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As more patients turn to diabetes medications for other uses, a shortage has taken hold. But doctors say going off these drugs can take a toll.
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As a subscriber, you have 10 gift articles to give each month. Anyone can read what you share.(Video) What Happens When You Stop Taking Ozempic (Semaglutide) For Weight Loss
By Dani Blum
Teri Parris Ford felt awful on her Ozempic medication. Two years ago, her doctor had prescribed it to treat Ms. Ford’s pre-diabetes, for which it was effective. Ms. Ford, a 57-year-old art teacher, experienced a drop in her A1C (a measure of average blood sugar) and lost 20 pounds in six months.
But Ozempic made her nauseated. On the days that she used the medication, which she injected with a needle in her stomach, she would dry-heave.
For a while, Ms. Ford took her doses on weekdays so she wouldn’t waste a weekend being sick. But eventually, she told her doctor she didn’t want to feel queasy so often. They agreed that she could stop the medication.
In just two months, Ms. Ford said, she gained all the weight back. On Ozempic, her appetite had practically vanished — a common side effect of the drug, which was first authorized to treat diabetes and is now being used off label for weight loss. She might pick at a few French fries at a lunch with friends, but she never finished a meal. After she stopped the medication, she could finish a plate of fries and a burger and still crave dessert. “I was insatiable,” Ms. Ford said. “I was like, ‘Oh, my God, what’s going on? I’m hungry all the time.’ It shocked me how fast it happened.” Her doctor prescribed additional medications to manage her blood sugar, but she ended up on Ozempic a second time in an effort to shed the weight again.
Ozempic and another drug, Wegovy, both contain semaglutide, which regulates blood sugar and insulin. It also reduces appetite and causes the stomach to empty more slowly, so that a person feels fuller faster. These drugs have become increasingly popular in the past year for their weight-loss effects. But for people who take them to manage diabetes as well as those who do so primarily to manage weight, going off them suddenly can take a toll. Doctors say patients should be aware of these ramifications.
Weight Loss Drugs
- Ozempic:This semaglutide treatment, originally designed as a diabetes drug,has gained attention as celebrities and TikTok influencershave described taking it to lose weight.
- Side Effects: Diabetes treatments used for weight loss like Ozempic can expose those who take them to risks including facial aging, thyroid cancer and kidney failure. Going off the drugs can also take a toll.
- Insurance Issues: Many insurance companies are refusing to cover new weight loss drugsthat their doctors deem medically necessary.
- Childhood Obesity: The American Academy of Pediatrics released new guidelinesrecommending early and intensive interventions, including the use of weight loss drugs, for children who are overweight or obese.
While some patients who try the drug choose to stop it, more and more have stopped simply because they can’t find it anymore. The Food and Drug Administration has listed Ozempic and Wegovy as “in shortage” for months; Trulicity, another diabetes drug that can lead to weight loss, joined the list in December.
Dr. Andrew Kraftson, a clinical associate professor in the division of metabolism, endocrinology and diabetes at Michigan Medicine, said that he was “overwhelmed” by messages from obesity and diabetes patients who wondered where their next dose was and how they would cope without the medication. “When people cannot get it,” Dr. Kraftson said, “it’s a big SOS.”
We asked doctors what happens in the brain and body after someone stops taking these drugs.
Blood sugar rises
Dr. Janice Jin Hwang, chief of the division of endocrinology and metabolism at the University of North Carolina School of Medicine, said patients would probably notice the effects of stopping Ozempic or Wegovy after a week or so.
“Like any medication, when you stop taking it, it stops working,” said Dr. Robert Gabbay, chief scientific and medical officer of the American Diabetes Association. When people suddenly stop semaglutide, the amount of glucose in their blood can surge, Dr. Gabbay said. Patients with diabetes may experience blurry vision, fatigue and excessive thirst and urination — symptoms that may have led them to be diagnosed with diabetes originally. Some may end up in the emergency room from exhaustion, Dr. Gabbay added, often because of spikes in blood sugar. They may also become more susceptible to yeast or other fungal infections, which are linked to higher blood sugar.
Dr. Hwang said that physicians often try other therapies to help control blood sugar in patients with diabetes, like metformin or insulin. But starting and stopping drugs can be disorienting for patients and doctors as they cobble together a plan, she said.
Cravings come back
Semaglutide mimics a hormone called glucagon-like peptide-1, which we produce in our intestines and which signals to our bodies that we are full. The medicine affects the brain by blunting hunger signals and making people feel indifferent to, or even actively repulsed by, food. “They’re not ruminating about it all the time,” Dr. Kraftson said. “They just have this low-drama relationship with food.” For some, that’s “very liberating,” Dr. Kraftson said, but when a patient stops taking the drug, those cognitive effects can dissolve quickly. Some patients, he said, become more hungry after forgetting to take just one dose of the medication. “People will say they feel cravings come back,” Dr. Hwang said. After weeks or months without Ozempic or Wegovy, many will gain weight.
A trial published in the spring and funded by Novo Nordisk, the company that manufactures Ozempic and Wegovy, examined people who had taken semaglutide once a week for 68 weeks and then stopped using it. After a year, participants gained back twothirds of the weight they had lost.
Doctors say that, anecdotally,they’ve seen this kind of rebound in patients, too. Dr. Kraftson said, “I’ve seen people and they’ve lost maybe 50 pounds, and then they’re off of it for a month and then I see them back in clinic and they’ve gained 20 pounds.”
Side effects subside
In some cases, when people stop taking the medication, they realize that they had been experiencing side effects while on semaglutide, Dr. Kraftson said, like mild headaches or upset stomachs. For those with side effects, ending the medication can be a relief. Lee Levin, 67, who started Ozempic to help manage Type 2 diabetes, had such intense nausea that she once went to the emergency room. When she stopped the medication, she said, that near-constant queasiness went away “almost immediately.”
Those who return to a full dose rather than ramping up their intake gradually may experience more severe side effects at first, Dr. Kraftson said, including vomiting and diarrhea. Dr. Kraftson also warned that patients might not follow all the guidelines from when they first started taking the medications, like chewing slowly and avoiding heavy foods so that they don’t feel so full that they become sick. For those who slowly work up to their original dose, it may take even longer to lose weight, adding another hurdle to an exhausting cycle of medication.
“It’s been a whirlwind for our patients, and not in a good way,” Dr. Hwang said.
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What happens if you suddenly stop taking Ozempic? ›
Recent research published in the journal Diabetes, Obesity and Metabolism indicates that once patients stop using semaglutide drugs like Wegovy and Ozempic any weight they've lost is likely to return.What happens when you stop taking mounjaro for weight loss? ›
In a study that allowed patients to stop taking Mounjaro after one year, most patients regained the weight they lost, indicating a need to take a maintenance dose. To maintain results, research is needed to determine maintenance dose vs. treatment dose.Do you gain weight after stopping Ozempic? ›
A study found that a majority of people who take semaglutide — branded as Ozempic and Wegovy — gain most of the weight back within a year of stopping the medication.Can I stop Ozempic cold turkey? ›
Do not suddenly stop taking Ozempic because doing so could increase your blood sugar levels. If you really need to stop using Ozempic, consult your doctor and ask for instructions on how to do so safely. You may need to take a gradually decreasing dose to prevent adverse effects.What happens if I stop taking Ozempic for weight loss? ›
Drugs like Wegovy and Ozempic lower a person's appetite to help with weight loss, but experts say the weight can come back if they're no longer used.Can you stop Ozempic immediately? ›
Do not stop using OZEMPIC® without talking to your doctor. If you stop using it, your blood sugar levels may increase. Usual dose: When you first start using OZEMPIC®, the starting dose is 0.25 mg once a week for four weeks.How long do you stay on Ozempic for weight loss? ›
Ozempic can be used for as long as it facilitates weight loss or maintenance and does not cause significant side effects. Ozempic's safety and efficacy were studied in four 68-week trials, according to the FDA. Ozempic should thus be safe to use for up to 68 weeks.Do you have to take Mounjaro forever? ›
Will I need to use Mounjaro long term? Yes, it's likely that you'll take Mounjaro long term. This drug helps manage type 2 diabetes, which is a long-term condition. So, if Mounjaro works for you, your doctor will likely recommend taking it long-term.How long does it take for Ozempic to get out of your system? ›
In general, mild side effects of Ozempic should be temporary or manageable while you're using the drug. However, after stopping Ozempic, it could take your body about 5 weeks after your last dose to fully clear the drug from your system.What happens if you stop taking semaglutide? ›
Findings from this study suggest that discontinuation of semaglutide is associated with weight gain and may be associated with reversal of cardiovascular benefits seen while on this therapy.
How often do you increase Ozempic for weight loss? ›
The starting dose of Ozempic is 0.25 mg injected once weekly for 4 weeks. Then, your dose is moved up to 0.5 mg once weekly. After that, your dose may be increased every 4 weeks up to 2 mg once weekly, depending on how you respond to the medication. There are many ways to save on Ozempic.What are the dangers of Ozempic? ›
- inflammation of your pancreas (pancreatitis). ...
- changes in vision. ...
- low blood sugar (hypoglycemia). ...
- kidney problems (kidney failure). ...
- serious allergic reactions. ...
- gallbladder problems.
- Fried, greasy foods. Many of the most common side effects of Ozempic are gastrointestinal—things like nausea, bloating, and gas. ...
- Sugary foods and drinks. ...
- Refined carbohydrates. ...
- High-glycemic vegetables. ...
Ozempic is a glucagon-like peptide-1 receptor agonist (GLP-1RA) that slows down stomach emptying. It may present with mild to moderate stomach upset and nausea. These symptoms could be temporary and last for a few weeks. To relieve indigestion symptoms, eat smaller portions of foods throughout the day.Can stopping Ozempic make you sick? ›
In general, mild side effects of Ozempic should be temporary or manageable while you're using the drug. However, after stopping Ozempic, it could take your body about 5 weeks after your last dose to fully clear the drug from your system. So you could have side effects during this period.How long can you go without taking Ozempic? ›
If you miss a dose of Ozempic®, use it as soon as possible within 5 days after your missed dose. If you miss a dose for more than 5 days, skip the missed dose and go back to your regular dosing schedule.When should Ozempic be stopped? ›
Stop using Ozempic® and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat. gallbladder problems.What is the downside of Ozempic? ›
Semaglutide (Ozempic, Wegovy, Rybelsus) can cause side effects that some people are unable to tolerate. Following dosing guidelines can help manage these side effects. Nausea, vomiting, and diarrhea are the most common semaglutide side effects. But they usually subside after a few weeks of using the medication.