Semaglutide, known by brand names like Ozempic and Wegovy, is a medication approved for chronic weight management in adults. It functions as a glucagon-like peptide-1 (GLP-1) receptor agonist, mimicking a natural hormone in the body. This action helps regulate appetite, promoting a feeling of fullness and reducing hunger. Additionally, semaglutide slows down how quickly food leaves the stomach, extending feelings of satiety. It also influences blood sugar levels by enhancing insulin secretion and decreasing glucagon production.
Semaglutide as a Long-Term Medication
Semaglutide for weight loss is typically prescribed as an ongoing treatment because obesity is recognized as a chronic disease requiring continuous management. This approach is similar to managing other long-term conditions such as high blood pressure or diabetes, where consistent medication use helps maintain health outcomes. Clinical trials have shown that semaglutide can lead to sustained weight loss with continuous use. For instance, in the STEP 1 trial, participants who continued semaglutide therapy for an additional 48 weeks maintained a mean weight loss of 16.9%, while those switched to placebo regained significant weight.
Further evidence from the SELECT trial, which spanned an average of 40 months, indicated that semaglutide users experienced sustained weight loss for up to four years, achieving an average body weight reduction of 10.2%. Without ongoing pharmacological support, the body’s natural physiological responses may lead to weight regain, highlighting the need for continuous treatment to maintain weight and health improvements.
Long-Term Safety and Monitoring
Semaglutide is associated with certain side effects. The most common adverse effects are gastrointestinal, including nausea, vomiting, diarrhea, abdominal pain, and constipation. These symptoms are usually mild to moderate and often decrease as the body adjusts to the medication.
Less common, but more serious, side effects can include acute inflammation of the pancreas (pancreatitis) and gallbladder issues like gallstones or gallbladder inflammation. Semaglutide also carries a boxed warning regarding the risk of thyroid C-cell tumors, observed in rodent studies, though the risk in humans is currently unclear. Individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 are advised against using semaglutide. Ongoing medical supervision, including regular check-ups and blood tests, is important to monitor for these potential issues and adjust treatment as needed.
Life After Semaglutide
Discontinuing semaglutide often leads to weight regain, a phenomenon sometimes referred to as “Ozempic rebound.” This occurs because the medication helps regulate appetite and satiety, and once stopped, these physiological mechanisms may revert to their previous state, leading to increased hunger and a return of cravings. Studies, such as the STEP 1 trial extension, have shown that participants who stopped semaglutide regained approximately two-thirds of their lost weight within a year.
Maintaining weight loss without semaglutide requires lifestyle interventions. These strategies include adopting a balanced diet rich in nutrient-dense foods like vegetables, fruits, lean proteins, and whole grains. Regular physical activity is also important, with recommendations suggesting at least 150 minutes of moderate-intensity aerobic exercise weekly, along with strength training. Behavioral therapy can provide additional support, helping individuals develop sustainable habits and coping mechanisms. It is important to have a comprehensive discussion with a healthcare provider before discontinuing semaglutide to develop a personalized plan for weight maintenance, which may include considering other maintenance medications if appropriate.