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As the year winds down, many people are preparing to lose coverage for their weight-loss medications, and most don’t have a plan for what comes next. That uncertainty can make weight cycling much more likely, placing real strain on your metabolic health.

In this post, I’ll break down what weight cycling does inside the body, why planning ahead with your medical team matters, and the practical steps you can take now to stay steady through coverage changes.

What Weight Cycling Does to Your Body

Weight cycling refers to that repeated pattern of losing weight and gaining it back. But we’re not talking about the usual 5–10 pound shift that everyone sees from time to time. I mean the bigger swings that happen when a medication stops suddenly, when you’ve been overly restrictive, or when there wasn’t a long-term plan in place.

These cycles aren’t just emotionally draining, they change how your body functions, and they make each round of weight loss more difficult than the one before.

Your body reads quick or repeated weight loss as a threat. It’s thinking, “Alert! We’re starving! Slow everything down!”

That means internally, a few things start happening:

• Your metabolic rate drops as your body tries to conserve energy.
  
• Muscle mass decreases, which makes your metabolism even less efficient.
  
• Visceral fat increases when the weight returns—this is the deeper, more harmful fat around the organs.
  
• Hunger hormones shift, making you hungrier and less satisfied after eating.
  

And the slowdown can be pretty dramatic. Studies show:

• A 22% drop in metabolic rate after six weeks of calorie restriction
  
• A 36% drop after six months
  

If you’ve ever felt like you’re working harder and getting less out of it, you’re not imagining that. Your body is quite literally adapting.

Beyond that, repeated cycles increase cardiovascular risk and raise visceral fat levels. So it’s not just “gaining the weight back.” It’s gaining it back in a way that leaves you more vulnerable metabolically than before.

The Muscle Mass Factor

One thing I talk about a lot (because it’s so overlooked) is muscle mass. If someone starts their weight-loss journey already low in muscle, they’re starting at a metabolic disadvantage. And no medication can completely override that.

Sometimes the smartest, healthiest thing you can do is focus on building muscle and improving metabolic strength first, then focus on fat loss. I know that can feel frustrating when all you want is to see the scale move. But this is about setting the foundation so that the progress you make is progress you actually get to keep.

And remember: plenty of thin people still have metabolic disorders. The number on the scale simply isn’t the full story.

Why planning ahead matters

If you know insurance changes are coming, the absolute worst thing you can do is wait until you’re out of medication to decide what’s next. That “I’ll figure it out later” approach is a huge reason people fall into the weight-cycling trap.

Here’s why planning ahead matters:

• You may need to titrate down the medication you’re on while titrating up a different one.
  
• Your doctor can help you look at alternative options, including combination therapies.
  
• You can create a clear plan months in advance (no last minute panic).
  
• You avoid the hormonal swings that lead to hunger, regain, and frustration.
  

When you stay in touch with your medical team and go into January with a plan, you’re not at the mercy of your medication schedule. You’re in control, and that stability is what enables progress.

What a long-term plan actually looks like

A long-term plan doesn’t mean you need every single step laid out perfectly. It just means you know what the next step is.

Here’s what that usually includes:

1. Assess your current metabolic health

This includes muscle mass, labs, symptoms, energy—all the pieces that tell the deeper story.

2. Identify your next treatment option

It might be a single medication, a combination, or a different class entirely.

3. Create a transition timeline

This is how you avoid the “cold turkey” crash that leads straight into weight cycling.

4. Check in regularly with your physician

This isn’t a one-and-done process. Adjustments are normal and expected.

5. Prioritize muscle-building habits

Strength training and adequate protein support your metabolism better than anything else.

Having this framework is what prevents those big swings and keeps your progress from unraveling.

Don’t wait until January

Every year, people put this off until the new year. But by the time February rolls around, they’ve been off medication for weeks, and weight cycling is already happening.

Your body doesn’t like sudden stop-and-start changes. A gradual taper and a gradual ramp-up protect you far more than reacting in the moment.

A quick caveat here: not all weight return is unhealthy.

After significant weight loss, especially after bariatric surgery or very rapid changes, it’s completely normal for your body to settle a little higher than your lowest number. That’s not weight cycling. That’s your body finding its true maintenance point.

The real problem is when weight steadily comes back far beyond that because of abrupt medication changes or lack of support.

Stability is the goal

Remember: the goal here is not to get everything perfect. It’s to stay steady. Whether you're navigating insurance changes or simply want to protect your metabolic health long-term, planning ahead gives you a far better chance of maintaining your progress.

Your medical team can help you create a strategy that feels realistic and personalized, keeping you supported, informed, and confident. Now is the time to ask questions, make a plan, and think about your next step.

Want to hear more about weight cycling and metabolic health? Listen to the full episode of The Obesity Guide podcast for an in-depth conversation about protecting your progress and creating a sustainable path forward.

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance.   

 Welcome back to another episode of the podcast. I can't believe how fast this year is going by. I hope that you're having a good month of December. I feel like December is one of my favorite months. I celebrate Christmas and we have the Christmas tree up that whole month, and there's something so nice about coming down the stairs in the morning and the tree is on.

My husband's amazing. He sets a timer so that the tree goes on before I come down. That is my version of him making a pot of coffee in the morning for me. Do you know what I mean? It's the tree being on, so I could say, I could say a million amazing things. But that is one where I'm just, it, it, it just, I'm so incredibly happy.

This is a month that, while there's always a lot of stuff going on, I always make sure to take enough time to just literally enjoy some of these moments. Having the hot chocolate with my son looking at the tree. This is just for me, even though it gets dark so early. Things like that. I like to focus on.

A candle being lit. The beauty, those warmer moments, because that's what really I think makes me not get depressed over this time of year. Alright, so today I want to talk about weight cycling because we're getting to that dreaded end of the year when so many people are gonna lose coverage for their medications.

You might not have insurance coverage come January and. Many of you are not gonna talk to your doctor, you're gonna have no plan of what to do, and weight is gonna come back on, and I am making this episode here. To plead with you to get in touch with your medical team if that's the case, and make a plan now of what you're gonna do.

There are other interventions, other medications, other things that you can do. Do not just go into it and I'm gonna figure it out. Horrible plan. And I wanna go through today why weight cycling is so harmful. I want you to imagine every time you're gaining and losing and gaining and losing. You get more and more biologic adaptation.

So what is this? This is where your body, I want you to imagine as you're losing weight, especially if you're losing weight fast, we could go into several things what ends up happening is that your body inside, I want you to imagine that a red siren light goes over and it says, alert, alert, alert.

We're starving. This isn't good. We're gonna die. And so what does it do? It wants to preserve energy. This is one of the things that happens. How do you preserve energy? You make what you have last longer. So you're not gonna have the metabolic engine that, that, that fire that's giving you all the energy, it's gonna become a lot less.

You need to use what you have longer. So the metabolism needs to go down. One statistic that I got here from a recent course that I did, they said metabolic rate suppression occurs with calorie restriction, 22% at six weeks. 36% at six months. Let's recap that. That is almost a fourth of your metabolic rate is down by a month and a half in, and then half a year in 36% down.

That should give you chills to the bone and this is validating to many of you that are hearing this because you say, I know that I keep having to work harder and harder and harder. I believe you. I always say I believe you 'cause I know, I know the statistics behind it. So. That is the case.

You can do things differently. The other statistic that I wanna tell you is some of you're gonna say, well, I have no option. It's just how it is. And your weight's gonna continue to go up and down and up and down.

And I'm not talking about five 10 pounds. I'm talking about massive fluctuations. Okay? There are different shades of gray here. Okay? So your weight cycling, it increases your cardiovascular risk and visceral fat. This is really the sick fat, the one that is causing all the metabolic problems for you.

It's not just that, oh, you regained weight, you have more visceral fat now. You become sicker and sicker and sicker. And I don't want this for you. There are real consequences to going up and down on these things. You really want to work with your physician to come up with a long-term plan.

Long-term plans are not made all at once. You might be doing something right now and it's working and then that doesn't work and you try something else, but there are steps to it. There's a progression. When I was meeting with my physician here recently for my. Uh not annual checkup.

'cause I see the doctor more than once in the year. But every so many months I see this physician and we talked through where I am right now. We did make an adjustment and then we said, okay, well if that adjustment doesn't give me X, Y, Z result, then in a few months, here's another thing we're gonna do.

And here's the thing after that that we could do. Do you know why I am so? Not panicked with this road, even though it's been slow as can be with me, because I always know there's another lever on the back end to pull. I always know that, and it's not obvious it might present itself, but I am willing to keep checking in and do whatever it takes to make this a top priority.

For you, I know that it's so unfair some of you that are listening in other countries where these medications are covered, you just have no idea what I'm talking about. So you're just sitting here like, what? This is sadistic that you know that suddenly someone's doing so great and they get their metabolic health back and suddenly these medications are getting ripped.

It's a reality in the us. And so if that's the case, I really do believe that there are either monotherapies, single medications or cocktails of medications that could help you to not gain all the weight back because it's not about the weight. Your health likely, massively improved in some capacity, and that is the line I wanna maintain.

It is not that I care if you would just, if you, if no consequence would happen, if the weight came back on, I would not care. But hearing these numbers and hearing what happens, you can see how it just becomes incredibly tough for you. One thing that I was looking at the other day online, Dr. To, she's another.

Obesity medicine physician. I just love her work she made a comment on one of my videos where she just sees that the patients that come in with a low muscle mass, that they just, at some point they can't do it. That basically, it's just not something that the GLP one can overcome. And I see this too clinically.

If I have someone come in. And they're just starting at too much of a disadvantage metabolically, I will work on that first with them before we work on weight loss. Now, this is annoying to people because remember, everyone's only obsessed with the number on the scale, but, but if you've listened to any of the previous episodes, you know that one out of four people, even if they're thin, can still have metabolic disorders.

So that's not really the thing that we should be chasing. If the muscle mass is too low, I will work on getting that up first, and then I will work on fat loss. It's almost like at some point you run someone into the ground if you don't do this, and that's just one simple example, but I want things to be different for you.

I want you to go talk to your medical team if you are in this position where you know that coverage or something is gonna happen coming up. And by the way, many of you will tell me, well. I have so many injections at home and I can probably get through till February or into March, but then you have no plan.

This is the time that you figure it out. This is the time, not February 1st, in a panic when you've been out for two, three weeks. And then you wonder what can we do quick? A lot of these therapies, as you titrate down from one, you titrate the other one up. That is how you don't have these massive swings in weight.

That is how you keep metabolically things under control. You don't just cold Turkey it and then suddenly a few months later, all right, let's just start another random therapy. The people typically that do the best are really getting a lot of help along this road. Okay, so I'm not gonna say it one more time, but I would really love for you this next year to have no more weight cycling.

And to have stability with it, and I would rather that you lose less and keep that off than you losing and regaining and just like a hamster wheel going at it because something is going on. If that's the case, now, one exception I wanna give it is very common. Post bariatric surgery or just weight loss in general, that people will reach a certain lowest number, but that's not necessarily their optimal number.

So then they might, it looks like a regain quote unquote five, 10 pounds, but that's actually where their body likes to live. And they were really like artificially doing weird things and restrictive to get down to that lowest number. But that's not really optimal for them. That is not a regain, okay?

That's just your body figuring out where it wants to maintain, but it is not, you suddenly regaining. Everything that you lost. Alright, I'm gonna leave it there. I wanna ask you a big favor. If you're loving these episodes, please make sure that you give us a review. I'm trying to get to 500, we're getting closer, so please leave a review if you can.

Alright, I'll see you next week.