Ozempic, Mounjaro and Wegovy: How to keep weight off after stopping the injections

Stopping a weight-loss injection does not simply end treatment. It can remove the pharmacological brake on appetite while the body remains adapted to a lower weight, according to endocrinologist Friedrich Mittermayer.

The specialist explains that GLP-1 medicines, and in some cases GIP medicines, act on satiety centers in the brain, slow stomach emptying and reduce appetite. Once the drug is stopped, those effects fade and the body can return to its previous regulation of hunger and appetite.

Weight loss also changes energy needs. As body mass falls, the basal metabolic rate declines because the body requires less energy. If appetite returns and a person eats even slightly more than before, weight can increase again. Mittermayer says this is not unique to these medicines, but a known physiological phenomenon that occurs with practically every form of weight loss. Hormonal changes also play a role, including a rise in ghrelin, a stomach hormone that signals hunger to the brain.

“

Obesity is a chronic disease and not a question of willpower. We still encounter this stigmatization very frequently in practice, and the new medicines will hopefully also help change this image in public.

“Obesity is a chronic disease and not a question of willpower,” Mittermayer says, arguing that stigma remains common in medical practice and society. He hopes the newer medicines will help change that public perception.

He also rejects the idea that GLP-1 products are lifestyle products. “They are prescription medicines with side effects and belong in medically supervised treatment,” he says. In his view, the most sustainable results come when medication is combined with lasting changes in behavior, especially eating habits and lifestyle.

The interview discusses Victoza and Saxenda, which contain liraglutide, as well as Ozempic and Wegovy, which contain semaglutide, and Mounjaro, which contains tirzepatide. All are prescription medicines. In Austria, they are generally covered by health insurers for obesity treatment only in exceptional cases and after approval by a senior medical reviewer. Mittermayer also addresses the differences between injections and pills expected to become available in Austria, along with future weight-loss drugs already in development.

“

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