Dr. Hwang said that physicians often try other treatments, such as metformin or insulin, to help control blood sugar in patients with diabetes. But starting and stopping medications can be disorienting for patients and doctors as they make a plan, she said.
the cravings come back
Semaglutide mimics a hormone called glucagon-like peptide-1, which we produce in our intestines and which signals our body that we are full. The drug affects the brain by blunting hunger signals and making people feel apathetic, or even actively repulsed, toward food. “They’re not thinking about it all the time,” Dr. Craftson said. “He has this less-dramatic relationship with food.” For some, it’s “very liberating,” Dr. But those cognitive effects can quickly dissipate when a patient stops taking the drug, Craftson said. He said that some patients feel more hungry after forgetting to take only one dose of the medicine. “People will say they feel the craving come back,” Dr. Hwang said. After weeks or months without Ozempic or Vegovy, many people will gain weight.
A trial published in the spring and funded by Novo Nordisk, the company that makes Ozempic and Vegovy, examined people who took semaglutide once a week for 68 weeks and then stopped using it. After one year, the participants had lost two-thirds of their weight.
Doctors say that, anecdotally, they have seen this type of withdrawal in patients as well. “I’ve seen people and they’ve lost maybe 50 pounds, and then they’re off it for a month and then I see them back in the clinic and they’ve gained 20 pounds,” Dr. Craftson said.
side effects are reduced
In some cases, people find they were experiencing side effects while on semaglutide when they stop taking the drug, Dr. Craftson said, such as a mild headache or upset stomach. For those with side effects, discontinuing the drug can be a relief. Lee Levin, 67, who started Ozempic to help manage type 2 diabetes, had nausea so severe she once went to the emergency room. When she stopped the drug, she said, the near-constant discomfort went away “almost immediately.”
Doctor. People who return to full doses instead of gradually reducing their intake may experience more serious side effects, including vomiting and diarrhea, said Craftson. Dr. Craftson also cautioned that patients can’t follow all of the guidelines when they first start taking the drugs, such as chewing slowly and avoiding heavy foods so they don’t feel so full that they get sick. For those who work up to their original dose slowly, it may take even longer to lose weight, adding another hurdle to the exhausting cycle of the drug.
“It’s been a whirlwind for our patients, and not in a good way,” Dr. Hwang said.