Millions of Americans who have successfully lost weight using popular obesity drugs like Wegovy are now facing a new dilemma: what happens when they stop taking these medications? Many individuals are concerned that they will regain the weight they lost and revert to their old habits. Clinical trials have shown that patients who paused the drugs often put back on most of the weight they had previously lost. However, some people are opting for a do-it-yourself approach to gradually ease off the drugs and maintain their slim figure by stretching out doses, taking the medication intermittently, or stopping and starting again as needed.
Donna Cooper, a 62-year-old woman from Front Royal, Virginia, who lost nearly 40 pounds in nine months using Wegovy alongside diet and exercise, views the drug as a helpful aid. However, she doesn’t want to rely on it forever and believes that at some point, she will need to come off of it. Cooper represents one of the millions of Americans who are prescribed these medications each month. According to recent data from health technology company IQVIA, over 3 million prescriptions for obesity drugs like Wegovy and Mounjaro are dispensed monthly in the U.S.
Unfortunately, many individuals do not continue taking 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 specifically designed and tested for continuous use.
Dr. Andres Acosta, an obesity researcher and medical adviser at the Mayo Clinic, emphasizes that these drugs should not be used intermittently or in an off-label manner. 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.” However, some patients who have achieved their health and weight goals with these drugs are seeking ways to reduce their dosage or ultimately discontinue the medication. Dr. Amy Rothberg, a weight-management and diabetes treatment program director at the University of Michigan, acknowledges that many patients want to step down or de-escalate their dose and eventually stop taking the medication.
The reasons for pausing these drugs can vary. Some patients experience side effects such as nausea and constipation, while others want to take breaks for holidays or special occasions. Additionally, the high cost of these medications, ranging from $1,000 to $1,300 per month, and varying insurance coverage can force patients to ration or halt their doses. However, experts caution against hoping that the drugs’ benefits will persist even after stopping them. Obesity is a complex disease that affects how the body processes and stores energy, leading to weight gain. The new drugs alter this process, but when patients discontinue them, the disease often returns, sometimes even more aggressively.
Many individuals who stop taking these medications report a significant increase in symptoms of obesity, including intrusive thoughts of food, intense hunger, and decreased feelings of fullness when eating. Tara Rothenhoefer, who lost over 200 pounds after participating in a clinical trial for Mounjaro, now takes the lowest dose of the drug every four to eight weeks. However, she still worries when her weight fluctuates by a few pounds, as it scares her to see the numbers on the scale going up. Some patients who stop and restart these drugs find that they can no longer tolerate them or that the drugs are less effective upon restarting. While intermittent use may be an option for select patients, there is currently no long-term data on its effects.
Donna Cooper, who is on her last box of Wegovy injections, hopes to be an exception to the common trend of weight regain after stopping the drugs. She plans to continue with a strict diet and exercise plan once she completes her course of medication. Cooper, who has gone from a size 16 to a size 10, views the drug as a crutch that helped her get everything back in order and is excited to be done with it.
In conclusion, millions of Americans who have achieved weight loss through obesity drugs face the dilemma of what happens when they stop taking these medications. While some individuals opt for a do-it-yourself approach to gradually reduce their dosage or discontinue the drugs, experts emphasize that obesity is a chronic condition that requires ongoing management. Discontinuing these medications often leads to weight regain and a return of obesity symptoms. However, further research is needed to determine the long-term effects of intermittent use. Ultimately, each individual must work with their healthcare provider to determine the best course of action for their specific situation.
