While the news has mostly been amazing for manufacturers of GLP-1 receptor agonist drugs such as Ozempic and Wegovy — including the first downturn in U.S. obesity rates in decades — recent studies show that discontinuing the use of the drugs results not only in weight gain but also harmful health issues.

Maya Goldman, a health policy journalist, writes in AXIOS Health that “people’s hunger can return voraciously when they drop off the drugs.” A study of 327 participants found an average weight loss of 17.3% of body weight after 68 weekly injections of semaglutide. However, Goldman notes:

[W]ithin one year of withdrawal, the participants regained two-thirds of their prior weight loss, with corresponding changes in risks for conditions like heart disease and Type 2 diabetes.

Connor Iapoce, an editor for HCP Live, just released a systematic review and meta-analysis of discontinuation rates for GLP-1 drugs, finding that nearly half (49%) of those taking the drug for obesity without diabetes discontinued use within the first year. Those taking the drug for Type 2 diabetes had a stronger continuation rate after one year of treatment.

The review cites one study where the first-year discontinuation rate was 74%. The main reason cited for discontinuation was gastrointestinal distress. There was some correlation with demographic factors, with those quitting being poorer, younger, and more male. Studies indicate that one year after withdrawing from the use of GLP-1 drugs patients regained two-thirds of the lost weight.

One takeaway from the research is the need for more counseling of patients by medical practitioners about what to expect from Ozempic and similar drugs. Indeed, Goldman notes, “Fewer than 1% of U.S. physicians are board-certified in obesity medicine.” She recommends counseling about diet, exercise and side effects. 

Studies have shown that lifestyle changes can ward off the weight gain that comes when GLP-1 drugs are discontinued. Patients who receive cognitive behavioral therapy (CBT) at the same time as GLP-1 drugs lose more weight and are able to keep it off more easily. They also are less likely to discontinue use of GLP-1 drugs due to side effects.

Goldman interviewed several physicians who recommended that obesity be treated as a chronic condition requiring lifetime medication, just like heart disease and diabetes. Their prescription was that patients should be encouraged to stay on the drugs indefinitely, despite the side effects. Meanwhile, everyone involved is recommending more research into the impact of cycling on and off GLP-1 drugs.

Written by Steve O’Keefe. First published January 9, 2025.

Sources:

“GLP-1 withdrawal can have lasting health effects,” AXIOS Health, January 2, 2025.

“GLP-1 RA Discontinuations Frequent in People with Obesity Without Diabetes,” HCP Live, January 3, 2025.

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