Losing weight can be a challenging process, and for many people, simply changing diet and increasing physical activity isn’t enough.
In recent years, weight loss medications like Wegovy have made it possible for more people to achieve lasting results. But what happens after you’ve lost the weight and stop taking the medication?
In this article, we explore how weight loss medications work and what you can do to maintain healthy habits and ensure the weight doesn’t come back.
How weight loss medication (Wegovy) works
Weight loss medications are designed to support people struggling with their weight by helping them on their weight loss journey. Wegovy is one of the newest and most effective weight loss drugs on the market, developed for individuals who find it difficult to lose weight through diet and exercise alone. The active ingredient in Wegovy is semaglutide, a GLP-1 receptor agonist. This type of medication mimics a natural hormone in the body that regulates appetite and digestion.
Semaglutide works by affecting the areas of the brain that control hunger and feelings of fullness, resulting in a reduced appetite and a longer-lasting sense of satiety. This can make it easier to eat less, reduce calorie intake, and ultimately lead to weight loss.
Who is Wegovy for?
Wegovy is intended for adults with a Body Mass Index (BMI) of 30 or higher, or for those with a BMI of 27 or higher who also have weight-related health issues such as type 2 diabetes or high blood pressure. This medication isn’t meant for short-term use; rather, it should be part of a long-term strategy for weight loss and weight maintenance.
Expected results
Clinical studies have shown that Wegovy can be highly effective for weight loss. In one of the largest studies involving over 2,000 participants, one group took Wegovy while the other received a placebo. The results revealed that those taking Wegovy lost about 15% of their body weight over a 68-week period, compared to a 2.5% weight loss in the placebo group. This shows Wegovy can be a powerful aid for people who struggle to lose weight through lifestyle changes alone. However, the studies also indicate that participants often lose a significant amount of lean body mass (muscle and water) in addition to fat mass.
How to take Wegovy
Wegovy is administered as a once-weekly injection. It’s recommended to take the medication on the same day each week to maintain a consistent dosage in the body. Like all medications, there can be side effects. The most common side effects of Wegovy include nausea, diarrhoea, and constipation. These are usually mild and tend to subside as your body adjusts to the medication. However, it’s important to contact a healthcare professional if the side effects become severe or persistent.
If you’re considering weight loss medication like Wegovy, it’s essential to consult with a doctor to determine if it’s the right option for you. Your doctor can provide more information on how the medication works, what to expect, and how best to incorporate it into your weight loss plan. Getting professional advice, such as lifestyle coaching, ensures you receive the proper treatment and support to reach your health goals.
What to be mindful of while on medication
When undergoing a weight loss programme, especially one that involves medication, there are several important factors to be aware of to ensure the treatment is appropriate and leads to sustainable results in the long term. This requires a combination of lifestyle adjustments, close collaboration with your coach, and guidance from your doctor or nurse.
During the treatment, it’s crucial to listen to your body and pay attention to how it reacts to the medication. Changes in weight, hunger, and fullness are parameters you should monitor. Common side effects like nausea, constipation, or diarrhoea should be taken seriously, as they may indicate that the dosage needs to be adjusted.
Another important side effect to watch for is loss of appetite, as it’s essential to still feel hunger during a weight loss journey. Hunger is the body’s natural signal that it needs energy, and if you no longer feel hungry and stop eating, it may be necessary to reassess the dosage.
Be cautious about losing weight too quickly
If your weight drops too quickly—more than a kilogram a week—it may be a sign that the weight loss is happening too fast. In such cases, you might need to increase your calorie intake or reduce the medication dosage, especially if your appetite is significantly suppressed. Rapid weight loss can slow down your metabolism and cause a larger portion of the weight loss to come from lean body mass rather than fat. This process should always be managed in close collaboration with your coach and healthcare professional, who can help adjust the medication and guide you on the best way to use it.
Remember this
The most important thing to remember when using weight loss medication is that the medication isn’t meant to do all the work for you.
Although the medication helps suppress appetite, it’s crucial to understand that it’s just like an electric bike—it can make the journey easier, but you still have to pedal to move forward. This means actively working on your habits, behaviours, and daily challenges such as diet, exercise, stress, and sleep. It’s essential to lose the right amount of body weight during your weight loss, as losing too much lean mass (which can happen without the right support) often leads to intense hunger that causes the weight to return to where it started.
This is why it’s important to address your challenges in partnership with your coach, who can help you understand what’s holding you back and provide strategies to overcome the obstacles you face in everyday life.
What happens when you stop taking weight loss medication?
One of the biggest fears for many people who start a weight loss programme with medication is what will happen afterward.
Most people have heard that you have to “take the medication for life,” but fortunately, that’s not what we see at Embla. Interestingly, it’s no harder to maintain your weight after a programme with weight loss medication than it is after a programme without medication, although it’s still very difficult.
A fascinating study published earlier this year gives insight into the biological forces at play after weight loss. The study used a mathematical model to show that for every kilogram lost during a weight loss programme, the body increases appetite by around 80–100 calories per day. When taking weight loss medication, this increase in appetite is reduced to about 50 calories instead of 80–100. But it still shows that the more you lose, the greater the increase in appetite—and therefore hunger—you may experience.
So, when you taper off and stop using the medication, it’s crucial to have established good habits, acquired mental tools and skills to navigate food thoughts and cravings, and set strategies for dealing with hunger when it arises.
Many people also find themselves reverting to old habits that helped them lose weight, such as eating more of a restricted food (like bread or sweets) or stopping physical activity. This often happens if we view the changes we make during weight loss as merely a means to an end. When we reach our goal, we may stop the behaviour.
6 tips for maintaining weight after stopping medication
1. Stick to your good routines
Even though you’re no longer losing weight and are focusing on maintenance, it’s important to keep the habits and routines you’ve built. This is key to maintaining your weight. Pay attention to your meal structure, as it helps with hunger control throughout the day. Think about healthy snacks like veggie sticks, yoghurt, eggs, and fruit. Don’t forget about daily physical activity, as it also plays a role in the weight loss balance.
2. Maintain a regular exercise routine
It’s no secret that exercise is important for weight maintenance. A recent Danish study showed that people who maintain their weight tend to have a regular exercise routine. As mentioned earlier, it’s essential to continue the same amount of physical activity as you did during your weight loss journey to maintain energy balance.
3. Fill up on protein and fibre
Some people may experience increased hunger. Make sure to eat more filling foods, especially those high in protein and fibre, like lean meats and dairy products such as yoghurt or chicken. Remember, fullness comes with a delay, so eat slowly and take a 15-minute break before going for a second portion.
4. Every little bit counts
Everything counts when it comes to exercise. On a bad day, a short walk is better than nothing, even if you usually run 10 kilometres. Likewise, 10 push-ups, squats, or burpees are better than none. Remember, your weight will naturally fluctuate by a few kilos day to day, but that doesn’t mean you’ve lost all your progress. It’s just a reminder to pay attention to what’s causing the fluctuation and how you can adjust.
5. Take a step back and gain perspective
When you’re faced with cravings or other challenges, take a moment to step back and gain a bigger perspective. It’s important to remind yourself that it’s not about one week or one day, but the bigger picture. A broader perspective can help prevent you from getting caught up in unnecessary small details.
6. Ask for help
It’s not a failure if you find yourself gaining a little weight again. Weight can fluctuate by 2–3 kilos without it meaning anything significant—this is often just a change in water weight, not fat. But if you feel like things are going in the wrong direction, don’t hesitate to ask for help. Life has its ups and downs, and new challenges or situations may arise, making it harder to stick to your weight maintenance plan. If what worked before isn’t working anymore, new strategies or a new structure may be needed. Reach out for support through apps, groups, or contact us at Embla—we’re always here to help.
How to Maintain Your Weight According to Our Clinical Study
In our TRIM study, conducted with our own members, 2,314 participants went through a weight loss programme with the support of a health coach. We collected data over a 52-week period, with participants being followed for an average of 32 weeks. Over 12 months, our members lost an average of 16.7% of their body weight – a better result than what is typically achieved through medication alone. Additionally, our members used 66% less GLP-1 medication compared to other weight loss programmes.
Of the 2,314 participants, 353 began tapering their semaglutide dosage under the supervision of healthcare professionals. Most started tapering after 52-72 weeks, and the process took an average of 9 weeks. Interestingly, some participants continued to lose weight during this period, and nine weeks after tapering, they had lost an additional 2.1% of their body weight on average. The study also showed that participants maintained a stable weight for the first 26 weeks after stopping the medication.
While the study does not provide a clear explanation for why the weight remained stable, our experience shows that having the right support and tools is crucial for maintaining weight loss. At Embla, we tailor the programme to suit your needs and offer ongoing support to help you sustain your results, even after stopping the medication.
Summary
It’s certainly possible to maintain your weight after stopping weight loss medication, but it’s just as challenging as maintaining weight after a traditional weight loss programme without medication.
If you have the right plan, with proper guidance on diet, exercise, and lifestyle, and tools to handle cravings and manage your thoughts, you’ll be in a good position. However, maintaining your weight requires you to stick with the behaviours that helped you lose it in the first place.
References
https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
https://pubmed.ncbi.nlm.nih.gov/32048787/