Ozempic is part of a class of drugs called GLP-1 agonists that treat diabetes. Ozempic—and drugs like it—have been remarkably popular in recent years thanks to one of its side effects: dramatic weight loss.
It’s not uncommon for patients to lose up to five pounds in a month! But, spoiler: If you stop taking Ozempic, it can be incredibly hard to maintain the weight loss. Here, everything you need to know about life after Ozempic, and the supplements and lifestyle habits that may help you keep off the pounds.
A little over a year ago, semaglutide drugs like Ozempic and Wegovy were virtually unknown outside of the medical and diabetes communities. But thanks to celebrities like Elon Musk and Dolores Catania endorsing the drug as a quick slim-down tool, now you’d be hard-pressed to find someone who hadn’t heard of semaglutide. In fact, Ozempic and Wegovy grew so much in popularity in early 2023 that it became difficult for patients to access the drug. And almost a year later, it’s still on the U.S. Food and Drug Administration (FDA) drug shortage list.
Originally developed to treat type two diabetes, semaglutide can help people eat less without feeling hungry, resulting in some pretty considerable weight loss, says nurse practitioner and dietician Brittany Brothers, APN-BC, RDN, CDCES, founder of Ocean Medical Nutrition. More than two-thirds of American adults are overweight or obese, and 67% of those with obesity are trying to lose weight—something that’s notoriously hard to do. So, it’s really no surprise so many are intrigued by a drug that can make dropping pounds easier.
But have you ever thought about what happens to patients long after their flashy Ozempic before and after pictures are posted online? Or what happens if they stop taking Ozempic because they can no longer access it or just don’t want to take it anymore? Do they quickly gain all the weight back? Are there steps they can take to maintain their weight loss? Can supplements like berberine (which has been touted on social media as “nature’s Ozempic”) help maintain weight loss—or lead to more weight loss? The Wellnest answers these questions and more below.
How Ozempic Works for Weight Loss
Ozempic is part of a class of drugs called GLP-1 agonists, which are used in the treatment of type 2 diabetes to help lower blood sugar levels. Obese and overweight adults who also have a weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol) can also be prescribed the drug for weight management. However, in recent years, many people who do not meet this criteria started taking the drug “off label” for weight loss, per a Trilliant Health report.
Administered via an injection under the skin, Ozempic mimics a naturally occurring hormone called GLP-1 that’s released after you eat. This causes your pancreas to release insulin, which lowers the amount of circulating blood sugar in the body, explains Amy Shapiro, MS, RD, the founder of Manhattan-based dietetics practice Real Nutrition. “As a result, blood sugar levels are stabilized, and food moves from the stomach to the small intestine more slowly. Both these things help increase feelings of fullness, and you lose weight as a side effect.”
Studies that have specifically looked at Ozempic’s impact on weight loss in people without diabetes show promising results. One New England Journal of Medicine study found that weekly semaglutide injections can help people lose nearly 15% of their body weight (an average of about 34 pounds) over a 16-month period when combined with diet and exercise. Other research has similar findings, with participants losing about 16% of their body weight, while those in a placebo group not taking Ozempic only lost 5.7%.
What Happens When You Stop Taking Ozempic?
According to Shapiro, here are some things patients may experience after they stop taking Ozempic or other GLP-1 agonists:
A Super-Charged Appetite
Ozempic causes food to move through the body slowly, which decreases appetite. But once the medication is stopped, the rate of digestion speeds back up, causing hunger to come back with a vengeance.
According to research, within a year of going off semaglutide, most patients regain almost all of the weight they lost. “You’ll likely gain the weight back since your brain will no longer be tricked into thinking you are full,” Shapiro explains. “Also, it can be harder to make healthy food choices when faced with hunger—especially if dietary habits weren’t improved while taking Ozempic.”
An Increase In Blood Sugar
If you have type 2 diabetes, your blood sugar will likely go back up after you stop taking Ozempic. Certain lifestyle changes can help to manage this, including regular exercise and following a low-carb diet, Shapiro notes.
No More Negative Side Effects
There is some positive news! Nausea, vomiting, constipation, and diarrhea—some of Ozempic’s most unsavory side effects—should dissipate after you go off the weight loss drug.
Life After Ozempic: Supplements & Lifestyle Changes For Weight Loss Maintenance
While it’s unlikely you’ll be able to keep off all of the weight after stopping Ozempic, certain lifestyle habits and supplements may contribute to weight loss maintenance. Here is a closer look at a few things you may want to consider.
Videos about berberine (AKA “nature’s Ozempic”) have been viewed over 114 million times on TikTok, with countless creators claiming it’s helped them lose weight. But the compound, which can be found in the roots and bark of a variety of plants, is far from new. It’s been used for thousands of years in Traditional Chinese Medicine to aid various conditions.
While there is limited human research on berberine’s impact on weight, experts say it may promote modest weight loss—about 2 to 4 pounds a month—by balancing blood sugar levels and lowering cholesterol, Shapiro explains. “Berberine also inhibits lipoprotein lipase in the body, which promotes fat storage,” explains Shapiro. “When we have lower blood sugar and are not storing fat, we burn fat for energy, which can aid weight loss.”
While Brothers agrees that there’s not enough research to definitely recommend berberine for weight loss or weight maintenance, she says that the success some TikTokers are having with the supplement may have something to do with GLP-1. “Some studies suggest that berberine promotes the secretion of GLP-1. Enhanced GLP-1 secretion can lead to weight loss through delayed gastric emptying and improved glucose metabolism, both of which can increase feelings of satiety, so you don’t need to eat as much to feel full.”
If you want to add a berberine supplement to your routine, just check with your healthcare provider first. Berberine isn’t right for everyone and has multiple known interactions with medications, so you’ll definitely want to get the all-clear.
Maintaining Muscle Mass
When it comes to keeping off weight, maintaining or increasing muscle is key, says Shapiro. “When you lose weight quickly, you lose muscle mass, which causes your metabolism to slow down. That means you burn fewer calories at rest, making it harder to lose additional weight or maintain weight loss.”
Packing on some muscle can help counteract all that. “I recommend all my clients start a weight training regimen if they decide to go on Ozempic, and maintaining a weight training routine is just as important when they stop taking it.”
Adding protein to your diet can also help maintain muscle mass. Active adults should aim for 1.2 to 2 grams of protein per kilogram of body weight. That means a 150-pound person should eat 82 to 136 grams each day, says Shapiro. Foods like chicken, tofu, grass-fed beef, eggs, fish, and protein powder are all good, lean sources of the nutrient.
Limiting Starchy Carbs
It can also be helpful to eat a lot of vegetables while limiting servings of starchy carbohydrates, such as rice, bread, and potatoes. “Larger servings of these types of foods can increase blood sugar levels and cause insulin spikes, and the body stores fat when insulin levels are high,” says Shapiro.
“When eating carbohydrates, choose whole grain, high fiber options and to limit your serving to about 1/4 of your plate. It is also important to pair carbohydrates with a protein and or fat to slow digestion and to prevent blood sugar spikes.”
Shapiro also recommends limiting overly processed foods, which are not conducive to weight loss or maintenance.
You already know that going off Ozempic can increase appetite, but did you know that not getting enough sleep can have the same effect? “When you don’t get enough sleep, it can impact hormone levels related to hunger and fullness,” explains Brothers.
If you generally have trouble logging enough ZZZs or sleeping through the night, there are a few things you can try. For starters, try to get at least two hours of natural light every day. “This will help keep your circadian rhythm healthy and may help you sleep more soundly,” Brothers explains. “You can also try going to bed and waking up around the same time each day—even on the weekends—again, this is something that may help with your circadian rhythm.”
Ozempic before and after pictures have inspired countless people to turn to the drug for dramatic weight loss results. However, maintaining weight loss after going off the drug can be extremely hard.
The good news? There are habits you can implement in your weekly routine and supplements you can take that may help to minimize the bounce back.
Always check with your healthcare provider before making any changes to your diet, workout, or supplement routine.