5 Things That Can Happen After You Stop Taking Ozempic
Ozempic has taken over our social feeds and conversations, but what happens when you stop taking it?
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Semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have taken the world by storm, but with high costs, shifting insurance coverage, and difficult side effects, many find themselves forced to discontinue the medication.
“I had to stop cold turkey,” says Sydney Anderson, 28, who lives in Lynchburg, Virginia. Anderson had lost 70 pounds (lb) using tirzepatide when her insurer canceled her coverage without warning. “I feel helpless,” she says. “I finally found something that was helping my health, and my ability to obtain it was taken away.”
About 1 in 8 American adults have taken a GLP-1 drug, but more than half say that it was difficult to afford. More than a third of new GLP-1 users stop taking their medication within one year.
GLP-1 drugs were originally designed to lower blood sugar. Semaglutide and tirzepatide also make people feel fuller and eat less, curbing the appetite and slowing stomach emptying. The results are game-changing for weight loss and offer comprehensive metabolic improvements. Those improvements, however, are not believed to last once the drug is discontinued.
Anderson was prescribed an older weight loss drug, phentermine, to help keep off the weight, but she has been disappointed with the results. She has regained 20 lb, and her polycystic ovarian syndrome symptoms, which had disappeared with weight loss, are returning.
Whether it’s the shortage, side effects, lack of insurance, or high out-of-pocket costs that prompt patients to stop taking GLP-1 drugs like Ozempic, they all face the same issue: how to maintain the results they got from the drug after they stop taking it, says Robert Kushner, MD, a professor and the director of the Center for Lifestyle Medicine at Northwestern University Feinberg School of Medicine in Chicago.
Weight loss and regain from going on and off Ozempic can affect the skin, particularly on the face.Stocksy
“Both diabetes and obesity are considered chronic diseases that require long-term treatment,” Dr. Kushner says. “The goal is to take the medication along with following healthy lifestyle changes to achieve and maintain health benefits — reduced body weight and improved blood sugar control.”
Here are five things to expect when you stop Ozempic.
1. Your Appetite Will Return
People eat less when they take Ozempic because semaglutide slows the digestion, keeping food in the stomach longer and increasing feelings of fullness, and because it triggers changes in the brain that decrease hunger and blunt the feelings of satisfaction that can accompany eating.
“I used to be able to eat half a pizza, but now on semaglutide, I take a few bites and feel full,” says David Shafer, MD, an attending plastic surgeon at Lenox Hill Hospital and Northwell Health in New York City. “If I miss a dose, my consumption increases as I lose the effect of feeling full.”
But that rapid feeling of satiety produced by semaglutide goes away as soon as people stop taking Ozempic, says Kushner.
“Once Ozempic is stopped, all the benefits from the medication cease,” Kushner says. “If the patient experienced a reduction in appetite and body weight that resulted from consuming a lower-calorie diet, the individual’s appetite will increase back to baseline when the medication is stopped, making it harder to follow a lower calorie diet.”
2. You Will Regain Weight
Because people stop feeling full and their food cravings return when they stop Ozempic, weight gain is likely, Kushner says. Studies have shown that people who stop taking semaglutide and tirzepatide regain most of their lost weight in a year or less.
Whether people take Ozempic for obesity or type 2 diabetes, medication should be just one piece of a treatment plan that also includes healthy lifestyle changes like eating a balanced diet and getting plenty of exercise.
“Ozempic should always be taken along with making healthy lifestyle changes in diet and physical activity,” Kushner says. “These changes should be continued even after stopping the medication and can help maintain some of the health benefits seen with body weight and blood sugar control.”
In one study, a structured exercise plan helped people keep weight off for an entire year after discontinuing GLP-1 medications.
3. ‘Ozempic Face’ Will Go Away
Rapid weight loss spurred by Ozempic can change the skin and reduce fat volume all over the body, including in the face. Many people who shed dramatic amounts of weight with Ozempic find their face can take on a gaunt, shrunken, and dehydrated appearance that’s been dubbed “Ozempic face.”
These changes can be addressed with injectable facial fillers administered by a board-certified dermatologist or plastic surgeon, says Joshua Zeichner, MD, an associate professor of dermatology at Mount Sinai Hospital in New York City.
Stopping Ozempic will also reverse facial changes caused by the drug. “Ozempic face will go away if you gain back the weight you lost from the drug,” Dr. Zeichner says. “The face can get full the way it used to, just as you can regain the weight in your body.”
4. Side Effects Will Subside
Ozempic has other common side effects, including nausea, constipation, vomiting, heartburn, gas, headache, and dizziness.
Not everyone experiences side effects, and they may be mild for others. They can also be avoided or minimized by ramping up dosage more slowly from the lowest starter dose of Ozempic to the higher dose that’s typically used for ongoing treatment, Kushner says.
How you eat — and what you eat — also makes a difference. “Side effects can be greatly mitigated by reducing dietary fat, consuming smaller portions, and not skipping meals,” Kushner says.
Anyone who experiences side effects but still sticks with treatment would see those side effects go away when they stop taking Ozempic, Kushner adds.
5. Blood Sugar Climbs
For people with type 2 diabetes who take Ozempic to manage their blood sugar, halting treatment may cause blood sugar to rebound to around pre-medication levels, says Beverly Tchang, MD, an endocrinologist and an assistant professor at NewYork-Presbyterian and Weill Cornell Medicine in New York City.
“Since Ozempic treats the chronic disease of diabetes, people can potentially see a worsening of their diabetes when they stop Ozempic,” Dr. Tchang says.
Because Ozempic helps people eat less, a halt to treatment may lead them to consume more calories and eat larger portions, leading to an increase in blood sugar, Tchang says. And even if people manage to maintain the eating habits they developed while on Ozempic, their blood sugar might still rise when they stop treatment, because the drug boosts the production of insulin, a hormone involved in blood sugar control.
These realities are among the reasons many doctors have expressed concern over Ozempic shortages potentially driven by people using the drug to shed unwanted pounds. These shortages are harming people with type 2 diabetes who need the drug for blood sugar control.
The good news is that people with diabetes still have other medicines they can take instead of Ozempic, including several in the same family of medicines as semaglutide, Tchang notes. Ozempic is what’s known as a glucagon-like peptide-1 (GLP-1) receptor agonist, a class of drugs that also includes liraglutide (Victoza), dulaglutide (Trulicity), and exenatide (Bydureon).
The Takeaway
GLP-1 drugs are believed to be lifetime medications. If you stop using Ozempic or a related drug, you can expect both the benefits and side effects to go away.
Most people who discontinue a weight loss drug will experience a return of hunger and weight regain. People with diabetes will probably see their blood sugar rise.
Healthy lifestyle changes, such as a balanced diet and regular exercise, give you the best chance of sustaining the benefits achieved while on the drug, even after you stop.
Adam Gilden, MD, MSCE, is an associate director of the Obesity Medicine Fellowship at University of Colorado School of Medicine and associate director of the Colorado University Medicine Weight Management and Wellness Clinic in Aurora. Dr. Gilden works in a multidisciplinary academic center with other physicians, nurse practitioners, registered dietitians, and a psychologist, and collaborates closely with bariatric surgeons.
Gilden is very involved in education in obesity medicine, lecturing in one of the obesity medicine board review courses and serving as the lead author on the Annals of Internal Medicine article "In the Clinic" on obesity.
He lives in Denver, where he enjoys spending time with family, and playing tennis.
Lisa Rapaport is a journalist with more than 20 years of experience on the health beat as a writer and editor. She holds a master’s degree from the UC Berkeley Graduate School of Journalism and spent a year as a Knight-Wallace journalism fellow at the University of Michigan. Her work has appeared in dozens of local and national media outlets, including Reuters, Bloomberg, WNYC, The Washington Post,Los Angeles Times, Scientific American, San Jose Mercury News, Oakland Tribune, Huffington Post, Yahoo! News, The Sacramento Bee, and The Buffalo News.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
KFF Health Tracking Poll May 2024: The Public’s Use and Views of GLP-1 Drugs. KFF. May 10, 2024.
Do D et al. GLP-1 Receptor Agonist Discontinuation Among Patients With Obesity and/or Type 2 Diabetes. JAMA Network Open. May 24, 2024.
Wilding JP et al. Weight Regain and Cardiometabolic Effects After Withdrawal of Semaglutide: The STEP 1 Trial Extension. Diabetes, Obesity & Metabolism. August 2022.
Aronne LJ et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. January 2, 2024.
Jensen SBK et al. Healthy Weight Loss Maintenance With Exercise, Glp-1 Receptor Agonist, or Both Combined Followed by One Year Without Treatment: A Post-treatment Analysis of a Randomised Placebo-Controlled Trial. eClinical Medicine. February 19, 2024.
