Many individuals in the United States who have lost weight and improved their overall wellbeing through the use of well-known weight-loss medications such as Wegovy now face a decision: What are the consequences of ceasing to take these medications?

There is a valid concern that after pausing their medication, individuals may regain lost weight and revert to their previous habits. Clinical studies have shown that patients who stopped taking the medication typically gained back a significant amount of the weight they had previously lost.

However, some individuals are taking a risk by attempting a self-directed approach to managing their drug intake in hopes of maintaining a slim figure. This involves spacing out doses, taking the medication on an intermittent schedule, or ceasing and resuming use only as necessary.

Donna Cooper, 62, from Front Royal, Virginia, shared that using Wegovy in combination with a healthy diet and regular exercise helped her shed almost 40 pounds in just nine months. She sees it as a helpful tool, but recognizes that she eventually needs to wean off of it and hopes to not rely on it indefinitely.

Recent data from the health technology company IQVIA shows that more than 3 million prescriptions for these new medications are being filled every month in the United States. These medications include semaglutide, found in Ozempic and Wegovy, and tirzepatide, found in Mounjaro and Zepbound.

However, numerous individuals do not adhere to it. A recent study published in the journal Obesity revealed that only 40% of patients who obtained a prescription for Wegovy in 2021 or 2022 were still utilizing it after one year.

Medical professionals treating obesity emphasize that it is a long-term illness requiring ongoing management similar to heart disease or hypertension. The recently introduced injection medications function by imitating hormones in both the digestive system and the brain to control hunger and satiety. According to experts, these drugs were developed and evaluated to be used continuously.

Dr. Andres Acosta, a medical adviser from the Mayo Clinic and obesity researcher, clarified that they are not a clinic that offers injections. He added that using injections intermittently is not recommended as they are not approved for such use and do not have the desired effect in that manner.

Although the directive was given, Dr. Amy Rothberg, who supervises a weight-management and diabetes treatment program at the University of Michigan, reported that some patients who successfully reached their health and weight targets with the medications are now seeking an alternative approach.

She mentioned that a lot of people are interested in decreasing their dosage or stopping the medication altogether.

TAKING ‘A BREATHER’

Dr. Katherine Saunders, an obesity specialist at Weill Cornell Medicine and co-founder of Intellihealth, stated that there are various factors that may lead to pausing drug treatment. These may include experiencing undesirable side effects like nausea and constipation, wanting to take a break for holidays or special events, or simply not wanting to continue with weekly injections indefinitely.

A 53-year-old man from New York who was under the care of Saunders successfully lost 70 pounds in the previous year by using Mounjaro. He recently expressed his desire to temporarily cease taking the medication to observe his body’s response. Upon Saunders’ recommendation, he has been gradually increasing the time between injections from weekly to every 10 days or two weeks since December.

Some patients have had to limit or stop taking their prescribed doses because the medications are expensive – ranging from $1,000 to $1,300 per month – and coverage from insurance companies varies. Additionally, the high demand for these drugs has exceeded the available supply, according to Rothberg.

She stated that they are being forced to do it, as they have no choice but to stop taking medication and figure things out on their own.

According to experts, expecting the continued benefits of drugs after stopping them disregards the inherent biological mechanisms of obesity. This medical condition impacts the body’s ability to regulate and store energy, leading to weight gain. While the new drugs change this process, once patients cease taking them, the disease typically resurfaces, often with greater intensity.

Many individuals experiencing symptoms of obesity have noticed an increase after stopping their medication, including food-related distractions or intrusive thoughts, intense cravings, and a decrease in satiety after eating.

Rothberg stated that these medications act as highly-effective inhibitors of our body’s natural signals. It can be anticipated that this will be the case.

48-year-old Tara Rothenhoefer, a resident of Trinity, Florida, shed over 200 pounds by participating in a clinical trial for Mounjaro four years ago. She currently takes the minimum dosage of the medication every four to eight weeks, but becomes concerned when her weight varies slightly.

She expressed concern over the increasing numbers on the scale.

According to Acosta, certain patients may experience difficulties with tolerating their medication if they discontinue and then resume it. This can result in significant gastrointestinal side effects. Additionally, Saunders noted that for some individuals, the effectiveness of the medication may decrease upon restarting it. However, there is currently no available data on how intermittent usage may affect long-term outcomes.

Saunders stated that while this may not be a feasible approach for the majority of individuals, it could potentially serve as a viable choice for specific patients.

Donna Cooper has been informed that individuals typically regain lost weight after discontinuing the use of medication. However, she is hopeful to be an anomaly in this situation. Currently, she is in possession of her final batch of Wegovy injections. After completing them, Cooper plans to maintain a disciplined dietary and workout regimen.

Cooper, who has slimmed down from a size 16 to a size 10, explained, “I simply needed some extra support to get my life back on track. Now that I am finished, I’m thrilled.”

___

The Science and Educational Media Group of the Howard Hughes Medical Institute provides support to the Associated Press Health and Science Department. The AP is fully responsible for all of its content.