How to maintain weight after treatment with Wegovy, Ozempic or Saxenda

In recent years, drugs such as semaglutide (known as Wegovy or Ozempic) and liraglutide (Saxenda)—both GLP-1 agonists—have gained significant attention in obesity therapy. Originally developed to treat type 2 diabetes, they offer a new way to curb appetite and achieve significant weight loss. Studies show that patients treated with Wegovy were able to lose an average of up to 15% of their body weight within one year ( Wilding et al., 2021 ).

Despite these impressive results, there are also challenges, especially regarding the sustainability of the results after discontinuation of the medication. This article examines how GLP-1 agonists work, the successes and challenges, and how programs like Hello Inside can help maintain weight long-term.

How do GLP-1 agonists work?

GLP-1 agonists mimic the hormone glucagon-like peptide-1 (GLP-1), which is produced in the gut. This hormone plays a crucial role in regulating blood sugar and appetite ( Kawai et al., 2020 ). They act through two main pathways:

1. Appetite reduction: GLP-1 agonists slow gastric emptying and promote satiety, leading to lower calorie intake ( Blundell et al., 2017 ).
2. Blood sugar control: The drugs improve insulin release and reduce glucagon production, which stabilizes blood sugar levels ( Hinnen, 2017 ).

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Successes of GLP-1 agonist therapy

• Significant weight reduction: Studies such as STEP 4 show that patients with semaglutide can lose around 15% of their body weight, a remarkable result compared to traditional diets ( Wilding et al., 2021 ).
• Improvement of metabolic health: In addition to weight reduction, GLP-1 agonists often lead to an improvement in insulin sensitivity and a reduction in blood pressure and cholesterol levels ( Moiz et al., 2024 ).
• Improved quality of life: Patients report improved physical and mental health and a greater joy of life ( Blundell et al., 2017 ).

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Challenges and problems

1. Weight gain after discontinuation : A study shows that many patients regain their weight after discontinuing GLP-1 agonists ( STEP 4, 2021 ).
2. Loss of muscle mass: Rapid weight loss can reduce muscle mass, which in the long term lowers basal metabolic rate. Therefore, regular strength training is recommended to counteract this ( Pi-Sunyer et al., 2015 ).
3. Side effects: Common side effects include nausea and gastrointestinal discomfort, which occur particularly at the beginning of therapy ( Raccah, 2017 ).

How Hello Inside programs can help you maintain your weight

Hello Inside offers comprehensive programs that, through real-time feedback on almost all daily activities, quickly enable participants to establish sensible daily routines without GLP-1 agonists and stabilize their weight long-term. The focus is on individual needs and scientifically sound support for participants:

1. Dietary change with CGM and personalized feedback
   1. Real-time blood glucose monitoring (CGM): With a continuous glucose monitor (CGM), participants can continuously track how their body reacts to different foods. Foods that cause sharp blood sugar spikes and could inhibit fat loss are identified and can then be replaced with more suitable alternatives.
   2. Optimized meal planning: Tips for protein- and fiber-rich meals help keep blood sugar levels stable. This not only helps avoid cravings but also promotes sustainable fat burning.
      
      
2. Personal goal setting and AI-supported analytics
   1. Setting individual goals: Participants work with coaches to define concrete, realistic, and long-term goals. These can range from stabilizing blood sugar to specifically improving sleep quality.
   2. Daily analytics: Using AI-powered tools, Hello Inside provides detailed analytics to help you stay motivated and more quickly identify areas that require special attention. This data provides a solid foundation for continuous improvement.
      
      
3. Exercise and reduction of muscle loss
   1. Maintaining muscle mass: Regular exercise is actively integrated into the programs. This helps stabilize the basal metabolic rate and reduce the loss of muscle mass that often accompanies rapid weight loss.
      
      
4. Stress and sleep management
   1. Stress reduction: Chronic stress increases cortisol levels, which can inhibit fat burning and lead to weight gain. Hello Inside offers stress coaching to learn relaxation techniques such as mindfulness or breathing exercises.
   2. Improve sleep quality: Poor sleep affects hormones like leptin and ghrelin, which regulate appetite. These programs help analyze and improve sleep habits to balance these hormones.
      
      
5. Individual coaching and behavioral therapy
   1. Personal support: Each participant
      receives individualized support from experts. Personal consultations and behavioral coaching strengthen motivation to develop new habits and maintain them long-term.
   2. Behavioral change: The focus is on gradually establishing sustainable changes – such as mindful eating or avoiding emotional eating.
      

When is the combined therapy of Hello Inside and GLP-1 agonists suitable?

Hello Inside recommends using the program specifically to mitigate potential challenges during and after GLP-1 therapy. The program offers valuable support, especially during the last three months of therapy, when dosages are reduced and the effects diminish. It helps to effectively manage this transition phase by:

• Gaps in medication are bridged: Participants
  learn how to balance cravings and metabolic fluctuations with a stabilizing diet and a balanced lifestyle.
• The foundation for the period after therapy is laid: With the help of personalized coaching approaches and targeted blood sugar evaluations, long-term, healthy habits are established.
• Achieved goals are secured: Through a sustainable concept of nutrition, exercise and stress management, previous successes can not only be maintained but further expanded.

With Hello Inside, participants are optimally prepared for a time without medication support – for a healthy and stable life based on self-determined decisions and sustainable strategies.

Sources:

1. Blundell, J., Finlayson, G., Axelsen, M., et al. (2017). Effects of once weekly semaglutide on appetite, energy intake, control of eating, food preference, and body weight in subjects with obesity. Diabetes, Obesity and Metabolism , 19(9), 1242–1251.
   
2. Ghusn, W., De la Rosa, A., Sacoto, D., Cifuentes, L., Campos, A., Feris, F., Hurtado, MD, & Acosta, A. (2022). Weight loss outcomes associated with semaglutide treatment for patients with overweight or obesity. JAMA Network Open , 5(9), e2231982.
   
3. Hinnen, D. (2017). Glucagon-Like Peptide 1 Receptor Agonists for Type 2 Diabetes. Diabetes Spectrum , 30(3), 202–210.
   
4. Jensterle, M., Ferjan, S., & Janez, A. (2024). The maintenance of long-term weight loss after semaglutide withdrawal in obese women with PCOS treated with metformin: a 2-year observational study. Frontiers in Endocrinology , 15, 1366940.
   
5. Kawai, T., Sun, B., Yoshino, H., et al. (2020). Structural basis for GLP-1 receptor activation by LY3502970, an orally active nonpeptide agonist. Proceedings of the National Academy of Sciences , 117(47), 29959–29967.
   
6. Lean MEJ, Carraro R, Finer N, et al. (2014). Tolerability of nausea and vomiting and associations with weight loss in a randomized trial of liraglutide in obese, non-diabetic adults. International Journal of Obesity , 38(5), 689–697.
   
7. Liu, Y., Zhang, X., Chai, S., et al. (2019). Risk of malignant neoplasia with glucagon-like peptide-1 receptor agonist treatment in patients with Type 2 Diabetes: A meta-analysis. Journal of Diabetes Research , 1534365.
   
8. Moiz, A., et al. (2024). Long-term efficacy and safety of once-weekly semaglutide for weight loss in patients without diabetes: A systematic review and meta-analysis of randomized controlled trials. American Journal of Cardiology , 222, 121–130.
   
9. Pi-Sunyer, X., Astrup, A., Fujioka, K., et al. (2015). A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine , 373(1), 11–22.
   
10. Raccah, D. (2017). Safety and tolerability of glucagon-like peptide-1 receptor agonists: unresolved and emerging issues. Expert Opinion on Drug Safety , 16(2), 227–236.
    
11. Tak, YJ, & Lee, S.Y. (2021). Long-term efficacy and safety of anti-obesity treatment: Where do we stand? Current Obesity Reports , 10(1), 14–30.
    
12. Wadden TA, Bailey TS, Billings LK, et al. (2021). Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity. JAMA , Feb 24, 2021.
    
13. Wilding JPH, Batterham RL, Calanna S, et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine , 2(10), doi: 10.1056/NEJMoa2032183.