You’ve been on the weight-loss drug Wegovy for obesity, and you’ve had good results, so you might be wondering whether you still need it. Or maybe you’re thinking about taking the drug for a few months to lose weight before a big event, as many celebrities seem to do. It could be that you’re taking Ozempic for type 2 diabetes and want to know how changing your dose might affect the weight loss that’s come as a result.
What happens if you stop taking Wegovy or Ozempic, the drugs making headlines for their ability to spur weight loss?
We spoke to Andrea Coviello, MD, medical director of the UNC Health Medical Weight Program, to find out.
Stopping the Medication Affects Hunger
Wegovy and Ozempic are made of the same compound, known generically as semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. Both drugs are approved by the Food and Drug Administration—Wegovy for weight management and Ozempic for diabetes.
“These drugs are a synthetic version of natural gut hormones that are secreted after you eat to make you feel full,” Dr. Coviello says. “The synthetic versions have a longer half-life, so they stay in your system longer. This has an amplified effect on your metabolism and appetite regulation.”
Dr. Coviello says that when people begin taking semaglutide, they report less hunger and decreases in cravings for fatty foods and sweets, indicating that the drugs affect appetite pathways in the brain.
However, it doesn’t seem that the brain is automatically retrained to resist food or cravings once you stop taking the drug.
“You will still have the natural gut hormones in your system, but they won’t last as long,” Dr. Coviello says. “After stopping the drugs, people experience a return of cravings and hunger, and most people in clinical trials gain back 50 percent of weight lost in 12 to 18 months.”
These Drugs Are Part of a Long-Term Solution
Because of the risk of rebound weight gain after stopping semaglutide, people prescribed Wegovy for obesity may need to take the drug for the rest of their lives. Lifestyle modifications on their own don’t always prevent weight gain, research shows.
Still, drugs such as Wegovy and Ozempic are most effective when paired with healthy lifestyle changes related to nutrition, exercise, sleep and stress. If you don’t want to be on a lifelong drug, adopting these habits early can prevent the need to take one.
“Everyone can work on nutritional quality and quantity,” Dr. Coviello says. “Look for food with better nutritional values than fast food and processed foods, which are high in sugar, fat and salt. Be aware of how many calories you consume. Some people lose weight by tracking and becoming more mindful of their dietary patterns.”
Dr. Coviello says that regular physical activity is key to weight management.
“You need to find exercise you can commit to doing for the long term,” she says. “Walking daily has significant benefits and can improve your overall health.”
A lack of sleep and increased stress are also associated with obesity. It’s especially easy to reach for unhealthy foods during times of stress as a way to meet emotional needs.
“There are excellent resources available to help people rethink how they respond to stress,” Dr. Coviello says. “A tool like appetite awareness training can help people learn how to respond to stress without giving in to a food craving.”
Although there is a perception that weight loss is a matter of eating less and exercising more, it’s not that simple for people seeking treatment for obesity.
“There has been a fundamental shift in the medical community in understanding and treating obesity as a chronic disease,” Dr. Coviello says. “Earlier weight-loss drugs were meant for short-term use only. Now that we understand the health risks of obesity, we know that this chronic disease requires lifelong treatment.”
Consider This When Preparing to Stop Weight-Loss Drugs
Some people opt to stop taking weight-loss medications because of their side effects, which can include nausea, diarrhea and constipation. Dr. Coviello says the side effects will cease once the medication is out of your system, which may take about six weeks.
Others may choose to discontinue the medication if they don’t see results.
“Some people have more weight loss than is typical, some have less,” Dr. Coviello says. “That reflects the variability of underlying reasons for weight excess. These gut hormones do work for most people to some extent, but in the future, we may have more nuanced tools to address what’s causing obesity.”
Whatever the reason for stopping a weight-loss drug, Dr. Coviello says it’s important to be ready for changes in appetite.
“Have a plan for dealing with rebounds in hunger and possible weight gain,” she says. “Monitor your responses to food, and if there are gains in weight, you may need to see your provider again and consider your plan.”
Dr. Coviello advises against stopping and starting the drugs.
“When you go off the drugs and then take them again, you’re more likely to experience the gastrointestinal side effects again,” she says, noting that these tend to lessen as you get used to the medication.
Discuss concerns about your weight or weight-related health problems with your doctor. Need a doctor? Find one near you.