-Setting Beyond “No”
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More Than A “No”
A lot of people struggle with boundary-setting, and it’s not always the way you might think.
The person who “can’t say no” to people probably comes to mind, but the problem is more far-reaching than that, and it’s rooted in not being clear over what a boundary actually is.
For example: “Don’t bring him here again!”
Pretty clear, right?
And while it is indeed clear, it’s not a boundary; it’s a command. Which may or may not be obeyed, and at the end of the day, what right have we to command people in general?
Same goes for less dramatic things like “Don’t talk to me about xyz”, which can still be important or trivial, depending on whether the topic of xyz is deeply traumatizing for you, or mildly annoying, or something else entirely.
Why this becomes a problem
It becomes a problem not because of any lack of clarity about your wishes, but rather, because it opens the floor for a debate. The listener may be given to wonder whether your right to not experience xyz is greater or lesser than their right to do/say/etc xyz.
“My right to swing my fist ends where someone else’s nose begins”
…does not help here, firstly because both sides will believe themself (or nobody) to be the injured party; for the fist-swinger, the other person’s nose made a vicious assault on their freedom. Or secondly, maybe there was some higher principle at stake; a reason why violence was justified. And then ten levels of philosophical debate. We see this a lot when it comes to freedom of expression, and vigorous debate over whether this entails freedom from social consequences of one’s words/actions.
How a good boundary-setting works (if this, then that)
Consider two signs:
- No trespassing!
- Trespassers will be shot!
Superficially, the second just seems like a more violent rendition of the first. But in fact, the second is more informationally useful: it explains what will happen if the boundary is not respected, and allows the reader to make their own informed decision with regard to what to do with that information.
We can employ this method (and can even do so gently, if we so wish and hopefully we mostly do wish to be gentle) when it comes to social and interpersonal boundary-setting:
- If you bring him here again, I will refuse you entrance
- If you bring up that topic again, I will ask you to leave
- If you do that, I will never speak to you again
- If you don’t stop drinking, I will divorce you
This “if-this-then-that” model does the very first thing that any good boundary does: make itself clear.
It doesn’t rely on moral arguments; it doesn’t invite debate. For example in that last case, it doesn’t argue that the partner doesn’t have the right to drink—it simply expresses what the speaker will exercise their own right to do, in that eventuality.
(as an aside, the situation that occurs when one is enmeshed with someone who is dependent on a substance is a complex topic, and if you’re interested in that, check out: Codependency Isn’t What Most People Think)
Back on track: boundary-setting is not about what’s right or good—it’s about nothing more nor less than a clear delineation between what we will and won’t accept, and how we’ll enforce that.
We can also, in particularly personal boundary-setting (such as with sexual boundaries’ oft-claimed “gray areas”), fix an improperly-set boundary that forgot to do the above, e.g:
“How about [proposition]?”
“No thank you” ← casually worded answer; contextually reasonable, and yet not a clear boundary per what we discussed above
“Come on, I think you’d like it”
“I said no. No means no. Ask me again and I will [consequences that are appropriate and actionable]”What’s “appropriate and actionable” may vary a lot from one situation to another, but it’s important that it’s something you can do and are prepared to do and will do if the condition for doing it is met.
Anything less than that is not a boundary—it’s just a request.
Note: this does not require that we have power, by the way. If we have zero power in a situation, well, that definitely sucks, but even then we can still express what is actionable, e.g. “I will never trust you again”.
“Price of entry”
You may have wondered, upon reading “boundary-setting is not about what’s right or good—it’s about nothing more nor less than a clear delineation between what we will and won’t accept, and how we’ll enforce that”, can’t that be used to control and manipulate people, essentially coercing them to do or not do things with the threat of consequences (specifically: bad ones)?
And the answer is: yes, yes it can.
But that’s where the flipside comes into play—the other person gets to set their boundaries, too.
For all of us, if we have any boundaries at all, there is a “price of entry” and all who want to be in our lives, or be close to us, have to decide for themselves whether that price of entry is worth it.
- If a person says “do not talk about topic xyz to me or I will leave”, that is a price of entry for being close to them.
- If you are passionate about talking about topic xyz to the point that you are unwilling to shelve it when in their presence, then that is the price of entry for being close to you.
- If one or more of you is not willing to pay the price of entry, then guess what, you’re just not going to be close.
In cases of forced proximity (e.g. workplaces or families) this is likely to get resolved by the workplace’s own rules (i.e. the price of entry that you agreed to when signing a contract to work there), and if something like that doesn’t exist (such as in families), well, that forced proximity is going to reach a breaking point, and somebody may discover it wasn’t enforceable after all.
See also: Family Estrangement: More Common Than Most People Think
…which also details how to fix it, where possible.
Take care!
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A drug that can extend your life by 25%? Don’t hold your breath
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Every few weeks or months, the media reports on a new study that tantalisingly dangles the possibility of a new drug to give us longer, healthier lives.
The latest study centres around a drug involved in targeting interleukin-11, a protein involved in inflammation. Blocking this protein appeared to help mice stave off disease and extend their life by more than 20%.
If only defying the ravages of time could be achieved through such a simple and effort-free way – by taking a pill. But as is so often the case, the real-world significance of these findings falls a fair way short of the hype.
Halfpoint/Shutterstock The role of inflammation in disease and ageing
Chronic inflammation in the body plays a role in causing disease and accelerating ageing. In fact, a relatively new label has been coined to represent this: “inflammaging”.
While acute inflammation is an important response to infection or injury, if inflammation persists in the body, it can be very damaging.
A number of lifestyle, environmental and societal drivers contribute to chronic inflammation in the modern world. These are largely the factors we already know are associated with disease and ageing, including poor diet, lack of exercise, obesity, stress, lack of sleep, lack of social connection and pollution.
While addressing these issues directly is one of the keys to addressing chronic inflammation, disease and ageing, there are a number of research groups also exploring how to treat chronic inflammation with pharmaceuticals. Their goal is to target and modify the molecular and chemical pathways involved in the inflammatory process itself.
What the latest research shows
This new interleukin-11 research was conducted in mice and involved a number of separate components.
In one component of this research, interleukin-11 was genetically knocked out in mice. This means the gene for this chemical mediator was removed from these mice, resulting in the mice no longer being able to produce this mediator at all.
In this part of the study, the mice’s lives were extended by over 20%, on average.
Another component of this research involved treating older mice with a drug that blocks interleukin-11.
Injecting this drug into 75-week old mice (equivalent to 55-year-old humans) was found to extend the life of mice by 22-25%.
These treated mice were less likely to get cancer and had lower cholesterol levels, lower body weight and improved muscle strength and metabolism.
From these combined results, the authors concluded, quite reasonably, that blocking interleukin-11 may potentially be a key to mitigating age-related health effects and improving lifespan in both mice and humans.
Why you shouldn’t be getting excited just yet
There are several reasons to be cautious of these findings.
First and most importantly, this was a study in mice. It may be stating the obvious, but mice are very different to humans. As such, this finding in a mouse model is a long way down the evidence hierarchy in terms of its weight.
Research shows only about 5% of promising findings in animals carry over to humans. Put another way, approximately 95% of promising findings in animals may not be translated to specific therapies for humans.
Second, this is only one study. Ideally, we would be looking to have these findings confirmed by other researchers before even considering moving on to the next stage in the knowledge discovery process and examining whether these findings may be true for humans.
We generally require a larger body of evidence before we get too excited about any new research findings and even consider the possibility of human trials.
Third, even if everything remains positive and follow-up studies support the findings of this current study, it can take decades for a new finding like this to be translated to successful therapies in humans.
Until then, we can focus on doing the things we already know make a huge difference to health and longevity: eating well, exercising, maintaining a healthy weight, reducing stress and nurturing social relationships.
Hassan Vally, Associate Professor, Epidemiology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Blackberries vs Grapes – Which is Healthier?
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Our Verdict
When comparing blackberries to grapes, we picked the blackberries.
Why?
It’s not even close:
In terms of macros, blackberries have more than 5x the fiber, for about half the carbs, resulting in a notably lower glycemic index. They also have more than 2x the protein, but unlike the fiber, it’s not much in either fruit, so we might disregard it. Still, an easy win for blackberries either way.
In the category of vitamins, blackberries have more of vitamins A, B3, B5, B9, C, E, K, and choline, while grapes have more of vitamins B1, B2, and B6. Another clear win for blackberries.
When it comes to minerals, blackberries have a lot more calcium, copper, iron, magnesium, phosphorus, selenium, and zinc, while grapes have slightly more manganese and potassium. Once again, blackberries emerge victorious.
Looking at polyphenols, both have an abundance of many polyphenols, but blackberries have more, both in types and in total mass (mg/100g).
Thus, blackberries overwhelmingly win the day, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Can We Drink To Good Health? ← while there are polyphenols such as resveratrol in red wine that per se would boost heart health, there’s so little per glass that you may need 100–1000 glasses per day to get the dosage that provides benefits in mouse studies.
If you’re not a mouse, you might even need more than that!
To this end, many people prefer resveratrol supplementation ← link is to an example product on Amazon, but there are plenty more so feel free to shop around 😎
Enjoy!
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Are Fruit & Vegetable Extract Supplements Worth It?
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At 10almonds we are always extolling the virtues of fruits and vegetables, but how much do those benefits still exist when we’re looking at a fruit and vegetable extract supplement?
We examined one aspect of this previously, here;
Mediterranean Diet… In A Pill?
This looked at getting the anti-inflammatory benefits of the Mediterranean diet, in supplement form, by providing extracts of 16 key plant extracts—which also provides an excellent shopping list, by the way, if you just want to skip the supplements and buy those plants; if nine top scientists (anti-aging specialists, neurobiologists, pharmacologists, and at least one professor of applied statistics) came to the conclusion that to get the absolute most bang-for-buck possible, those are the plants to get the phytochemicals from, then we’re not going to ignore that!
And yes, the short answer was “it does very significantly improve anti-inflammatory markers”, by the way.
But when it comes to benefits from polyphenols, anti-inflammatory powers are very much “low-hanging fruit”, so to speak. It’s the “fork found in kitchen” level of shocking revelation. It’s what polyphenols are best at (tied with antioxidant powers, which directly mediate their anti-inflammatory powers).
So, what about something more challenging, like brain benefits?
Underrated Brain Boosters
A European research team (Dr. Begoña Cerdá et al.) looked at the effects of polyphenol-rich nutraceuticals (plant extracts) on cognitive function and neuroprotection biomarkers.
It was a randomized, crossover, double-blind, sex-stratified, placebo-controlled clinical trial that had people take the supplement or a placebo for 16 weeks, have a 4-week washout phase (to minimize leftover effects contaminating the data) and then switching groups (still blinded to the placebo control) for 16 weeks.
They tested cognitive function and neuroprotection biomarkers in various ways before and after each of the testing phases (so, four testing sessions in total per person: before and after the supplement + before and after the placebo).
The results:
❝The results suggested that participants who consumed the polyphenol-rich nutraceutical demonstrated significant improvements in cognitive performance compared to the placebo group.
The Stroop Test scores indicated enhanced attention and inhibitory control, while RIST results suggested improvements in logical reasoning and memory. The Trail Making Test also revealed increased cognitive flexibility, highlighting the supplement’s potential to boost overall mental agility.
Furthermore, the ELISA results showed a notable increase in BDNF and CREB levels among participants who took the active supplement. BDNF is a protein that is essential for neuronal growth and survival, and its levels were significantly elevated, reinforcing its role in synaptic plasticity and long-term memory formation.
Additionally, CREB, a transcription factor involved in learning processes, also showed increased levels, supporting its function in cognitive enhancement.
Importantly, the correlation between improved test scores and higher biomarker levels suggested that polyphenols may directly influence brain function rather than merely offering general health benefits.
While the study focused on healthy adults, the findings also raised questions about whether similar interventions could benefit populations at risk for cognitive decline, including older adults and individuals with neurodegenerative conditions.❞
Key to abbreviations:
- RIST = Reynolds Intellectual Screening Test
- ELISA = Enzyme-Linked ImmunoSorbent Assays
- BDNF = Brain-Derived Neurotrophic Factor
- CREB = cAMP-Response Element Binding Protein
- cAMP = Cyclic Adenosine MonoPhosphate
Source: Daily fruit and vegetable extracts may boost brain power ← we quoted a pop-sci article for the above summary, for easier readability while still having the critical conclusions in one place
For those who do want to dive into the actual data and a lot more detail about the study methodology (which is well worth reading if you have the time, as it’s very good), here is the actual study:
If nothing else, be aware that the usual benchmark for statistical significance is p < 0.05, whereas the results in this study ranged from p < 0.01 to p < 0.001, in other words, ranging from 5x more significant than is required to be called “significant”, to 50x more significant than is required to be called “significant”.
In fewer words: impressively significant
In lay terms: the scientists are about as sure as scientists ever get about anything, that this supplement produces significant results
What was the supplement they tested?
Good news! It was…
- a commercially available supplement (JuicePlus), which is convenient, because it means we (and you, dear reader) can get it if we so choose
- not paid for by JuicePlus or anyone associated with them (indeed, the funding declaration on the study is “This research received no external funding”), so not subject to any conflict of interest that might introduce bias into the study
As for why they chose that one:
❝A unique aspect of the polyphenol-rich nutraceutical evaluated in this study lies in its composition, which integrates a blend of fruit, vegetable, and berry juice powders.
This product, Juice Plus+ Premium®, contains over 119 distinct polyphenolic compounds, including flavanols, anthocyanins, and flavones, as demonstrated in prior compositional analyses.
Compared to other polyphenol-based interventions, this nutraceutical stands out due to its comprehensive formulation, combining a wide range of bioactive compounds with complementary antioxidant and neuroprotective effects.
These characteristics ensure a more diverse interaction with neurobiological pathways, including those related to oxidative stress mitigation, synaptic plasticity, and cognitive function❞
Source: Ibid. (it’s in the introduction)
Want to try some?
We don’t sell it, but for your convenience, here’s where to get JuicePlus supplements Amazon 😎
Enjoy!
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‘Sleep tourism’ promises the trip of your dreams. Beyond the hype plus 5 tips for a holiday at home
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Imagine arriving at your hotel after a long flight and being greeted by your own personal sleep butler. They present you with a pillow menu and invite you to a sleep meditation session later that day.
You unpack in a room kitted with an AI-powered smart bed, blackout shades, blue light-blocking glasses and weighted blankets.
Holidays are traditionally for activities or sightseeing – eating Parisian pastry under the Eiffel tower, ice skating at New York City’s Rockefeller Centre, lying by the pool in Bali or sipping limoncello in Sicily. But “sleep tourism” offers vacations for the sole purpose of getting good sleep.
The emerging trend extends out of the global wellness tourism industry – reportedly worth more than US$800 billion globally (A$1.2 trillion) and expected to boom.
Luxurious sleep retreats and sleep suites at hotels are popping up all over the world for tourists to get some much-needed rest, relaxation and recovery. But do you really need to leave home for some shuteye?
RossHelen/Shutterstock Not getting enough
The rise of sleep tourism may be a sign of just how chronically sleep deprived we all are.
In Australia more than one-third of adults are not achieving the recommended 7–9 hours of sleep per night, and the estimated cost of this inadequate sleep is A$45 billion each year.
Inadequate sleep is linked to long-term health problems including poor mental health, heart disease, metabolic disease and deaths from any cause.
Can a fancy hotel give you a better sleep?
Many of the sleep services available in the sleep tourism industry aim to optimise the bedroom for sleep. This is a core component of sleep hygiene – a series of healthy sleep practices that facilitate good sleep including sleeping in a comfortable bedroom with a good mattress and pillow, sleeping in a quiet environment and relaxing before bed.
The more people follow sleep hygiene practices, the better their sleep quality and quantity.
When we are staying in a hotel we are also likely away from any stressors we encounter in everyday life (such as work pressure or caring responsibilities). And we’re away from potential nighttime disruptions to sleep we might experience at home (the construction work next door, restless pets, unsettled children). So regardless of the sleep features hotels offer, it is likely we will experience improved sleep when we are away.
Being away from home also means being away from domestic disruptions. Makistock/Shutterstock What the science says about catching up on sleep
In the short-term, we can catch up on sleep. This can happen, for example, after a short night of sleep when our brain accumulates “sleep pressure”. This term describes how strong the biological drive for sleep is. More sleep pressure makes it easier to sleep the next night and to sleep for longer.
But while a longer sleep the next night can relieve the sleep pressure, it does not reverse the effects of the short sleep on our brain and body. Every night’s sleep is important for our body to recover and for our brain to process the events of that day. Spending a holiday “catching up” on sleep could help you feel more rested, but it is not a substitute for prioritising regular healthy sleep at home.
All good things, including holidays, must come to an end. Unfortunately the perks of sleep tourism may end too.
Our bodies do not like variability in the time of day that we sleep. The most common example of this is called “social jet lag”, where weekday sleep (getting up early to get to work or school) is vastly different to weekend sleep (late nights and sleep ins). This can result in a sleepy, grouchy start to the week on Monday. Sleep tourism may be similar, if you do not come back home with the intention to prioritise sleep.
So we should be mindful that as well as sleeping well on holiday, it is important to optimise conditions at home to get consistent, adequate sleep every night.
Good sleep hygiene doesn’t require a passport. Maridav/Shutterstock 5 tips for having a sleep holiday at home
An AI-powered mattress and a sleep butler at home might be the dream. But these features are not the only way we can optimise our sleep environment and give ourselves the best chance to get a good night’s sleep. Here are five ideas to start the night right:
1. avoid bright artificial light in the evening (such as bright overhead lights, phones, laptops)
2. make your bed as comfortable as possible with fresh pillows and a supportive mattress
3. use black-out window coverings and maintain a cool room temperature for the ideal sleeping environment
4. establish an evening wind-down routine, such as a warm shower and reading a book before bed or even a “sleepy girl mocktail”
5. use consistency as the key to a good sleep routine. Aim for a similar bedtime and wake time – even on weekends.
Charlotte Gupta, Senior postdoctoral research fellow, Appleton Institute, HealthWise research group, CQUniversity Australia and Dean J. Miller, Adjunct Research Fellow, Appleton Institute of Behavioural Science, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What happens when I stop taking a drug like Ozempic or Mounjaro?
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Drugs like Ozempic are very effective at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.
But does weight come back when you stop using it?
The short answer is yes. Stopping tirzepatide and semaglutide will result in weight regain in most people.
So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.
It’s a long-term treatment, not a short course
If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.
For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.
Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)
Obesity drugs only work while you’re taking them. KK Stock/Shutterstock Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.
Why do people stop?
Research trials show anywhere from 6% to 13.5% of participants stop taking these drugs, primarily because of side effects.
But these studies don’t account for those forced to stop because of cost or widespread supply issues. We don’t know how many people have needed to stop this medication over the past few years for these reasons.
Understanding what stopping does to the body is therefore important.
So what happens when you stop?
When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to move out of your system. As it does, a number of things happen:
- you start feeling hungry again, because both your brain and your gut no longer have the medication working to make you feel full
When you stop taking it, you feel hungry again. Stock-Asso/Shutterstock - blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a low glycemic index to stabilise your blood sugars
- over the longer term, most people experience a return to their previous blood pressure and cholesterol levels, as the weight comes back
- weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.
While you were on the medication, you will have lost proportionally less skeletal muscle than fat, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.
Is stopping and starting the medications a problem?
People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of yo-yo dieting.
When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to deal with spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can stress your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.
Interestingly, the risk to the body from weight fluctuations is greater for people who are not obese. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.
How can you avoid gaining weight when you stop?
Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:
- getting quality sleep
- exercising in a way that builds and maintains muscle. While on the medication, you will likely have lost muscle as well as fat, although this is not inevitable, especially if you exercise regularly while taking it
Prioritise building and maintaining muscle. EvMedvedeva/Shutterstock - addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is fat-phobic and discriminates against people in larger bodies
- eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.
Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.
Read the other articles in The Conversation’s Ozempic series here.
Natasha Yates, General Practitioner, PhD Candidate, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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