SubEx

Myth check

Coming off Wegovy or Ozempic: does the weight stay off?

Mostly not. When stopping was randomised, weight came back while staying on took more off. A year after a trial ended, with coaching stopped too, most of the loss had returned.

Semaglutide

Semaglutide, the drug in Wegovy and Ozempic, is often talked about as a reset: take it for a while, then stop. After 20 weeks of building up to the full dose, one trial switched people at random to a dummy injection; over 48 weeks they put on 6.9% while those still injecting lost more. A year after a second, 68-week trial ended, most of the loss had returned in 327 people who had lost more than average, and coaching stopped with the drug. It works less like a course than a treatment you stay on.

The findings behind this

1↓
Metabolic & weightStopping put weight back on while staying on it took more off

After 20 weeks reaching the full 2.4 mg dose, 803 adults were split: over 48 weeks the placebo group put on 6.9% and the group still injecting lost another 7.9%.

★★★Well replicated — this finding’s sources average out to meta-analyses, systematic reviews or high-powered trials.Everyone had already tolerated 20 weeks of dose escalation before being randomised, so the people most likely to quit were gone before the clock started. Lifestyle support carried on in both arms, which is not the same as stopping everything. Four in five participants were women.Click to keep this openManage weightSemaglutide
2↓
Metabolic & weightA year after the last injection, most of the weight had returned

Among 327 people followed a year after the 68-week trial ended, weight went from 17.3% below baseline to 5.6% below. The coaching stopped with the injections.

★☆☆Contested — the evidence disagrees with itself, or the finding carries a caution. A caution or conflict always shows one star, however strong the sources are.CautionThe extension was exploratory and powered for nothing. Its 327 people came from high-recruiting sites rather than a random slice of the 1,961 randomised, and they had lost more than the trial average to begin with. Drug and lifestyle support were withdrawn together, so the regain cannot be pinned on the drug alone. Nobody was randomised after week 68, so there was no control arm left to compare against.Click to keep this openManage weightSemaglutide

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