What Happens If You Stop Taking GLP-1s?

For patients who stop taking prescription weight loss GLP-1 medicines like Ozempic, Wegovy or Mounjaro due to drug shortages, issues with side effects, or difficulty paying the high prices, regaining all the weight they’ve lost — and then some — is possible. This weight “boomerang” or weight cycling can be very difficult.

GLP-1 medications like Ozempic and Mounjaro have recently made headlines from the Oscars to social media influencers. Also in the headlines are potential shortages of these medications, as pharmaceutical companies try to increase their production. These prescription medicines have helped many people lose a significant amount of weight, but many are now wondering whether they will continue taking these medicines long-term and, if not, what will happen. Shortages are also raising questions around what happens if someone misses a dose, or is temporarily unable to continue taking these medications.

Hello Alpha’s Chief Medical Officer, Dr. Mary Jacobson (affectionately known as Dr. J) stresses that, “obesity is a chronic illness. As with any other chronic illness, most patients will need to take the medication for their entire lives to maintain the benefits, which, in this case, means keeping the weight off.”

What are these medicines?

There are different categories of prescription medications to support weight loss. Every body is different, so your provider may prescribe medication depending on your desired results, co-existing health conditions, and family history. Here is a quick overview of the injectables that are relatively new to the market today:

• Semaglutide, known by the brand names Wegovy, Ozempic, or Rybelsus. Semaglutide medications are in the GLP-1 class of drugs, which mimic the action of a hormone called glucagon-like peptide-1. This medication acts on several systems to decrease appetite by producing feelings of fullness. It affects the appetite centers of the brain and slows down how quickly the stomach empties, which leaves you feeling full for longer. Semaglutide also acts on the pancreas to increase insulin secretion and decrease glucagon. (This reduces blood sugar levels after you eat.) Another way semaglutide works is by converting white fat-storing cells into brown fat, which increases energy expenditure. Semaglutide medications are typically taken once weekly via injection.
• Tirzepatide, known by the brand name Mounjaro. Like semaglutide, tirzepatide mimics GLP-1 but also includes GIP (glucose-dependent insulinotropic polypeptide). Tirzepatide works similarly to semaglutide medications to reduce appetite and increase feelings of fullness. It is also taken once weekly via injection.

Why would someone stop taking weight loss medication?

There are several reasons why patients have interrupted or stopped taking semaglutide or tirzepatide. These drugs faced widespread shortages due to its popularity and global supply constraints, and that has led to patients having difficulty accessing the medicine. Although some dosages are still experiencing delays, manufacturer Novo Nordisk has recently been reassuring patients that it is working to address supply issues.

Another prohibiting reason is cost. Semaglutide costs about $1,400 each month when insurance doesn’t cover it, and at that price point, many people can’t afford to stay on the medication for the long term.

“And when people stop taking it, there’s often rebound weight gain that may be difficult to control,” Dr. J says.

What happens when you stop taking GLP-1s?

When you lose weight, your body goes through changes that make it harder to keep the weight off in the long term and this means that sometimes people who lose weight end up gaining it back again. This remains true with GLP-1s and, in fact, a study found that most people gain back most of the weight within a year of stopping the medicine.

Two of the ways that semaglutide and tirzepatide work is by suppressing appetite and increasing satiety (feeling of fullness) which often leads to weight loss. Very quickly after stopping taking the medicine, the body’s fat mass set point will revert to its pre-medication set point and people will regain weight.

These GLP-1s often come with common — and uncomfortable — side effects like nausea, constipation, heartburn, and more. Anyone who experienced side effects but still continued with treatment usually see those side effects go away when they stop taking the medication, however, the American Hair Loss Association has recently noted that Ozempic may cause significant and possibly permanent hair loss.

Because these medicines help people eat less and feel full sooner, a halt to treatment may lead them to consume more calories and eat larger portions, which in turn may lead to insulin resistance and type 2 diabetes.

What if I need to go off these medications?

While there are lifestyle changes that are within patients’ control, there’s no way to completely manage chronic conditions like diabetes or high blood pressure just through willpower. Weight management is the same. “They are chronic medications,” Dr. J says, “which means you basically take them just like you take blood pressure medicine or diabetes medicine.”

If you do need to go off the drugs or restart the same or a different type of weight loss medication, a healthcare provider who’s familiar with the nuances of GLP-1s, tirzepatide, and weight loss management in general, can help manage this process. People with diabetes have other medicines that they can take to help control blood sugar levels and a skilled healthcare provider, possibly in partnership with a registered dietitian, can help with lifestyle changes to maintain weight loss without the support of these medications.

To learn more about prescription weight loss medications, please read:

• Dear Dr. J: What should I know about weight loss medication?
• Hello Alpha Reddit AMA on Weight Loss Medication
• Women’s health conditions that affect weight loss
• How building muscle can help with weight loss

PLEASE NOTE: THIS BLOG DOES NOT PROVIDE MEDICAL ADVICE.

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