Do You Regain Weight After Stopping a GLP-1 like Ozempic, Wegovy, Mounjaro, Zepbound: Why It Is So Hard?

I often hear patients' reluctance about GLP-1 medications due to concerns for weight regain after stopping the medication. These are important concerns, and they underscore a common misunderstanding about obesity as a disease and its treatment.

Obesity as a Disease

Obesity is a disease. It is not a willpower problem, a self-control issues, or a personality failing. It is in the same category of disease as diabetes, hyperlipidemia, and hypertension. The markers of disease, or elevated numbers, go down with medication. We don't expect someone with diabetes to take their diabetes medication until their blood sugar is normal and then stop the medication and maintain normal blood sugars. Why do so many expect that with the disease of obesity?

Obesity is a complex disease with many factors that can play into severity. For many people, appetite dysregulation is at the core of their obesity. There are physiological processes that cause increased appetite and inadequate satiety. GLP-1 medications turn down the dial of the physiological drive to eat. While someone is on these medications, their appetite is decreased from their baseline. After stopping the medication, appetite seems to return to baseline levels.

Appetite with GLP-1 Medication

Once on a GLP-1 medication, my patients often have an easier time making intentional choices about what they decide to eat. Before, the physiological drive to eat sweets and refined carbs was so high that it overrode the cognitive desire to choose other foods. Now they can eat as they always cognitively wanted. If they stop the GLP-1 medication, they experience the physiological drive for sweets and refined carbs at the original high level, and that makes it take literally superhuman effort to withstand that physiological drive. Their cognitive abilities have not changed. Only their physiology.

Despite all that, I have seen some patients stop GLP-1 medication and maintain weight loss. Each one of those cases is a special and unique circumstance. I have my own theories about those cases why each one was able to maintain the weight loss. I would not expect that for the typical patient considering a GLP-1 medication.

Do People Regain Weight After Stopping Medication Like Ozempic?

So do you regain weight after stopping Ozempic, Wegovy, Mounjaro, or Zepbound? Most patients will. And not through their own lack of willpower or limits of the medication. GLP-1 therapy turns down appetite. It does not fix the underlying cause of why that person has a higher appetite to begin with.