What happens with weight loss drugs long-term? After about two years of taking Ozempic for diabetes or weight loss, people say they still have to stay diligent about diet and exercise.

Given the immense demand for Ozempic, the blockbuster drug that treats diabetes and is also prescribed off-label for weight loss, it’s not unusual to know someone who is starting or already taking the medication.

Data from Novo Nordisk, which makes Ozempic, suggests that U.S. providers were writing around 60,000 new weekly prescriptions for the drug as of April. But far fewer patients have been on the drug for years, given that it’s relatively new, can cause side effects and is expensive without insurance coverage.

Weight Loss Drugs Long-Term Personal Experiences

What is it like to be on weight loss drugs long-term?

Barbie Jackson-Williams, 54, of Des Moines, Iowa, said she started taking Ozempic in early 2021 to lose weight and manage her Type 2 diabetes.

• She said the medication has helped her make changes that she’d previously found challenging, like subbing out pasta — her old favorite — for lean proteins and cutting out sweetened iced coffees from her diet.

• People are just taking it just to get skinny and that’s not true, she said. You have to do the work, and people don’t realize that.

NBC News identified and talked with several people who have been on Ozempic for between one and a half and two and a half years.
• All generally agreed that the medication was not a fast pass to good health.
• Although Ozempic has helped them either shed pounds, lower their blood sugar levels or both (reasons for taking the medication vary from person to person), maintaining those changes takes effort, they said.

Edward Matias’ experience:

• Matas has been on Ozempic for a year and seven months.

• “This isn’t a magic bullet or pill,” said Edward Matias, 45, a Connecticut resident who works in IT.

• “It’s not the fountain of youth. It takes work and commitment. If people are asking for this med because they want to lose weight and think they can eat anything at all, they’re in for a rude awakening.”

• Matias said that because of his diabetes, he still has to be careful about eating foods high in sugar or carbohydrates.

• But his weight has dropped from about 310 pounds to 230 while taking Ozempic, he said.

Most of those interviewed said that rather than being a cure-all, Ozempic has kick-started lifestyle changes, such as enabling them to exercise in ways they couldn’t before.

Jackson-Williams said that losing weight has led her to feel more energetic and less inclined to be stationary:
• “I want to be active. I want to be doing stuff.
• I can’t sit and watch TV like I used to,” she said.

Benefits of Weight Loss Drugs

Ozempic and its sister medication, Wegovy — approved for weight loss for people who are obese or overweight with weight-related medical conditions — are considered long-term or lifelong treatments.

• But Ozempic has been on the market for less than six years, and Wegovy for two, so doctors and patients are learning in real time what it’s like to use the drugs for extended periods.

• Dr. Eduardo Grunvald, an obesity medicine physician at UC San Diego Health, said he’s waiting on the results of trials to see if Ozempic and Wegovy reduce the risk of heart disease, as is the case with Trulicity, another weight-loss medication in the same class.

• There’s also a possibility the drugs might lower bone density or raise the risk of thyroid cancer, which has been detected in animal studies involving Ozempic, Grunvald said.

• “Are we going to see that pop up with millions and millions of patients on these medications?” he asked. But most likely, he said, the benefits “probably still outweigh the risk.”

Ozempic may enable people to exercise more

Ozempic may enable people to exercise more, but several people said they saw their weight creep up when they stopped exercising or ate more than usual while on Ozempic.

Arnob Alam said he takes the drug to help him control his blood sugar and shed extra pounds but has gained back about 17 of the 25 pounds he originally lost after starting the drug.

Travel and returning to the office disrupted some of his healthy routines, Alam said, though he still feels more agile.

Grunvald said many people taking Ozempic or Wegovy have an easy time losing weight in the beginning, but eventually their bodies resist further weight loss. Regardless, he said, it’s healthiest to exercise and eat well in tandem with taking the medication.

“These drugs should be used with lifestyle modification. If you have to watch your diet and exercise with the medications, that’s what they’re meant for,” Grunvald said.

Challenges to maintaining weight loss

Ozempic and Wegovy are both versions of semaglutide, a medication that can lower blood sugar and suppress appetite by mimicking a hormone that signals to the brain that a person is full.

Like many drugs, the effects don’t last after patients go off them, so people tend to regain most of the weight they lost if they stop taking the medication.

Grunvald said many patients are under the false impression that they can stop taking Ozempic or Wegovy after they hit their goal weight.
Others, he said, see their weight plateau and mistakenly assume they aren’t making progress.

“Many people think that the drug’s not working anymore,” Grunvald said. “It’s working great, because otherwise you would have regained the weight.”

Weight Loss Drugs Long-Term Effects

Although much remains to be learned about the long-term effects of Ozempic and Wegovy, similar drugs could offer insight.

• In a study of people on the weight-loss medication Saxenda, about half of those who lost at least 5% of their body weight after a year kept the weight off after three years of taking the drug in combination with regular exercise and a low-calorie diet.

• But only 25% of those treated with Saxenda in 2021 stayed on it for more than a year, according to data from Novo Nordisk.

• For those committed to staying on Ozempic long term, high price tags and supply shortages can pose challenges.

• The Food and Drug Administration has reported limited availability of the three lowest doses of Wegovy and the highest dose of Ozempic.

• The medications can also cost more than $1,000 a month without insurance.

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