Thinking about stopping Ozempic? Two doctors on how to do it safely, and what to expect after

A doctor is speaking to a patient for a consultation and explaining treatment. (PeopleImages)GLP-1 medications can make a big difference for people who live with Type 2 diabetes and other conditions. However, they're not for everyone. If you want to stop taking a GLP-1 medication, you may discover that the decision is complicated. To simplify things, I spoke with two doctors to find out what patients who are taking Ozempic, Mounjaro, Wegovy, or other GLP-1 medications need to know before quitting. Dr. Cynthia Odogwu and Dr. Nneoma Oparaji had this to say.

About our experts: Cynthia Odogwu, MD is a board-certified family medicine physician. Nneoma Oparaji, MD, DipABLM, DABOM. is a physician who is triple board-certified in internal medicine, obesity medicine, and lifestyle medicine.

Nausea, diarrhea, vomiting, constipation and abdominal pain are the most common reasons patients walk away from GLP-1 medications.

Dr. Oparaji told me the most common reasons her patients stop taking GLP-1 medications are common side effects such as nausea, diarrhea, vomiting, constipation, and abdominal pain. People also sometimes stop because it's not affordable for them. Others have insurance barriers or don't want to make the commitment to using the medication long-term.

Dr. Odogwu has seen the GLP-1 side effects play out dramatically. "I once had a patient who told me she would never go near a GLP-1 medicine again, after having severe diarrhea that lasted several days. It was also distressing because it contributed to missed days off work."

However, side effects aren't the only reason doctors sometimes recommend stopping. Dr. Oparaji said she actively advises patients to discontinue when "the risks are beginning to outweigh the benefits", including situations involving severe side effects like pancreatitis, pregnancy, severe loss of lean muscle, excess weight loss, or malnutrition.

Once the medication stops, appetite signals return, and so does the food noise, often within weeks.

The changes begin quickly. "Soon after GLP-1 is discontinued, the food cravings, hunger, and food noise start to come back," cautioned Dr. Oparaji. "This is because the body starts losing the signals that suppress appetite."

Dr. Odogwu explained the mechanics: "Once the medicine is stopped, we start to see that hunger increases. This is because the medication's ingredients are no longer available to control the appetite center of the brain. In the stomach, food no longer moves slowly and as a result, people aren't staying full."

Beyond hunger, the health changes extend further than most patients expect. Dr. Oparaji noted that patients often start noticing "rise in blood sugar levels if they had diabetes, increase in blood pressure and cholesterol levels, stronger food cravings, and a decrease in ability to get full after eating." Dr. Odogwu added that studies showed "within 16 weeks of stopping Tirzepatide, blood sugar increases and diabetes gets worse."

Research shows blood sugar can climb within 16 weeks of stopping tirzepatide, with blood pressure and cholesterol following.

The cardiovascular benefits also begin to slip away. Dr. Odogwu said, "We start to see increases in blood pressure at around 16 weeks and other cardiometabolic parameters go back to baseline within 12 months of stopping the medication." Dr. Oparaji agreed, noting that "within months, the cardiovascular benefits can start to wear off and could be lost by 18 months especially if intentional lifestyle changes are not maintained."

Quitting cold turkey is medically safe, but doctors often favor a gradual taper to give new habits time to take hold.

Dr. Oparaji explained that stopping GLP-1 medications cold turkey is medically safe since it is not an addictive medication. However, she leaned toward a gradual taper for practical reasons. "It is better to gradually taper off medication to give patients enough time to optimize lifestyle changes. This helps avoid rapid weight gain that can happen with stopping cold turkey."

Both physicians recommend a high-protein, high-fiber eating pattern be firmly in place before the last dose, not after.

Both doctors were emphatic on this point: stopping without a plan is a mistake. Dr. Oparaji put it plainly: "Stopping GLP-1 without a plan in place is like taking off a cast before the bone is healed." She recommended patients have a high-protein, high-fiber diet established, consistent exercise that incorporates strength training at least twice a week, and regular follow-up with a weight loss clinician.

Dr. Odogwu echoed this, saying she always recommends that patients "use any time they have on the medication to develop the lifestyle habits that help with maintaining a healthy weight. These lifestyle habits include things like regular exercise and developing a taste for meals that are high in fiber and protein while being low in refined carbohydrates."

Strength training at least twice a week helps protect the lean muscle that GLP-1 users can lose along with fat.

According to Dr. Oparaji, it's important to refrain from making assumptions when you stop the medication. She said, "The biggest mistake is thinking that once the weight comes off with GLP-1, it cannot be regained when the medication is discontinued."

The patients who fare best after stopping do a lot of preparation. "These patients have taken the time to establish the healthy lifestyle habits that work for them to maintain a healthy weight," said Dr. Odogwu. "They approached the medication as a tool and not just a stand-alone savior. They worked with a multidisciplinary team that can include a dietitian, therapist, health coach and doctor, to approach weight loss from not just the body aspect but also the mind."

Dr. Oparaji recommended following up with your doctor within four to six weeks of stopping. "This is when changes in appetite start to show up," she explained.

The conversation about stopping should start with your doctor, who can discuss tapering, alternatives and a follow-up plan.

"If you're able to stay on the medicine, I strongly recommend doing that because it has benefits for one's health, beyond weight loss," said Dr. Odogwu. "If you must get off the medicine, be prepared for the possibility of gaining all the weight lost, back. You may also want to discuss with your doctor as there are alternative medications available that can help."

Stopping a GLP-1 medication doesn't have to mean undoing everything you've worked for. The key, both physicians agreed, is that the conversation about stopping should start with your doctor. The plan for what comes next is something no patient should have to figure out on their own.

Thank you for reading. For more on health and wellness, I invite you to follow me on Yahoo.

More About Our Experts: Nneoma Oparaji, MD, DipABLM, DABOM. is a physician who is triple board-certified in internal medicine, obesity medicine, and lifestyle medicine. She aims to protect cultural food heritage while reducing chronic disease risk through education and community-centered care. Cynthia Odogwu, MD is a board-certified family medicine physician with over 10 years of experience. She helps patients treat, reverse and prevent chronic conditions such as diabetes, hypertension, heart disease, and obesity. Dr. Odogwu is also CHEF coaching certified by Harvard medical school and is trained in positive intelligence (PQ coaching) and neuro-linguistic programming (NLP).

Please Note: I am a journalist, not a medical professional. This article is intended for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider regarding any health concerns.