Thinking about, or already on, a weight loss drug like Ozempic, Wegovy, Compounded Semaglutide or Mounjaro? You might also be wondering what happens when you stop. To get the most out of your investment into your health, keep your weight loss on track, and take positive steps to avoid rebound weight gain or losing muscle mass – here’s what our Levity experts recommend you to do.
First, How Does Ozempic Work?
Semaglutide injections (GLP-1 receptor agonists) like Ozempic are a type of diabetes and weight loss treatment. They work by controlling your appetite and food cravings, as well as balancing your blood sugar levels. If you’ve struggled to lose weight through diet and exercise alone, these drugs can give you an extra boost to start losing weight, get motivated and stick to a sustainable plan. (1)
Will You Regain Weight After You Stop Ozempic?
To answer this question, here are two studies that look into what happens after a person stops taking semaglutide (the active ingredient in GLP-1 agonist weight loss medications like Ozempic).
A study called the ‘Step 1 Trial’ involved 1961 non-diabetic participants who had either:
- A body mass index (BMI) of at least 30, or
- A BMI of 27 or over, with at least one weight-related comorbidity like high blood pressure, which was either caused by or made worse by their weight.
Participants were divided into two groups. One was given semaglutide, the other was given a placebo. By 68 weeks, the mean weight of participants in the Semaglutide group dropped by 14.9%. The placebo group only saw an average weight loss of 2.4%.
More research was done on 327 people involved in the original trial. When the group taking semaglutide stopped their medication, from weeks 68-120 they regained 11.6% of their body weight back. The placebo group regained 1.9% of their body weight. The semaglutide group therefore lost 5.7% overall, whereas the placebo group lost 0.1% overall.
In summary, those who took semaglutide did regain some weight – but there wasn’t a complete reversal of the medication’s effects. (2)
In another double-blind study, which is considered the gold standard method in clinical trials, the ‘Step 4 Trial’ study also found that everyone who stopped using GLP-1 medications gradually regained some of the weight they lost after 20 weeks. In comparison, those that continued using the medication for 68 weeks kept losing weight. So regaining weight is a potential side effect once you stop the medication. (3)
Can You Keep Weight Off After Stopping Ozempic?
Yes, some people can keep the weight off. But we want to caveat this by saying, everyone is different, and there’s no shame in regaining the weight after you stop. Obesity is a chronic disease. And, like high blood pressure, this medication can be taken for life to control it.
If you do want to stop, and give yourself the best chance at maintaining your weight loss goals, you’ll need to do some preparation.
There are diet, exercise and healthy lifestyle changes you can make. We need to get your body in the best condition while you’re on Ozempic, so you have the highest chance of managing and losing weight after you stop.
Step 1: Avoid Losing Muscle Mass
Any weight loss, whether you use Ozempic or not, will involve both muscle and fat loss.
While dieting, we want to avoid muscle loss as much as possible for several reasons.
- Muscles give you a higher metabolic rate
- They support your posture, body composition and movement
- They help improve insulin sensitivity (4)
So throughout your Ozempic journey, it’s really important to continue building muscle.
How To Prevent Muscle Mass Loss
Resistance Training
Weight training or resistance training is vital for holding onto and building muscle. You don’t need to be lifting heavy in the gym every day, but try to move every major body part 2-3 days a week. That could look something like (but isn’t limited to):
Upper Body Push: Arm and back exercises like push ups, chest press, overhead press, tricep dips and planks.
Upper Body Pull: Arm and back exercises like (assisted) pull ups, bent over rows and bicep curls.
Hip And Thigh Hinging: Front or back squats, step-ups, deadlifts and lunges.
If you’ve never done these kinds of exercises before or you have injuries, consider getting a professional trainer. They can give you personalized tips, tailor exercises to your fitness level and check your form, so your workouts work for you. (5)
Step 2: Optimize Your Diet
Semaglutide injections mimic the hormones in your gut that help you feel fuller for longer and balance your blood sugar levels. This is an absolute game-changer for consistent weight loss, but you still need to fuel your body with the right nutrients at mealtimes to stay healthy and energized.
Protein
To maintain and build muscle, aim to eat around 0.8g of protein per kilogram of your body weight. So if you weigh 100kg (or 220 pounds), you’ll want to aim for around 80g (or 2.8oz) of lean protein per day.
Pairing your protein-rich meal with fiber can help stabilize your blood sugar too. (6)
Fruit and Vegetables
We’ve all heard of the term “eating the rainbow”, but here’s why eating a variety of fresh or frozen fruits and vegetables will help when you’re losing weight, and after you stop taking semaglutide medications like Ozempic.
- The different plant nutrients and polyphenols from fruits and vegetables keep your gut microbiome healthy and thriving.
- They’re also high in fiber and relatively low in calories, preventing obesity.
- Fruits and vegetables are full of vitamins and minerals that boost your immune system and enhance how well your body absorbs nutrients.
A good rule of thumb is to have five to six cups per day. Find ones you think are delicious and switch up the cooking methods, eat them cooked or raw, so you’re absorbing a variety of nutrients. (7)
What’s more, the better your gut microbiome functions, the more it can support your body’s production of the hormones that tell you when you’re full.
Step 3: Drink Plenty Of Water
Find it hard to drink enough water? That’s not uncommon at all. In fact, another side effect of semaglutide injections is that it can make you feel less thirsty. (1) Plus, generally it can be hard for most of us to drink enough water anyway – even without Ozempic.
But water keeps every system in your body working the way it should, including your digestion. According to Harvard Medical, you should try to drink at least 4-6 cups of plain water every day. (8)
In a study, researchers found that people who drink more plain water may eat fewer total calories, drink fewer sweetened drinks, and take in less fat, sugar, salt, and cholesterol. Adding just one to three extra cups of plain water a day could make you eat up to 205 fewer calories. Over time that could help with weight loss. (9)
You may need to drink more plain water if:
You are moving more: While exercising, you lose more water through sweating and may need to drink more.
It’s hot outside: If the temperatures are high outside, you might sweat more and feel thirstier faster.
You are older: As we age, we’re not as good at sensing how thirsty we are compared to when we’re younger. (8)
Just because Ozempic can make weight loss easier, doesn't mean it's time to kick back and relax. While you’re still on the medication, you’ll be giving yourself the best chance of success by practicing healthier habits. However, if you stop and regain weight, don’t forget this is normal for many people, too.
Our Levity experts are huge proponents of doing what you can during your treatment plan to leave your body in a better condition than when you started. And if you’re a customer, we’ll always be here to support you at every step of your journey.
Find out more about the treatments we offer here.
References
- Kommu S, Whitfield P. Semaglutide [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK603723/
- Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism [Internet]. 2022 May 19;24(8):1553–64. Available from: https://pubmed.ncbi.nlm.nih.gov/35441470/
- Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA [Internet]. 2021 Apr 13;325(14):1414–25. Available from: https://jamanetwork.com/journals/jama/fullarticle/2777886
- Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Advances in Nutrition: an International Review Journal. 2017 May;8(3):511–9.
- Ralston GW, Kilgore L, Wyatt FB, Buchan D, Baker JS. Weekly Training Frequency Effects on Strength Gain: A Meta-Analysis. Sports Medicine - Open [Internet]. 2018 Aug 3;4(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081873/
- Moon J, Koh G. Clinical Evidence and Mechanisms of High-Protein Diet-Induced Weight Loss. Journal of Obesity & Metabolic Syndrome [Internet]. 2020 Sep 30;29(3):166–73. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539343/
- Lakshmanan AP, Mingione A, Pivari F, Dogliotti E, Brasacchio C, Murugesan S, et al. Modulation of gut microbiota: The effects of a fruits and vegetables supplement. Frontiers in Nutrition. 2022 Sep 23;9.
- Harvard Health Publishing. How much water should you drink? [Internet]. Harvard Health. Harvard Health; 2020. Available from: https://www.health.harvard.edu/staying-healthy/how-much-water-should-you-drink
- Marshall M. The big benefits of plain water - Harvard Health Blog [Internet]. Harvard Health Blog. 2016. Available from: https://www.health.harvard.edu/blog/big-benefits-plain-water-201605269675