Weight-loss injections like Ozempic, Wegovy, and Mounjaro are all the rage right now. But what happens when you stop taking the medication—and how can you maintain your new weight long-term? In addition, Dr. Friedrich Mittermayer, a specialist in internal medicine, endocrinology, and metabolism at our Co-Ordination Medical Center, was interviewed by the daily newspaper “Die Presse.”
Why Many People Gain Weight Again After Weaning
GLP-1 medications act on the satiety centers in the brain, slow gastric emptying, and suppress appetite. If the medication is discontinued, this suppressing effect disappears—the body returns to its original mechanism for regulating hunger and appetite. At the same time, the body’s metabolism has adapted during weight loss: the basal metabolic rate decreases, the body needs less energy, and hunger hormones such as ghrelin rise again. If you then eat just a little more than before, you’ll easily gain weight again. Dr. Mittermayer emphasizes: This is not a failure, but a well-known physiological phenomenon that occurs with nearly every form of weight loss.
The crucial phase comes after the injection
According to Dr. Mittermayer, , the first few months after reducing the dose or stopping the medication are particularly critical because appetite returns relatively quickly. But the years that follow are important, too—because maintaining a healthy weight is an ongoing process, not a one-time event. It is therefore crucial to use the medication phase to make lasting changes to diet, exercise, and overall lifestyle. If these habits are established during treatment, the chances of maintaining your weight afterward are significantly better.
Medication and behavioral changes go hand in hand
A common objection: If it were that easy to change one’s lifestyle, there would be no need for medication. That’s exactly the point—losing weight isn’t just a matter of willpower. In cases of severe obesity, the brain’s regulation of hunger and satiety changes; the body actively “defends” a higher weight, for example through increased levels of hunger hormones and constant thoughts about food. GLP-1 medications target this very mechanism and dampen this excessive hunger signal. According to Dr. Mittermayer, , this is what creates the biological window within which smaller portions and new exercise routines can actually be sustained over the long term. So medication does not replace behavioral change—it makes it possible in the first place.
Not lifestyle products, but medicine
A key concern of Dr. Mittermayer is to focus on the disease itself: “Obesity is a chronic disease and not a matter of willpower.” Stigmatization is still very common in clinical practice. GLP-1 medications are not lifestyle products, but prescription drugs with side effects that require medically supervised treatment. The most sustainable success comes when medication and accompanying behavioral changes go hand in hand—and that is precisely the approach we take at Co-Ordination.
Outlook: Tablets and New Active Ingredients
In this interview, Dr. Mittermayer also discusses upcoming developments: With the oral version of semaglutide and other active ingredients, more and more weight-loss pills are coming onto the market, which can be a sensible alternative for some patients—such as those with a fear of needles. At the same time, researchers are working on active ingredients with a broader hormonal effect and less frequent dosing schedules. The tablets aren’t a “revolution,” but they do noticeably expand the product lineup.
Read the full interview
The in-depth interview, complete with all the details, was published in “Die Presse”:
