If you are considering stopping GLP-1 medications such as Ozempic, Mounjaro or even Wegovy, it is crucial to understand what happens next. The changes you could encounter after stopping the medication will be explained in detail in this article with scientific evidence. Whether you’re stopping for personal reasons, financial reasons or even due to adverse reactions, getting to know what to expect could make your decision safer and better. 

What are the GLP-1s and why do people take them?

The GLP-1R is a G-protein coupled receptor (GPCR) that controls the digestion of glucose. It is mostly produced in the pancreas and stimulated by the hormone Glucagon-like peptide-1(GLP-1). When activated, GLP-1R improves insulin secretion, decreases glucagon release, slows stomach emptying, and increases sensations of fullness. Its effects make it an important therapeutic target for type 2 diabetes and obesity treatment.¹

Furthermore, the GLP-1 receptor signalling aids in weight management by decreasing hunger, adding to its significance in metabolic disorder treatment. GLP-1R has been discovered in organs including the brain and heart, implying that it may have neuroprotective and cardioprotective characteristics. Ozempic (semaglutide) and exenatide, two GLP-1 receptor agonists, have gained popularity due to their usefulness in the treatment of type 2 diabetes and obesity. They lower blood glucose levels, help in long-term weight loss, and have even been linked to cardiovascular health advantages. Patients are increasingly being prescribed these medications unauthorized, to treat excessive eating, food addiction, and impulse control.²

What happens when you stop: A physiological breakdown

When you quit taking GLP-1 receptor agonists, your body may go through a series of physiological changes as the drug's effects fade. These changes can include: 

• increased appetite
• decreased satiety
• raised blood sugar levels
• weight gain

Such consequences are not necessarily withdrawal symptoms, but rather the loss of the medication's therapeutic advantages. For example, discontinuing Ozempic might cause: 

• increased hunger
• decreased satiety
• higher blood sugar levels
• weight gain
• cardiovascular abnormalities such as high blood pressure³

Appetite, weight and craving after discontinuation

GLP-1 receptor agonists are effective in decreasing appetite and increasing satiety (sense of fullness). Patients frequently experience an increase in appetite and food cravings after discontinuing the medication, which leads to weight gain. Clinical research has indicated that a large fraction of the weight lost on GLP-1s is regained within a year of discontinuation, particularly if the medication was the primary tool used for weight management. For example, the STEP 1 trial discovered that patients recovered two-thirds of their original weight loss one year after stopping Ozempic.⁴

Addiction-related effects after stopping GLP-1s

GLP-1 receptor agonists have also demonstrated promise in lowering addictive behaviours, especially those related to smoking and drinking. Chuong et al. (2023) found that Ozempic significantly lowers excessive alcohol intake in animals, indicating that GLP-1 receptor agonists may alter the neurobiology of addictive behaviours. This emphasises how these drugs could lead to new options for alcoholism therapy. Potential explanations for these effects include modifications to the reward systems in the brain. Dopamine is one neurotransmitter system that is closely associated with addiction and is influenced by the GLP-1 system. Ozempic decreased alcohol consumption in rats, prevented relapse, and changed dopamine levels and associated gene expression in the nucleus, according to Aranäs et al. (2023). Therefore, if a person who has benefited from these neurobehavioral effects quits taking the medicine, they may experience a rebound of compulsive behaviours, cravings, or problems with impulse control, especially if the drug was indirectly reducing these tendencies.^5,6

GLP1-s mental health and rewards system

These reliable findings across a variety of GLP-1 receptor agonists and illicit substances provide compelling evidence that this class of medications may alter circuits linked to addiction. A groundbreaking pilot study was carried out in 2021 by Yammine et al. to investigate the effects of exenatide, a GLP-1 receptor agonist, in quitting smoking when combined with nicotine patches. The researchers found that exenatide users had greater rates of abstinence and lost less weight after stopping the medication. 

Given that many people who wish to quit have trouble with this issue, this is encouraging. The possibility that exenatide could reduce cocaine self-administration and cravings was further examined by Angarita et al. (2021). Although the results showed a little decrease in use, cravings did not change significantly. Discontinuation may result in the loss of cognitive and behavioural benefits, especially for patients who are unknowingly getting support in fields such as addiction, mood control and even eating disorders.^7,8

Withdrawal symptoms that come from discontinuation.

There is no indication that GLP-1 receptor agonists cause the same kind of withdrawal symptoms as benzodiazepines or opioids, nor are they habit-forming in the conventional sense. Nevertheless, a sudden stop may result in blood sugar rises in diabetics, increased appetite, irritation, exhaustion, and the resurgence of compulsive behaviours like smoking or binge meals. The body returning to its normal state without GLP-1 receptor activity is what these are, not withdrawals in the traditional sense. Increased hunger, decreased satiety, higher blood sugar, weight gain, and cardiovascular abnormalities like elevated blood pressure are some possible side effects individuals stopping Ozempic may experience.⁹

Behavioural and psychological recovery

Agonists for the GLP-1 receptor have been shown to affect addictive behaviours, such as the use of alcohol and nicotine. Stopping these practices could lead to their recurrence. In animal models, GLP-1 receptor agonists were shown to decrease alcohol consumption, indicating a potential role for them in altering reward systems linked to addiction. Furthermore, studies in humans have shown that GLP-1Receptor Agonist therapy reduces alcohol cravings, suggesting that it may be useful in treating addictive behaviours. Thus, discontinuing GLP-1RA treatment may cause past addiction tendencies to resurface, highlighting the necessity of all-encompassing management techniques.¹⁰

Risk of addictive behaviour relapse

For those with a history of addictive tendencies, stopping GLP-1 receptor agonists may raise the chance of relapse. Additionally, perhaps by reducing alcohol-induced dopamine release in the brain, GLP-1RAs have been shown to reduce the desire to drink and avoid relapse drinking. These results imply that stopping GLP-1RA treatment would eliminate these protective benefits, raising the risk of recurrence.¹¹

Limitations and on-going research

Research has certain drawbacks, such as limited sample numbers and a lack of diverse cohorts, notwithstanding the positive outcomes. Animal models, which may not adequately represent the psychological and social complexity of human addiction, have been utilised in the majority of trials. As biological, psychological, and environmental elements all play a role in the complexity of addiction, treating GLP-1 receptor activation alone might not be sufficient. GLP-1 receptor agonists must be used in conjunction with other strategies to address the complexity of addiction. To fully comprehend the long-term impacts of stopping GLP-1 receptor agonists on weight maintenance and addiction behaviours, more research is required.¹²

FAQs

Will I gain weight back if I stop taking Ozempic? 

Yes, It is common to regain weight back once the medication is discontinued.¹³

Will stopping GLP-1s have an impact on my behaviour and mood?

It is possible for the mood and the behaviour to be impacted when quitting the medication, although the precise effects and degree of severity may differ between individuals. Some might feel anxious and have mood swings while others do not.¹⁴

Summary

Blood sugar fluctuations, weight gain, increased hunger, and possibly the resumption of compulsive or addictive behaviours can all result in stopping GLP-1s. Instead of being "withdrawals," these side effects represent a reversal of the drug's positive effects. 

If you intend to quit using GLP-1s, particularly after prolonged use, you must:

• Consult with your healthcare provider about tapering or alternative options
• Develop a comprehensive strategy for diet, exercise, and behavioural support
• Pay great attention to your emotional and mental wellbeing

GLP-1s are a useful tool, not a treatment, and their abrupt stopping without a strategy may hinder long-term improvement.