Ozempic and Other Weight-Loss Drugs: How to Lose Weight Sustainably Without the Yo-Yo Effect

Weight-loss injections can help control appetite, but the difficult phase may begin when treatment stops or the dose is reduced. Friedrich Mittermayer, a specialist in internal medicine, endocrinology and metabolism, says sustainable weight control depends on what happens after the medication is withdrawn.

Mittermayer rejects the idea that obesity is simply a matter of willpower. “Obesity is a chronic disease and not a question of willpower,” he says, adding that this stigma remains common in medical practice and public discussion. He also warns that GLP-1 medicines are not lifestyle products. They are prescription drugs with side effects and belong in medically supervised treatment.

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Obesity is a chronic disease and not a question of willpower, and we still encounter this stigmatization very frequently in practice.

The drugs used to treat obesity include liraglutide products such as Victoza and Saxenda, semaglutide products such as Ozempic and Wegovy, and tirzepatide, sold as Mounjaro. They act on GLP-1 receptors, and in some cases GIP receptors, in brain areas linked to satiety. They also slow stomach emptying and reduce appetite.

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GLP-1 preparations are not lifestyle products. They are prescription medicines with side effects and belong in medically supervised treatment.

When treatment ends, that pharmacological brake disappears. At the same time, the body’s energy needs fall during weight loss because there is less body mass. If appetite returns and a person eats slightly more than before, weight can rise again. Mittermayer describes this as a known physiological response that can follow almost any form of weight loss. Ghrelin, a stomach hormone that signals hunger to the brain, can also increase.

For that reason, he says medication must be paired with lasting changes in eating and other behavior. “The most sustainable success always occurs when medication and accompanying behavioral change take place together,” he says. He also discusses differences between injections and pills expected to become available in Austria, as well as future weight-loss medicines already in development.

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The most sustainable success always occurs when medication and accompanying behavioral change take place together.