Millions of Americans who have used popular obesity drugs like Wegovy to lose weight and improve their health are facing a new dilemma. “What will happen if I stop taking my medicine?”
Understandably, many people are worried that they will gain the weight back and fall back into their old habits. In clinical trials, patients who stopped taking the drug regained most of the weight they lost.
But bet on do-it-yourself strategies to moderate drug use and stay slim by lengthening the dose, taking it intermittently, or stopping and restarting the drug only when necessary. Some people are.
“For me, it’s a help and a help,” said Donna Cooper, 62, of Front Royal, Virginia. She utilized Wegovy along with her diet and exercise and lost nearly 40 pounds in nine months. “At some point you have to get out of those shoes. I don’t want to wear them forever.”
More than 3 million prescriptions for new drugs are written every month in the U.S., according to recent data from health technology company IQVIA. These include Ozempic and Wegovy’s drug semaglutide and Mounjaro and Zepbound’s drug tirzepatide.
But many people don’t stick to it. A recent study published in the journal Obesity found that only 40% of patients who filled prescriptions for Wegovy in 2021 or 2022 were still taking the drug a year later.
Physicians who treat obesity emphasize that it is a chronic disease that must be permanently managed, just like heart disease or high blood pressure. A new injectable drug mimics hormones in the gut and brain to regulate appetite and satiety. Experts say they are designed and tested to be taken continuously.
“We’re not injectors,” says Dr. Andres Acosta, an obesity researcher and medical consultant at the Mayo Clinic. “I don’t think it should be used intermittently. It’s not approved for that kind of thing. It doesn’t work that way.”
Despite this directive, some patients who have met their health and weight goals with drugs are still looking for a way out, says Amy Rothberg, an endocrinologist at the University of Michigan who directs the weight management and diabetes treatment program. the doctor said.
“Many of them want to reduce their dose or reduce their dose,” she says. “And they also want to eventually stop taking the medication.”
Take a “breather break”
Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of obesity treatment company IntelliHealth, says there are a variety of reasons people stop taking drugs. Some patients dislike side effects such as nausea and constipation. Some people like to stop for holidays or special occasions. Or maybe you just don’t want to take weekly photos indefinitely.
One of Sanders’ patients, a 53-year-old New York man, lost 70 pounds using Munjaro last year. He told Mr Saunders he wanted to take a “breather” from taking the medication to see how his body reacted. On her advice, I’ve been extending my injections to every 10 days or every two weeks since December, instead of weekly.
Other patients are forced to ration or stop taking the drug because it is expensive at $1,000 to $1,300 a month, has different insurance coverage, or because demand far outstrips supply, Rothberg said. did.
“It’s being forced on them,” she said. “Inevitably, they have to come off the medication and figure something out.”
But expecting the drug’s effects to continue even after stopping the drug ignores the basic biology of obesity, experts said. This disease affects how the body processes and stores energy, causing weight accumulation. New drugs change that process, and when patients stop taking them, the disease returns, often with a vengeance.
Many people who stop taking the drug report a sharp increase in obesity symptoms. They include so-called food noises and intrusive thoughts about food. Severe hunger. And you feel less full when eating.
“These drugs are just powerful suppressors of these innate signals,” Rothberg said. “And we should expect that to happen.”
Tara Rosenhoefer, 48, of Trinity, Florida, lost more than 200 pounds after participating in a clinical trial of Maunjaro about four years ago. She currently takes the lowest dose of the drug every four to eight weeks, but she worries when her weight fluctuates a few pounds.
“I get scared during the day when I see the number on the scale going up,” she said.
Acosta said some patients who stop and restart the drug cannot tolerate it and end up having severe gastrointestinal problems. Sanders added that for some people, the effects wear off when they restart the drug. However, there is no data regarding the long-term effects of intermittent use.
“I don’t think this is an effective strategy for most people, but it could be an option for some patients,” Sanders said.
Donna Cooper has heard stories of people gaining weight back when they stop taking drugs, but she wants to be the exception. She is taking her last box of Wegoby injections. Once that’s done, Cooper said she will just continue with her strict diet and her exercise regimen.
Ms Cooper, who went from a size 16 to a size 10, said: “I needed crutches to get everything back on track and I’m excited to be done.”
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