this post was submitted on 07 Jul 2025
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But with Ozempic there is some serious long-term shit going on, which is bad, as you basically have to take this stuff forever or bounce back hard faster than you saying "supersize this burger meal".
It hospitalized my ex for 12 days. The side effects are real. He's in a class action suit against the company.
Truth is that everyone is an individual and side effects will happen with any drug. He unfortunately, experienced a debilitating one but there are millions who do not experience that. So, it is true, he is unlucky but I have seen so many patients who decide to go ahead because they just don't believe they will be that small percentage to experience the bad ones.
It actually is more complex than that and the makers of Ozempic didn't disclose this side effect.
https://www.med.ubc.ca/news/weight-loss-drugs-linked-to-stomach-paralysis-other-serious-gastrointestinal-conditions/
I think most medications are meant to be accompanied with permanent lifestyle changes where possible. No, you should not take this drug “forever”. If you take ozempic for weight loss but choose to continue eating like shit then it isn’t the drug’s fault. Assuming of course there isn’t some other medical disorder leading to weight gain, but again, balancing the negative health effects of obesity vs any negative effects of weight loss drugs needs to be examined by patient and physician.
That's not how it works. Ozempic simply opresses the hunger feeling, therefor helping you lose weight. Problem is that still existing, but empty/depleted fat cells basically scream "we are hungry", so as soon as you get off Ozempic, you basically can't stop eating until you regained at least the former state. That was - for me - the reason not to start on Ozempic, it's like the "bounce back" effect after a diet, but on steroids. That current research has found other issues (heart problems, ocular nerve damages) just enforced my rejection (I was offered this on a free prescription base).
That is a very idealistic view, at least on some medication. With Ozempic, this is basically impossible due to the circumstances written above, with other medications it is simply due to the fact that no "lifestyle changes" can change e.g. genetic defects.
You completely ignored the “permanent lifestyle change” aspect. It doesn’t matter whether the person in need of weight loss does it via diet and exercise or via diet and ozempic, the diet/lifestyle that they got themselves fat on has to change.
You’re basically blaming the drug for the person’s inability to psychologically deal with diet. That isn’t what the drug does. No, you don’t need to eat back to your old weight, that’s the part where permanent change to diet comes in.
I already stated a caveat for conditions that may be outside the user’s control, so don’t use that as an excuse for all users. Yet again, the doctor and patient have to discuss the risks. I’m done here.
No, I don't. I'm just stating facts on how the human body works. With extreme willpower you might be able to counter this for a time, yes. But it will be a serious uphill battle, and the messenger chemicals from the depleted fat cells do not just stop because you will them to. You will just have to live in a state of perpetual raving hunger then. The few who can successfully overcome this for a significant time are rare, indeed.
I’m down 100lbs and been chilling there for a a while actually. (I do bulk/cut cycles of around 30lbs for bodybuilding so my total weight loss fluctuates from like 120lbs to 90lbs depending on how that’s going. Just for disclosure)
But I’ve heard a few people mention this idea that “fat cells stick around forever” and “send hunger signals to fill you back up”. Do we have a scientific source for this?
My other thing with it is like, that’s not the reason someone gets fat the first time right? Because the idea is your fat cells start multiplying after a certain weight? So regardless it still seems important to address that first cause and not repeat it
But for me personally I just haven’t really experienced it at all lol. I’ve found that actually the type of food I eat makes me hungry and more likely to go off track. Like any fast food, most prepackaged snacks and prepared meals from the grocery store.
Like I could eat an 800cal pint of ice cream then have dinner 45 minutes later. But 200 calories of frozen grapes and I’m like, stuffed lol. Or I’ve also noticed if I have a doughnut in the morning (work offers them) I’m hungry all day, but eggs cheese oats and yogurt leave me satisfied to the point where I’m not hungry at all when I get home, and eat just because I know I need the nutrition from dinner.
Anyway sorry for rambling, really I’m just curious to get to the bottom of the “depleted fat cell” thing. I had never heard of it the entire time I was losing weight/maintaining then all of the sudden I’m hearing it pop up in lots of places, even lemmy now
Because hunger has to do with vitamin balancing and a lot of people don't get enough of certain vitamins which keeps them always behind.
Eg vitamin A makes your skin slough off in excess and can kill you in very high doses. To treat high vitamin a in the ER, doctors use vitamin e. Vitamin E can make you bleed in excess if you have a deficiency of vitamin K, so vitamin e excess is treated with vitamin k. Vitamin e deficiency can also cause blood clots. Vitamin D interacts with all of the above as well and they actually all interact with each other and make uo a large part of the immune system with downstream effects on other vitamins including b vitamins.
For a lot of people, once they understand how to balance their vitamins, they dont feel hungry anymore. But people alwyas want a magic pill that splves everything instead
https://pubmed.ncbi.nlm.nih.gov/29991030/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4371661/
This one's not as easy for me to quote.
Basically the gist of the whole idea is that your body maintains the level of fat cells pretty steadily as an adult. When you gain or lose weight the cells just grow or shrink, but they can only grow so big before you need new cells to store more energy and your body will build them. Each of the fat cells have a part to play in signaling that you're in a deficit and need to consume more calories (when we didn't have such calorie dense foods readily available this was probably correct most of the time). So, if you have 2 or 3 times the number of fat cells then you "should" that's increasing the signaling you receive to eat, making it harder not to (simplifying that a lot). In normal maintenance, your body still maintains that turnover pretty steadily so it generally doesn't go away.
I’ve read the first study already, it doesn’t comment at all on the hunger signaling aspect.
The second study is just proposing this as a mechanism which may account for weight regain. They spin off pretty quickly into a more matter-of-fact tone while presenting the hypothesis itself, but at the moment it remains speculation. I obviously haven’t had the time to click through to every reference in there, but so far the links I have checked similarly lead to speculation.
Basically I think it’s somewhat dishonest to present this hypothesis as a statement of fact. I feel like the inevitable result of this mischaracterization will cause people to not even try. Why bother if something is probably impossible, or only one in a million could do it?
Thank you for linking it however, and I will be very interested to know if Professor MacLean verifies the concept. Of note, in the conclusion they propose that environmental and behavioral interventions will be important for combatting this effect, if it does turn out to be true
You're right the second article probably doesn't support the hunger bit enough. As i understand it, the hunger signaling is largely an absence of leptin, which is a hormone that regulates appetite. The increase in fat cells from obesity leads to more leptin production and then leptin resistance, so it's less effective. When you diet and lose the weight the fat cells aren't producing as much leptin and you're resistant to what they are producing so you're comparatively hungrier than you may have been if you stayed at a healthier weight. I believe the leptin sensitivity can recover and be improved through other ways but I'm not an expert.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6354688/
Thank you again for the link, but it seems like you’re just reiterating the hypothesis without any supporting evidence? We have a proposed mechanistic explanation for the phenomena that requires further study. My point of contention is that it should be presented as such, and not as a granted fact
Maybe my sources aren't great, I use kagi nowadays over Google and they have an academic filter (like Google scholar). That's all I used to find the few things I linked.
It's well established that your fat cell count is relatively stable as an adult and that as you gain significant weight that your body creates more fat cells to store this energy. It's known that the number of cells stay relatively stable even after losing weight, they just shrink. It's also known that leptin, or lack there of, affects your hunger. These things specifically are well documented. Other points of what I shared, and the overall impact may be, still hypothetical.
I'm not going to keep looking for and reading articles because I'm not finding what you're looking for and that's all good. I don't want to act like I'm an expert, I'm just a nerd reading things on the internet.
That's not to say, though, that this fat cell count is the end all be all and it's impossible to lose weight because you've already gained too much — your own situation is proof of that. It's just added context, not a barrier. Highly satiating foods like what you've mentioned, grapes over ice cream, eggs oats and yogurt over donuts, these make a much bigger impact on your overall hunger. I feel it too, I'm overweight and working on losing it, and if i snack on something like chips, it almost feels like it does nothing for me. That's why all the weight loss advice mentions high protein and High fiber foods.
Gotcha, yeah and thanks once again for the discussion. What I’m looking for basically is just evidence for the claim posted above us, specifically that “it is a fact that weight loss results in lifelong ravenous hunger due to fat cell signaling”
Scientists all the time come out with reviews and proposals that ultimately fizzle out without supporting evidence. So before I am able to believe any specific claims I need to see that it’s an actual scientific finding rather than just something tentative that has caught headlines (like I said, it happens all the time).
Since you like reading studies in general, for your own amusement I would suggest investigating the claim “cooking rice with coconut oil, then leaving it in the fridge overnight, will reduce the calories absorbed by your body by half!”
It’s a total and blatant piece of misinformation based on a chain of bad news reports made about a study that claimed something totally different, and was subsequently never confirmed. Yet I have met people in real life who swore by the method (even though they struggled to lose weight regardless of this supposed calorie cutting “hack”).
The weight loss space in general is totally flooded with this type of misinfo which is why I get so particular about it. Thank you again!
In my reading the the literature there is nothing to support this "fat cells make you hungry" theory.
At best there is an association between fat people and fat cell population, but given hyperplasia is more common in people of european descent its not a causal connection. Plus this theory doesn't account for fat people from hypertrophic populations (asians).
That reminds me of that peanut butter, professor nutz. They claim that due to adding certain fibers to their peanut butter, it reduces the digested calories from around 200 calories to 36 calories. They took a concept that exists, fiber-fat bonding, and an in house pilot study of 6 people over 2 weeks, and use that to market this as some kind of miracle peanut butter. Is it technically possible that somebody eating that peanut butter only digests 36 calories per serving? Yes, but it's (to me) very unlikely and changes person to person (which they admit).
The "fat cells are multiplying" is normal when having surplus calories in the body. The "empty fat cells scream hunger" is something that was suspected basically for ages, but has finally be proven not long ago, the paper is less than half a year old. It had been referred to here on Lemmy, at least to a science or nature article that pointed to the paper.
Could you direct me to the paper where it was proven? There seems to be a notable amount of bad journalism and broad misrepresentation of the science on this topic.
We are basically discussing whether or not obesity is an inescapable condemnation, so we should not sensationalize the topic whatsoever, and we should especially not present it as a fact if it is not a fact
Adipogenesis is actually pretty regulated by the body but can be encouraged by some things. Not hunger though - that causes adipolysis, aka less adipocytes.
Sadly, no. I sat down and tried to remember the title, but it won't come up. It is not old, two to three months at most, I'd say. I'm going to bed now, maybe it will pop up tomorrow. In that case, I'll update this.
Thank you, no rush! If so could you please reply in a new comment so I get a notification?
Found it. It was older than I thought, though: https://www.nature.com/articles/s41586-024-08165-7
Righteous, thank you! I’m in the muck right now at work but I’ll give it a read when I can
To be honest, reading thru the study and poking at some of the discussions about it online, it seems to not be remotely saying what people are saying it’s saying lol.
Like they weren’t able to find many of the results they expected in actual human samples compared to the mice. They also found that slower weight loss seemed to correspond with fewer and less severe epigenetic changes.
That second point there was never really expanded on beyond a throwaway statement, but it jumped out at me because the humans studied received bariatric surgery. Which causes massive weight loss very quickly. They even cited that as a potential confounding variable.
It’s also not really about “fat cells multiplying” at all, but rather how a collection of dozens of different factors differ between never obese and formerly obese samples, and only at the two year mark after a weight loss intervention.
Their own conclusion is that “they have not proven” their findings have anything to do with weight regain. This is then bizarrely and immediately followed by what can only be described as an unprompted advertisement for Ozempic, along with speculative musing that further study is needed to determine if it could be used to “erase or diminish” the epigenetic memory (despite semaglutide being unrelated to the experiments and appearing nowhere else in the paper?). Interestingly enough, there’s also an extant conflict of interest statement linking one of the researches to several pharmaceutical companies, including Novo Nordisk
All in all, it strikes me as nothing more than yet another case of bad science reporting. With people kind of going in with preconceived notions, glossing over all of the details, and emerging with snippets taken out of context (body remembers being fat! It changes your genetics!). Lo and behold all the online discussion centers around just the provocative headline and the speculative sections of the paper.
It seems like the researches even deliberately tried to use language to bait this type of response from the general public (although this is now just speculation on my part). In summary, I am unpersuaded by the available evidence. Thank you however for linking it! There is a lot of other interesting info in there
While your point is technically true, you're ignoring the bigger picture. Some people are genetically predetermined to having an uncontrollable appetite. We're talking about something that for some people is so extreme it's worse than the worst addictions. Willpower is just outright a nonstarter, especially when you factor in the presence of our toxic food environment (ie., the way super markets are so stuffed full of junk food and junk food advertising that it becomes virtually guaranteed that the vast majority of people will habitually eat poorly).
Ozempic is absolutely an appropriate choice for people who struggle with appetite control. It may not be perfect, and ultimately it is best to do whatever we can for lifestyle interventions, but sometimes we just have to work with what we've got too.
Did you even bother to read what I wrote instead of reiterating points I already made?
I don't think that is quite right. If people on Ozempic use the opportunity to adapt to a low carbohydrate diet, when they come off the drugs they won't be suffering from the save sugar craving addiction cycle.
Fat cells don't scream "we are hungry" they scream "we are full" that is what leptin signaling is for, but carbohydrate addiction is a much stronger signal for many people.
Because weight gain is from not having enough vitamins or a correct balance of vitamins. Taking fat soluble vitamins (esp E&K1&coq10) made me lose weight and exercise more without trying.
I'm sorry, but what? Weight gain is most primarily the result of calorie surplus, with genetics playing a major role as well. Telling people to take random vitamins, especially when you don't know the full story of their dietary and micronutrient status is just completely inappropriate and unhelpful.
That's such a simplistic look at weight gain lol. Wanting food is caused by neurochemicals in your body first before you even eat a bite. Eg Prader-Willis patients gain weight because they have excess ghrellin which makes them super hungry. (It's obvious they do not have Prader-Willis).
Vitamins are over the counter. We are supposed to eat them every day. Doctors literally ask you if you eat a balanced diet as their first screening question because they are supposed to fix vitamin deficiencies first before treating anything else (lol as if they do that). I think adults, who walk by these same vitamins every day at the store and see ads for them, can read a vague internet comment that they know is a stranger, and know if they should talk to their doctor about their health conditions etc or not. I think they can decide for themselves if they want to try a vitamin regimen, that again, is over the counter and has recommended daily intakes by nutritionists so your body can function.
Further, there is no overdose range for vitamin k, as in, we haven't found an upper limit where it'll kill you, although if deficient in vitamin e, then blood clots can happen. COQ10 is likewise very safe. https://pubmed.ncbi.nlm.nih.gov/19096117/
Vitamin E is pretty safe unless you macrodose it every day for a while, and even then, as long as you've got vitamin k (and in some weightlifters do vitamin C) on board it shouldn't be an issue. And again, I never said to macrodose or gave any dose, so why the shaming and policing?
Last, most overweight people are eating a lot of animal products that contain retinol type vitamin a instead of beta carotene type vitamin a found in plants. Because of the way retinol works, you HAVE to absorb it. To deal with the extra retinol, you need vitamin e and vitamin k, so you start craving fats. Then often people want meat and cheese or a pasta with meat, lasagna, pizza, etc, (which btw I eat too and I eat meat) and yeah they get some vitamin k in that, but not enough vitamin e to deal with the retinol. Which then causes stuff like eczema, allergies, pink irritated skin, dry skin, headache, high blood pressure, nausea, diarrhea - the stuff on the accutane side effects list.
So the craving continues and feeds itself. I used to be hungry AFTER I ATE and wished I could eat more, and that's not uncommon in people who eat caloric excess - because they actually DO need to eat something else.
If you take vitamin e, it treats vitamin a overdose symptoms relating to the skin sloughing off and heightened immune system issues. But also vitamin e should be given with vitamin k since vitamin k is relatively benign anyway and helps produce osteocalcin which helps people exercise and want to move/feel good moving.
Look at my last few comments. I'm well aware of the psychological role and appetite in weight loss, I literally brought it up elsewhere. I didn't bring it up here because it wasn't relevant, I was speaking strictly about the physiological side of weight. It's just basic thermodynamics. If you take in more energy than you use, you're going to accrue a surplus. And if you're burning more energy than you take in, your stores are going to deplete. There might be various factors that attenuate this equation plus or minus, but every real, science-backed, time-tested weight loss plan still respects the central role of calorie management.
And of all the absurd weight loss strategies I have ever heard of, a handful of fat-soluble vitamins is news to me. It literally just sounds like your own personal anecdote. And aside from it not seeming to have any real evidence behind it, and the issue of it likely not being a broadly helpful protocol for most other people even if it somehow maybe helped you; the issue I take with it is that wherever feasible, a person should get their micronutrients from whole food sources. We evolved eating food, not supplements. The way nutrients interact in our bodies is can in some cases be completely different if they're in an isolated form, than if they're in their intact whole food form. Getting nutrients from food, particularly if you're managing to eat a diversity of foods, also makes it a lot less likely that you're going to overdose on them.
Which brings me to the other side of that. All of this stuff you're saying about toxicity just sounds like copium. It's especially aggravating because if you ask any nutritional expert, they will tell you straight away that the fat soluble vitamins are exactly the ones you should be most careful with. Those are the ones that accumulate in the body over time, and most easily get to toxic levels.
Seriously, your advice is irresponsible. You really need to stop, and by the sounds of it, maybe dial down your vitamin doses.
Yikes, dawg.
The brain is the body. They aren't separate.
I brought up caloric excess in my other comment. I'm aware caloric excess causes weight gain simplisticly, but like I said, that is a simplistic take that ignores eveything else about the body and how people function as bodies. It's a great attitude if you have an eating disorder or want to punish people for being fat though while ignoring their vitamin needs.
Food cravings are physiological in nature. Why people even WANT to eat when they already know about calories is what matters.
Foods are made of vitamins, minerals, proteins, carbs, fats (which many are vitamins), and probably stuff I'm not thinking of. Plus we eat stuff like microplastics, dust in the air, lint, whatever incidental things. And then we also have a microbiome that interacts with all this, and that respond adaptively to pathogens, eg hydrogen peroxide producing bacteria, plus the pathogens themselves. We come into contact with pathogens a LOT, and most of the time our immune system just deals with it, it's not a big deal. Same with cancer actually.
There's stuff going on under the hood, is my point, and we don't know what our cellular buddies are dealing with and if they need more of a certain vitamin or not, they don't burden us with minutiae. We just think, "fuuuuck, a goat cheese hummus salad would slap right now," because biochemical pathways in our brain light up and we start feeling hunger.
Calories follow basic thermodynamics, yes, but your body is very complex. The goal isn't thin and malnourished and sick, the goal is usually healthy and fit and feeling good.
This is what I mean by simplistic. You wave your hand and say your body is simply "burning energy," when it is actually an endlessly intricate bioelectrochemical dance between entire cities of unicellular life and tiny multicellular life (and some viruses) with whole lives of their own. It's crazy what happens inside us and how we adapt.
There is actually a lot of literature (like since before the 50s) on fat soluble vitamins and I linked some elsewhere itt for general reading on how it relates to insulin and Ozempic in simple terms. That you don't know that, that I know more than you, is obvious and you should probably stop externalizing. There's also tons of modern dieticians and nutritionists (with doctorates) who practice this exact philosophy, and indeed it is what our entire recommended daily intake is based on.
Supplements are made from food, especially the ones I listed. Go look at the ingredient labels. And people know they can get vitamins from food and can look that up, as that is common knowledge.
They don't HAVE to take a stranger's advice lmfao.
Again there's no safety issues with the supplements I was talking about. I'm aware of which supplements are more dangerous.
We didn't evolve to breathe car exhaust every day and we do, so maybe there are external oressure we have these days we didn'thave before. 0I think our bodies are very adaptable given the wide range of biomes (incl sun exposure/vitamin d availability) we occupy, and we might need some extra vitamins every now and then. Supplement or whole food, either way.
People overdose on selenium with brazil nuts pretty often, because it takes so few to overdose and they don't realize. Arctic explorers ate a ton of polar bear liver with 1,000,000 times recommended retinol in one bite, one died and the other's feet sloughed off and almost died. You yourself simply don't eat food sources that will kill you, because everything you eat is from a super market lol and safe. Some whole foods can kill with vitamin dosages and can vary widely in their dose. With supplements, you know the exact amounts and are somewhat less likely to "overdose" based on that alone. Plus, you can take vitamins individually/independently for a while and see how your body responds to know if that specific vitamin is helpful or not, then choose a whole food source once you understand what vitamins you need.
Drs say that because they don't want you to take retinol in excess or be careless with your doses. It's okay to take a normal daily dose. Some doctors have eating disorders and fat phobia too by the way, and those doctors tend to be pretty ignorant about fat soluble vitamins and nutrition itself. And again, vitamin k has no upper threshold at all. We inject it into newborns at pretty high doses and have since the 60s. You aren't going to get "toxic levels" of vitamin e or coq10 in your body either lol unless you deliberately megadose.
Ps liver and heart are good whole food sources of these vitamins
Pss laughable you criticize recommending vitamins when people here want to casually take Ozempic because their favorite anorexic celeb did it and looks great (on tv with filters and editing). And just shows your anger is misplaced
I've enjoyed reading this discussion. I would like to contribute that the most significant factor in excessive obesity isn't a typically a nutrient deficiency, or even a moral failing in CICO - it's carbohydrate addiction.
Yes, hunger can be driven by low-levels of essential nutrition, pica during pregnancy is a great example of that. Many people are over-fed and under-nourished, so when they get hungry they continue to go to their deficient food source (probably something carbohydrate heavy).
Addictions aren't real, or at least not like how we thought of them in the 90s.
It is an imbalance of carbohydrates and "bad" fats (no such things but in excess they become "bad") that your body needs other vitamins to deal with. It's not an "addiction," the word is meant to demonize and scare people, and it's fat phobia to call it that imo.
No food has everything we need in it.
Addictions are real things in both my experience and reading - can you explain how they are not real?
Carbohydrates are not necessary for human nutrition, so there is no such thing as a carbohydrate imbalance.
Eating saturated fat does not become bad at any level of consumption.
Meat has everything we need in it, its the perfect food.
It's a word used to demonize people doing normal human things like consuming things in excess.
Carbohydrates are a regular source of energy in food that nearly every unicellular and multicellular form of life utilizes, and are evolutionarily ancient. Everything you eat, must be processed and dealt with, and that takes vitamins. Carbohydrates need to be balanced with other nutrients like all nutrients.
https://www.ncbi.nlm.nih.gov/books/NBK9841/
Fats need to be balanced.
"Meat" - no, not all meat is the same meat. It's regularly an issue with people feeding their pets a raw diet - they only use muscle meat and no organ meat and the pet becomes malnourished.
Are you eating thyroid? Thymus? Liver? Heart? Testicles? Ovaries? Brains? These all have different nutrients and hormones in them and we still make medicine today from some of these parts.
Meat does not have enough vitamin e or vitamin k unless you eat liver, but it also has vitamin a and each liver can have varying amounts of what vitamins are stored in it. Vitamin C is also lacking in an all meat diet devoid of organ meats.
I know weightlifters who are in their 60s regularly macrodosing vitamin e and vitamin c for this reason and they've won competitions in their younger years and had very few serious injuries compared to others. I'm gunna say these vitamins are necessary and your "meat" argument is lacking.
Excess and normal are contradicting each other in this sentence.
Yes cellular metabolism can use glucose, but that glucose in humans does not need to be eaten in the form of carbohydrates, the body is perfectly able to make its own glucose via gluconeogenesis
What does this mean?
Vitamin C is in meat in small amounts, but if one is eating only meat then there is not glut4 competition and that vitamin c is very effective.
They are not contradictory.
Ok so no issue with glucose or carbs in isolation
I explained above and elsewhere, you'll have to search my history or the thread re balancing fats
It is not enough vitamin C
I'm not really interested in debating your eating disorder/orthorexia
That's... Not a side effect.
That's from people losing weight on their normal diet because of Ozempic, but never changing their diet for their new lower weight selves, so naturally they immediately gain it back.
No, it is just the way this drug works. You take Ozempic, it supresses your hunger feeling, and you automatically change your diet as you are not as hungry anymore.
Problem is that the depleted fat cells still exist, and a depleted fat cell releases signals that scream "I'm hungry! Feed me!", and the more they are depleted, the louder the call. While you take Ozempic, this is supressed, but as soon as you get off it, your body demands food to re-fill the depleted cells, and will not stopping before it has reached at least the former status quo.
Just like the bounce back effect after a diet, only worse.
You can't eat the same way you did pre-Ozempic while you're on Ozempic and still lose weight...