T“Anxiety is always in the back of your mind,” says Suzie Cox, who has been signed up to Wegovy for about six months and on Friday morning stepped on the scales to see the number start at 10 stone for the first time in five years.
“I’m excited,” she continues, “but I’ll be honest: when I lose weight and my clothes are too big, I usually triumphantly take them to a charity shop. This time I’ve hidden them all under my bed. I’m terrified that as soon as I stop taking the drugs I’ll be back to a size 16, 18 or 20.”
Cox is one of several people whose lives have been transformed by Ozempic and other weight-loss drugs such as semaglutide and tirzepatide. Independent The announcement was made in June, but like many others taking the drug, Cox now faces a dire prospect: While the drug is highly effective when taken regularly, some users report that when they taper off or stop taking it altogether, their “extreme” hunger returns as soon as they stop taking it, and many report regaining much of the weight they’d lost.
Ozempic recipients are now seeking support on TikTok and Reddit after stopping the drug to deal with uncontrollable hunger. “What do I eat to feel full? I can’t stay full,” influencer and comedian Claudia Oshry shared in a recent post. “I just ate a 12 ounce steak and now I’m hungry so I’m eating popcorn. How am I staying full?”
“That’s exactly how I was after Monhaulo,” reads one of many agreeing comments below. “I was starving! No answers, just prayer.”
Demand for Ozempic has been consistently high and continues to increase since it was approved for weight loss on the NHS in September 2023. Ozempic is primarily used to treat type 2 diabetes – a chronic metabolic disease that occurs when the body cannot use insulin properly – and its weight loss benefits have determined its popularity.
The drug is currently available from pharmacies across the city for between £149 and £297 a month depending on the dose and its use is so widespread that some people are using it for lifestyle reasons such as “dropping a dress size” before a big event or holiday.
One acquaintance told me that there were so many people taking the drug at a friend’s 50th birthday party that he had to throw away most of the food. Spotting Ozempic’s face among celebrities and influencers has become something of a national sport.
Clinical studies have shown that in about the first 10 months of taking Ozempic, users lose an average of 13 to 15 pounds. Although the amount of weight lost varies depending on starting weight, lifestyle factors, and dosage, people typically lose 10 to 15 percent of their body weight in the first year of taking Ozempic.
But clinical studies limit people taking the drug for weight loss to two years, and many stop taking it after a year, at which point many run into problems, says Richard Holt, professor of diabetes and endocrinology at the University of Southampton.
“It’s very hard to avoid regaining the weight,” he says, “because Ozempic is effectively telling your brain that your body doesn’t need to eat and that your weight is normal.”
“Even before food was abundant, the body had very complex mechanisms to try to protect its weight. Losing weight was a really big survival issue for humans, so naturally the body has very powerful physiological mechanisms to keep weight roughly constant.”
Ozempic can hijack the mechanisms, or receptors, that signal hunger, allowing people to eat less and lose weight, Holt said. “It does this very effectively,” he said.
“But the problem is that as soon as you stop taking the drug, your body thinks it’s in a state of starvation and the mechanisms that prompt you to start eating again kick in again. So in all studies of people taking GLP-1 semaglutide, people regain weight very rapidly when they stop treatment. This weight gain can last for up to a year after they stop taking the drug.”
Fear of withdrawal symptoms is widespread Sophie Medlina consultant dietitian and president of the British Dietetic Association in London, has recently seen a sharp increase in the number of patients struggling to tapering or stop taking weight-loss medication.
“People say they feel like they can’t control their appetite anymore. While they were on the medication, they never felt hungry, and just being aware of hunger again can feel really overwhelming,” Medlin explains. Once they stop taking the medication, food cues can ramp up to max levels again, making people feel scared and less confident they can make good food choices, she says.
“Because the difference between being on the medication and not taking it is so big. Once the medication is completely out of your system, you start to panic that you’re not going to maintain the weight or the gains you were making.”
Psychologically, this can be extremely difficult to deal with – and for someone like 46-year-old Cox, who has struggled with her weight since her teenage years and lost two stone in three months, it’s an excruciating dilemma.
“At this point, I’d sooner cancel my gym membership than I would cancel Wigobee,” Cox admits. Regardless of what medical or physical effects the drug has had, she says it’s the benefits to her mental health and control over her life that have been the most transformative.
Coming off Ozempic, recognizing that psychologically nothing may have changed, and then having to work to lose weight is incredibly difficult.
“I’ve talked to everyone I know about how this has affected us emotionally,” she said. “I feel like the best version of myself, and I don’t want to lose that.”
Like many people who take the drug, Cox found that her alcohol consumption naturally decreased while she was taking it — something she had been hoping to cut down on for years, and several studies back up this effect.
“This can be really difficult for people who have always struggled to regulate their appetite and intake,” Holt says. “We’re talking about people who may have woken up thinking about what they’re going to eat next their whole life, or who have obsessed with food, and who have found a medication that gives them relief from that experience.”
“Then when you try to lose weight, it’s incredibly difficult to realise that psychologically nothing may have changed and that you still have to make an effort to lose weight. It’s very difficult.”
Holt argues that drugs like Ozempic, which often improve people’s quality of life and relieve a lot of psychological distress, shouldn’t be limited to two years. (“If you’re using a drug to treat something else, like high blood pressure, you don’t stop taking it after two years, right?” he says.)
Weight shame and social stigma play a big role in this, he adds, even though many people are simply genetically heavy.
“To make matters worse, many patients taking drugs like Ozempic are eating diets that are very poor in nutrients,” Medlin said. “I’ve seen patients who can’t be bothered to prepare meals and are basically just eating chips or small snacks.”
Is the body making up for lost time after being “starved” of food for an extended period of time?
To an extent, yes, says Medlin: “When you feel like you’re lacking nutrients or your body is really lacking food, your appetite increases and you’re more likely to want to eat more.”
Medlin advises her patients to develop healthy habits and routines before attempting to lose weight, otherwise, as other fads have shown, weight will constantly fluctuate due to restrictive dieting rather than lifestyle changes.
She added that people who use Ozempic and Weebozi inappropriately to aim for an unhealthy low BMI, or who use them secretly from friends and family, are most susceptible to the condition.
The latter, she says, “is something you’ve probably been complimented on for losing weight, and it makes it even more painful because people think, ‘I felt more valuable to my friends and family because I lost weight, and now I might gain it back. How will that make me feel?'”
But there’s good news: “Your final weight after stopping Ozempic is often, on average, probably about 5 to 10 percent lower than when you started taking it,” Holt says, “so it’s lower than it was before, but not as low as it was when you were actually taking the drug.”
Cox says she has friends who are now gradually tapering their weekly doses, and she’s eager to see what happens next. For many, that’s the problem — it’s a new drug and has never been used so widely before, so we don’t know yet. But there’s hope: you can stash your baggy clothes under your bed.
