If you stop using Ozempic injection for type 2 diabetes or weight loss, much of the weight you have lost will most likely return within a few months to one year after you stop treatment, your blood sugar levels will rise and you may lose any positive benefit for heart or kidney health.

Contact your doctor before you stop Ozempic. Type 2 diabetes, obesity or being overweight and chronic kidney disease are long-term health conditions. Your healthcare provider may recommend that you transition to another treatment, reduce your dose to help with possible side effects, and maintain your exercise and diet plan to help control weight gain.

If you are having trouble accessing Ozempic due to a drug shortage or cost concerns, your healthcare provider can recommend alternatives or money-saving options. Novo Nordisk, the manufacturer, may be able to offer copay assistance or patient financial assistance, if you qualify.

Learn more: Will my insurance cover Ozempic?

What happens to your body if you stop Ozempic?

When you stop using Ozempic, all of the drug mechanisms at work to help with blood sugar control, weight loss, and heart and kidney protection will stop. Your medical conditions may worsen and your risk for serious events (like a heart attack, stroke or kidney failure) may increase. Your risk for death due to heart disease event may increase.

When you stop Ozempic, your full appetite may return within a week, increasing your calorie intake and leading to weight regain. In addition, your blood sugar levels may spike, worsening the effects of type 2 diabetes on your blood vessels, which can lead to eye, heart and nerve disease.

Any common, non-serious side effects you may be experiencing should also stop, for example, stomach side effects (diarrhea, nausea or stomach pain) or injection site reactions. Usually these side effects are temporary and clear up once you reach your regular, weekly dose.

How Ozempic works in your body

• Ozempic (semaglutide) belongs to a class of medicines called glucagon-like peptide-1 (GLP-1) agonists. It mimics a hormone in the body that helps to control blood sugar levels, insulin secretion and digestion.
• Ozempic also helps with weight loss by lowering your appetite and slowing down gastric emptying. This can make you feel full for a longer period of time and decrease your calorie intake, leading to weight loss.

Studies on stopping semaglutide treatment

STEP 1 trial extension study for semaglutide

The STEP 1 trial extension study looked at weight regain and other effects on the body after stopping treatment with semaglutide. Other studies have shown that stopping weight management treatments usually lead to a regain of the lost weight.

Initially, 1961 adults with overweight or obesity received treatment for 68 weeks with semaglutide 2.4 mg (the usual weight loss dose) or a placebo (an inactive agent), in addition to diet and exercise counseling.

After 68 weeks, 327 of the original 1961 participants stopped treatment and counseling for up to 120 weeks. Investigators wanted to see how stopping treatment for 52 weeks changed weight and effects on the body, like blood sugar levels (HbA1c), blood pressure, cholesterol (lipid) levels and markers of inflammation (called C-reactive protein), which may indicate a risk of heart disease.

Of the 327 participants in the original 68 weeks study, those who had received semaglutide had lost on average 17.3% of their body weight compared to 2% of body weight in the placebo group.

Weight regain

• At 52 weeks after stopping treatment and diet and exercise counseling, weight loss was reversed in both the semaglutide and placebo groups, but not completely.
• The people who received semaglutide regained 11.6% (about two-thirds) of their original weight and the placebo group regained almost all of their weight (1.9%) before treatment started.
• Those receiving semaglutide still had an overall weight loss of 5.6% of their original weight, but the placebo group was close to their original starting weight.

Effects on the heart

• Improvements on heart health, like blood pressure and inflammatory markers and type 2 diabetes were reversed during the extension phase of the 120 week study.
• However, some measures, including blood sugar levels, cholesterol and inflammatory markers were still improved at the end of 120 weeks in those who received semaglutide.

Related questions

• Mounjaro vs Ozempic: Which is right for you?
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Why do people stop using Ozempic?

Side effects with Ozempic - like nausea, vomiting, diarrhea, stomach pain or constipation - are common and may be one reason why people stop Ozempic. In most people, these effects usually lessen over a few weeks with continued treatment and slower dose increases.

In studies, about one-third (over 30%) of patients receiving Ozempic experienced stomach side effects, compared to 15% taking a placebo (an inactive treatment). About 3% to 4% of people had to stop treatment due to stomach side effects.

Stomach side effects can get worse with higher doses, so your doctor will slowly increase your dose to help lessen these reactions.

If you and your doctor decide that you should stop treatment because of stomach side effects, these side effects will usually lessen or go away over about one week to one month.

If you restart Ozempic, your doctor will slowly increase your dose to help avoid stomach side effects. Higher doses of Ozempic at the beginning of treatment may worsen these reactions.

Related: What are 4 key Ozempic side effects to watch out for?

5 tips to prevent weight gain after stopping Ozempic

Putting weight back on after stopping a weight loss treatment is common, so know that you are not alone. But there are a few things you can do to help prevent regaining all of your weight.

• Talk to your doctor about alternative treatments for weight loss. There are many other options, including Wegovy (semaglutide) and Saxenda (liraglutide) that are in the same drug class as Ozempic and are approved for weight loss. If stomach side effects were a problem with Ozempic, discuss other options to GLP-1 agonists with your doctor.
• In Ozempic studies, people regained about two-thirds of their weight after stopping treatment, but they had also stopped their exercise and diet counseling. Talk to your doctor about the best routine to stay active and maintain any weight loss you had with Ozempic. This can help you control your blood pressure and insulin sensitivity, as well.
• Prioritize a consistent sleep schedule and get between 7 and 8 hours of sleep each night.
• Meet with a registered dietician to discuss meal planning, calorie intake and food choices. Avoid fatty foods and high-glycemic choices like sugar or refined carbohydrates. Focus on fresh fruits, vegetables and lean protein. Avoid empty calories like alcohol, junk or fast food, and soft drinks.
• Stay hydrated by drinking plenty of water throughout the day, which will help you to feel full without extra calories.

Will you gain weight if you stop other weight loss medicines like Wegovy or Zepbound? Yes, it appears weight regain is common with other incretin mimetics when treatment is stopped, as also shown in studies with tirzepatide (Mounjaro, Zepbound).

In studies with tirzepatide, patients who stopped treatment after 36 months of use regained 14% of their body weight, compared to a 25% weight loss in those who stayed on the medicine.

Learn more: What happens when you stop taking Zepbound?

Finally, don’t beat yourself up. It’s hard to lose weight, we all know that. And putting weight back on, after initially losing it, can take a toll on your mental health. Keep your mood and strength up by staying active, eating healthfully, maintaining your social circles and talking to a trusted friend, family member or healthcare provider when needed.

This is not all the information you need to know about Ozempic (semaglutide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

• Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553‐1564. doi:10.1111/ dom.14725
• Ozempic (semaglutide) prescribing information. Novo Nordisk. Bagsvaerd
  Denmark. Revised Oct 2022. Accessed Sep 18, 2023 at https://www.novo-pi.com/ozempic.pdf
• Aronne LJ, Sattar N, Horn DB, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. Published online December 11, 2023. doi:10.1001/jama.2023.24945

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