Docs sound off on the unknowns of lifetime use of Ozempic
Key Takeaways
Doctors emphasize that obesity is a chronic condition that requires chronic treatment. For some patients, treatment can come in the form of semaglutide medications like Ozempic or Wegovy.
Semaglutide drugs have only been FDA-approved for weight loss since 2017; the most recent studies on long-term use only cover a 2- to 4-year duration, so many unknowns remain.
Current guidelines say there is no limit to how long a patient can stay on Ozempic or Wegovy, so long as they are eligible for the drugs and are able to afford it.
Over the last few years, semaglutide drugs like Ozempic and Wegovy have been hailed as miracle weight loss drugs. But these drugs have also been criticized for a slew of potential health risks.
Notably, reports show that many people who stop using semaglutide for a year regain about two-thirds of their weight loss—which may renew their risks for developing weight-related health issues.[]
Some doctors specializing in weight loss say that post-semaglutide weight gain can be a normal response to stopping medication, and that its prevalence supports a growing consensus that obesity is a chronic disease that requires long-term management.
But if long-term use is recommended for patients, to what extent should doctors set limits? How long is too long for someone to be on semaglutide for weight loss?
How long is too long?
There’s currently no limit for how long a patient can stay on Ozempic or Wegovy, so long as they are eligible for the drug and can afford it.[][] Studies over the past few years on the safety and effectiveness of using semaglutide drugs longer term (2 to 4 years) are effective in helping patients lose and maintain weight.[][][]
However, as both drugs were only approved by the FDA a few years ago—Ozempic in 2017 and Wegovy in 2021—future research and longer duration studies will help us more fully understand the risks, benefits, and safety of taking them chronically.[]
Mir Ali, MD, a board-certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, says that, similar to people who receive ongoing treatments for diabetes or high blood pressure, people with obesity may benefit from taking semaglutide long-term, so long as people do not have bad reactions to the drug or underlying health issues that put them at risk.
Michael Snyder, MD, FACS, FASMBS, a medical advisory board member of FuturHealth and medical director of the Bariatric Surgery Center at Rose Medical Center, says that no one really knows the long-term effects of Ozempic and Wegovy due to the relatively new arrival of the drugs.
“Ozempic has been on the market for diabetes in the United States since 2017. So, no one knows about ‘lifetime use,’” Dr. Snyder says. “However, as a diabetes medication that is used to regulate blood sugar (its approved use), it is like all other such medications for glucose control: A lifelong or long-term tool, as long as [it’s] tolerated and effective.”
Potential problems
Like most drugs, medications intended for weight loss are not risk free. However, Dr. Snyder says problematic symptoms “are virtually always ‘cured’ by coming off of the meds.”
While it is important to be wary of risks, the good news, according to Dr. Snyder, is that there are no studies correlating drug side effects or symptoms like gastroparesis to cancer development.
Loss of muscle mass can also be concerning, which can contribute to conditions like sarcopenia. People may also become “undernourished” if they do not adhere to a healthy diet. “A lot of people using [Ozempic and Wegovy] are under-nourished—few are probably malnourished,” Dr. Snyder says. “If possible, work directly with an RD.”
Why lifetime use may be necessary
As with other chronic conditions, managing obesity can require ongoing treatment. But long-term use of semaglutide drugs may help the body push through the biological blockers that make weight loss or weight maintenance difficult, Dr. Ali says. He explains that, just like how individuals may have their own weight goals, “the body has a set point, too, and that's also variable.”
“Maybe they reach a weight that is a stable weight—a reasonably healthy weight—but maybe not the weight they want to be at,” Dr. Ali says. “Getting past that typically requires more effort.”
Fighting against finances
Despite the perceived benefits of chronic treatment, not everyone who is eligible for Ozempic or Wegovy can afford to continue using the medication in the long term.
Whether insurance coverage or personal finances get in the way, people may have no choice but to discontinue use of the medication and continue their weight loss journey without medication. Going forward, Dr. Ali says that he cannot predict whether insurance companies will start covering semaglutide for long-term use. If change is to come, he says, it is unlikely to come easily.
For people who need to discontinue medication for financial—or other—reasons, Dr. Ali stresses the importance of discussing healthy lifestyle habits for weight loss, such as maintaining a nutritious diet and sustainable exercise routine. Implementing healthy habits is necessary for weight loss on or off semaglutide medications, he says.
“We emphasize to our patients that nothing is magic—all of these things require effort and making the right choices,” Dr. Ali says. “The medications are a tool to help you do that.”
What this means for you
Semaglutide drugs for weight loss may need to be taken chronically for best results—while sufficient long-term data does not exist just yet, physicians assert that if a ‘maintenance dose’ of semaglutide is well tolerated, there is no need to take the patient off the drug. Due to limited insurance coverage or other financial restraints, however, many people only take them temporarily.