This as-told-to essay is based on a conversation with a 42-year-old doctor working in the Midwest who recently stopped taking his injectable GLP-1 medication, semaglutide. This doctor has requested to remain anonymous. Business Insider has verified his identity, medical license, and Weight Loss. The conversation’s been edited for length and clarity.
When I started taking Ozempic just over two years ago, I knew I didn’t want to be on this drug for life.
I’m a doctor, so I know all about how people can develop a tolerance to the drugs they take, and I worried that over time, my body might become less sensitive to this medicine, making it less effective for blood-sugar control and Weight Loss. Besides, I felt a little weird about the idea of messing with my hormones indefinitely.
I’ve lost about 25 pounds on this drug, and while I could probably stand to lose a few more, I feel pretty satisfied with my progress. I’ve undergone DexaFit body scans that have shown the level of dangerous visceral fat around my liver and intestines has gone down while I’ve gotten stronger and developed more lean (muscle) mass! Win-win.
So, over the course of the past several months, I’ve developed and executed a plan to wean myself off of semaglutide, the diabetes drug most people know better by its brand name, Ozempic.
So far, my results have been really good, but I’m still keeping close tabs on my body weight and overall health to see whether I need to readjust my plan.
It’s only been two months since I quit Ozempic, so I think it’s still a little too early to say definitively that this plan worked. I could still be in the honeymoon phase, and it’s likely there’s still some trace amount of semaglutide in my body, helping regulate my blood sugar and suppress my appetite just a little bit.
My old appetite is back, but I’m not snacking like I used to
I was nervous that coming off this hormone-mimicking drug would cause my weight to rebound, as it has for so many others in clinical trials. I’ve struggled with my size since I was a kid. Could two years really be enough of a reset for me?
Now, I try to weigh myself regularly and stay busy throughout the day, so I’m not fixating on food. I have a number in my head — if my weight starts to creep beyond that digit, I’ll know it’s time to start medication again.
If I’m being totally honest with you, I definitely avoided the scale for several days after Thanksgiving. I did not hold back on that turkey! It’s nice to enjoy food again. I can tell my old appetite has returned, and my hunger is much stronger than when I was on the medication. Back then, I couldn’t even make room for sides, such as a little green salad with dinner. But I have noticed that, for whatever reason, I still eat less now than I used to before Ozempic. I’m generally able to subsist on a modest breakfast, small to medium-sized lunch, and then dinner with the family, which is usually my biggest meal of the day and a time to connect with my wife and my kids.
I feel like I don’t need snacks and treats like I used to, and my three square meals last me through the day. Maybe my stomach got slightly smaller? Maybe I’ve just been really busy lately. Maybe it’s a combination of a bunch of different factors, including a reset of some of the areas of my brain that control my appetite and my behavior. Who knows.
One unexpected perk of coming off semaglutide has been that I feel so much more energetic and upbeat than I did while I was taking the drug. This could all be in my head, but I feel like I had more low-energy days when I was on Ozempic, and I would often be totally wiped out come 8 or 9 p.m. My wife also said it seemed like I was more negative, generally, and that she’d never seen me quite so down, almost like I had dysthymia, a type of mild depression. At the time, I chalked this phenomenon up to the regular ups and downs of everyday life, dealing with family and work. But I’m recognizing now that it’s possible that the subtle amount of extra calories I eat these days is boosting my spirits, or perhaps there’s something else we don’t totally understand about how the drug works that negatively impacted my mood. Or, this all could have nothing to do with the drug whatsoever, and I’m just feeling a little more pep in my step at the moment.
Coming off semaglutide meant starting another metabolism-regulating drug and upping my dose of metformin, too
The first thing you should know about my maintenance-after-Ozempic plan is that I’ve been on the diabetes drug metformin since the beginning of this experience, and I recently upped my dose from 1,000 mg to 1,500 daily in an effort to better maintain my Weight Loss. Studies show that people who are on a combination of Ozempic and metformin, or Ozempic and insulin, tend to lose more weight, and we know that metformin on its own often prompts a few pounds of Weight Loss (though not near as much as GLP-1 drugs like Ozempic.) I’m hopeful that the drug will help me maintain the progress I’ve made over the past two years. It’s certainly a much more affordable option in the long run, costing just pennies a day.
The other thing I started doing roughly two months before the end of my time on Ozempic was taking rapamycin. It’s an immune-modulating drug that’s also popular with longevity biohackers and antiaging scientists. It’s possible that rapamycin, which also has some modest effect on metabolism, might help me maintain my new size. We shall see.
Maybe I’ll get lucky, and this metformin-plus-rapamycin strategy will be enough. But it’s also possible that I’ll have to cycle back on to GLP-1 drugs sometimes, adopting a use-as-needed approach, like Oprah. I’d also be OK with that.
If you have a story you’d like to share about quitting Ozempic or another GLP-1 drug, reach out to this reporter at hbrueck@businessinsider.com
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