They lost weight with Wegovy, the same drug as Ozempic. This is what happened when they called it quits

Key learning points

  • Ozempic, Wegovy, and other GLP-1 drugs work by suppressing appetite.

  • A 2022 study found that after people stopped taking Wegovy, they regained two-thirds of the weight they lost on the drug.

  • Experts say GLP-1 drugs should be considered long-term treatments for obesity, just like drugs for high blood pressure, high cholesterol or diabetes.

The recent wave of social media excitement over Ozempic and Wegovy has made the injectable weight loss drugs household names. The so-called miracle weight loss drugs are in high demand and there are even nationwide shortages.

Ozempic is currently FDA-approved for the treatment of type 2 diabetes, but doctors often prescribe it off-label for weight loss. Wegovy, the same drug as Ozempic, is FDA-approved for weight loss.

The excitement about this class of drugs is well deserved. They are glucagon-like peptide-1 agonists, or GLP-1s, that mimic the effects of a hormone in the body and help regulate blood sugar and appetite. They are much more effective for weight loss than other obesity drugs.

“They mimic exactly the same thing that occurs naturally in the body — or should happen — in that they will increase your sense of satiety or fullness,” says Dr. Lydia Alexander, chief medical officer for Enara Health and president-elect of the Obesity Medicine Association. This suppresses your appetite and makes you eat less.

Monika Smyczek, 40, who started using Wegovy in the summer of 2021, says it made her forget about food in the most pleasant and benign way.

“In a way, it felt like a panacea,” she says. “It allowed me to restrict calories in a way that was sustainable. As someone who has had a fraught relationship with food, it felt really nice not to have to fight with this thing that had always taken up so much of my mind.

Alexander says these drugs are best for people who have a “significant” amount of weight to lose—that is, at least 40 pounds or more—especially if you have at least one obesity comorbidity, such as high blood pressure, cholesterol, or sleep apnea. And the health benefits are significant.

“For example, we know that someone with a BMI over 40 or 45 will live eight to 10 years less than someone who doesn’t have that BMI, and that equates to smoking,” she says. “So reducing weight over the long term increases both quality and quantity of life. By treating obesity, we are addressing the root cause of many of the different chronic conditions that primary care providers treat.”

Judging by a GLP-1 medication

After the birth of her third child, 46-year-old Liz Baker lost the weight she gained during pregnancy without much effort. But a few months later, she noticed that the scales slowly began to creep back up, even though she was still breastfeeding and hadn’t changed her eating habits.

“I saw my endocrinologist and said, ‘Hey, there’s something going on here that isn’t based on willpower,'” she says.

Her doctor agreed and prescribed Wegovy. Eight months later, Baker had lost 50 pounds. Other than some early nausea and vomiting, things went smoothly. Then suddenly her insurance told her they would no longer cover it.

Wegovy’s average out-of-pocket costs of $1,400 a month meant it was financially off the table for Baker. She stopped taking the medication.

Over the next six months, she gained back all the weight she had lost, plus another 10 pounds. In addition, her A1C and fasting glucose levels rose, putting her at risk for diabetes — a problem she hadn’t dealt with before starting the medication.

“I didn’t know it would be such a rapid change,” she says. “I had reached my ideal weight and size and was very comfortable and happy with where I was. And then, boom. My appetite and cravings went crazy for a while. I was just hungry all the time. I craved sugar all the time.”

Finally, she and her doctor were able to get her on Mounjaro, a combination GLP-1/glucose-dependent insulinotropic polypeptide (GIP) medication that the FDA approved in 2022 for controlling glycemic control in people with type 2 diabetes.

So far she has lost 18 pounds. Mounjaro is not yet approved for weight loss treatment, but Baker’s insurance will cover it — for now — because of her prediabetic blood sugar.

High costs also forced Smyczek to give up her “wonder drug.” She had rearranged her family budget to afford the “special price” of $800 a month, but once that ran out, the price skyrocketed to $1,400.

“For a hot second I thought, ‘Okay, what do I have to do to pay for this drug? Do I have to get another job?’,” she says. “And then I realized it was time to explore what else could can work.”

After gaining back 25 of the 40 pounds she lost with Wegovy, Smyczek said she tried not to be too disappointed in herself.

“I try to be kind to myself,” she says. “The problem is, it’s like without the drug you haven’t necessarily built the skills you need, nor have you learned how to deal with the hunger or the cravings or the things that will inevitably come back. “

A long-term medical condition, not a personal failure

GLP-1 drugs are usually not prescribed for cosmetic or aesthetic purposes, or for a quick fix, says Dr. Amanda Velazquez, director of obesity medicine in the department of surgery and acting assistant professor of surgery and medicine at Cedar Sinai.

They are considered long-term medications for obesity, much like treatments you would take to control blood pressure, high cholesterol, or diabetes.

“Obesity is a disease where the body works against you for life,” she says. “So to prevent that biological pressure from working against you, we need the drug on board. Once you take the drug off, you should expect weight gain.

A 2022 study that looked at what happens after you stop taking Wegovy found that people regained two-thirds of the weight they lost on the drug.

“The goal of these drugs is always to get it to work together with healthy behaviors, and it helps patients adhere to those healthy behaviors more easily because it helps the physiology to work together,” says Velazquez. “But if you take the drug away and the physiology goes back to trying to make you feel hungrier, lower your metabolism, and sabotage your efforts, it’s going to be very hard to sustain that weight loss.”

Monika admits that she struggles with the idea of ​​having to take medication for the rest of her life to maintain a healthy weight, but that she is “mentally trying to get there.”

“What I struggle with is that diet culture has completely permeated my worldview,” she says. “Diet culture does not approach obesity as a chronic condition. So even if I understand that this is a drug to be used long term to treat obesity, I still feel that message is plain: lose weight by any means. But what then? What happens next?”

Baker, who is already on several other long-term medications, such as thyroid treatment, sees it in more straightforward and practical terms.

“Among other things, I know that this weight is something that’s chemically messed up and it’s not something I can get my willpower out of,” she says. “If I have to take something for the rest of my life to help me manage it and keep me out of type 2 diabetes, I can deal with that.”

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They lost weight with Wegovy, the same drug as Ozempic. This is what happened when they called it quits

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