Ozempic and Zepbound users face 6 rebound risks after stopping, doctor warns

Internal medicine physician Dr. Frank Dumont, executive medical director at Virta Health in San Francisco, outlined six potential risks patients may face after discontinuing GLP-1 medications such as Ozempic, Wegovy, and Zepbound, speaking with Fox News Digital. Research shows many patients stop taking these drugs within a year due to side effects like nausea, vomiting, and diarrhea, or because they prefer not to remain on long-term medication. Dr. Dumont noted that serious side effects such as acute pancreatitis, though rare, prompt immediate discontinuation, and the drugs carry warnings about thyroid tumors based on animal studies.

The first risk is the return of intense cravings and a sharp spike in appetite, often called "food noise." Dr. Dumont said, "Unless you have significantly changed what you're doing in terms of the types of foods you're eating, it's likely you'll go back to the same foods you were eating before, and hunger and cravings will go up." Major medical organizations including the American Medical Association and the Obesity Medicine Association classify obesity as a chronic condition requiring ongoing management.

Second, weight regain is typical. In the STEP 1 trial extension, participants regained about two-thirds of lost weight within a year of stopping semaglutide and lifestyle interventions. In the SURMOUNT-4 trial for tirzepatide, patients switched to placebo after 36 weeks regained more than half the lost weight over the following year, even with diet and exercise counseling. Dr. Dumont called this "devastating for people who felt like they'd finally found a solution that would work."

Third, biomarkers such as blood sugar, blood pressure, and cholesterol levels — which improve during treatment — can reverse if diet is not changed. Improvements in fatty liver disease may also fade. Dr. Dumont said, "When you go off the medicine, if you go back to eating the way you did before, those numbers have a tendency to worsen."

Fourth, weight loss on GLP-1s includes loss of lean muscle mass. In a body-composition study of tirzepatide, about 25% of weight lost was lean mass. Dr. Dumont warned of a "ratcheting-down effect" where patients lose fat and muscle, regain fat after stopping, then lose fat and muscle again upon restarting, compromising metabolism and physical function.

Fifth, stopping can take a heavy toll on mental health. Patients who view GLP-1s as a final solution after years of failed diets may experience a "regression on all fronts" that is "really devastating from a mental health standpoint," making them feel disheartened and out of control.

Sixth, an observational study published in BMJ Medicine found adults with type 2 diabetes who stopped GLP-1 treatment had a higher risk of major cardiovascular events than those who continued, with longer periods off treatment associated with greater risk. Dr. Dumont emphasized that lower inflammation and improved cholesterol and blood sugar during treatment reduce risks of heart attacks and strokes, but stopping without dietary changes can worsen these markers and increase risk. He concluded, "The GLP-1 is not the only solution. It needs to be coupled with ... a way of eating that's going to work for you for the long term that allows you to stop the medicine successfully if you need to."