18-month warning for anyone coming off Ozempic or Wegovy

People who stop taking GLP-1 drugs like Ozempic, Wegovy and others for weight loss are projected to regain the lost weight within around 18 months, research shows. The paper, which is a review of existing research, also said former users regain weight four times more quickly than those who had lost weight using behavioural techniques like dieting and exercise . Millions of people use GLP-1 drugs for weight loss. They work by cutting cravings for food, slowing digestion and keeping you feeling full for longer. But a paper published in the British Medical Journal in January, which reviewed 37 earlier studies involving 9,000 people, concluded that "cessation of weight management medications (WMMs) is followed by rapid weight regain and reversal of beneficial effects on cardiometabolic markers". It added: "Regain after [weight management medication] was faster than after [behavioural weight management programmes]. These findings suggest caution in short-term use of these drugs without a more comprehensive approach to weight management." GLP-1 drugs use active ingredients like semaglutide, a medication used to manage Type 2 diabetes that is now also used to support weight management. Obesity is a chronic and relapsing condition which affects almost two billion adults worldwide and increases the risk of morbidity and premature mortality. The BMJ researchers said weight loss "improves cardiovascular risk factors" and said a recent trial showed that "continuous use of semaglutide over four years reduced major cardiovascular disease events in individuals with existing cardiovascular disease". However, researchers said the benefits of weight loss on diabetes and other cardiovascular disease risk markers were lessened by weight regain after treatment was stopped. They added: "We have shown that weight regain is faster (0.8 kg/month) and a return to baseline weight projected at 1.5 years after cessation of treatment, implying that the benefits on cardiovascular health will probably also attenuate more rapidly." It added that because "obesity is a chronic and relapsing condition, prolonged treatment with WMM may be required to sustain the health benefits" and concluded: "WMMs are associated with a reduction in weight and improvements in cardiometabolic health that are attenuated soon after treatment ends, with no evidence of benefit 1.7 years after the cessation of treatment. This evidence cautions against short-term use of WMMs, emphasises the need for further research into cost-effective strategies for long-term weight control, and reinforces the importance of primary prevention." The research included studies using "any drug intervention that is currently or has previously been licensed for weight loss, or where there is reason to believe that the drug studied shares a class effect with a currently or previously licensed drug". The several drugs looked at included semaglutide (used in Ozempic, Wegovy and others) tirzepatide (used in Mounjaro and others), liraglutide (used in Saxenda) and many more. A second study, published last month by researchers at the University of Cambridge , also found that "when individuals stopped taking the medication, they underwent rapid initial weight regain" and added: "By 52 weeks, individuals had regained 60% of their original weight loss." Brajan Budini, a medical student at the School of Clinical Medicine and Trinity College, University of Cambridge, said: "Drugs such as Ozempic and Wegovy act like brakes on our appetite, making us feel full sooner, which means we eat less and therefore lose weight. When people stop taking them, they are essentially taking their foot off the brake, and this can lead to rapid weight regain." The researchers in this second study said that the reasons some users do not return to their original weight even a year after stopping the medications include the fact that by reducing appetite in the first place, the drugs "may help individuals develop healthier eating habits, such as reduced portion sizes or more nutritionally-balanced meals, and these habits may persist even after treatment is discontinued". Steven Luo, also a medical student at the School of Clinical Medicine and Trinity College, said: "When stopping weight loss drugs, doctors and patients should be aware of the potential for weight regain and consider ways to mitigate this risk. It’s important that people are given advice on improving their diet and exercise , rather than relying solely on the drugs, as this may help them maintain good habits when they stop taking them." In response to the release of the BMJ report in January, pharmaceutical company Novo Nordisk, which makes Wegovy and Ozempic, told the BBC : "These findings highlight the chronic nature of obesity and suggest that ongoing treatment is necessary to maintain improvements in weight and overall health for patients, similar to the management of other chronic conditions such as diabetes or hypertension."