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Discontinuing Ozempic (semaglutide) and other GLP-1 receptor agonists can raise some important questions and concerns regarding weight management.
These GLP-1 medications are commonly prescribed for weight management and have been shown to greatly accelerate and improve weight loss, with the majority of Ozempic clinical trial participants losing between 5-10% of their body weight. (Ahren, 2018) Unfortunately, it is not uncommon for people to experience weight regain after stopping this medication, something often referred to as “Ozempic rebound”. (Wilding, 2022)
So what happens when you stop taking GLP-1 medications? Does the weight come back? How can you maintain your weight loss? Here’s what you need to know.
How do GLP-1 medications work?
Glucagon-like peptide 1 receptor agonists (GLP-1RAs) were originally developed to treat type 2 diabetes, but are becoming increasingly popular for the treatment of obesity because they are effective at helping people lose weight. (Ard, 2021)
GLP-1 receptor agonists work by mimicking the GLP-1 hormone that is naturally found in the gut. (Ard, 2021) This hormone is responsible for regulating your blood sugar and reducing your appetite. When someone injects a GLP-1 receptor agonist, the medication binds to naturally occurring GLP-1 receptors and encourages the body to release more insulin, helping to lower blood sugar levels and reduce the production of glucagon, which suppresses appetite. (Ard, 2021) GLP-1 medications also slow the release of food from the stomach, which increases feelings of fullness after eating. (Ard, 2021)
How to avoid gaining weight after stopping GLP-1s
GLP-1s can be a very effective tool for losing weight, but it can be easy to regain some or all of the weight back if you don’t have an effective strategy and ongoing weight management plan. One study found that the majority of GLP-1 patients regained two-thirds of their prior weight a year after discontinuing their medication. (Wilding, 2022)
However, it is possible to keep the weight off for good- it just requires consistent exercise, a healthy diet, and a thoughtful drug discontinuation plan. (Sartain, 2024) A study found that tapering patients off of semaglutide over a course of 9 weeks while being coached on diet and exercise led to sustainable weight management after being off of the medication for 26 weeks. (Sartain, 2024)
To sustain your progress and prevent weight gain after stopping Ozempic or other GLP-1 medications, consider implementing the following strategies:
1. Slow and steady discontinuation
Stopping GLP-1 medications abruptly may lead to rapid weight regain. It’s best to follow your healthcare provider’s instructions for slowly decreasing your dose and tapering off your medication to avoid negative effects. (Sartain, 2024) By adjusting your dose gradually, you give your body more time to adjust to the change in medication, minimizing the risk of rebound weight gain.
2. Keep up healthy nutrition habits
GLP-1s work best when paired with a healthy diet and exercise. (Wilding, 2021) The goal is to build healthy habits while taking your medication that you can sustain for life. Without a healthy diet, you are more likely to experience rebound weight gain. (Wilding, 2021) (Wilding, 2022) Healthy nutrition habits include:
Balanced diet: Maintain a diet rich in whole foods, including fruits, vegetables, lean proteins, and whole grains. Limit the intake of processed foods and added sugars.
Portion control: Be mindful of portion sizes to avoid overeating. Using smaller plates and paying attention to hunger and fullness cues can assist in managing food intake.
Regular meal patterns: Establish consistent eating habits to regulate appetite and prevent excessive hunger, which can lead to overeating. (Nairn, 2022)
3. Prioritize physical activity
In addition to healthy nutrition habits, it’s also important that you maintain a regular exercise routine. Physical activity is a must for healthy weight loss and weight management. (HHS, 2022)
It’s recommended that healthy adults engage in at least 150 minutes of moderate-intensity aerobic activity per week, such as brisk walking or cycling. Additionally, try to incorporate strength training exercises at least twice a week to build muscle mass and work all of your major muscle groups. (HHS, 2022)
4. Lifestyle and behavioral changes
Other lifestyle factors can also influence your weight and overall health. Here are some tips for improving the way you interact with food, activity, and weight management.
Mindful eating: Practice mindful eating by focusing on the sensory experience of eating and recognizing hunger and fullness signals. This approach can prevent overeating and promote healthier food choices. (Nelson, 2017)
Stress management: Implement stress-reduction techniques such as meditation, yoga, or deep-breathing exercises. Chronic stress can lead to emotional eating and weight gain. (Wijnant, 2021)
Adequate sleep: Aim for 7-9 hours of quality sleep per night. Poor sleep can disrupt hunger hormones and increase appetite, leading to weight gain. (Schmid, 2008)
5. Get medical support
Your healthcare provider is a great resource for medical weight management, including medications, guidance, and programs outside of GLP-1s. Some options include:
Alternative medications: Discuss with your healthcare provider the possibility of transitioning to other weight management medications or treatments that may support your weight maintenance efforts. Other options include oral medications, such as the Fighting Weight Weight Loss Stack combining bupropion, naltrexone, and metformin.
Professional guidance: Regular consultations with a registered dietitian, personal trainer, or weight management specialist can provide personalized strategies to aid in your diet and exercise routines.
6. Community and support systems
Some people find that building a supportive community is a helpful way to maintain their weight loss and stay accountable. Some options include weight maintenance support groups, which can offer a safe space for encouragement, sharing experiences, and providing practical tips for sustaining weight loss. Family and friends are also a great resource to lean on during your health journey.
7. Monitoring and accountability
To maintain a healthy lifestyle, it’s also important to keep a close eye on your weight and regularly check in with yourself and your provider on your vitals, lifestyle habits, dietary intake, and physical activity levels.
Set realistic goals that you can achieve to stay motivated, and be sure to manage any underlying conditions that may influence your weight, such as mental health concerns, chronic conditions, stress levels, and more.
Moving forward with healthy weight management
With dedication, provider support, and a supportive community, it is possible to meet and sustain your ideal weight. By implementing some of these strategies, you can enhance your ability to maintain weight loss after discontinuing Ozempic or other GLP-1 medications. Remember that individual experiences can vary, and it's essential to consult with healthcare professionals to develop a personalized plan that suits your specific needs.
Want to speak to qualified providers online? Get started with Fighting Weight today.
Citations:
Ahrén, B., Atkin, S. L., Charpentier, G., Warren, M. L., Wilding, J. P. H., Birch, S., Holst, A. G., & Leiter, L. A. (2018). Semaglutide induces weight loss in subjects with type 2 diabetes regardless of baseline BMI or gastrointestinal adverse events in the SUSTAIN 1 to 5 trials. Diabetes, obesity & metabolism, 20(9), 2210–2219. https://doi.org/10.1111/dom.13353
Wilding, J. P. H., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., Kushner, R. F., & STEP 1 Study Group (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, obesity & metabolism, 24(8), 1553–1564. https://doi.org/10.1111/dom.14725
Ard, J., Fitch, A., Fruh, S., & Herman, L. (2021). Weight Loss and Maintenance Related to the Mechanism of Action of Glucagon-Like Peptide 1 Receptor Agonists. Advances in therapy, 38(6), 2821–2839. https://doi.org/10.1007/s12325-021-01710-0
Sartain, Marie. (May 16 2024) Coming off GLP-1s slowly could be the key to preventing weight regain. American Pharmacists Association. https://www.pharmacist.com/Pharmacy-News/coming-off-glp-1s-slowly-could-be-key-to-preventing-weight-regain
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., Kushner, R. F., & STEP 1 Study Group (2021). Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine, 384(11), 989–1002. https://doi.org/10.1056/NEJMoa2032183
Rayven Nairn (December 9, 2022) TIMING IS EVERYTHING: WHY EATING ON A REGULAR SCHEDULE SUPPORTS OVERALL WELL-BEING. Johns Hopkins University. https://wellbeing.jhu.edu/blog/2022/12/09/timing-is-everything-why-eating-on-a-regular-schedule-supports-overall-well-being/
US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans. 2nd ed. US Department of Health and Human Services; 2018. https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines (PDF; 14.8 MB)
Nelson J. B. (2017). Mindful Eating: The Art of Presence While You Eat. Diabetes spectrum : a publication of the American Diabetes Association, 30(3), 171–174. https://doi.org/10.2337/ds17-0015
Wijnant, K., Klosowska, J., Braet, C., Verbeken, S., De Henauw, S., Vanhaecke, L., & Michels, N. (2021). Stress Responsiveness and Emotional Eating Depend on Youngsters' Chronic Stress Level and Overweight. Nutrients, 13(10), 3654. https://doi.org/10.3390/nu13103654
Schmid, S. M., Hallschmid, M., Jauch-Chara, K., Born, J., & Schultes, B. (2008). A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. Journal of sleep research, 17(3), 331–334. https://doi.org/10.1111/j.1365-2869.2008.00662.x
