Of late, there have been many questions about maintaining weight loss after using Ozempic (semaglutide) and whether the process kick-started by the drug can be sustainable in the long run. Ozempic works by mimicking a natural hormone called GLP-1, which helps regulate blood sugar levels, reduce appetite and slow down emptying of the stomach. While it can lead to significant weight loss during treatment, keeping that weight off once you stop or transition from the medication is a challenge.
That’s because the body fights back against weight loss after the drug’s effects wear off. As you lose weight because of drug dependence — without backing it up with diet and lifestyle changes — your metabolism or the rate at which you burn food for energy slows down. That’s because your body senses you’re losing fat and eating less, so rationalises a slowdown to preserve remaining fat stores. This reduces the number of calories you burn each day. Rapid weight loss can lead to a decrease in lean muscle mass, which impacts metabolism further. That’s why after the initial kick, the weight loss plateaus out because of the following factors.
WHY WEIGHT COMES BACK
1. Hormonal changes: Ozempic works through hormones related to appetite and satiety. So when it is stopped, the body may revert to its pre-treatment hormonal state, which can lead to increased hunger or cravings. This is why the calories pile up all over again in what is known as Ozempic rebound. If calorie intake is not reduced after stopping Ozempic, or the required calorie-deficit is not maintained through diet, weight regain is a certainty.
2. Behavioural Factors: Ozempic does not address the root causes of overeating or physical inactivity. So once the medication is stopped, individuals may return to previous eating habits, leading to weight gain. Many individuals develop dependence on the medication to such an extent that they see it as a substitute for lifestyle modification. Fact is Ozempic tops lifestyle modification, is complementary, not the only approach. It is recommended when lifestyle management measures fail in controlling an individual’s weight.
3. Sustainability of treatment: A significant number of people discontinue the medication due to the cost or when their weight plateaus. No weight loss drug is to be taken for just one or two months but for a certain period of time as recommended by the doctor so that you can get off the overweight category and then sustain the weight loss with diet, lifestyle and exercise. In one study, individuals who stopped taking semaglutide (the active ingredient in Ozempic) and quit lifestyle interventions, gained two-thirds of their weight back a year later.
HOW TO MAINTAIN POST-OZEMPIC WEIGHT LOSS?
Go for a calorie-deficit diet because it forces your body to use stored fat and sustain weight loss. Follow the healthy plate formula, which is half a plate of green, leafy and non-starchy vegetables, a quarter of plant or animal protein and a quarter of carbohydrates. Have more fibre like fruits, vegetables, beans, legumes and whole grains. Eliminate outside food and preservatives.
Do regular aerobic exercises and resistance training for at least 30 minutes every day to reduce fat volume, which can then be taken over by lean muscles. Reduce stress, sleep well, practise deep breathing, relaxation and meditation.
(The author is Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai)
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