30 months in, longest of anyone on this thread I think. Down 71lbs and maintaining. One thing that hasn't been mentioned — my relationship with exercise completely changed. Before sema I exercised purely to burn calories and I hated every second. Now I exercise because it feels good and makes me stronger. The decoupling of exercise from punishment-for-eating is something I didn't expect and I'm grateful for every day.

Something I want to mention for the long-term crowd: has anyone noticed the "food aversion" effect intensifying or changing over time? At 2+ years, my food preferences are dramatically different from pre-sema. Foods I used to love (fast food, pizza, super sweet desserts) now genuinely repulse me. Not just "I don't crave them" but actually disgust.

I'm not sure if this is the medication or if my palate has just changed from eating differently for 2 years. Either way it's fascinating.

same! I used to eat Taco Bell like 3x a week. Drove past one last week and the smell made me slightly nauseous. My body just does not want that food anymore. It's wild how much has changed.

Love hearing from all of you. The common themes seem to be:

• Weight stabilizes around month 12-18 and most of us have been maintaining since
• Side effects are minimal to none at 2+ years
• Many have been able to reduce dose for maintenance
• The mental/emotional benefits are arguably more significant than the physical
• Food preferences permanently shift in ways we didn't expect
• The "forever" question doesn't bother us as much as we thought it would

Posting this summary for anyone searching this thread in the future. Two years in, the consensus seems to be: it works, it's sustainable, and most of us have zero regrets. 💯