If there is one single question that users of weight-loss medications like Wegovy and Mounjaro might face, that would be when to stop the treatment and what happens if they do so. It is quite common for patients using these popular obesity medications to come off of the medication at some point, or to stretch out doses by taking the medication intermittently or stopping and restarting only if needed. In fact, one American study found that only 40% of patients who filled a prescription for Wegovy in 2021 or 2022 were still taking it a year later.
Let's dive into the answer. In clinical trials, patients who paused the drugs regained most of the weight they lost. Doctors who treat obesity stress that the disease is a chronic condition that must be managed indefinitely, like heart disease or high blood pressure. The biology of obesity affects the way the body processes and stores energy, causing it to accumulate weight. The new injection drugs alter that process by mimicking hormones in the gut and the brain to regulate appetite and feelings of fullness. As such, they were designed, tested and approved to be taken continuously; so no wonder that when patients stop, the disease returns.
The reasons for pausing the drugs can vary. Some patients don’t like side effects such as nausea and constipation. Others want to stop for holidays or even cost might be a barrier.
What should one expect when the medications are stopped? Many people stopping these medications report a sharp rise in symptoms of obesity including so-called food noise or intrusive thoughts of food, raging hunger, and decreased feelings of fullness when they eat. According to some obesity experts, some patients who stop the drugs and start again find they can’t tolerate the medications and experience severe gastrointestinal side effects. Others find the drugs don’t work as well when they restart them. It is important to keep in mind that there’s no data on the long-term effects of intermittent use.
The take away message? It is important to understand the biology of obesity and how these injectable obesity medications fight against it. An open discussion with your clinician before starting treatment is advised with the goal of having a clear understanding of your treatment plan.
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