The skyrocketing demand for fast weight loss ushered in an era of a new class of medications — like Ozempic and Mounjaro — approved by the Food and Drug Administration specifically for weight loss based on surprising results from diabetes drugs.
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While many tout the benefits of these weight loss drugs, there are also downsides, including what it’s like coming off medications like Ozempic and Mounjaro.
Here’s what to know about what happens when you stop taking weight loss drugs and how you can minimize rebound weight gain.
[READ Side Effects of the New Weight Loss Drugs: Are They Safe?]
Mounjaro, Ozempic, Wegovy and Zepbound: Similarities and Differences
A variety of weight loss drugs are available by prescription:
Ozempic and Wegovy (semaglutide)
Ozempic and Wegovy are brand-name medications with the active ingredient semaglutide, which belongs to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. Both are administered as a weekly injection, but they are FDA-approved for different reasons:
— Ozempic has become the catch-all name associated with weight loss drugs, but it was approved by the FDA in 2017 for adults with Type 2 diabetes to help lower blood sugar levels and reduce the risk of heart attack, stroke or death.
— Wegovy was approved in 2021 for adults and children over 12 who are overweight or have obesity to lose weight, when used in tandem with diet and exercise. Wegovy is administered at a higher dose than Ozempic.
Mounjaro and Zepbound (tirzepatide)
Mounjaro and Zepbound are brand-name medications of the same drug, tirzepatide. Both drugs work by activating two receptors simultaneously: the GLP-1 (like semaglutide) and glucose-dependent insulinotropic polypeptide, or GIP, receptors. Because of this dual action, tirzepatide has been shown to be even more effective than semaglutide in supporting weight loss.
Although they are the same drug, they are FDA-approved for different purposes:
— Mounjaro was approved by the FDA in 2022 to help adults with Type 2 diabetes improve blood sugar.
— Zepbound was approved in November 2023 for weight loss.
These weight loss medications can be real game changers for people who have struggled to lose weight.
“These (medications) are finally actually dealing with multiple dimensions of the pathophysiology of obesity, which is why they’re so effective,” says Dr. Shiara Ortiz-Pujols, an obesity and lifestyle medicine specialist with Staten Island University Hospital in New York.
[READ: Do Weight Loss Pills Work? What You Need to Know]
Side Effects of Stopping Weight Loss Drugs
Whether you’re taking diabetes medications (like Ozempic or Mounjaro) or weight loss drugs (such as Wegovy or Zepbound), they all have similar side effects when you stop.
Potential side effects of stopping weight loss drugs include:
— Return or increase in appetite.
— Changes in blood sugar levels.
— Rebound weight gain.
Because these medications may cause gastrointestinal issues, you also may experience a reduction of diarrhea, nausea, upset stomach or other side effects after stopping the medication.
Wegovy withdrawal symptoms
What happens when you stop taking Wegovy? Patients who go off Wegovy may regain weight.
In a 2021 study published in JAMA, adult participants who were overweight or had obesity completed a 20-week weekly treatment of semaglutide, the active ingredient in Ozempic and Wegovy, in a randomized clinical trial, reporting a mean weight loss of 10.6%. From week 20 to 68, some were randomized to continue receiving semaglutide while others received a placebo, withdrawing treatment. Mean weight change was 7.9% weight lost versus 6.9% gained, respectively.
The results showed that participants gradually regained weight after stopping the weight loss drug, which the researchers point out is consistent with findings from other withdrawal trials of anti-obesity medications.
Zepbound withdrawal symptoms
Similarly, patients who stop taking Zepbound may experience weight regain.
In a JAMA study published in December 2023, participants who were overweight or had obesity completed a 36-week dose of tirzepatide, the active ingredient in Mounjaro and Zepbound, followed by a 52-week period during which time participants were randomized to switch to a placebo or continue tirzepatide.
All participants had a mean weight reduction of 20.9% in the first 36 weeks. Coming off tirzepatide led to a significant regain of weight, whereas participants who continued with tirzepatide maintained and augmented their initial weight loss. Participants who swapped to the placebo experienced a 14% weight regain, and those who continued on the weight loss drug had an additional 5.5% weight reduction.
[READ: How Many Calories Per Day to Lose Weight]
How Long Should You Use Weight Loss Drugs?
There’s no set limit to how long someone can be on weight loss medications, experts say.
In fact, because some health care providers are starting to treat obesity more like a chronic disease, like diabetes or heart disease, many believe patients should be on these medications long term or permanently to maintain weight loss.
However, any kind of intervention for obesity — whether it’s diet, medication or bariatric surgery — is just one tool to help adopt a healthier lifestyle. In order to maintain a healthy weight and good habits, a more holistic approach is required.
“If they’re just using medications and not thinking about long term, then there’s a higher chance of weight regain when they stop this medication,” says Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.
How to Stop Taking Weight Loss Drugs Safely
Your health care provider may advise you to go off a weight loss drug if you’re experiencing any adverse side effects that outweigh the benefits. For example, if you’re regularly experiencing gastrointestinal effects — including nausea, stomach pain, vomiting, diarrhea or constipation — it may be better for your health to go off the medication, but it’s important to work closely with your doctor or registered dietitian when going off any weight loss drug.
“Tolerability to these medications is something that requires a lot of monitoring from a medical team,” Ortiz-Pujols says.
With the right guidance from a licensed medical professional, most people can be walked through any adverse effects. But if medications are prescribed by people who are not familiar with the medications’ side effects or if there isn’t close monitoring of the patient, people may go off medications too quickly and have resulting issues, Ortiz-Pujols says.
Will You Gain Weight Back After Stopping Weight Loss Drugs?
Unless you actively maintain a robust exercise regime and calorie restriction, you will likely experience rebound weight gain after stopping the regimen.
“When you stop the medication, your physiology goes back to what it was before your medication,” Ali says, adding that the effect can be immediate.
Importance of a healthy lifestyle
People who go off the drug experience the same hunger levels and often the same cravings as they did before going on the drugs. As a result, they can regain the weight they lost. However, if patients are able to focus on maintaining a well-balanced diet and healthy lifestyle habits, they have a better chance of success, experts agree.
“All of the super exciting results that we are seeing in scientific literature — not these anecdotal things where you see people are using it to lose 10 pounds — it has all been coupled with (healthy) lifestyle,” Ortiz-Pujols says.
In a 2021 JAMA study, all participants — whether taking semaglutide or the placebo — also received lifestyle intervention for the 68-week study duration, an often-overlooked component when weight loss drugs are hyped on social media and in the news. The study’s lifestyle intervention incorporated monthly counseling with a health professional, a reduced-calorie diet and increased physical activity.
Similarly, in a 2023 JAMA study, all participants — whether taking tirzepatide or the placebo — received lifestyle counseling from a qualified health care professional for the duration of the study. Through counseling, participants were encouraged to eat in a 500-calorie deficit and get at least 150 minutes of weekly physical activity.
“Make sure that your nutrition is in place and that you are moving,” Ortiz-Pujols emphasizes.
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What Happens When You Stop Taking Weight Loss Drugs? originally appeared on usnews.com
Update 04/22/24: This story was previously published at an earlier date and has been updated with new information.
