Wondering if you have to take GLP-1s forever? Here’s what you need to know

It goes a little something like this: you start taking a GLP-1 receptor agonist medication for weight loss like Ozempic® off-label or Wegovy® (both semaglutide) until you reach your goal weight. You’re ecstatic—you’ve met your digits and you think, “Well, I don’t need to take this medication anymore.” But what happens if you stop taking it? 

The thing is, while GLP-1 medications are effective at reducing body weight, they aren’t meant to be a quick fix. When you stop taking a GLP-1*, there can be rebound weight gain that can be both hard to control and devastating. In the Step 1 trial published in Diabetes, Obesity, and Metabolism, participants who paired weekly semaglutide for weight loss with a structured lifestyle intervention regained an average of two-thirds of the weight they’d lost within one year after stopping both.  Studies have also found weight gain among those taking liraglutide (like Saxenda® or Victoza®) for weight loss once the medication is stopped.

How GLP-1 receptor agonists work

Let’s reel it back in for a sec. If you aren’t familiar with GLP-1s or glucagon-like peptide 1 receptor agonists—they’re popular medications for weight loss. They work by mimicking GLP-1, a hormone your body naturally releases after you’ve eaten that stimulates your body to release insulin. Not only do GLP-1s help to regulate blood sugar levels, but they also help reduce appetite and slow digestion. 

Most GLP-1 receptor agonists are approved by the Food and Drug Administration (FDA) to treat type 2 diabetes. But semaglutide, under the brand name Wegovy, is FDA-approved to treat obesity. Healthcare providers can also prescribe certain medications off-label to help treat obesity. This is done when a substantial body of research shows that a drug can help with conditions beyond what they’ve been initially approved for by the FDA. Taking prescription medication off-label is effective. 

What happens if you stop taking GLP-1s?

So we talked about how most people regain weight after stopping GLP-1s, which makes sense. The medication mimics your natural GLP-1 peptide hormone, making you feel satisfied after a meal and have fewer cravings. But when you stop taking that medication, you may experience both heightened cravings and blood sugar levels. 

It’s not just the weight that goes back up, either. In the trial mentioned above, one year after stopping the GLP-1 medication, participants also saw:

• Blood pressure levels go back up
• C-reactive protein levels (an indicator of inflammation) increase
• VLDL cholesterol (a type that leads to hardened arteries) goes up
• Triglycerides (a type of blood fat) go up
• Hemoglobin A1c increases (meaning the level of sugar in the blood)

At high levels, these health markers are associated with conditions like type 2 diabetes, obesity, hypertension, and heart disease, to list a few. However, despite the increases, the study found that even after stopping the semaglutide and lifestyle intervention, these health markers still saw a residual improvement over the baseline at the start of the study. But those who had successfully reached normal blood glucose levels while on semaglutide returned to a state of prediabetes after stopping the medication. 

Interestingly, those who lost a high percentage of their body weight on semaglutide regained it the fastest. Researchers from the study concluded that weight-loss medication and lifestyle change support should be continued for the long haul to maintain both health and weight improvements. 

Why it’s important to take GLP-1s long-term 

Based on what science tells us, people who take GLP-1s for weight loss will most likely need to take them long-term. Rekha Kumar, MD, Found’s Chief Medical Officer and former medical director of the American Board of Obesity Medicine, says that anyone starting medication for a chronic condition—including obesity and diabetes—should consider it a long-term commitment. “If someone is taking Ozempic for diabetes (the only FDA-approved indication), they’ll have to take it long-term to control blood sugar,” Dr. Kumar explains, adding that those taking Ozempic off-label or Wegovy would need to continue taking it for weight maintenance, too. Think of it like this: if you need to take insulin because you have type 1 diabetes, but you stop taking it, your body won’t magically start making insulin on its own. So although you may have met your goal, taking GLP-1s long-term helps you with weight management. Both liraglutide (Saxenda) and semaglutide (Wegovy) are FDA-approved for long-term use.

Bottom line

It’s up to you and your provider to decide how long you should stay on GLP-1 medications to achieve and maintain sustainable weight loss. GLP-1 receptor agonists are meant to be taken long-term, but that will look different for each individual. 

GLP-1*

GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.

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