I have been taking a statin every day for over a year now. My cholesterol numbers are good, but I harbour no illusions about what would happen if I stopped.
They would climb right back up. Before the medication was prescribed, I had attempted to control my numbers through exercise and diet alone. It didn’t work. Sometimes genetics gets in the way.
A study published this week in The BMJ suggests that the blockbuster GLP-1 weight-loss drugs, better known by their brand names Ozempic, Wegovy, and Mounjaro, work the same way. If you stop taking them, the weight comes back.
GLP-1 drugs are the blockbuster drugs of our lifetime. Science magazine named them Breakthrough of the Year in 2023. Around 12% of adults in the United States now take them. If you do not know anyone taking them, you will soon. And you might be taking them yourself before long.
Sales in the weight-loss segment rose 115% in 2025 in India, and Eli Lilly’s Mounjaro became the country’s top-selling drug within months of its March launch. Semaglutide’s patent expires in India this year, and branded generics are expected to enter the market at perhaps a quarter of current prices. Grey-market versions and compounded copies are already circulating. With over 135 million pre-diabetic adults and rising obesity rates in urban populations, the appetite for these drugs is enormous.
Some of the biggest medical news of the past year have been how GLP-1 drugs benefit people in unexpected ways. These started as diabetes treatments, then the benefits for weight reduction were noticed. More recently, evidence for cardiovascular protection, fatty liver disease, sleep apnoea, and even addiction has been piling up.
But a question has lingered since day one: what happens when you stop taking these obesity drugs? We knew from earlier studies that much of the weight lost was regained. This new study, which is a meta-analysis of existing data, takes that conclusion to another level. The speed of that weight return is remarkable.
University of Oxford researchers analysed 37 studies involving over 9,000 people who had been on weight-loss medications for an average of 10 months. After stopping, participants regained weight at about 0.4 kilograms per month. At that rate, they were projected to return to their starting weight within less than two years.
The heart and metabolic improvements the drugs had delivered, such as more controlled blood pressure, cholesterol, and blood sugar, followed a similar path back to where they were before medication within about 1.4 years.
The most striking finding was the comparison with behavioural programmes. Weight regain after stopping GLP-1 drugs was nearly four times faster than after stopping diet-and-exercise interventions, regardless of how much weight had been lost during treatment. In short, these drugs help you lose weight faster, but once you stop, the rebound is steeper.
Headlines will frame this as a shortcoming of GLP-1 medications and a reason to avoid them. They should not. The study confirms what researchers have long noted: obesity is a chronic condition that behaves like hypertension or diabetes, and not like an infection you can cure with a course of antibiotics.
And even if weight is regained, is it necessarily a bad thing? Even temporary weight loss has benefits. For example, participants in a diabetes prevention programme who regained lost weight still had lower rates of diabetes years later than those who never lost weight at all. The same may hold for GLP-1 users.
But there’s a question worth asking. Why is the rebound after discontinuing GLP-1 drugs so much faster than with weight loss by other means? One plausible theory involves biology. GLP-1 drugs flood the body with a synthetic version of a gut hormone that signals fullness to the brain. Maintain artificially high levels long enough, and receptors may become less sensitive to the hormone at natural concentrations. Remove the drug, and normal satiety signals feel muted by comparison, and appetite returns with force. So those who plan to stop taking these drugs should work on transitioning to healthier dietary and lifestyle habits while still on them.
I wrote earlier in Hindustan Times that another recent study has found that semaglutide reduces heart attacks and strokes by 20% in people with obesity and cardiovascular disease. Now we have evidence that these cardiovascular protections also dissipate once the drug is discontinued.
This is important because roughly half of the people prescribed GLP-1 drugs stop taking them within a year. Among older adults with diabetes, that number climbs to 60%. Reasons include high cost, gastrointestinal side effects such as nausea and vomiting, and the inconvenience of weekly injections. Many patients start these medications expecting a short course, planning to lose weight, and then stop. That expectation sets them up for potential disappointment.
But there is some good news for those worried about cost and injections. A few weeks ago, the US Food and Drug Administration approved oral Wegovy, a once-daily semaglutide tablet that delivers weight loss comparable to the weekly injection. In clinical trials, patients taking the 25-milligram pill lost about 17% of their body weight, similar to what the injectable version achieves. (An oral version, Rybelsus, is available in India for diabetes, though not approved for weight loss yet.)
Lastly, it bears repeating that GLP-1 drugs are not miracle cures that can replace healthy eating and exercise. Public health measures, including taxing unhealthy food, clear food labelling, and making the surroundings suitable for light exercise, matter.
As these drugs become easier to take and cheaper to produce, and as second and third-generation formulations reduce side effects, they may become a second line of defence for anyone who needs them, like statins are for cholesterol.