It’s one of the greatest dilemmas patients taking revolutionary weight-loss drugs face: Will they ever be able to stop taking the injections?
The weekly jabs – which include Ozempic, Wegovy and Mounjaro – are the most effective slimming medicines ever developed, with overweight patients able to lose up to a fifth of their body weight within a year of beginning treatment.
However, research shows that roughly half of patients who eventually stop using the medicines – known collectively as GLP-1 drugs – will put some weight back on.
Worryingly, nearly one in five who come off them will regain all – or even more – of the weight they lost.
This means that many patients who take the appetite-suppressing drugs are hesitant to stop using them – opening up the daunting possibility that thousands may remain on the medicines for the rest of their lives.
However, it’s not an issue that TV celebrity Sharon Osbourne has faced.
Instead, months after coming off the injection Ozempic, the reality TV star and music manager is reportedly struggling to regain any weight at all.
The 72-year-old has spoken publicly about her decision to start taking the weight-loss jab Ozempic last year. Sharon said she lost 3st in a matter of months.
Sharon Osbourne is struggling to regain any weight months after coming off Ozempic
However, her weight loss was so severe that many online observers raised concerns about her stick-thin appearance.
Earlier this month, the Mail revealed that Sharon had come off the jabs in March but was still struggling to regain weight.
Friends said that she had been eating a high-calorie diet in an attempt to bulk up, including roasts, burgers and club sandwiches.
Yet she has reportedly not regained any weight, leaving friends worried that the drugs have permanently damaged her body.
Now, experts have revealed the shocking reason why some patients like Sharon are finding they cannot regain any weight after coming off GLP-1 injections.
And, while they say the effect is rare, some argue that there are steps that every GLP-1 patient can take to ensure they can come off the jabs without piling the pounds back on…
The ‘mystery’ Ozempic patients who can’t put any weight back on
Experts say that Sharon Osbourne is not the first patient to suffer this strange side-effect of GLP-1 injections.
The drugs mimics a hormone found in the pancreas that is released when the stomach is full after eating.
This means that patients on the injections have a smaller appetite, so they eat significantly less and lose weight.
When they stop taking GLP-1 injections, their appetite returns and, as a result, so too does some or all of their weight.
However, experts say a small percentage of GLP-1 patients struggle to regain weight, regardless of how much more they eat.
‘We’ve found that roughly 5 per cent of people who come off these injections seem not be able to put weight back on,’ says Dr Alex Miras, consultant endocrinologist at Ulster University, who has been involved in several major GLP-1 trials.
‘It’s a very unusual situation, and the exact cause is still a mystery.’
Experts say that, while it is impossible to know exactly who will experience this side-effect, it does appear more common in people who historically have seen their weight drastically rise and fall.
This is an issue that has affected Sharon Osbourne too. Last year, she told Good Morning Britain that her constantly fluctuating weight was one of the main reasons she started taking Ozempic.
But expert say they have also identified another potentially at-risk group.
‘Many of these patients have nothing in common, but it does seem that people with diabetes are more likely to struggle to regain weight after coming off these drugs,’ says Dr Robert Andrews, professor of diabetes at the University of Exeter.
GLP-1 drugs were first designed to treat diabetes, as the injections can lower the dangerously high blood sugar levels experienced by millions of patients.
However, experts say they are still mystified why some diabetes patients become super-sensitive to the effects of GLP-1 drugs.
‘It’s not what you’d expect to see,’ says Dr Andrews. ‘People with diabetes tend to put on weight more easily.’
The patients most likely to regain weight after stopping the jabs
Much more is known about the patients most at risk of putting weight back on after coming off GLP-1 drugs, according to experts.
Research shows that patients who stop taking semaglutide – the active ingredient in Ozempic and Wegovy – on average regain about two-thirds of their weight.
However, patients who lose a large amount of weight in a short period of time are far more likely to regain it compared to those who only slightly slimmed down on the medicine.
Experts say that this may be due to a phenomenon known as the set point theory, the idea that the body has a natural weight range, or set point, that it is always working to maintain.
This weight varies from person-to-person, and experts argue it explains why some people are naturally thin, while others are larger.
‘One of the biggest factors that can predict how you will fare once coming off these drugs is how quickly you lost the weight to begin with,’ says Dr Nerys Astbury, a diet and obesity expert at the University of Oxford.
‘This might be due to the fact that the body has a weight it’s trying to get back to, and it’s much heavier than what you are when you stop the injections.’
Another theory is that patients who lose their excess weight quickly are more likely to return to unhealthy eating habits.
‘If you experience rapid weight loss and then immediately come of the drugs, then it’s unlikely you will have developed new healthy eating habits,’ says Dr Astbury. ‘Instead you might return to excessive eating, reversing the progress made.’
Regardless of the cause, experts agree that those who come off GLP-1 drugs and immediately put weight back on tend to have one thing in common: They do not exercise.
‘It’s clear that people who regularly do physical activity maintain weight loss much better than those who do not,’ says Dr Astbury. ‘So some exercise is better than none.’
The exercise routine that personal trainers say is crucial to maintaining the Ozempic weight loss
While research suggests that all forms of exercise help limit the amount of weight patients regain after coming off GLP-1 injections, experts say that there are certain routines which are more likely to have the desired effect.
Multiple studies now show that physical activity is crucial in the fight against post-GLP-1 weight gain.
One Danish study found that, on average, patients who stop taking the drug liraglutide – an older and less effective version of Ozempic – put on around 20lb.
But those who had a number of fitness coaching sessions with a personal trainer before coming off the medicine regained less than 9lb.
Experts say that similar results are seen across all GLP-1 drugs and are proof that the key to limiting weight regain is building up good habits.
However, according to Bret Durney, a personal trainer who regularly works with GLP-1 patients and founder of the London exercise studio Fitness Lab, the type of workout is crucial to limiting weight regain.
‘We are getting our clients who are taking drugs such as Wegovy or Mounjaro to focus on strength-training,’ says Mr Durney.
‘So this includes resistance exercises such as deadlifts, squats, or chest presses.’
GLP-1 drugs such as Ozemic were initially designed as a treatment for diabetes
Experts say strength training is crucial for this cohort because research shows that patients on GLP-1 drugs lose a significant amount of muscle.
Studies suggest that roughly a quarter of the weight loss triggered by these medicines is actually due to muscle shrinkage.
This can have dangerous consequences, particularly for older people, who are more at risk of falls when they lack muscle.
However, Mr Durney argues that patients with less muscle are also more likely to put weight back on after stopping the injections.
‘Muscle uses up more energy than fat,’ he says. ‘So if you have a good amount of muscle when you come off these drugs, then the extra energy you are getting from your increased appetite will go there first before becoming fat.
‘But, if you come off them and you have lost muscle in the process, as you begin to eat more, you are going to replace lost muscle with fat, and perhaps even end up heavier than you were before you started the drugs.’
For this reason, Mr Durney recommends short periods of strength training, usually involving six to 12 repetitions of the movement, with around a minute to 90 seconds of rest between each set.
‘It’s all about muscle-mass,’ he says. ‘There’s no point in doing lots of endurance activity such as running, as that doesn’t help build muscle.’
Why it’s OK to stay on the jabs if you really need to
There is no reason that patients cannot stay on a GLP-1 drug indefinitely, experts say.
While GLP-1 drugs have been licensed for weight loss only in the past few years, they have been used to treat diabetes for nearly two decades.
This means that researchers know with some certainty that long-term use of the injections is unlikely to trigger any serious medical issues.
In fact, all the evidence suggests that coming off GLP-1 drugs negatively impacts the body.
Patients who stopped taking Ozempic or Wegovy not only regained weight, they also saw their heart health worsen, with cholesterol, blood pressure and blood sugar levels all rising in those who quit.
And while some super-sensitive people, such as Sharon Osbourne, lose a worrying amount of weight, experts say this is rare.
Research shows that the vast majority of GLP-1 users lose a maximum of around 20 per cent of their body weight.
Of course, one reason patients may want to stop taking GLP-1 drugs is the cost. A private prescription usually costs around £200 a -month and access to the injections on the NHS is still limited to those who are severely obese.
For those thinking of stopping the jabs, experts say that healthy diet and exercises habits are crucial – but so too is realism.
‘The majority of people who come off these drugs will put some weight back on and that’s OK,’ says Dr Astbury.
‘Weight gain shouldn’t be viewed as a failure, it’s inevitable. But sticking to sensible portion sizes, eating plenty of fruit and vegetables, avoiding fatty food, and, of course, exercise, will help limit the amount you put back on.’
