Healthcare companies are promising to help patients quit Wegovy. There's just one problem with that.

• Evidence is building that new drugs like Wegovy must be taken long term to sustain weight loss.
• But weight-loss companies are promising to help people quit the drugs, without regaining weight.
• Quitting the drugs is something of an informal medical experiment, and it could be harmful.

A giant question is looming over the rise of Ozempic, Wegovy, and the other drugs that caught fire for helping people lose dramatic amounts of weight: Once you go on them, do you really have to take them forever?

The FDA, the drugmakers, and obesity-medicine doctors argue that these drugs should be taken long term, maybe for life.

But a growing number of healthcare companies are rejecting that consensus. They're turning their efforts toward helping people quit GLP-1 drugs like Ozempic, Wegovy, and Mounjaro and suggesting they can maintain a lower weight and the health benefits that come with it. In doing so, these companies are at the forefront of an informal medical experiment that evidence suggests is likely to fail and risks harming patients in the process.

"It's very unscientific," said Dr. Michael Albert, the chief medical officer of the virtual obesity-care clinic Accomplish Health. "It's unethical, in my opinion, because you're misrepresenting the science and making promises that aren't supported in the science."

Principally, the companies' pitch is about cost. These drugs can carry a price tag of more than $1,000 a month, though the cost is often lower for employers. Many employers saw their prescription-drug spending spike in the past year as workers sought weight-loss prescriptions. To cope, some quickly moved to restrict access or pulled coverage altogether. So what if there were another way to have healthier employees without the interminable expense?

"The pressure to find an off-ramp strategy for these drugs is very, very high," said Sami Inkinen, the CEO of a Denver-based company called Virta Health, which has raised more than $130 million.

Virta has historically focused on helping people with Type 2 diabetes by putting them on restrictive, low-carb diets. Now, it's taking that expertise and using it to treat patients with obesity.

Inkinen said Virta can help patients quit GLP-1 drugs and keep weight off by adjusting the foods they eat to help them feel full, similar to how the drugs reduce feelings of hunger. He said the company has early data showing its approach helps former GLP-1 users sustain a lower weight, albeit among patients with Type 2 diabetes.

Noom, the weight-loss and fitness app, and the diet-industry giant WeightWatchers are making similar claims, namely that they can help patients quit taking obesity drugs but maintain a lower weight and other health benefits.

There's just one problem. At least for now, there's no evidence that most people can stop taking medication and keep the weight off, obesity experts say. There is, however, a growing pile of research suggesting the opposite — that once people stop taking them, their weight creeps back up.

Weight-loss companies say they can get workers off Wegovy

Noom just started prescribing GLP-1s to patients in May and plans to work with employers starting in January. Noom's chief of medicine Dr. Linda Anegawa said in an interview that tapering patients off their medication is a joint decision between a Noom clinician and patient.

The program is new, and the company's ability to study its outcomes has been limited by shortages of the drugs. But she said there are groups of Noom patients who are sustaining their weight loss without taking a drug.

As for Virta, Inkinen pointed to an unpublished study, currently undergoing peer review, that compares diabetes patients on the company's low-carb diets who stopped taking GLP-1 drugs with those who continued taking them. Both groups of patients gained back some weight, but weight didn't differ significantly between the groups up to 12 months later.

Inkinen acknowledged that employers and health plans are turning to his company to help them cut costs. They don't want to pay for weight-loss drugs forever. But he said there are real benefits for patients, too. Many people don't want to inject themselves for the rest of their lives, and the drugs can have unpleasant side effects. About 82% of patients taking Wegovy experience gastrointestinal issues like nausea and diarrhea.

WeightWatchers didn't provide Insider with published data to support its claims that it can help people keep weight off after quitting weight-loss drugs.

It's worth noting what these companies are pushing people to do instead of taking anti-obesity drugs: diet and exercise. Those weight-loss-industry standbys have a poor long-term track record. People tend to have a tough time sticking with restrictive diets or ambitious exercise regimens, so the weight they lose usually returns.

Studies have found that patients regain weight when they quit GLP-1 drugs

There is strong and growing evidence that most people's weight rebounds once they stop taking anti-obesity drugs. Experts who study obesity say that shouldn't come as a surprise. Obesity, they say, is a chronic disease that can be controlled by medication but not cured.

A study published this month found that people who were overweight or obese and took tirzepatide — the main ingredient in the diabetes drug Mounjaro and the obesity drug Zepbound — and then stopped, gained back more than half of the weight they lost in a year, despite receiving diet and lifestyle counseling. People who continued taking the drug kept losing weight, according to the study, which was funded by the drugs' manufacturer, Eli Lilly.

A 2022 study found that people who quit taking semaglutide, the main ingredient in the diabetes drug Ozempic and the weight-loss drug Wegovy, gained back two-thirds of the weight they lost on the drug. In this study, funded by the drugmaker Novo Nordisk, patients weren't given any lifestyle coaching after quitting the drug. These studies build on earlier ones that also showed patients regain once they quit prescription obesity medication.

In the simplest terms, drugs like Wegovy and Zepbound work by telling a person's brain that they aren't hungry, said Randy Seeley, the director of the Michigan Nutrition Obesity Research Center at the University of Michigan. Like many other obesity experts, Seeley has worked as a paid consultant for Novo Nordisk and Eli Lilly.

He also advises the weight-loss startup Calibrate, which tapers some patients off GLP-1 drugs after they reach a certain body-mass index. Insider's previous reporting found that some Calibrate patients gained significant amounts of weight after they stopped getting their medication.

Once a person stops taking a GLP-1 drug, they will be hungrier and more likely to overeat and start gaining weight back, Seeley said.

This is obvious when you talk to patients, he said: People on GLP-1s commonly say the "food noise" — the constant thoughts about meals— that disappeared when they started taking the drug came rushing back once they quit.

Experts wonder if going off GLP-1s could harm patients' health

To be clear, there's plenty that doctors and researchers don't know about drugs like Wegovy.

They don't know if they must be taken forever. They can't answer whether patients can move to lower doses, take more time between shots, or take breaks from treatment entirely and still maintain weight loss. They don't know if older, cheaper, oral drugs could be used to maintain a goal weight once it's reached.

Much more research is needed to answer these questions, and the answers could go a long way to helping us figure out how to afford these medications.

But is it fair for weight-loss companies to conduct those experiments on patients who might not have a say?

There are "creative ways" to potentially lower the costs of treating people with GLP-1 drugs, said Dr. Robert Kushner, an obesity expert at Northwestern University who conducted a critical study of semaglutide, paid for by Novo Nordisk.

"But it all needs to be researched. We can't just go out there and do it," Kushner said.

These experiments might not be harmless. One study showed that improvements in health measures like blood pressure and hemoglobin A1c, a measure of a person's average blood sugar, tend to reverse once people stop taking Wegovy.

GLP-1 drugs also slash the risk of heart attacks, strokes, and cardiac-related death. Drugmakers are studying whether the drugs can prevent other health problems such as kidney disease and sleep apnea.

Seeley wonders whether stopping the drugs would eliminate that protection against heart disease, even if a patient managed to keep the weight off. He also wonders if someone who gains weight rapidly after coming off of medication would be at greater risk for developing diabetes.

"Are we putting people at greater risk for these other kinds of things?" Seeley said."It's not just about their weight. The scale is only one piece of the health picture of these individuals."

An even bigger issue, Albert said, is the potentially devastating emotional toll of programs that rip medication away from a patient.

Lisa, an Ohioan who works for an auto-insurance company, panicked when she found out she would lose coverage for Wegovy next year.

She said she's tried every diet gimmick under the sun. Wegovy and before that Mounjaro were the first things that worked, and she's lost more than 90 pounds. Now she has more energy, she's more active, and the pain she used to feel in her back and joints is gone.

She refuses to let all that go. To afford her medicine on her own, she went out and found a second job as a bartender.

"I'm not willing to go back to the person I was, where I was uncomfortable and in pain all the time," she said.