What happens when you stop taking Ozempic? 

If you have been taking Ozempic for type 2 diabetes or weight loss, you may wonder what could happen if you stop taking the drug. Like many prescription medications, stopping a drug like Ozempic, or lowering its dose, should be done under the care of a health provider. 

Read on if you’re tapering down on Ozempic and wondering what to expect. We explain what can happen if you stop taking Ozempic, and what you can do to keep the weight off.

What is Ozempic?

Ozempic is a prescription diabetes medication that, in combination with diet and exercise, treats type 2 diabetes by controlling blood sugar levels. Ozempic works by mimicking a hormone that regulates your appetite — glucagon-like peptide-1, or GLP-1 for short — which is produced by your gut. Whenever your blood sugar levels get too high, GLP-1 binds to GLP-1 receptors in the brain, signaling to your pancreas that it’s time to release more insulin. This helps people with type 2 diabetes keep their blood sugar levels in check.

Ozempic also reduces sugar production in the liver and slows down the digestion process. Together, these effects further prevent blood sugar spikes and curb your appetite. Since your stomach takes longer to empty, you feel fuller sooner and longer. As a result, people taking Ozempic tend to eat less and lose weight. 

Ozempic is administered via a subcutaneous (under the skin) injection in the upper arm, thigh, or abdomen. Each Ozempic pen comes pre-filled with your dosage. To minimize side effects, health providers typically prescribe Ozempic at a lower starting dose (0.25mg, once per week), slowly increasing it to the full dosage or the dosage that’s best tolerated.

Side effects of Ozempic may include (FDA, 2020):

• Abdominal pain

• Constipation

• Diarrhea

• Nausea

• Vomiting

The U.S. Food and Drug Administration (FDA) currently has approved Ozempic to improve blood sugar control in people with type 2 diabetes, in combination with diet and exercise. It is also FDA-approved to reduce the risk of serious cardiovascular events, such as a heart attack, in people with type 2 diabetes and heart disease. Off-label, Ozempic can be prescribed to people with obesity and overweight.

4 things that can happen when you stop taking Ozempic

Ozempic has proven to be a very effective treatment for managing blood sugar levels and reducing the risk of heart attacks and strokes in people with type 2 diabetes, as well as significantly reducing body weight in people with obesity. However, whether due to the costs of Ozempic, the side effects, the drug’s availability or another reason, some people may want or need to stop taking Ozempic. 

You should always consult your health provider before you stop taking a prescription drug, including Ozempic. Once you stop Ozempic, the benefits from the medication typically cease within a week after the last injection. Here’s a look at what can happen when you stop taking Ozempic. 

1. Your appetite will come back

The active ingredient in Ozempic — semaglutide — not only stimulates the release of insulin. It also slows down gastric emptying, so you feel full faster. It is also thought to further reduce appetite by interacting with areas of the brain in charge of feeling full and satisfied.

When you stop taking Ozempic, that interaction no longer happens. So, your old appetite will return. You won’t feel full as quickly, and you’ll stay hungry longer. 

2. You’ll regain some of the weight you lost

Ozempic should be part of a comprehensive treatment plan that also includes diet and exercise, so keeping up with your diet and exercise routine can help prevent some of the rebound weight gain that can happen when you stop taking Ozempic. However, your appetite and food cravings will return, so you will likely regain some of the weight you lost on Ozempic. 

For example, one study found that within 68 weeks of taking the highest weekly dose of semaglutide (2.4mg per week) individuals lost an average of 17.3% of their body weight. One year after they stopped taking the drug, they regained two-thirds of that weight. It’s important to say that those who regained two-thirds of that weight also stopped lifestyle interventions in addition to stopping the drug. 

3. The appearance of Ozempic face may go away

“Ozempic face” is a nonmedical term that describes the gaunt, wrinkled appearance your face can take on when you lose a significant amount of weight in a short period of time. The drooping or sagging of the facial skin occurs because your face holds a lot of fatty tissue, which gives your face volume. But when you lose weight, these fat cells shrink faster than the skin on top of them, resulting in a wrinkled appearance.

While “Ozempic face” occurs with any kind of weight loss — particularly rapid weight loss — it has become associated with Ozempic or other GLP1 medications due to the drug going viral on TikTok and social media for its weight loss effects. Facial fillers can help restore the volume that occurs with weight loss. However, if you regain weight after stopping Ozempic, some of that weight will return to your face, reducing the appearance of Ozempic face.

4. You may experience more blood sugar spikes

As a diabetes drug, Ozempic helps people with type 2 diabetes keep their blood sugar levels in check. When blood sugar climbs after a sugary meal, Ozempic encourages the pancreas to release more insulin to bring it back down. 

If you have type 2 diabetes and you stop taking Ozempic, your body may have a tougher time managing your blood sugar levels, which can lead to blood sugar spikes.

Keeping weight off after Ozempic

Weight loss can offer a number of benefits for people dealing with excess weight and obesity, including improved self-esteem, quality of life, and mitigating medical conditions linked to excess weight, like high blood pressure. If for whatever reason you need to stop Ozempic, there are steps you can take to keep the weight off. 

Stick to your exercise routine

Ozempic is most effective when combined with diet and exercise. Maintaining your exercise routine can help you prevent rebound weight gain after stopping Ozempic. Regular exercise lowers body weight by decreasing body fat and improving muscle mass. 

Exercise provides additional benefits to people with type 2 diabetes, such as improved blood pressure and insulin sensitivity, as well as reduced cardiovascular risk.

Follow a healthy diet

While there is no official diabetes diet, avoiding certain eating behaviors and foods — and replacing them with healthier ones — can help you manage both your blood sugar levels and body weight. 

For example, health experts recommend people avoid fatty, fried foods and so-called high glycemic foods like sugars, starches, and refined carbohydrates. Eating more whole foods with high fiber, lots of protein, and a low glycemic index can help you feel full sooner and longer, staving off cravings and weight gain.

Consider Ozempic alternatives

Around one in four people with type 2 diabetes taking a GLP-1 medication like Ozempic switch to an alternative within a year of starting treatment. If Ozempic wasn’t a good fit for you, it’s possible that an Ozempic alternative could be. 

Ozempic is one of several GLP-1 receptor agonists, a drug class that can treat type 2 diabetes and weight loss and includes Bydureon, Victoza, Saxenda, Mounjaro, Tanzeum, Trulicity, and Wegovy. These medications improve blood glucose control and slow digestion, which can reduce appetite and lead to weight loss. These can have slightly different side effects and be tolerated differently by different people, so it may be worth talking to your health provider about another option.

Follow weight loss best practices

Every weight loss journey is unique to the individual. However, there are some tried and true techniques that many find effective when managing their weight. Consider whether any of the following weight loss steps may be helpful for you.

• Set specific, sustainable goals that focus on health, rather than weight loss. For example, strive to exercise a set number of days per week, eat a certain number of fruits each day, or limit your alcohol intake. 

• Find ways to stay motivated. Try pairing your treadmill exercise with a favorite podcast, tracking your weight, or asking a friend to help you stay on track. Remember to celebrate the small wins along the way.

• Sleep well. Poor sleep is associated with higher body weight, increased appetite, and reduced insulin sensitivity. Plus, with better sleep, you’ll feel more energized and positive, which helps you stay motivated and stick to your weight loss plan.

• Stay hydrated. Drinking water is essential for our survival, but research suggests that it also helps with skin health, weight management, cognition, and mood. Keep water by your side and drink it throughout the day.

Do the side effects of Ozempic go away after stopping?

Around one in three people experience nausea, vomiting, and diarrhea when taking Ozempic. If you’re one of those people, the side effects should stop once you stop taking the drug. 

To minimize side effects, health providers usually start Ozempic at the lowest dose and slowly titrate up the dosage. Side effects are more common when taking higher doses of Ozempic and when increasing your dose. For many, the side effects range from mild to moderate, and become less intense and common as their body gets used to the drug. However, for around 4% of people, the side effects can be bothersome enough to lead them to stop taking Ozempic.

You may be able to minimize the side effects of Ozempic by avoiding certain foods while taking Ozempic, such as refined carbohydrates, alcohol, and fried, greasy, or sugary foods and drinks. Also, adjusting your eating habits can mitigate side effects. Novo Nordisk, the manufacturer of Ozempic, recommends eating smaller portions, eating more slowly, drinking ice-cold water, and not lying down after meals.

When should you stop Ozempic?

For most people, stopping Ozempic cold turkey is not recommended. When to stop Ozempic is an individual decision you should come to with the help of your healthcare provider. If your health provider agrees it’s time to stop taking Ozempic, they will provide you with instructions for tapering off your dose. 

In general, you should not stop taking Ozempic without consulting a healthcare provider first. However, there are a few exceptions. For example, if you plan to get pregnant, the FDA recommends stopping Ozempic at least two months before you get pregnant to ensure the semaglutide fully washes out of your system. Also, if you notice any of the following serious side effects, you should stop taking Ozempic and consult a health professional immediately:

• Severe abdominal pain, with or without vomiting

• Changes in vision

• Signs of low blood sugar, such as dizziness, sweating, confusion, slurred speech, rapid heartbeat, mood changes, weakness, or feeling jittery or shaky

• Kidney failure

• Itching, rash, or difficulty breathing, which may indicate a serious allergic reaction to Ozempic

Studies have shown that obesity is a chronic condition, best managed with long-term pharmacological treatment, much like high blood pressure. If you have high blood pressure, you also need to keep taking your medicine to keep your blood pressure down—and the same idea applies to treating overweight and obesity with Ozempic. You'll need to stay on the drug to keep seeing weight loss effects from Ozempic. If you stop taking it, you will most likely regain the weight you’ve lost. 

Felix Gussone, MD

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.