GLP1 in pregnancies

[Purpletree]

Hi,

I started taking tirz not even a month ago at my starting weight 88.6kg, 161cm as a 26 y/o. Eventually, we would like to have another child (in the future, AFTER i manage to get to my goal weight - around 55kgs) and I started looking up data about continued usage in pregnancy and obviously found almost nothing except a lady on reddit who found out close to the third trimester about the pregnancy and then stopped taking it and the baby turned out fine. I know it feels selfish of me to think that I would like to continue taking even a microdose of tirz during pregnancy but I can’t help thinking that I will gain the usual pregnancy gain + the hunger horrors that come back when stopping the medication. This was somewhat acceptable until i actually read that the second time around taking tirz, its effectiveness decreases significantly and I also saw some doctors say that in the future there might be medically accepted to continue taking glp1’s because obesity is a chronic disease and medication is necessary for lifetime… i just don’t know how to feel after i will eventually lose the weight to know that i will get it all back on + some from the pregnancy. I know it’s not guaranteed that i will gain it all back but the reason why I started tirz is excessive food noise which i know will be back as soon as i stop it and i guess i will be amongst the people that do gain it back.

Any kind of insight is appreciated. I am in no way looking for medical advice, just for opinions. I am pretty sure that there are more people out there having the same fear that i have.

 

[DunningKruger]

I completely understand why you’re thinking this. If you’ve finally found something that quiets the food noise, the idea of giving it up is scary.

But if your goal is to have another child, I’d make that the priority over everything else.

Right now, the recommendation is to stop GLP-1 medications before trying to conceive because we simply don’t have enough human safety data to know they’re safe during pregnancy. One reassuring story on Reddit is not evidence that the risk is low, nor is it permission to take the same risk.

People who have healthy outcomes are also much more likely to post than those who don’t.

Ask yourself this: if something went wrong with the pregnancy, even if no one could ever prove the medication played a role, would you always wonder whether it did?

For me, that answer alone would make it a hard no.

If you’re worried about the food noise or weight gain, I’d work on that before conception. Taper off gradually with your prescriber, slowly increase calories as needed, and give your body time to adjust before trying to become pregnant. That problem can be managed. The potential consequences of taking unnecessary risks during pregnancy can’t always be.

 

[eidos]

Only a very small minority of medications are tested during pregnancy because of the potential risks to the embryo/fetus.

We know very little about GLP-1 analogs, and I haven't seen anything regarding gestation.

I'm just going to remind you of a few biological facts because you don't seem to be taking them into account.

The fetus needs high-quality nutrition to grow and be viable. Eat whatever your body demands; it's your instinct that does the job. Except for a couple of weird things where the taste changes, but the people around you will let you know.

Human females build up reserves equivalent to the energy needed to breastfeed until the next prosperous season. And since nature doesn't have a smartphone to check the date, it's made to last about a year. That's how our ancestors survived and how we exist today.

And if you don't want to breastfeed, you can always pump your milk and donate it, which will help you lose the fat. You'll have plenty of time afterward to get back on the Reta.

And everyone will tell you that pregnancy makes you glow.

 

[ohemaaluxe]

I had the same concerns as you about pregnancy and gaining weight. I had actually taken tirz for 4 months then had to stop (lost 30lbs) gained it all back and then some within the next few months after, then got on tirz again and lost 45 pounds. Right when I got under 200lbs is when I found out I was pregnant (I’m 6 months now). I will confirm that tirz was slightly less “effective” the second time around but mainly in the sense that I wasn’t able to stay on the lower doses for as long as I did the first time around. But the appetite suppression, etc were all there. When I found out that I’m pregnant, I was so scared about gaining weight but luckily or unluckily depending on how you view it lol, I didn’t have any major food noise and actually lost weight my first trimester due to intense food aversion and vomiting. Now that I’m in my second trimester I’ve gained 6 pounds, but still no food noise. So I’m trying not to fixate too much on my weight because I know it’s normal to gain weight and my main concern is for my baby to be healthy.

Am I planning to jump right back on tirz after I give birth and breastfeed a few months? Heck yes lol. My stash is waiting patiently. But for now I’m just happy I have peace of mind that I’m not doing anything to potentially hurt the baby.

I would say that you shouldn’t worry too much about it and just focus on getting as healthy as possible before the trying to conceive, because it makes a huge difference. I’m so glad I lost those 45 pounds before which I feel has made my pregnancy MUCH more comfortable.

 

[lessthanhalf]

So far there have been several studies showing women who were taking GLP drugs before they knew they were pregnant, so basically early pregnancy only, but then stopped them, had no significant increases in fetal malformations, miscarriages or bad outcomes. This is aided by the fact that they can increase the chances of getting pregnant in some women.

So it is not a disaster if you get pregnant on them then stop, but the recommendation is stop them a month or 2 before trying to get pregnant.

There are an awful lot of neurones in the brain and other sites with GLP receptors and GIP receptors. No one has the faintest idea what these drugs might or might not do to those neurones while they are developing in the fetus, or if there are harmful metabolic effects on the fetus as it grows. ( would it lower fetal blood sugar and affect growth? ) There are very good reasons to not expose a growing baby to GLP's on the face of it , it is easy to see where it might cause problems, and there will not be studies as it would be considered unethical and too dangerous to the fetus to do the studies, so like with a lot of drugs in pregnancy the advice is going to be to avoid them unless there is no choice , and the medical risks of stopping GLP drugs are pretty minor in the long term, as opposed to drugs needed to maintain maternal health during the pregnancy where the need outweighs the possible risks such as treating high blood pressure or epilepsy for example. I doubt good answers to their safety in pregnancy will happen soon, usually it takes an analysis of a large number of people accidentally taking it while pregnant to accumulate any sort of reliable data to go on which can take decades. No one wants to do prospective trials for drug safety in pregnancy , it would be a minefield.

Gaining excess weight in pregnancy is not ideal either, but no one is going to recommend staying on GLP drugs to prevent it, and of course you can always restart them after the baby is out, even if it does mean regaining some weight and having to lose it again, but at least these drugs exist now, that option was not there just a few years ago. I can certainly understand not wanting to stop them given I rely on them to help keep off 55% of my body weight, but some risks are not worth taking.