Mounjaro, Ozempic and Wegovy: Keeping the Weight off After You Stop

Popular weight loss medications Ozempic, Rybelsus, and Wegovy all contain the same active ingredient, semaglutide, but only Wegovy is licensed for weight loss in the UK.

Ozempic and Rybelsus are both semaglutide medications used to treat type 2 diabetes. While Ozempic and Wegovy are given as once-weekly injections, Rybelsus is a tablet that's taken every day. Currently, in the UK, semaglutide tablets are not licensed for weight loss.

Mounjaro, also licensed for weight loss in the UK, is the newer of the anti-obesity medications and contains a different active ingredient called tirzepatide, and is also given as a once-weekly injection.

All 4 medications can effectively support weight loss. However, after stopping the medications, many people find that they regain the weight they've lost.

In this article, we'll discuss these medications in more detail, the importance of losing weight in a healthy and sustainable way, and discover how weight maintenance can be achieved.

Understanding Mounjaro, Ozempic, Rybelsus and Wegovy

What Are These Medications and How Do They Work?

Ozempic, Wegovy, and Rybelsus belong to the glucagon-like peptide-1 (GLP-1) receptor agonist family, whilst Mounjaro is both a glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist. But what does that actually mean?

Essentially, all 4 drugs have similar structures to a hormone found naturally in the body called GLP 1. Mounjaro is different in that it also exerts the effects of a hormone called GIP, increasing insulin sensitivity and release.

When taking any of these weight loss medications, your body thinks that the level of this hormone (or hormones) has increased and reacts accordingly. This means that the weight loss drug, similar to the hormone, makes you feel fuller, slows down stomach emptying, and improves blood sugar control.

Feeling fuller leads you to eat less improving weight loss outcomes.

The Role of Medication in Weight Management

These medications can be a really helpful tool for losing weight, but they're only a short-term strategy. Many people lose 15% or more of their body weight whilst taking semaglutide. However, to avoid gaining weight after stopping semaglutide, it's important to make lifestyle changes whilst taking the medication.

Long-term and sustained weight loss is only possible with a healthy diet and regular exercise routine. Medication is just a part of the weight loss journey.

The Challenge of Weight Regain

Why Do People Regain Weight?

People often regain weight after losing it due to various physical, psychological, and metabolic factors. Physical adaptations to weight loss, such as changes in appetite-related hormones, energy output, and metabolism, favour weight regain.

As you lose weight, your metabolism often slows down. It's your body's way of conserving calories as you're reducing energy stores, but it's unhelpful when you're trying to lose weight.

The "set point" theory of weight loss suggests that your body will aim to regain weight and get back to a "set" point. This may offer another explanation as to why people gain weight again after losing it.

Studies have shown that hunger hormones are also to blame. People who regain weight are more likely to have higher hunger hormone levels and lower levels of the hormone ghrelin that tells that body it's full.

As weight loss medications work by suppressing appetite, once you stop taking them your appetite is likely to increase, increasing hunger levels, which leads to eating more and therefore gaining weight.

Health Risks Associated with Weight Regain

Studies indicate that repeated cycles of weight loss and weight gain may increase the risk of cardiovascular disease, type 2 diabetes, and other metabolic disorders.

Initial weight loss has several benefits such as improving cardiovascular risk factors, such as blood pressure, cholesterol, and blood sugar levels. Even after weight regain, some studies suggest these improvements can remain to a lesser degree.

Psychologically, weight cycling can cause stress and negatively impact your mental health. It's also harder to motivate yourself. So what can you do to keep the weight off?

Strategies for Maintaining Weight After Stopping Medication

Dietary Changes for Sustained Weight Loss

For sustained, healthy weight loss, a balanced diet rich in whole foods and healthy fats is key. Eating plenty of lean protein may help prevent weight regain, as it can promote feelings of fullness.

A low-calorie diet, with a calorie deficit of 500-750 calories a day, is best for sustained weight loss. This means eating 500-700 calories fewer than you're burning. Need help working this out? Use this NHS BMI and calorie calculator tool.

Very-low-calorie diets of fewer than 800 calories a day aren't generally recommended as they can put your body into starvation mode, counteracting your hard efforts. They are also difficult to sustain.

Try to base your food intake around the Mediterranean diet, eating more fruits and vegetables, legumes, fish, whole grains, and healthy unsaturated fats like olive oil.

Managing portion size is also crucial for sustained weight loss. Reading food labels, choosing healthy snacks, and incorporating non-meat options, such as beans or lentils, instead of meat, can reduce saturated fat intake and add more healthy fibre to your diet.

The best diet is one that you can stick to, and small changes can add up to significant results.

Incorporating Regular Physical Activity

Regular physical activity has many health benefits, including improved cardiovascular health, weight management, reduced risk of chronic diseases, and enhanced mental well-being.

Both aerobic and resistance exercises are great to include in your fitness routine. Aerobic exercises, such as walking, swimming, or cycling, help improve heart health and use up more calories.

Resistance training, such as weightlifting or bodyweight exercises, helps build muscle strength, maintain bone density, and improve overall metabolic health. More muscle can also increase your basal metabolic rate, helping to burn more calories at rest.

It's most important to choose activities that are enjoyable and can be easily incorporated into your daily life. That way, it'll be easier to keep them up.

The Importance of Mental Health

Looking after yourself mentally is crucial for successful weight loss and long-term weight management. Weight regain can be influenced by psychological factors, including stress, emotional eating, and changes in self-image.

Developing a growth mindset - the belief that abilities can be developed through effort and learning - can help you overcome challenges along the way.

During your weight loss journey, seek help and support from loved ones. You may also benefit from talking therapy, especially if you struggle with body image, self-confidence, or disordered eating.

Lifestyle Adjustments for Long-term Success

We've already talked about the importance of eating better and exercising, but stress and poor sleep are also linked to weight gain.

Try to build good sleep habits and aim for 7-9 hours of sleep each night. Lack of sleep can lead to irritability, cravings, and fatigue, which can derail lifestyle changes.

Building better stress management habits can help stick to a healthy lifestyle plan. Scheduling personal time, regular physical activity, seeking emotional support from friends and family, and possibly meditation or therapy are all steps in the right direction. It's important to find out what works for you when trying to lose weight.

Key Factors in Long-term Weight Management

Understanding and Adapting to Your Body's Needs

Listen to your body and its hunger cues. Adjust your eating schedule as needed, and try to avoid strict meal times or rules. Give yourself time to adapt to your lifestyle changes, and try to do things gradually in order to maintain long-term success.

The Role of Healthcare Professionals

Health experts can be really helpful in supporting you through your weight loss journey. Research has shown that receiving advice from healthcare professionals helps with motivation and knowledge.

Healthcare professionals can provide counselling and information which may help when trying to lose weight. They can offer referrals to dietitians, nutritionists, and psychologists. They're also able to prescribe weight loss medications, with follow-ups to help you adjust your weight management plan.

Takeaway

Maintaining weight loss after stopping medications like Mounjaro, Ozempic, Rybelsus, and Wegovy can be achieved, but it requires a holistic approach. Long-term lifestyle changes, including a balanced diet, regular exercise, and stress management techniques are important parts of any weight management plan.