How to Get off Glp-1 Medications Like Wegovy & Zepbound

With all the continued hype surrounding GLP–1 weight loss medications like Wegovy and Zepbound, there hasn’t been much discussion on how to get off these drugs. You may ask why you should be thinking about getting off these drugs. After all, you may have just started them or are still losing weight. Why worry about when the excitement will end? Well, it’s always important to plan because patients must know several caveats to every weight loss medication.

Limited Durability

First, weight loss medication will eventually cease to offer a significant benefit. These medications provide exceptional weight loss in the first year or two. However, we fully expected that most patients will plateau. You’ll have noticed that clinical trials show a maximum weight loss of about 20% in Zepbound patients. But remember, this is not 20% across the board. This result was only achieved by a fraction of the patients studied. Just like any other weight loss program, whether it’s diet, exercise, or even bariatric surgery, patients must understand that their willingness and ability to follow a comprehensive postoperative lifestyle that includes improved diet and exercise habits are critical to not only continuing weight loss, but also maintaining any weight loss that they have already achieved.

Insurance Considerations

Insurance coverage is still spotty, and we certainly don’t know much about how insurance companies will respond to the long-term use of GLP-1 agonist, especially when patients have lost “enough weight,” according to the insurance company. In other words, the insurance company is unlikely to continue paying for treatment when it believes the patient has maxed out their weight loss potential. This may mean 20% bodyweight loss or less, conceivably. We don’t have guidance from insurance companies as this is still a developing issue, but we know that insurance companies prefer not to pay claims.

Long-Term Effects

We don’t yet know the long-term effects of these medications. At the same time, these medications have indeed been around for a long time, treating and managing type-2 diabetes. However, the weight loss versions are administered at higher dosages, and we do not know what the results of this trend will be in the next five or even ten years. As such, if patients can reduce their reliance on the pills, not only will they reduce the risk of long-term side effects, but they will also create a more sustainable option for weight loss in the future.

A Big Confidence Boost

One of the reasons why many of our patients are taking GLP-1 agonists is because they finally admitted that they could not go alone. This is a huge step forward. However, taking over from the medication and losing weight is an incredible achievement that shows tenacity, focus, and determination. These qualities extend beyond weight loss and can benefit other parts of life. As patients lose weight, they may be more able to perform their job at a higher level, but even maintaining this requires the mentioned qualities and traits. Our relationships with others, including spouses and kids, could also do with renewed focus and motivation. Ultimately, the benefits and pride of “doing it themselves” can also benefit many other parts of their lives.

Cost

Related to the insurance coverage mentioned above, cost is always a factor when it comes to medications, especially new medications that have not gone generic. The cost of these weight loss drugs can be reasonable when covered by insurance or when there is a subsidy from the drug manufacturer, but it can still be a significant burden. Granted, the cost is partially offset by a reduction in other medications, doctor visits, and less food consumed due to losing weight, but why not eliminate even more and put that into a vacation budget or toward bills?

Limited Effectiveness

Finally, for some with morbid obesity, getting off GLP-1s may be a must. In other words, a BMI over 40 or 50 will not typically receive enough benefit from weight loss medication to substantially improve or eliminate the diseases and conditions associated with excess weight and obesity. To that end, at some point, patients must understand that the drugs will not do enough and that there is another option, such as weight loss surgery, that may be precisely what’s needed.

The Bottom Line

Ultimately, staying on any drug, including a weight loss drug, is not ideal. For some, this may be a lifelong requirement, but this indeed becomes less and less attractive the younger the patient is. On the other hand, we can use these drugs as a stepping stone toward longer-term self-sufficiency – taking control and losing or maintaining the weight ourselves. This offers several significant benefits and reduces the reliance and cost associated with medication. We always look forward to seeing patients and talking to them about their weight loss options in the office. Feel free to contact us and schedule a consultation with Dr. Higa to learn more.