Weight-loss drugs such as Mounjaro have been praised for triggering dramatic weight loss for about 1.6 million people in the UK.
But recent findings suggest keeping the weight off after stopping the so-called miracle drugs can be extremely challenging.
Researchers at the University of Oxford discovered that people on drugs such as semaglutide – marketed under names such as Wegovy, Ozempic and Rybelsus – and tirzepatide, marketed under the name Mounjaro, lose weight during treatment. But they often regain it within 20 months of stopping the jabs, which is four times faster than traditional dieters.
Doctors and nutritionists have told The Independent that those who have lost weight need robust support to make lifestyle changes to maintain their progress, from exercise to diet advice.
One doctor warns against “going cold turkey” and stopping the drug entirely, suggesting reducing the dose could help ease patients off the medication.
Ashley Nickson, 36, managed to lose more than six-and-a-half stone by using weight-loss drug Mounjaro after finding herself stuck in a frustrating cycle of dieting, losing weight, and gaining it all back again.
“Since I was 16, I have done Weight Watchers, Slimming World, and every daft diet going,” she said. “I’d lose a few stone, then life got busy, and it all crept back on.”
The mother-of-two from Liverpool weighed 17 stone 10 lbs at her heaviest and started taking Mounjaro 13 months ago through Voy, an online obesity clinic. She has now been off it for seven months, but has maintained her progress.
Weight-loss injections, also known as GLP-1 receptor agonists, work by mimicking the natural hormone which regulates blood sugar, appetite and digestion.
They can be prescribed to lower blood sugar in people living with type 2 diabetes, but can also help people to lose weight by reducing food cravings and slowing down how quickly food is digested.
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“When I started Mounjaro, I committed to doing reformer pilates – I had to make time for it. Once I got into the habit, I started going back to the gym too,” Ms Nickson said, adding that she has received advice along her weight-loss journey.
“You learn to deal with yourself differently. The food noise quietens down, and you start thinking about what’s good for your body. As long as you change your habits while you’re on it, you’re fine.”
However, without guidance on diet and exercise, many people struggle to keep the weight off.
Kim Pearson, a nutritionist who specialises in weight loss, told The Independent: “Weight-loss injections work largely by reducing appetite and food noise. When someone stops taking them without having worked to establish healthy habits, appetite and cravings typically return and people are left relying on willpower alone which is rarely sustainable.”
Ms Pearson explains eating regular meals that contain plenty of fibre, protein and healthy fats four to five hours apart can help reduce hunger cravings.
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She stressed eating enough protein is “non-negotiable” because it supports satiety, stabilises blood sugar and protects muscle mass, which is critical for long-term weight maintenance.
“Many people regain weight because they lose muscle during rapid weight loss and never rebuild it,” Ms Pearson added.
“When it comes to food noise specifically, eating enough, eating regularly and eating foods that genuinely satisfy us helps reduce the constant thoughts of food. Avoiding addictive ultra-processed food, which is designed to drive overconsumption, is also essential.”
Dr Earim Chaudry, NHS GP and chief medical officer at Voy, also suggests reducing the dose of weight-loss drugs in addition to making lifestyle changes.
“I’d usually never recommend coming off cold turkey once you’ve finished your treatment. That isn’t how these medications work most effectively or safely. A maintenance programme that allows you to slowly reduce your dose, gives the body time to adjust and lowers the chance of weight regain,” he told The Independent.
“Maintenance programmes can generally mean applying a customised dose that leads to the right balance of food noise.
“Some patients may manage to taper down over a number of months and come off the medication and sustain the weight loss. Others may need that long term, but we may find that we’re able to come down to a lower dose.”