Aug. 7, 2024 – You’ve achieved your weight loss goals after taking an anti-obesity drug, and you’re excited for a new chapter. So, what comes next?
You have a few options, from stopping cold turkey, to phasing out the drugs, to looking for a maintenance dose.
First, you could quit the medication altogether. In fact, you can abruptly stop taking these drugs without any major side effects (except for Qsymia at its highest dose),according to Ethan Lazarus, MD, an obesity medicine specialist and owner of Clinical Nutrition Center in Greenwood Village, CO.
This option comes with weighty words of caution. Along with promoting weight loss, anti-obesity medications like Wegovy or Ozempic can help with weight maintenance, too. Stopping the medication will likely cause your appetite to come roaring back, usually leading to weight gain.
“During weight loss, the body undergoes a process of metabolic adaptation, characterized by a slowing of the metabolism and an increase in hunger,” said Lazarus. Anti-obesity drugs help help the body overcome this metabolic change. “Coming off the medication will return the appetite to its abnormally elevated state due to the weight loss and metabolic adaptation and is the trigger for weight regain.”
Katie Kabala took a different approach. After losing 95 pounds in 18 months on Contrave – which she describes as “the best thing that’s ever happened” in her life – she stayed on the same dosage she used for weight management. Kabala, 40, says this decision stemmed from Contrave’s ability to quiet the food noise that led to previous struggles with obesity. The drug, which is in a different class than the popular GLP-1s now dominating the market, also helped her track the 1,200-calorie-per-day diet she followed during weight loss.
Despite common stigmas about weight loss medications or medical interventions to combat obesity, like bariatric surgery, Kabala says that she refuses to feel guilty.
“I just think it's so important to let everyone know that you do deserve the help,” said Kabala, who works in zoning and planning in South Carolina. “With Contrave, I feel like for me, it really just leveled the playing field to allow me to diet.”
Some people get nervous about taking a weight loss drug long-term. Another approach would be switching to a lower maintenance dose, said Jonathan Kaplan, MD, owner of Pacific Heights Plastic Surgery in San Francisco. For example, instead of taking the drug once per week, you could try taking the shot every 10 days, or biweekly, which could save you money, too.
A few other things to keep in mind: You should stop the medication if you’re having serious complications – such as pancreatitis – or there’s been a medical shift that could greatly help you sustain your weight loss, such as bariatric surgery, Lazarus said.
If you significantly lower your dose of a weight loss medication, focusing on lifestyle changes – like getting enough sleep, following a healthy eating plan, and adopting an exercise routine with a focus on resistance training – could greatly help avoid weight gain, he said.