Weight Regain Is Common If You Take Popular Weight-Loss Drugs

Popular weight-loss medications could help people who are significantly overweight shed pounds, but that weight could rebound. Here's what you should know.

Thanks to celebrity and influencer endorsements, demand for semaglutide (brand names Ozempic and Wegovy) has fueled a global shortage of the popular weight-loss drug. The dramatic weight loss attributed to weight-loss drugs has enticed many Americans to try them.

In one study, people who were obese lost an average of 15 percent of their body weight after taking semaglutide for just over one year, compared to a 2 percent weight loss in those who relied on lifestyle changes.

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Researchers at the University of California, Irvine, estimated semaglutide could potentially lead to 43 million fewer cases of obesity and prevent up to 1.5 million heart attacks, strokes, and other harmful cardiovascular events over a 10-year period.

Yet evidence suggests that people who trim down with semaglutide eventually put most of the weight back on. Given the potential side effects, taking the medication could be a gamble that may not pay off.

What is semaglutide?

Semaglutide belongs to a group of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. The drugs act like the GLP-1 hormone that’s released into your gut when you eat. GLP-1 lowers your blood sugar, stimulating your pancreas to release more insulin.

In higher amounts, the hormone also acts on your brain to increase the feeling of satiety. When you feel full, you eat less and lose weight.

Semaglutide comes in three brand-name drugs:

• Ozempic and Rybelsus are approved to lower blood sugar in adults with type 2 diabetes, but they are sometimes used off-label for weight loss. Ozempic comes as a weekly injection. Rybelsus is a daily tablet.
• Wegovy is an injection approved for people 12 and over who are either obese or overweight and have a condition like type 2 diabetes, high cholesterol, and high blood pressure.

Weight rebound with semaglutide

The Semaglutide Treatment Effect in People with Obesity 1 study included about 1,900 people in 16 countries. Participants were adults with either a body mass index (BMI) of 30 or higher (considered obese) or a BMI of 27 or higher (considered overweight) and had at least one weight-related health condition (high blood pressure, high cholesterol, obstructive sleep apnea, or heart disease). All of them had tried to lose weight dieting, without success.

Researchers divided participants into two groups. One group received semaglutide once a week. The other got a placebo (inactive shot). Both groups were counseled on diet and exercise.

After just over a year, participants stopped taking the drug. About 330 of them were followed for an additional 45 weeks.

People who took semaglutide lost, on average, 17 percent of their body weight, compared to a 2 percent weight loss in the placebo group. The treatment group also had improvements in blood pressure, blood sugar, cholesterol, and triglyceride levels, as well as markers of inflammation.

Yet after going off the drug and lifestyle intervention, participants regained an average of two-thirds of the weight they had lost within a year. People who’d lost the greatest amount of weight had the most dramatic weight regain.

Those in the semaglutide group did maintain at least some improvements in cardiovascular risk factors like cholesterol, triglycerides, and inflammatory markers after one year off treatment.

Semaglutide side effects

Regaining weight isn’t the only potential downside of taking semaglutide. The medication also causes several side effects. The most common ones are GI upset, such as:

• Belly pain
• Constipation
• Diarrhea
• Nausea
• Vomiting

Semaglutide also increases your risk for gastroparesis, a disorder that slows or stops the movement of food from your stomach to your small intestine. A personal injury law firm sued the manufacturers of Ozempic and Mounjaro, claiming they failed to adequately warn consumers of the risk.

The weight-loss drugs are also linked to less common but more serious side effects, including:

• Diabetic retinopathy (eye disease) complications
• Gallbladder disease
• Kidney damage
• Low blood sugar
• Pancreatitis, inflammation of the pancreas
• Severe allergic reactions

What you can do

If you’re obese or overweight and have a chronic health condition, semaglutide might help you shed some weight and reduce your risk for heart disease. It isn’t a magic cure for obesity, however.

You’ll probably have to take the drug long-term to maintain weight loss, putting you at risk for unpleasant side effects.

Weight-loss medication isn’t meant to be used in isolation. It works best when you take it as part of an overall healthy lifestyle, which includes a well-balanced diet and exercise. A pill or injection should be an addition to healthy lifestyle modifications — not a replacement for them.

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