The short answer is “No.”
The long answer is “Maybe you want to be”.
I will review a research article at then end of this blog addressing this question, but I’d like to start with challenging some assumptions.
Getting back to the question “Do I have to be on weight loss medication forever?”. The answer is, “You never have to be on any medication forever”. But this question should be followed up with….
- “Do I want to be on this medication long term and is it worthwhile?”
- “What are the risks versus benefits of being on a weight loss medication that helps me stay at a healthy weight”?
- “Do the benefits outweigh the risks?”
I often hear “You will just gain weight once you come off of __________ (fill in the blank)”. And it’s usually said in a condemning or accusatory tone, as if the medicine or the person is a failure. But I’d like to challenge such a statement. Do we say antibiotics are a failure if someone stops them before their infection has been eradicated? Do we say someone is a failure if they must take thyroid replacement medication? If someone’s blood pressure is high and appropriately lowered with an antihypertensive medication, do we judge the person or the drug as failures when the medication is taken away and their blood pressure goes back up? No!
Likewise, I think it would be healthy to approach weight loss medications with a new mindset. Do lifestyle and dietary habits play a role in weight gain or loss? Absolutely. Do we have agency over how we live and eat? Of course! I do not mean to absolve anyone of rightfully placed responsibility and ownership. However, peoples’ lives and bodies are more complex than these black and white lines. Contributors to weight gain are also in our environment- outside one’s control. I will give you examples:
- 42-year-old Nancy exercises 5 times/ week at the gym and doesn’t overeat- yet she can’t lose weight. Nancy learns her blood insulin levels are sky high- blocking her bodes ability to lose any weight. Her insulin levels are lowered, and her weight drops easily.
- 55-year-old Frank is a businessman, traveling all the time for work. He knows he doesn’t eat the best, but he does the best he can. He doesn’t make time to de-stress. His portion control efforts aren’t tipping the scale. Frank learns that his blood cortisol levels are elevated, causing dysregulation of all his other hormones and raising insulin levels. He works with his provider to reduce cortisol levels and support his adrenal glands producing cortisol. His stress decreases, his life improves, and he loses weight.
- 32-year-old Desiree is a mom of 4 young kids. She runs around all day taking care of her kid’s needs. She can’t seem to lose her post pregnancy weight, despite her best efforts. She finds herself snacking even when she doesn’t want to. Her blood work shows her estrogen and progesterone levels are out of balance, cortisol is high, and thyroid is not optimized. She gets the treatment she needs and starts losing weight.
- 38-year-old Michael is a dad, newly remarried with stepchildren. He finds juggling all his new relationship responsibilities along with his career is a battle. He wants to show up for the most important people in his life. If that weren’t enough, he finds he is exceptionally tired and gaining weight. He wonders, “is this just mid-life?” His bloodwork shows his testosterone levels are in the basement. He gets treatment and finds renewed zest for life, his relationships, and motivation for work. His weight also improves.
- 22-year-old Lisa and her 51-year-old mom know they struggle with overeating. They have tried every diet known to man. Hopes lifted, only to be dashed. Nothing they try seems to curb their food noise and hunger. Lab work shows they have high levels of toxins known to be “endocrine disruptors” (this is another entire blog!). Their blood work shows high levels of inflammation, elevated triglycerides and LDL from the processed foods, along with nutritional deficiencies. They get treatment and they start to lose weight and make lifestyle changes. Maybe this is the beginning of a new chapter for them and the end to the questions as to “Why me?”
Maybe you find yourself in one of these stories. And there are so many more variations. There is diabetes, sleep apnea, PCOS, menopause or even those who “do everything right.” We cannot judge a book by its cover. Nor can we jump to conclusive treatment answers without investigation.
Wherever you fall on the spectrum of health, body weight, disease, lifestyle or diet, if you need help, then please reach out!
Here is where you can order your own labs tests (Click me!)
A study presented at the European Congress on Obesity (ECO) 2024 found that personalized, lower doses of semaglutide (Wegovy or Ozempic) combined with a digital weight loss program helped patients maintain their target weight up to six months after tapering off the medication. The study was led by Dr. Henrik Gudbergsen from Embla, a digital weight loss clinic, the research showed that patients using about a third of the recommended semaglutide dose lost a median of 14.8% of their body weight over 64 weeks. These results were comparable to those in phase 3 trials of semaglutide but with fewer side effects.
Participants engaged in lifestyle changes, supported by health professionals, which helped them sustain weight loss even after stopping the medication. The study involved 2,246 individuals with obesity or overweight-related comorbidities. Findings indicated that weight loss was achievable regardless of initial BMI or semaglutide dosage. After tapering off the drug over approximately nine weeks, many of the participants maintained their weight, highlighting the effectiveness of combining medication with lifestyle interventions.
Here is another link where you can order your own lab tests (Click me!)
However, after six months of having tapered off semaglutide, some participants began to regain weight due to increased hunger and a reduced metabolic rate. To prevent the yo-yo dieting cycle and to prevent obesity-related diseases, many participants opted to stay on a low dose of semaglutide. Despite some skepticism about long-term weight maintenance, the study suggests that lower doses of semaglutide, along with lifestyle modifications, can effectively manage weight loss and support ongoing weight maintenance.
Reference: https://www.medscape.com/viewarticle/weight-loss-maintained-slow-taper-semaglutide-2024a100095i?ecd=wnl_confwrap_endo_ECO-NONSPON_240526_mscpedit_etid6540223&uac=406528SJ&impID=6540223