How to Keep the Weight Loss Off After Ozempic

Wondering how to keep the weight loss off after Ozempic? Here are some tips.

While most people gain weight back after stopping medications like Ozempic, Mounjaro, and Wegovy, health experts say there are steps you can take to reduce your risk.

While many people find they do lose a significant amount of weight while taking these drugs, a large number of people who stop taking them discover they can quickly regain the weight they’ve lost and more — commonly referred to as Ozempic rebound.

But is weight gain inevitable after you stop taking a GLP-1 drug? Health experts say it’s complicated, and though people generally do, they can take steps to significantly reduce their risk and keep the weight off.

Why people regain weight after stopping drugs like Ozempic

Obesity is now thought of as a chronic condition, much like diabetes or hypertension. “Therefore, it should be treated like a chronic disease, and patients need to continue the medication long-term,” Ali says.

In other words, stopping insulin might cause a spike in a patient’s A1C levels, and a person who ceases use of beta blockers for hypertension could see elevated blood pressure. It’s the same with a GLP-1. And, like diabetes, there is no “cure” for obesity.

“These medications are treatments and not cures,” says Dr. Daniel B. Maselli, MD, ABOM, a bariatric endoscopist and obesity medicine physician at True You Weight Loss in Georgia.

As with other medications, GLP-1s like Ozempic affect a person’s biochemistry.

“These medications bind to and activate receptors in the body — GLP-1 for semaglutide,” says Maselli. “These receptors promote downstream pathways that are important for appetite regulation, insulin sensitivity, and metabolism, among other benefits, and so lead to improvements in weight and metabolic health.”

Ali adds that the stimulation slows stomach emptying, increasing the chance a patient is satiated longer (and therefore eats less).

But, without the medication to block and promote pathways that can affect a body’s biochemistry, a person is more likely to return to consuming more calories and regaining weight.

“This is not a unique phenomenon to GLP-1 medications and is similar to what we observe with medications that treat other chronic conditions, like high blood pressure, asthma, or inflammatory bowel disease,” Maselli says.

How to keep the weight loss off after Ozempic

Experts shared the following tips on how to keep the weight off after Ozempic of one of the other GLP-1 medications.

Seek support

Even if a provider doesn’t recommend going off of a medication, they can still provide support and answer questions. Use them as a sounding board. “Everyone who has lost a significant amount of weight inevitably hits bumps in the road,” Saunders says. While Saunders feels that stopping an anti-obesity medication is a huge hurdle for a person to climb, life changes and new medications can also present challenges.

“The patients who fare best are those who reach out early to their care team for help,” Saunders says. If possible – and you don’t have one already — add a member to your support team, like a weight-inclusive registered dietitian.

“This support system can help you navigate the mental and emotional aspects of weight fluctuations while offering health-promoting strategies that don’t rely upon a return to restrictive dieting,” says Cara Harbstreet, MS RD LD of Street Smart Nutrition.

Eat mindfully

Maselli says that no diet can perfectly mimic the biochemical effects of drugs like Ozempic and Wegovy. However, some foods can help a person feel fuller longer.

“Fiber and protein, for instance, take more time to move through the stomach and digestive tract — similar to how GLP-1 medications delay stomach emptying — and so are more filling than other types of foods,” he says.

Harbstreet agrees that foods rich in fiber and protein are beneficial. The timing of consumption also matters. “Since protein has a similar effect for satiety, spread your protein intake throughout the day,” says Harbstreet. “In other words, avoid a pattern of small meals or lower protein foods all day before filling up on tons of protein at dinnertime.”

Harbstreet says legumes like beans offer both fiber and protein. Whole grains and leafy green vegetables are packed with fiber. Additionally, she says that foods like avocado with healthy fats can increase and prolong full feelings.

Exercise regularly

Consistent physical activity is a hallmark recommendation for overall health and weight loss maintenance, whether a person is or isn’t on an anti-obesity medication. “Regular exercise has a number of benefits, including increasing cardiovascular health, burning more calories, and building muscle,” says Ali. “It is important for a person to find some sort of activity that they enjoy and can do on a regular basis.”

Ali suggests doing at least 30 minutes of exercise per day, five times per week, though you may want to work up to that amount over time. “Starting slow and building up to a regular regimen is perfectly fine,” he says.

Seek out another type of therapy

While anti-obesity medications can offer significant benefits, patients have other therapies available. “Much like any other disease state, if one type of therapy isn’t feasible due to cost, access, tolerance, or just ineffectiveness for a specific patient, then pursuing an alternate treatment strategy is a very reasonable course of action,” says Maselli.

Maselli says these treatments may include endoscopic bariatric therapies like endoscopic sleeve gastroplasty, which can be performed as a same-day outpatient procedure and does not require long-term medication use.

Treat other underlying conditions

Maselli reminds people that obesity and overweight can put individuals at risk for more than 200 conditions, including hypertension and type 2 diabetes. A patient on a weight loss drug like Wegovy may have one or more of them. That’s why it’s important to continue to treat these conditions after going off an anti-obesity medication.

“Left untreated, many of these conditions can reduce energy and tolerance of physical activity,” Maselli says. “It’s critical to see your physician to screen for these common conditions and treat them if found.”

Additionally, Maselli recommends asking your healthcare professional if other medications you take list weight gain as a possible side effect. “It’s an incredibly common side effect, and many medications have a weight-neutral alternative that can be used instead,” Maselli said.

Set realistic expectations

Harbstreet says it’s important to manage expectations — you can do all of the above and still put weight back on. “This likely isn’t what you want to hear, but the reality is that weight regain is very likely,” Harbstreet says. “Weight cycling can have a negative effect on metabolic health, as well as body image and self-esteem, so resist the urge to start another fad diet or start heavily restricting. This increases the risk of disordered eating or developing an eating disorder.”

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