A common misstep for individuals using GLP-1 medications like Ozempic for weight loss is the assumption that they can stop taking the drug once they reach their target weight and revert to previous lifestyle habits, according to Dr. Sheila Nazarian, a board-certified plastic surgeon.
Dr. Nazarian, who prescribes GLP-1s through her practice Physique26, stated that the number on the scale is not the end of the process for weight regulation. She shared her own experience of regaining 13 pounds after stopping GLP-1s for two months. Upon restarting the medication, she found a higher dose was required to achieve the same effect, a phenomenon she has observed in many patients.
This cycle of stopping and restarting can be frustrating and costly. Dr. Nazarian has developed a strategy called 'microdosing,' where patients are gradually reduced to the lowest effective dose to maintain their results rather than continue weight loss. This approach aims for weight stability and allows patients to preserve health benefits while minimizing medication exposure and expense.
Exceptions to this strategy exist. Dr. Nazarian noted that discontinuing treatment may be recommended if a patient becomes excessively thin, loses significant muscle mass, experiences adverse side effects, or is pursuing an unhealthy or unattainable goal weight. She emphasized her responsibility as a physician is to help patients achieve their healthiest, not necessarily thinnest, selves.
The trend toward an extreme 'Ozempic skinny' appearance can create unrealistic expectations, and being underweight carries its own health risks, including nutritional deficiencies and reduced bone density. Some anecdotal evidence has also linked GLP-1s to eating disorder manifestations.
Despite potential risks, Dr. Nazarian believes GLP-1s can be life-changing when prescribed responsibly. Emerging research suggests potential benefits beyond weight loss, including a reduced risk of certain obesity-related cancers and significant cardiovascular advantages, such as decreased risk of heart attack and stroke. Investigations are also underway for potential protective effects against neurodegenerative diseases like Alzheimer's.
Dr. Nazarian advocates for a long-term perspective on weight management with these medications. "Why would you stop something that's working?" she posed, suggesting that intelligent, long-term use, potentially through microdosing, may be the future of managing weight and its associated health benefits.