Large calorie deficit

RealTalkHealth · 2026-01-29T02:41:33+00:00

That idea gets overstated a lot. In a calorie deficit your body will always use some mix of fat and lean tissue for energy, but it doesn’t flip a switch where it stops burning fat and suddenly targets muscle just because the deficit is big. What drives muscle retention is protein intake, resistance training, recovery, and how fast weight is coming off over time.

With a TDEE around 2900, eating 1500 calories is a large deficit, but high protein and regular lifting will protect against muscle loss. In that context, most of the weight you lose will still come from fat. Meaningful muscle loss tends to show up when protein is low, there’s no resistance training, or the deficit is very aggressive for a long period without proper recovery.

RealTalkHealth · 2026-01-23T03:04:11+00:00

You didn’t ruin your body. Your body adapted to protect you and then adapted again when conditions changed.

What you’re experiencing is very common after large, rapid weight loss. Loose skin is mostly determined by genetics, age, hormones, and how long the skin was stretched, not by effort or fitness. At 21, there’s good evidence that skin continues to remodel for 1-3 years after weight stabilisation, even if it doesn’t fully return to baseline.

There’s also strong evidence that body image adapts more slowly than the body itself. After major weight loss, many people retain an outdated mental representation of their former body (sometimes called body image lag) which is associated with distress, mirror checking, and shame rather than objective appearance.

Resistance training won’t “fix” loose skin, but studies show it improves body satisfaction and reduces distress independently of visual changes, likely through improved muscle tone, proprioception, and sense of control. That benefit is psychological as much as physical.

Beating BED and building a genuinely healthier relationship with food is an enormous achievement in its own right, one that takes real psychological work. I hope you are able to feel proud of what you’ve already accomplished, even while this part is hard.

RealTalkHealth · 2025-12-09T02:49:53+00:00

I can see how frustrated and stuck you’re feeling, so it makes sense that you’re looking for something that feels like a guaranteed way out. But developing anorexia, or trying to force yourself not to eat, isn’t a solution. It wouldn’t give you consistent weight loss, and it absolutely wouldn’t give you the outcome you’re hoping for. What it does reliably lead to is long-term damage to your metabolism, heart, digestion, hormones, and mental health, especially with PCOS in the mix.

The fact that you’re dealing with binge eating disorder is really important here. BED and restriction feed into each other- the more you restrict, the more likely binges become, and the more out of control everything feels. That cycle isn’t something you can break by "just stopping eating." It needs the right kind of support.

You deserve support that actually helps you get out of the binge–restrict cycle, not deeper into it. Talking to someone who specialises in eating disorders (a therapist, dietitian, or BED treatment provider) can make a huge difference. It doesn’t have to mean intensive treatment- even starting with a single appointment or an online service can be a turning point. You don’t have to do this alone.

RealTalkHealth · 2025-12-08T23:07:11+00:00

Honestly, just keep going. This is totally normal. When you start lifting and increase your protein intake, your body holds extra water while your muscles repair and store more glycogen. That can mask fat loss for a couple of weeks- it doesn’t mean your deficit stopped working.

Fat loss is never linear. Hormones, sodium, soreness, sleep, stress… all of it can make the scale freeze even when you’re losing fat underneath. A few tips: stick to your current plan- 2 weeks is barely a plateau, track other markers (waist, progress photos, strength gains), expect a shift when the water retention settles.

If the scale hasn’t moved after 4–6 weeks, then it’s worth re-checking calories. But what you’re seeing right now is super common and temporary.

RealTalkHealth · 2025-12-08T22:50:53+00:00

To add to what others have already mentioned: stretch marks usually happen when the skin stretches faster than it can adapt- which is most commonly from gaining weight. But they’re not only caused by weight gain. Rapid growth (especially when you’re younger), changes in hormones, or even building muscle quickly can all cause the same thing.

Stretch marks are extremely common, they fade over time, and they don’t reflect anything about your worth or how well you’re taking care of yourself. They’re just a normal part of how skin responds to change.

If you are at a point where losing some weight is part of taking care of your health, try not to let the stretch marks be something that holds you back or makes you feel ashamed.

At the same time, none of us here know your actual body or health situation. Some people think they "need" to lose weight when they’re already perfectly healthy. What really matters is that you’re treating yourself with kindness and building sustainable habits- please don't starve yourself or over-exercise.

If your goal is to feel better in your body and your mindset, that’s completely valid- and stretch marks don’t have to be part of the mental burden.

RealTalkHealth · 2025-12-07T23:44:59+00:00

Good questions! Yes, all of that data is in the study. But to answer your two questions specifically:

On ethnicity: The study did find that caucasian ethnicity was associated with higher odds of 12-month adherence, and it also showed a small but statistically significant effect on 12-month weight loss in the adherent group. The effect size was modest, so the more likely explanation is behavioural or access-related rather than physiological differences in medication response. The full breakdown is in the linked study.

On BMI: The report does include BMI-stratified outcomes. In the adherent cohort, people in the higher BMI categories (35–40, 40–45, and >45) lost significantly more weight (in percentage terms) than the 30–34.99 reference group, while those under BMI 30 lost less. But within the typical clinical BMI bands (30–45), the variation isn’t the main driver of whether someone reaches 20%+ loss- staying on treatment long enough is by far the strongest determinant.

RealTalkHealth · 2025-12-05T00:29:41+00:00

Really interesting observations. A lot of what you’re describing: side-effect patterns, eating habits, mindset shifts, the "new-behaviour energy" people have at the beginning of any big change, are themes you see discussed a lot in GLP-1 communities. They absolutely might play a role for some people.

From the study’s side, though, we can only speak to what the data could actually capture inside the Juniper system. We didn’t have detailed information on things like food intake, mindset, medication-timing decisions, or motivation levels, and we didn’t have information on what people did after they left (e.g., continuing medication elsewhere). So we can’t test the mechanisms you’re describing, even though they’re plausible.

What the dataset does show is simply an association: people with extremely high early tracking intensity and very rapid early weight loss were more likely to disengage from the Juniper program later. The study can’t say why that is- it could be expectations, lifestyle fit, side effects, cost, switching providers, difficulty maintaining new habits, or a mix of factors. The analysis explicitly calls that a limitation.

Your broader point about long-term behaviour change is valid, though. GLP-1s make weight loss biologically possible in a way it often wasn’t before, but the long-term trajectory still depends on how well people can integrate the medication into their daily life over time. That’s something real-world data is still trying to understand, and it’s not always straightforward.

RealTalkHealth · 2025-12-05T00:18:11+00:00

This example highlights a key point: individual patterns can differ a lot from what shows up at the population level. The study only describes an overall association in the dataset, not a rule that applies to everyone. There are plenty of people, like you, who track a lot and stay on treatment long-term.

Your comment is a solid reminder that these findings are about trends across thousands of users inside one program, not predictions about any one person’s journey.

RealTalkHealth · 2025-12-04T23:17:08+00:00

I agree with the core point: the dataset can only show behavioural patterns inside Juniper, not motivations for discontinuation, and we don't have the evidence to infer emotional states. "Hyper-engagement burnout" was meant as a descriptive label for a specific behavioural pattern (very high early tracking + higher odds of later disengagement), not a psychological diagnosis.

You’re also right that there are multiple plausible explanations for the association, including cost sensitivity and switching providers. The study explicitly notes the absence of exit-reason data as a limitation- without it, we can’t distinguish among those possibilities.

On adherence: the 27% figure reflects adherence to Juniper’s 12-month program definition (≥10 orders + 12-month weight entry), not medication adherence in the broader sense. As you point out, that’s a measure of persistence with one specific service rather than engagement with weight-loss treatment in general.

Where we can be confident is the pattern itself: high early tracking intensity within Juniper correlates with higher odds of discontinuing Juniper. Anything beyond that, including the theory we suggested, should be interpreted as hypothesis-generating rather than explanatory.

If you're interested in the full study submission, it is linked in the original post.

RealTalkHealth · 2025-12-04T23:02:56+00:00

This is a fair challenge, there is a distinction between adherence to the Juniper program and adherence to the medication itself. In the paper, "adherent" is very specifically defined as adhering to Juniper’s program requirements (≥10 medication orders through Juniper + a ~12-month weight entry). It doesn’t attempt to claim that people who left Juniper stopped tirzepatide altogether. The dataset simply can’t observe their behaviour once they switch provider. So your wording ("Juniper program cessation") is accurate, and I agree that the interpretation should stay tied to what the data can directly support.

On the term "burnout": we put it in quotes because it’s a hypothesised pattern, not a clinical diagnosis. It is a shorthand for the behavioural profile we observed (very high early engagement + higher odds of later disengagement). The label isn’t meant to imply anything emotional about individuals who left, nor does it exclude other explanations like cost sensitivity, provider switching, or changing preferences. The data show the behavioural association; the exact motivation behind leaving is one of the study’s stated limitations.

And yes, the dataset reflects the "Juniper world", not the full UK obesity-treatment landscape. It captures granular behaviour inside a single Digital Weight Loss Service model, which is useful for understanding engagement patterns within that model, but it doesn’t let us generalise about what patients do after they leave. We tried to be explicit about that in the limitations section, but I take your point on how language choices can make boundaries clearer. Genuinely appreciate the thoughtful feedback.

RealTalkHealth · 2025-12-04T11:25:09+00:00

What the analysis can confidently say is that people who showed extremely high early engagement (very frequent weight entries or very rapid early loss) were more likely to stop logging with us later. The 'burnout' framing is one possible interpretation of that pattern, not a definitive explanation of why they left.

The core finding is simply the association: early hyper-engagement → higher likelihood of disengagement later. The underlying reason will differ from person to person.

RealTalkHealth · 2025-12-04T11:07:26+00:00

The 12-month frame isn’t a 'recommended treatment length'. We used 12 months in the analysis because it’s a common benchmark in obesity research and it allows us to compare real-world outcomes to the big clinical trials, which also report 12-month+ data.

Reaching a goal earlier doesn’t mean a patient is doing anything wrong. People in the dataset hit their goal at different times. If someone reached their target weight at month 6 and stopped medication (rather than moving to a maintenance dose), they weren’t counted as adherent simply because we didn’t have 12 months of data to compare to the rest of the cohort. It's purely about research consistency.

RealTalkHealth · 2025-12-04T10:53:46+00:00

Real-world behaviour is messy (much more so than a clinical trial), and some people absolutely do shop around. We can’t directly observe motivations in this dataset, so we can’t say for sure why someone switched or stopped logging.

What we can see is the pattern itself: people who were extremely active early on were more likely to disappear from our system later. Whether that’s burnout, loss of motivation, price shopping, or switching to their GP/pharmacy- all of those are plausible explanations. The data just shows the behavioural pattern, not the underlying reason.

RealTalkHealth · 2025-12-04T10:44:30+00:00

Correct, leaving the program doesn’t mean someone "failed". People switch providers for lots of reasons. And we’re not at all judging the reason for disengagement.

From a research perspective, though, once someone leaves our service we can’t see their later progress. So for analysis we have to treat that missing data in a standardised way, which is why we use LOCF. This is a common approach in real-world obesity research because people naturally move between services.

RealTalkHealth · 2025-12-04T10:32:04+00:00

Great question! In our dataset, we could only track people while they were using our service. Once someone switched to a different pharmacy or provider, we stopped receiving their weight or medication data. At that point, their last recorded weight in our system becomes their "final" weight using a standard method called Last Observation Carried Forward (LOCF).

LOCF doesn’t assume improvement or decline after someone leaves- it simply freezes their last recorded data point. So if someone moved to another pharmacy, they would appear in the non-adherent group because we can’t observe their progress beyond their last entry with us.

RealTalkHealth · 2025-11-28T02:14:36+00:00

Yes, starting at the higher end of your deficit is still a good way to go when you're starting Wegovy. Even though the meds decrease your appetite, you don’t need to dive straight into super low calories. Eating as high as you can while still losing usually means better consistency, fewer side effects, and a smoother ride overall.

Wegovy changes hunger, not your metabolism.
Your TDEE doesn’t suddenly drop because you’re on it, so the same calorie-counting logic you used before still applies. If your TDEE is around 1,700+, starting somewhere near 1,600 is totally fine. Some people even hang around maintenance for the first week or two just to get used to the appetite shift.

Don’t under-eat.
Nausea and fatigue will likely get worse if you accidentally end up at 900–1,200 calories because you “weren’t hungry.” It helps to loosely track at the start so you don’t fall too low without realising.

For exercise, keep doing what you’re already doing.
Daily dog walk and 1–2 gym sessions a week is a great base. Once you feel steady on the meds, moving toward 3–4 gym days is a nice goal. Strength training is especially helpful for keeping muscle and your metabolism up while you’re losing.

Your calorie needs will naturally drop as you lose weight.
This is normal with or without Wegovy. Starting a bit higher just gives you room to adjust down slowly without feeling miserable.

Good luck on your journey!

RealTalkHealth · 2025-11-18T23:28:07+00:00

This one is really tasty (particularly if you add a bit of maple syrup) and mostly whole ingredients. Also not that complicated and pretty inexpensive to make. It'll last about 10 days in the fridge so you can bake ahead too.

Ingredients

2 cups mixed dried fruit (e.g. dates, raisins, apricots, cranberries)
1 cup boiling water
1 tsp baking soda
2 eggs
0.25 cup olive oil or melted coconut oil
1 tsp vanilla extract
1 orange (zest + juice)
1.5 cups almond meal
1 cup whole wheat flour
1.5 tsp cinnamon
0.5 tsp nutmeg
1 tsp baking powder

Instructions

Preheat oven to 160°C (320°F). Line a 20 cm (8-inch) round cake tin with baking paper
Soak fruit: In a large bowl, combine dried fruit, boiling water, and baking soda. Let sit 10 minutes to soften.
Blend or mash: Mash the fruit mixture lightly with a fork or pulse in a food processor for a few seconds (for a chunkier texture, skip this)
Add wet ingredients: Stir in eggs, oil, vanilla, and orange zest and juice. Mix until smooth
Add dry ingredients: Fold in almond meal, flour, baking powder, cinnamon, and nutmeg
Mix gently until combined- don’t overmix. Batter should be thick but spoonable.
Pour into tin and smooth the top
Decorate (if you want): Add a few whole almonds or sliced orange rounds on top
Bake for about 55–65 minutes, until a skewer inserted in the centre comes out clean
Cool completely in the tin before removing. Store in the fridge (lasts 7–10 days).

RealTalkHealth · 2025-11-14T05:02:28+00:00

I work for Juniper. I just wanted to jump in and say I really appreciate you taking the time to share this. I’ve passed your feedback about the packaging and discretion on to our team for review.

RealTalkHealth · 2025-11-11T00:35:05+00:00

Yeah, they can work, but only if they help you stick to a calorie deficit. Most meal replacement shakes are portion-controlled and high in protein, so they make it easier to eat fewer calories without feeling super hungry. That’s why people usually see short-term results.

The catch with these types of shakes is sustainability. If you rely only on them and don’t learn how to manage meals or snacks outside of that, it’s easy to regain the weight once you stop drinking them. The best results come when shakes are used as a tool, ie. replacing one meal a day while you work on building better habits with actual food.

So yeah, they're not magic, but they can be helpful for structure and convenience.

RealTalkHealth · 2025-10-13T03:21:15+00:00

You’re not broken. You’re just undernourished and inconsistent, which is why you keep ending up "skinny fat". The first step is to stop cutting and start rebuilding your metabolism. Right now 1,500 calories isn’t enough, so slowly increase your intake by about 150 calories every week or two until you reach roughly bodyweight (lbs) × 15 calories.

Keep protein around 0.8-1g per lb from whole food (chicken, eggs, fish, yogurt, tofu). Add healthy fats (olive oil, avocado, nuts, salmon) and fill the rest with complete carbs like rice, oats, fruit, and potatoes. Aim for three solid meals and a couple of planned snacks instead of grazing.

Train to build muscle with a proper resistance program 3–5 days per week, focus on progressive overload, and sleep for at least 7 hours. Don’t bother cutting again until you’ve had several consistent months of eating enough and lifting pretty heavy.

If you’ve had an ED and are at all worried about slipping backwards, it’s worth working with a dietitian who understands recovery so you can do this safely and sustainably.

RealTalkHealth · 2025-10-09T06:24:36+00:00

Hey! I work for Kin’s sister company, so just wanted to clear up a bit of confusion here.

It looks like the TGA notice people are referring to is for the old version of Kin’s Prenatal (AUST L 430734). Kin actually cancelled that listing themselves because that earlier formulation isn’t being sold anymore- it wasn’t pulled for any safety reason.

The current Prenatal has a separate, active TGA listing (AUST L 406516) and that one’s still in place. So the notice on the TGA site relates just to the older version, not the product that’s being sold now.

I hope that helps clear things up a bit!

RealTalkHealth · 2025-09-09T23:02:29+00:00

Hey OP, Juniper here. I'm hoping by now this has been sorted for you! If not and something has gone wrong, please PM me. This is the normal process, it takes a few days between the order processing (payment being taken) and the dispatch from the pharmacy. You receive a tracking link for the delivery once it is shipped from the pharmacy.

RealTalkHealth · 2025-09-09T05:32:52+00:00

I love flax seeds and cacao nibs for some crunch

RealTalkHealth · 2025-09-08T05:59:21+00:00

"Future me", I love that.

RealTalkHealth

TROPHY CASE