Weight rebound after discontinuation of semaglutide? Because you didn't do that

It is expected that by 2035, about a quarter of the global population will be classified as obese, compared to only 14% in 2020. Obesity not only affects individuals' physical and mental health, but also has a profound impact on the global economy. It is estimated that this impact is equivalent to 3.6% of the US gross domestic product, and the indirect costs caused by productivity losses may reach up to $1.24 trillion.

The emergence of GLP-1 drugs such as semaglutide has completely changed the weight loss market. However, while semaglutide is selling well, there are also a large number of people who give up continuing to use it after a period of tim

How many people have stopped taking medication?

A survey report published in the journal Obesity by researchers at Cleveland Clinic in the United States shows that semaglutide has the highest compliance among weight loss drugs, indicating that its side effects are relatively small. The study included several weight loss drugs such as semaglutide, liraglutide, pheniramine topiramate, naltrexone bupropion, and orlistat. Among obese patients who were prescribed weight loss pills, 44% continued to use them after three months, 33% continued to use them after six months, and only 19% continued to use them after one year. Among them, the proportion of patients who continued to use semaglutide after three months, six months, and one year was 63%, 56%, and 40%, respectively.

What will be the weight and health status after stopping the medication?

A clinical trial published in JAMA in 2021 explored the effects of discontinuing semaglutide. The study recruited approximately 800 participants who underwent a 20 week weekly injection therapy of semaglutide, while adjusting their diet, increasing exercise, and receiving professional health counseling. The results showed that their average weight loss was 10.6%.

Subsequently, the study switched some participants' medication to placebo and continued to observe for 48 weeks. The data shows that those who switched to placebo had an average weight gain of 6.9%, while the group that continued to use semaglutide further lost 7.9%.

Overall, during the 68 week trial period, participants who continued to use semaglutide and adhered to lifestyle interventions experienced an average weight loss of 17.3%. And for participants who stopped taking the medication for nearly a year, about two-thirds of the weight they lost was regained.

What are the reasons that prompt people to stop taking medication?

Common adverse reactions of GLP-1RA drugs include nausea, diarrhea, vomiting, constipation, abdominal pain, gastroenteritis, and gastroesophageal reflux disease, which will improve with treatment time.

Smeglutide has demonstrated good safety in the field of diabetes treatment, but this does not mean that it has no side effects at all. As a drug that can inhibit gastric emptying, it has shown outstanding performance in helping control postprandial blood sugar, but it is also prone to causing gastrointestinal problems. Clinical studies have shown that even with low-dose (0.5 mg) semaglutide, 17% of patients still report nausea symptoms, while the incidence of diarrhea and vomiting is 12.2% and 6.4%, respectively. As the dosage increases, the incidence of these gastrointestinal adverse reactions also increases. About 4% of patients with type 2 diabetes stop taking drugs due to side effects.

The drug supply of semaglutide has also encountered difficulties, as semaglutide has been in short supply since 2022.

In addition, when semaglutide is used for weight loss, it is usually not covered by medical insurance, so users need to purchase it at their own expense.

Of course, stopping medication may also be due to successfully reducing the target weight, or as time goes on, the weight loss effect enters a plateau period, where the weight remains stable and no longer continues to decline.

What is the best way to discontinue medication?

When using GLP-1 receptor agonists, it is usually recommended to start with the lowest dose and gradually increase the dose over several months. This dosage increasing medication method helps reduce potential side effects. Although doctors generally believe that such drugs need to be taken for a long time to maintain their weight loss effects, from a biological perspective, sudden discontinuation of medication does not cause withdrawal symptoms or other physiological hazards

However, clinical studies have found that some people experience a significant increase in hunger after discontinuing medication. To avoid this issue, gradually reducing the dosage may be more appropriate than abruptly stopping the medication, thereby reducing the risk of hunger rebound.

Experts suggest that patients who plan to discontinue medication should closely monitor their appetite and weight changes. If weight begins to rise, it is possible to choose to reapply medication from a lower dose without waiting until the previously lost weight has fully recovered before taking measures. Meanwhile, maintaining healthy eating habits and regular exercise after discontinuing medication is crucial to prevent weight regain.

The main reason why many patients stop using GLP-1 receptor agonists such as semaglutide is that weight loss enters a plateau phase. In this case, they often mistakenly believe that the medication has failed. In fact, this stagnation phenomenon is a normal stage in the weight loss process. If further weight loss is needed, the dosage can be increased under the guidance of a doctor, but attention should be paid to the risk of side effects that high doses may bring.

How to maintain a healthy lifestyle?

The use of weight loss drugs requires standardized management. It is difficult to achieve effective weight loss solely by relying on drugs for 'lying down'. Changes in lifestyle are equally crucial.

Foods to avoid: high-fat foods, trans fats and saturated fats, high sugar foods, high sodium foods, refined carbohydrates.