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What happens to weight when you stop Ozempic?

What happens when you stop taking Ozempic®? Weight loss caused by GLP-1 agonist drugs is not always permanent. In clinical trials, people who stopped taking semaglutide regained the majority of their prior weight loss with a year.

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What is obesity?

Obesity is a chronic health condition that affects an increasing number of people worldwide. In the United States, more than 70% of adults are overweight (often defined as having a BMI of 25-29 kg/m2), and more than 40% have obesity (BMI greater than or equal to 30 kg/m2). Complications of obesity include diabetes, heart disease, sleep apnea, anxiety, depression, and a reduced life expectancy. Because modest weight reduction can reduce many of these complications, scientists have developed prescription medications to help obese and overweight individuals achieve better weight control and have healthier, longer lives.

What are weight loss medications?

Since the 1990’s, multiple prescription medications have been evaluated and approved by the United States Food and Drug Administration (FDA) for weight management in overweight or obese individuals. Some of these drugs were better known for their undesirable side effects than for their weight loss benefits. Orlistat (Xenical®), which was approved by the FDA in 1999, was associated with oily rectal leakage, gassiness, or abnormal bowel movements. Lorcaserin (Belviq®), approved by the FDA in 2012, was withdrawn from the market in 2020 due to concerns that it caused cancer. There are also several so-called “weight loss supplements.” Unlike prescription and over-the-counter medicines, dietary supplements are not regulated by the U.S. Food and Drug Administration (FDA).

What are some new weight loss medications?

In 2014, the FDA approved liraglutide (Saxenda®) for chronic weight management in obese or overweight adults with weight-related medical conditions, and the FDA expanded the approval age range to those aged 12 and older in 2020. In 2021, the FDA approved semaglutide (Wegovy®) for chronic weight management in obese or overweight adults with high blood pressure, type 2 diabetes mellitus, or high cholesterol.

What are Ozempic®, Saxenda®, and Rybelsus®?

Liraglutide (Saxenda®, Victoza®) and semaglutide (Wegovy®, Ozempic®, Rybelsus®) belong to the “GLP-1 receptor agonist” class of drugs. GLP-1 is a hormone produced by the body in response to food intake. GLP-1 agonist drugs help the body make higher levels of GLP-1, which in turn can affect hunger, food intake, and weight. Since GLP-1 also affects insulin release and blood sugar control, some GLP-1 agonist drugs are also used to treat diabetes mellitus. GLP-1 agonist drugs are available in both oral and injectable forms. Rybelsus® is an oral formulation of semaglutide, while Wegovy® and Ozempic® are injectable. Saxenda® and Victoza® are injectable versions of liraglutide.

Ozempic® vs Wegovy®

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Ozempic®, Wegovy®, and Rybelsus® all contain the same active ingredient, semaglutide. However, the drugs are dosed differently, and are prescribed for treatment of different conditions. Ozempic® and Rybelsus® are only approved to improve blood sugar control in adults with diabetes, while Wegovy® is approved for weight management.

Table: common GLP-1 agonist prescription medications

Brand Name Generic Name Formulation Ozempic® semaglutide injection (0.25-2 mg per injection) Wegovy® semaglutide injection (0.25-2.4 mg per injection) Rybelsus® semaglutide oral (3, 7, and 14 mg tablets) Saxenda® liraglutide injection (0.6-3 mg per injection) Victoza® liraglutide injection (0.6-1.8 mg per injection)

How does Ozempic® work?

Ozempic® is not insulin, and acts on the body differently than insulin does. Because of their effects on food intake, members of the GLP-1 class of drugs, including semaglutide and liraglutide, have many potential effects in the human body that affect hunger and weight. These drugs slow the rate at which food is transferred from the stomach to the intestines (called “gastric emptying”), which enhances the feeling of a full stomach. The drugs also pass through the bloodstream into the brain, where they act on the nervous system to decrease both food intake and appetite.

Can you use Ozempic® for weight loss?

Ozempic® is approved by the FDA to improve blood sugar control and reduce risk of heart disease in diabetic patients. While Ozempic® is not currently FDA approved for use as a weight loss drug, many studies have investigated the effects of GLP-1 agonist drugs on weight loss. In a 2009 study that evaluated the weight-loss effects of liraglutide versus Orlistat® or placebo, individuals who used liraglutide lost, on average, 11-16 pounds (4.8-7.2 kilograms) over 20 weeks. In a 68-week trial published in the New England Journal of Medicine in March 2021, obese or overweight adults who took semaglutide had a 15% decrease on body weight, and also experienced improvements in physical function and risk factors for heart disease. The results of one study suggest that injectable semaglutide is more effective in promoting weight loss than oral liraglutide.

What happens when you stop taking Ozempic®?

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Weight loss caused by GLP-1 agonist drugs is not always permanent. In clinical trials, people who stopped taking semaglutide regained the majority of their prior weight loss with a year. In addition, those who stopped taking semaglutide also experienced increases in blood pressure, cholesterol, and blood sugar levels, suggesting that continued use of the medication is needed to maintain both weight loss and reduction in risk factors for heart disease.

Is semaglutide (Ozempic®) safe?

GLP-1 agonist drugs, including semaglutide (Wegovy®, Ozempic®, Rybelsus®), and liraglutide (Saxenda®), are generally well tolerated and are not associated with significant unwanted side effects. Common adverse effects of these medications include nausea, vomiting, abdominal pain, and diarrhea.

Does insurance cover Ozempic®?

While semaglutide (Wegovy®, Ozempic®, Rybelsus®), and liraglutide (Saxenda®) are approved by the FDA, individual insurance coverage policies for these medications can vary.

What do I do if I had a bad reaction to, or took too much, semaglutide (Wegovy®, Ozempic®, Rybelsus®), or liraglutide (Saxenda®)?

If you took too much or have unwanted or unexpected side effects after use of GLP-1 agonist drugs such as liraglutide (Saxenda®) and semaglutide (Wegovy®, Ozempic®, Rybelsus®), reach out to Poison Control immediately to find out what to do. Get a fast personalized recommendation online or call 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.

Kelly Johnson-Arbor, MD

Medical Toxicologist

For media inquiries, please contact Krista Osterthaler at osterthaler@poison.org.

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