Life After Weight Loss Meds

You would have to have been spending glorious hours lying on the beach on a desert island not to have heard all the buzz about the latest category of weight loss drugs, like Ozempic and Wegovy.

They are often referred to as “GLP-1s” because they mimic a hormone in the body called glucagon-like peptide-1 (GLP-1). Other weight loss medications in this category include Mounjaro, Zepbound, Rybelsus, Victoza, Trulicity, and Saxenda. While some people, particularly if they are taking one of these medications to help control blood sugar, might continue taking it indefinitely, others may wish to discontinue taking the medication when they have reached their weight loss goals, because of the potential gastrointestinal (GI) and other side effects, because they wish to become pregnant, or for some other reason.

But what can be expected when you stop taking a GLP-1 medication?

Note: If you wish to discontinue a medication, it is essential to seek the guidance of your prescribing health professional.

Rebound effects

Within the first few weeks of discontinuing medication, appetite increases, gastric emptying speeds up, and related GI side effects typically resolve. For a person with type 2 diabetes, blood sugar can rebound and return to a similar, elevated level as before starting the medication. It will become easier to gain weight again. For example, in a study of patients who discontinued their GLP-1 medication after 68 weeks of use, participants re-gained approximately two-thirds of the weight they had previously lost within one year of stopping use.1

When a person is no longer taking a medication to make them feel full while eating less food, it is particularly important to have the tools to help maintain their metabolic goals.

Diet and lifestyle tips

Eat foods that are filling.

There are ways to continue to feel full without adding a ton of calories. High-fiber foods promote satiety because they take longer to digest so they stay in your stomach longer.

• Avocados
• Lentils/split peas
• Brown rice
• Air-popped popcorn (seasoned with your favorite spices but leave off the butter)
• Most vegetables

Stay well hydrated.

Drinking water can contribute to feeling full – and also improve kidney, skin, hair, and nail health. But staying well hydrated doesn’t just mean drinking water. Foods with a high water content can also increase satiety. Most fruits and veggies are high in fiber and water, such as:

• Grapes (82% water; choose grapes over raisins; 1 cup of grapes has 104 calories while 1 cup of raisins has 410 calories)
• Carrots (88% water)
• Grapefruit (64% water)
• Watermelon (92% water)
• Cucumbers (a whopping 95% water; tzatziki anyone?)
• Lettuce (95% water)

Meal planning.

Avoid getting “hangry.” Planning healthy meals in advance and avoiding waiting until starvation sets in will prevent spontaneous, mindless nibbling. And planning should start when you are preparing your grocery list. If your pantry and refrigerator are filled with healthy choices, you’ll be more likely to put them on the menu.

Engage in regular exercise.

Look for enjoyable activities. We are all more likely to stick to exercise when it’s something we look forward to. Do you like exercising alone or do you enjoy group activities or walking with a buddy? It’s also best to choose activities that are convenient. If you exercise first thing in the morning, lay your clothes out the night before.

Manage stress.

Stress can result in binge eating or at least grabbing for the first junk food within reach. Stress can also increase cortisol that contributes to weight gain.

Get a good night’s sleep.

The importance of sleep for keeping the weight off can’t be stressed enough. Not only do studies show a link between short sleep duration and weight gain, but it might even be worse if you have artificial light on – like the TV. One study of 43,722 U.S. women enrolled in the Sister Study found women who slept with artificial light, compared to those who did not, experienced an average 11-pound weight increase over a 5.7-year follow-up.2

Focus on benefits beyond weight loss.

Focus on benefits that don’t rely just on the number on your bathroom scales. Victories related to positive lifestyle behaviors like exercise, good sleep, and stress reduction can include improved flexibility, reduced joint pain, increased muscle tone and strength, better self-image, and improved energy levels.

Support for your mental and emotional needs.
The rebound effects resulting in weight gain can lead to lowered self-esteem, so prioritizing mental health is a critical component to supporting overall health and well-being. Weight re-gain and the return of many food cravings and “normal” hunger/fullness cues can bring about feelings of failure and distrust. These negative associations with body image and food can contribute to disordered eating patterns and further exacerbate the mental and emotional effects of internalized weight stigma.

Self-compassion.

Although accepting and embracing full body positivity might feel like a stretch, viewing one’s body as a partnership and something that supports activities of enjoyment or accomplishment can be a powerful way to shift the view away from weight.

Food cravings and attitudes.

As cravings rebound after medication use and weight changes occur, food should not be looked upon as the villain. Societal views already demonize certain foods and praise others, but this is not the best approach to “healthy” eating. There is no one-size-fits-all method of eating that works for everyone’s lifestyles and food preferences. Working to identify the rules that dictate whether you label certain foods as “good” or “bad” can slowly remove morality from food choices and allow for a more neutral perspective toward body nourishment.

Questions to ask yourself.

Finding ways to support positive mental and emotional wellbeing during periods of major change while on and off a weight-loss program are key components to prioritizing overall health.

• Are there any foods I have labeled as “forbidden” foods?
• Where is the voice of the food police coming from? Is it helpful or hurtful?
• Do I have self-imposed “shoulds” of what foods to eat?

Supplements to support metabolism

Nutritional supplements can support weight maintenance. Speak to a qualified healthcare practitioner.