Ozempic, an injectable type 2 diabetes drug, has been in short supply for months now as a growing number of people seek it out for one of its side effects: dramatic weight loss.
The drug and another medicine, Wegovy, has the same active ingredient: semaglutide, which regulates blood sugar. Semaglutide also makes people feel fuller and eat less, curbing appetite and slowing digestion in the stomach. In addition to weight loss, semaglutide can cause side effects such as nausea, diarrhea, constipation and headaches.
Both Ozempic and Wegovy have been on the US Food and Drug Administration (FDA) drug shortage list for months. And while there are other type 2 diabetes drugs containing semaglutide that is effective at lowering blood sugar, these drugs don’t induce the same striking weight loss.
Whether it’s the shortage, side effects, lack of insurance, or high out-of-pocket costs that prompt patients to stop Ozempic, they all face the same issue: how to maintain the results they got from the drug after they stop taking it, says Robert Kushner, MD, a professor and the director of the Center for Lifestyle Medicine at Northwestern University Feinberg School of Medicine in Chicago.
“Both diabetes and obesity are considered chronic diseases that require long-term treatment,” Dr. Kushner says. “The goal is to take the medication along with following healthy lifestyle changes to achieve and maintain health benefits — reduced body weight and improved blood sugar control.”
Here are five things to expect when you stop Ozempic.
1. Your Appetite Will Return
People eat less when they take Ozempic because semaglutide slows digestion, keeps food in the stomach longer and increases feelings of fullness, and because it triggers changes in the brain that decrease hunger and blunt the feelings of satisfaction that can accompany eating, the FDA notes .
“I used to be able to eat half a pizza, but now on semaglutide, I take a few bites and feel full,” says David Shafer, MD, an attending plastic surgeon at Lenox Hill Hospital and Northwell Health in New York City who takes semaglutide. “If I miss a dose, my consumption increases as I lose the effect of feeling full.”
But that rapid feeling of satiety produced by semaglutide goes away as soon as people stop taking Ozempic, says Kushner.
“Once Ozempic is stopped, all of the benefits from the medication cease,” Kushner says. “If the patient experiences a reduction in appetite and body weight that comes from consuming a lower-calorie diet, the individual’s appetite will increase back to baseline when the medication is stopped, making it harder to follow a lower calorie diet.”
2. You Will Gain Weight
Because people stop feeling full and their food cravings return when they stop Ozempic, weight gain is likely, Kushner says.
Whether people take Ozempic for obesity or type 2 diabetes, medication should be just one piece of a treatment plan that also includes healthy lifestyle changes like eating a balanced diet and getting plenty of exercise.
“Ozempic should always be taken along with making healthy lifestyle changes in diet and physical activity,” Kushner says. “These changes should be continued even after stopping the medication and can help maintain some of the health benefits seen with body weight and blood sugar control.”
3. ‘Ozempic Face’ Will Go Away
Rapid weight loss spurred by Ozempic can change the skin and reduce fat volume all over the body, including in the face. Many people who shed dramatic amounts of weight with Ozempic find their face can take on a gaunt, shrunken, and dehydrated appearance that’s been dubbed “Ozempic face.”
These changes can be addressed with injectable facial fillers administered by a board-certified dermatologist or plastic surgeon, says Joshua Zeichner, MD, an associate professor of dermatology at Mount Sinai Hospital in New York City.
Stopping Ozempic will also reverse facial changes caused by the drug. “Ozempic face will go away if you gain back the weight you lost from the drug,” Dr. Zeichner says. “The face can get full the way it used to, just as you can regain the weight in your body.”
4. Side Effects Will Subside
Ozempic has other common side effects, including nausea, constipation, vomiting, heartburn, gas, headache, and dizziness.
Not everyone experiences side effects, and they may be mild for others. They can also be avoided or minimized by taking the ramp up in dosage more slowly from the lowest starter dose of Ozempic to the higher dose that’s typically used for ongoing treatment, Kushner says.
How you eat — and what you eat — also makes a difference. “Side effects can be greatly mitigated by reducing dietary fat, consuming smaller portions, and not skipping meals,” Kushner says.
Anyone who experiences side effects but still sticks with the treatment would see those side effects go away when they stop taking Ozempic, Kushner added.
5. Blood Sugar Climbs
For people with type 2 diabetes who take Ozempic to manage their blood sugar, halting treatment may cause blood sugar to rebound to around pre-medication levels, says Beverly Tchang, MD, an endocrinologist and an assistant professor at Weill Cornell Medicine in New York City .
“Since Ozempic treats the chronic disease of diabetes, people can potentially see a worsening of their diabetes when they stop Ozempic,” Dr. Tchang says.
Because Ozempic helps people eat less, a halt to treatment may lead them to consume more calories and eat larger portions, leading to an increase in blood sugar, Tchang says. And even if people manage to maintain the eating habits they developed while on Ozempic, their blood sugar might still rise when they stop treatment because the drug boosts the production of insulin, a hormone involved in blood sugar control.
These realities are among the reasons many doctors have expressed concern over Ozempic shortages potentially driven by people using the drug to shed unwanted pounds. These shortages are harming people with type 2 diabetes who need drugs for blood sugar control.
The good news is that people with diabetes still have other medicines they can take instead of Ozempic, including several in the same family of medicines as semaglutide, Tchang notes. Ozempic is what’s known as a glucagon-like peptide-1 (GLP-1) receptor agonist, a class of drugs that also includes liraglutide (Victoza), dulaglutide (Trulicity), and exenatide (Bydureon).