When to Consider Stopping Ozempic?
Despite the proven efficacy of Ozempic in promoting weight loss, several factors may lead individuals to consider stopping taking it. Dr. Hans Schmidt, director of the Center for Weight Loss and Metabolic Health, outlines three primary reasons:
- Side Effects: Approximately 15 percent of users experience significant side effects of Ozempic, commonly including nausea, constipation, and abdominal pain. These can impact quality of life and prompt discontinuation.
- Shortage: The high demand for Ozempic has led to supply chain issues, causing pharmacies to run out and making it difficult to fill prescriptions. Luckily, LookMeds provides affordable alternatives to Ozempic for those who can’t access it.
- Achieved Weight Goal: Some individuals may choose to stop the medication once they have reached their desired healthy weight. However, it's crucial to understand the potential for weight regain in this scenario.
Furthermore, insurance coverage can be a significant barrier. For those taking Ozempic solely for weight loss (off-label use), insurance companies may stop coverage once a target weight is achieved. Given the high cost of around $1,000 per month without insurance, it becomes an unaffordable option for many.
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What Happens to Your Body When You Stop Ozempic?
Discontinuing Ozempic can lead to a series of physiological changes, primarily due to the cessation of GLP-1 mimetic effects. While Ozempic doesn’t typically cause traditional withdrawal symptoms like some other medications, the body's response to its absence can be noticeable.
Return of Hunger and Cravings
Ozempic works by slowing digestion, keeping food in the stomach longer, and increasing feelings of fullness by influencing brain signals to decrease hunger. When you stop taking Ozempic, typically about a week after the last injection, these effects begin to diminish.
Your gastric emptying time returns to baseline, causing food to be metabolized more quickly, which can trigger hunger more rapidly. The suppression of food cravings also wanes, leading to a potential increase in the desire for food.
As Dr. Robert Kushner from Northwestern University Feinberg School of Medicine explains, the rapid feeling of satiety induced by semaglutide disappears once the medication is stopped. Individuals who experienced reduced appetite and calorie intake while on Ozempic will likely see their appetite return to its pre-treatment baseline, making it harder to adhere to a lower-calorie diet.
The Likelihood of Weight Regain
Due to the return of hunger and food cravings, weight gain is a common occurrence after stopping Ozempic. This phenomenon has been termed "Ozempic rebound." Studies have consistently shown that individuals who discontinue semaglutide and tirzepatide tend to regain most of their lost weight within a year.
A study published in Diabetes, Obesity and Metabolism indicated that stopping Ozempic or other weight-loss drugs resulted in most of the lost weight being regained within one year, highlighting the chronic nature of obesity and the potential need for continued treatment.
The STEP 1 trial extension further demonstrated this, with participants regaining two-thirds of their prior weight loss on average within 12 months of stopping semaglutide injections. Similarly, the STEP 4 study showed that participants who discontinued semaglutide after an initial weight loss of 10.6% regained an average of 6.9% of their body weight within about a year, while those who continued on semaglutide experienced further weight loss.
However, it's important to note that this rebound effect is not unique to Ozempic and can occur with any weight loss tool that is suddenly discontinued. While the majority of lost weight may return, some individuals may still maintain a portion of their weight loss, particularly if they have implemented sustainable lifestyle changes.
Blood Sugar Fluctuations
For individuals with type 2 diabetes who use Ozempic to manage their blood sugar levels, stopping the medication can lead to a rebound in blood sugar levels, potentially returning to pre-medication baseline.
Symptoms of high blood sugar levels (hyperglycemia) may include excessive thirst and urination, fatigue, headaches, and blurry vision. Dr. Beverly Tchang, an endocrinologist, notes that discontinuing Ozempic can worsen diabetes as the drug boosts insulin production, a crucial hormone for blood sugar control. Therefore, close monitoring of blood glucose is essential for diabetic patients who stop taking Ozempic.
Changes in Blood Pressure and Cholesterol
Semaglutide has been linked to improvements in blood pressure and cholesterol levels. Upon withdrawal, these health benefits may diminish or disappear, potentially leading to an increase in blood pressure and a worsening of cholesterol profiles.
However, one study showed that even with weight regain, some improvements in most cholesterol tests and a marker for inflammation (CRP) were maintained after stopping Ozempic, suggesting some lasting benefits for heart health. Conversely, most people's blood pressure returned to pre-Ozempic levels. More research is needed to fully understand the long-term cardiovascular effects of starting and stopping Ozempic.
Resolution of Some Side Effects
While stopping Ozempic can lead to negative consequences, such as weight gain and increased blood sugar, it also brings about the cessation of its side effects. Common side effects of Ozempic, such as nausea, constipation, vomiting, heartburn, gas, headache, and dizziness, will likely subside once the medication is discontinued.
Additionally, the facial changes sometimes referred to as "Ozempic face," characterized by a gaunt or shrunken appearance due to rapid fat loss, will likely reverse if weight gain occurs.
