A-Eye sayeth
Yes, there is real “bounce-back” after stopping Ozempic/Wegovy, and there are non-trivial complication risks. These drugs generally work well while you stay on them, but they’re not a one-and-done fix.
1. “Bounce-back” / weight regain data
Both Ozempic and Wegovy are semaglutide. Wegovy is just a higher dose, approved for obesity.
Key trial: STEP-1 extension (Wegovy 2.4 mg in people without diabetes)
- On the drug for 68 weeks → average 17.3% body-weight loss. PubMed+1
- Drug was then stopped and people were followed for another year (to week 120).
- During that off-drug year they regained ~11.6 percentage points of that weight loss.
- Net result: after 2 years total they were only about 5.6% below their original weight. PubMed+1
- Blood pressure, lipids, HbA1c, etc. also drifted back toward baseline.
So roughly two-thirds of the lost weight comes back within a year of stopping.
Other data:
- A big real-world study of >40,000 GLP-1 users found that weight regain after stopping was common, and even a 1% regain was associated with a higher chance of restarting the drug (people felt the rebound). JAMA Network
- A recent “Bounce-Back Effect” study in people with HIV using low-dose semaglutide also saw substantial regain after cessation, reinforcing that this pattern isn’t unique to one trial. PubMed+1
Big picture: for most people these behave like blood-pressure meds: they work while you take them. If you stop, biology (appetite hormones, energy expenditure) pushes you back toward your prior weight.
2. Complications & side-effects
Very common (especially at higher obesity doses)
From trials and the FDA label:
- GI issues – nausea, vomiting, diarrhea, constipation, abdominal pain.
- In one Wegovy trial, 62% on semaglutide vs 42% on placebo had GI side-effects; about 2–3% had to stop the drug because of them. novoMEDLINK+1
- Increased heart rate – average resting HR bump of a few beats per minute. AAFP
These are usually “mild to moderate” but can be miserable and can lead to dehydration.
Serious but uncommon risks
From FDA labels, reviews, and safety alerts:
- Acute pancreatitis – rare but documented; listed as a warning on both Ozempic and Wegovy. FDA Access Data+2Ozempic+2
- Gallbladder disease – cholelithiasis/cholecystitis risk is clearly increased (gallbladder problems in up to ~5% of semaglutide patients vs 1–3% with placebo). NCBI+1
- Kidney injury – usually secondary to severe vomiting/dehydration. Ozempic+1
- Diabetic retinopathy worsening in people with pre-existing retinopathy when glucose improves very fast. Ozempic+1
- Thyroid C-cell tumors (rodent data) – caused tumors in rats/mice; human risk is unclear, but there is a boxed warning and it’s contraindicated in people with personal/family history of medullary thyroid carcinoma or MEN2. FDA Access Data+1
- Mental-health signal – regulators (e.g., Australia’s TGA) have issued class warnings about suicidal ideation reports with GLP-1 drugs, including Ozempic and Wegovy, though a direct causal link isn’t proven yet. News.com.au
- Newer case reports/series suggest rare events like non-arteritic anterior ischemic optic neuropathy, acute kidney injury, etc., under investigation. PMC
3. How to interpret all this
- Effectiveness is real but maintenance requires staying on the drug or having a very strong long-term lifestyle plan; “bounce-back” is the rule, not the exception, when you stop.
- Most side-effects are GI and reversible, but there are real, albeit uncommon, serious risks that you want a clinician to stratify (pancreas, gallbladder, thyroid, eyes, kidneys, mental health).
- Long-term (>4–5 year) safety for obesity doses is still being accumulated; we have good medium-term data but not “lifetime” data yet.