Concerns and Strategies Surrounding the Use of Obesity Drugs: What Happens When Patients Stop Taking Them?
Millions of Americans who have successfully lost weight and improved their health with the help of popular obesity drugs like Wegovy are now faced with a new dilemma: what happens if they stop taking these medications? Many individuals are rightfully concerned that they will regain the weight they lost and fall back into old habits. Clinical trials have shown that patients who paused the drugs experienced significant weight gain. However, some people are taking a do-it-yourself approach to gradually reduce their dependence on these drugs, either by stretching out doses, taking the medication intermittently, or stopping and starting again only when necessary.
Donna Cooper, a 62-year-old from Front Royal, Virginia, who lost nearly 40 pounds in nine months using Wegovy alongside diet and exercise, sees the drug as a helpful aid but acknowledges the need to eventually come off of it. She does not want to rely on the medication indefinitely. According to recent data from health technology company IQVIA, over 3 million prescriptions for obesity medications like semaglutide (found in Ozempic and Wegovy) and tirzepatide (found in Mounjaro and Zepbound) are dispensed each month in the United States.
However, many individuals do not stick with these medications in the long term. A study published in the journal Obesity found that only 40% of patients who filled a prescription for Wegovy in 2021 or 2022 were still taking it a year later. Doctors who specialize in obesity treatment emphasize that obesity is a chronic condition that requires ongoing management, similar to heart disease or high blood pressure. The new injection drugs work by mimicking hormones in the gut and brain to regulate appetite and feelings of fullness. They were designed and tested to be taken continuously.
Dr. Andres Acosta, an obesity researcher and medical adviser at the Mayo Clinic, emphasizes that these drugs should not be used intermittently. He states, “We are not an injection shop. I don’t think they should be used in intermittent fashion. It’s not approved for that. They don’t work like that.” Despite this directive, some patients who have achieved their health and weight goals with these drugs are seeking ways to reduce their dependence on them or eventually discontinue their use.
Dr. Amy Rothberg, an endocrinologist at the University of Michigan, explains that many patients want to step down or de-escalate their dose and ultimately stop taking the medication. Reasons for pausing the drugs can vary, such as experiencing side effects like nausea and constipation, wanting a break for holidays or special occasions, or simply not wanting to take weekly shots indefinitely. Some patients have even had to ration or halt doses due to the high cost of the drugs or insurance coverage limitations.
However, experts caution against expecting the benefits of these drugs to persist after stopping them. Obesity affects the body’s energy processing and storage mechanisms, leading to weight gain. The new drugs alter this process, but when patients stop taking them, the disease often returns, sometimes with even more intensity. Many individuals who discontinue the medications report a significant increase in obesity symptoms, including intrusive thoughts of food, intense hunger, and reduced feelings of fullness when eating.
Tara Rothenhoefer from Trinity, Florida, lost over 200 pounds after participating in a clinical trial for Mounjaro four years ago. She now takes the lowest dose of the drug every four to eight weeks but becomes anxious when her weight fluctuates by a few pounds. She says, “It scares the daylights out of me to see the numbers on the scale going up.” Some patients who stop and restart these medications find that they can no longer tolerate them due to severe gastrointestinal side effects. Others discover that the drugs are less effective when they resume taking them. However, there is currently no data on the long-term effects of intermittent drug use.
Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine, acknowledges that while intermittent use may not be a suitable strategy for most individuals, it could be an option for select patients. Donna Cooper, who is nearing the end of her supply of Wegovy injections, hopes to be an exception to the common weight regain experienced by others who stop using these drugs. She plans to continue with a strict diet and exercise plan once she completes her medication. Cooper says, “I just needed a crutch to get everything back in order, and I am excited to be done.”
In conclusion, the use of obesity drugs like Wegovy has raised concerns about what happens when patients stop taking them. While some individuals attempt to gradually reduce their dependence on these medications, experts caution that obesity is a chronic condition requiring ongoing management. Discontinuing these drugs often leads to weight regain and a return of obesity symptoms. While intermittent use may work for select patients, it is not recommended for most individuals. Ultimately, the decision to
