What Happens When You Stop? A Compassionate Look at Life after Weight Loss Injections
Weight loss injections like Ozempic and Wegovy have soared in popularity in recent years, often framed as a breakthrough for those struggling with weight and health. For many, these medications represent hope - perhaps after years of dieting, battling emotional eating, or feeling stuck in a cycle of weight gain and loss.
But what happens if and when you stop taking them?
I understand the appeal of these injections for weight loss, and fully respect personal autonomy - your body, your choice. However, if you are currently on them, considering using them, or thinking about stopping, I believe it’s important to ask: What next?
The reality is, for most people, weight regain is common - sometimes even surpassing pre-treatment levels. If this happens, it is not a failure on your part - it is simply how the body works. Weight loss injections may help in the short term, but they can’t address the deeper relationship you have with food and your body.
The aim of this blog is not to judge or criticise, but to bring attention to the bigger picture, raise awareness of the challenges around coming off these medications, and explore how else you can support yourself in sustainable ways.
How Weight Loss Injections WorK
Most weight loss injections belong to a class of drugs called GLP-1 receptor agonists.
This means these medications mimic the GLP-1 hormone which plays a key role in regulating, appetite, digestion, and blood sugar levels. By activating these receptors, the drugs suppress appetite making it easier to eat less and reducing cravings, and slow gastric emptying leading to prolonged feelings of fullness.
Originally developed for the management of Type 2 Diabetes (e.g. brands: Ozempic, Mounjaro) they were later approved for obesity ‘treatment’ (e.g. brands: Wegovy, Saxenda).
And they can be very effective - perhaps too much so. While they can help some people improve their health, the rapid rise in popularity and increasing availability via private healthcare and online providers have introduced risks, especially when used off-label by people who do not meet medical criteria for obesity treatment.
THE RISE IN POPULARITY AND POTENTIAL MISUSE
Weight loss injections have become part of a growing cultural obsession with quick-fix weight loss. Their increasing availability means that:
Some people obtain them online without medical supervision, increasing the risk of serious side effects.
People with disordered eating may access them - with a potential risk of worsening their relationship with food.
They are often seen as a short-term weight loss tool, despite being designed for long-term use in medical conditions.
In the UK, NHS prescriptions are limited to those meeting certain medical criteria (BMI over 35 with ‘weight-related health conditions’), and prescriptions are typically capped at two years.
However, many people use these drugs privately, often at significant personal cost. What happens when they can no longer afford them - or when they no longer qualify?
And, given the potential for acute complications and troubling side-effects, both physical and mental, what happens when people can’t tolerate the medications or come off them at their own will?
What Happens When You Stop Taking Weight Loss Injections?
1. Hunger and cravings often return
GLP-1 receptor agonists override your body's natural hunger and fullness signals. When you stop taking them, your body will try to re-establish balance by increasing appetite.
This can lead to:
Increased hunger and stronger cravings
A tendency to eat larger portions
A rebound effect that leads to binge eating
If this happens to you, it’s really important to acknowledge it is not a personal failure - it’s just your body doing what it was designed to do.
2. Weight regain is common
Studies suggest that about two-thirds of the weight lost during treatment is regained within the first year after stopping. A large-scale study involving over 20,000 patients on semaglutide found that 18% returned to their starting weight within a year, while over 50% experienced some degree of weight regain. They also lost the positive cardiovascular effects they benefited from whilst taking the medications.
This suggests that these medications function a bit like a diet - a temporary fix. Because they suppress natural hunger cues without addressing the underlying reasons behind eating habits, stopping them often results in rebound weight gain.
Understandably, this cycle can be deeply disheartening - physically, emotionally and mentally.
3. Metabolic adjustments can make it harder to maintain weight loss
When weight loss happens rapidly, the body fights to restore balance through a process called metabolic compensation. Essentially a survival response, this means that after stopping weight loss injections, the body may:
Burns fewer calories at rest (lower basal metabolic rate)
Increase fat storage capacity (to ‘protect against future weight loss)
Intensify hunger cues (to replenish lost weight)
This isn’t about willpower - it’s about human biology.
4. Emotional and psychological shifts can be challenging
Many people experience relief when taking GLP-1 medications because food no longer dominates their thoughts. But stopping can bring back:
Food preoccupation
Anxiety about weight regain
Frustration if old eating patterns resurface
This is why self-compassion is so important. Your body is not betraying you - it’s simply adjusting.
Is long-term weight MAINTENANCE possible?
Right now, long-term research on what happens to weight after stopping GLP-1 medications is still developing. While studies indicate that many people regain weight after discontinuing these medications, the long-term trajectory beyond the first few years remains unclear.
However, it’s also important to remember that bodies naturally change over time. Weight control is not a fixed formula - our body size, composition, and metabolic needs shift throughout life, meaning fluctuations are normal.
Some research suggests that of those people who did manage to sustain weight loss after stopping GLP-1 medications, most developed sustainable habits whilst on them, such as:
Addressing emotional eating and food-related behaviors
Shifting their mindset around food and weight
Incorporating regular physical activity
One study found that more than half of participants maintained at least some of their weight loss, suggesting that lifestyle factors play a crucial role in long-term weight management.
This all highlights an important reality: weight loss injections only ‘work’ while they are being taken. Once discontinued, weight regain is likely unless other factors influencing body weight and eating behaviours can be addressed. Even then, I would argue there are no guarantees as body size and shape are uniquely influenced by a complex interplay of biology, emotions, habits, and environment at any given time.
However, if minimising rebound weight gain is a goal after stopping these medications, it is essential to consider these broader influences and develop sustainable strategies that support long-term wellbeing.
TAKING A SUSTAINABLE APPROACH
Weight loss medications might be a stepping stone towards a smaller body for some people, but they’re not likely to be permanent fix. Instead of relying solely on weight loss injections, a more sustainable approach could include:
Understanding your body’s natural appetite signals and learning to work ‘with’ your body.
Addressing emotional eating or binge eating patterns.
Focusing on supporting on your whole health, not just weight - for example, energy, digestion and mood all matter.
Building a sustainable, trusting relationship with food, not fearing it.
Learning to respect and care for your body - whatever it’s shape or size.
MY CONCLUSIONS
Using weight loss injections is a complex decision - perhaps more so than it seems on the surface. If you’ve taken them, or are considering them, it’s ok to ask yourself: What’s next?
What happens when the prescription ends?
What support do I have in place?
How can I work towards long-term peace with food and my body?
Food freedom and body peace ultimately come from self-trust, sustainable habits and compassionate care. If you’re exploring your options, please know you don’t have to do it alone. There is support available - beyond the medication.
Key Research Sources
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., ... & le Roux, C. W. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002.
Kushner, R. F., Calanna, S., Davies, M., Dicker, D., Garvey, W. T., Goldman, B., ... & Rubino, D. M. (2020). Semaglutide 2.4 mg for the treatment of obesity: Key elements of the STEP trials. Obesity (Silver Spring), 28(6), 1050-1061.
Wadden, T. A., Bailey, T. S., Billings, L. K., Davies, M., Frias, J. P., Koroleva, A., ... & Rubino, D. M. (2021). Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: The STEP 3 randomized clinical trial. JAMA, 325(14), 1403-1413.
Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F. L., Jensen, C., ... & Wilding, J. P. H. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial. JAMA, 325(14), 1414-1425.
Davies, M., Færch, L., Jeppesen, O. K., Pakseresht, A., Pedersen, S. D., Perreault, L., ... & Rosenstock, J. (2021). Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet, 397(10278), 971-984.
Take a nourishing step forward today
Are worries about food, weight, or overeating draining your time, energy, and peace of mind? Are you struggling with low mood, persistent food cravings, poor gut health or digestive challenges?
Old mindsets and habits can be hard to shift on your own. If you are looking to reset your eating patterns, make peace with your body, and reclaim your energy, I can help you.
Please check out my private programmes here, or book an exploratory chat to find out more.
