Medications from the GLP-1 family such as Ozempic, Wegovy, Saxenda, and Mounjaro have become stars of the health world in recent years. They help achieve significant weight loss, improve blood sugar balance, and reduce cardiovascular risk factors during use. But as use increases, a critical question also arises: What happens after stopping the medication?
A comprehensive new study published in eClinicalMedicine from The Lancet group provides a clear answer and highlights a fundamental limitation of these drugs.
The researchers reviewed 18 randomized clinical trials that included 3,771 participants with obesity, type 2 diabetes, or type 1 diabetes. All participants received GLP-1 treatment and then discontinued it, with follow-up of at least 12 weeks.
The researchers examined weight regain, waist circumference, blood sugar levels, blood pressure, and blood lipid levels: A phenomenon known as “metabolic rebound.”
The weight comes back – and sometimes sooner than expected
Among people treated for obesity, an average increase of about 5.6 kg was recorded after stopping treatment. Waist circumference increased by about 4 cm, and BMI rose accordingly.
Previous studies included in the analysis showed that rebound can begin as early as eight weeks after stopping the drug, and that up to 60% of the lost weight may return within a year. Weight gain was also observed among people with type 2 diabetes: About 2 kg on average. The more time that passed since stopping treatment, the more significant the rebound was.
The metabolic improvement also disappeared.
Stopping the medications was also accompanied by worsening metabolic markers:
● Increase in HbA1c
● Increase in blood pressure
● Worsening of the lipid profile
In many cases, the markers returned to values close to those before the start of treatment.
Not all medications are the same
The study found that stopping semaglutide (Ozempic/Wegovy) caused a stronger rebound compared to liraglutide (Saxenda): More weight gain, greater increases in waist circumference, and a larger rise in blood pressure.
The possible explanation: Semaglutide suppresses appetite more powerfully and acts longer in the body, and therefore stopping it triggers a stronger biological counter-response.
Why does this happen? The answer is that weight loss activates deep survival mechanisms:
● Increase in hunger hormones
● Decrease in energy expenditure
● Increased tendency to store fat
GLP-1 medications suppress these mechanisms as long as they are taken. But after stopping them, the body returns to operating according to its basic biology. That is, the rebound is not a failure of the patient, but an expected bodily response.
Why does the rebound effect occur?
From the perspective of functional medicine, the study’s findings are not surprising. GLP-1 medications treat symptoms, but do not solve the root causes of the problem.
They do not directly correct:
● Insulin resistance
● Poor diet quality
● Lack of sleep and chronic stress
● Physical inactivity
● Microbiome imbalance
When the medication is stopped, the underlying metabolic disruption remains, and therefore rebound is almost inevitable.
This is not to say that the medications have no place; for many patients they are an important and sometimes life-saving tool. But the data indicate that in order to preserve the benefit, most people will require long-term treatment, similar to medications for blood pressure or diabetes.
Is it really a “miracle drug”?
These medications are still relatively new. Alongside clear benefits, there is uncertainty regarding:
● Lifelong use
● Long-term risks
● Rare side effects
Therefore, more and more experts emphasize the need for a cautious, personalized approach, rather than expecting a magic solution.
What does this mean for patients? The conclusion is not that GLP-1 medications “don’t work.” They absolutely do.
But the study clarifies that sustainable metabolic health requires a broader approach:
● High-quality nutrition
● Adequate sleep
● Stress regulation
● Daily movement
● Support for the digestive system and metabolism
Without working on these foundations, stopping the medication will usually lead to the loss of a large part of the achievements.
This study reinforces the understanding that obesity is a chronic biological condition, not a temporary problem. GLP-1 medications are a powerful tool, but not a magic pill. Long-term success depends on how they are used, the duration of treatment, and addressing root causes in parallel.
For the website of Dr. Dalit Draiman-Medina, click here