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 considerable attention in obesity therapy. Originally developed for the treatment of type 2 diabetes, they offer a new way to curb appetite and achieve significant weight loss. Studies show that patients on Wegovy were able to lose an average of up to 15% of their body weight within a year (Wilding et al., 2021).

Despite these impressive results, there are also challenges, particularly in relation to the sustainability of results after stopping the medication. This article explores how GLP-1 agonists work, the successes and challenges, and how programs like Hello Inside can help maintain weight in the 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 intestine. This hormone plays a crucial role in the regulation of blood glucose and appetite (Kawai et al., 2020). Its effect is manifested in two main ways:

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 loss: Studies such as STEP 4 show that patients can lose around 15% of their body weight with semaglutide, a remarkable result compared to traditional diets (Wilding et al., 2021).
• Improvement in metabolic health: In addition to weight loss, 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 as well as greater enjoyment 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 weight after discontinuing GLP-1 agonists (STEP 4, 2021).
2. Muscle mass loss: Rapid weight loss can reduce muscle mass, which reduces the basal metabolic rate in the long term. Regular strength training is therefore recommended to counteract this (Pi-Sunyer et al., 2015).
3. Side effects: Common side effects are nausea and gastrointestinal complaints, which occur especially at the beginning of therapy (Raccah, 2017).

How Hello Inside programs can support weight maintenance

Hello Inside offers comprehensive programmes that use real-time feedback on almost all daily activities to quickly establish meaningful routines in everyday life without GLP-1 agonists and stabilize weight in the long term. The focus is on the individual needs and scientifically based support of the participants:

1. Dietary changes 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 severe blood sugar spikes and could block fat loss are identified and can now be replaced with more suitable alternatives.
   2. Optimized meal planning: Tips on protein and fiber-rich meals help to keep blood sugar levels stable. This not only helps to avoid cravings, but also promotes sustainable fat burning.
      
      
2. Personal goal setting and AI-supported analyses
   1. Setting individual goals: Participants work with coaches to define specific goals that are realistic and achievable in the long term. This can range from stabilizing blood sugar levels to specifically improving sleep quality.
   2. Daily analyses: With the help of AI-supported tools, Hello Inside provides detailed evaluations and thus helps to stay motivated and recognize more quickly what should be paid particular attention to. This data provides a good basis for making continuous improvements.
      
      
3. Exercise and reduction of muscle loss
   1. Maintaining muscle mass: Regular exercise, is actively integrated into the programs. This helps to stabilize the basal metabolic rate and reduce the loss of muscle mass, which is often associated with 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. Improving the quality of sleep: Poor sleep affects hormones such as leptin and ghrelin, which regulate appetite. The programs help to analyze and improve sleep habits in order to bring these hormones into balance.
      
      
5. Individual coaching and behavioral therapy
   1. Personal support: Each participant
      receives individual support from experts. Personal discussions and behavioral coaching strengthen motivation to develop new habits and maintain them in the 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 in a targeted manner to cushion possible challenges during and after GLP-1 therapy. Especially in the last three months of therapy, when dosages are reduced and the effect wears off, the program offers valuable support. It helps to manage this transition phase effectively by:

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

With Hello Inside participants are optimally prepared for the 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, M.D., & 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, M.E.J., 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, Y.J., & 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, T.A., Bailey, T.S., Billings, L.K., 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, 24 Feb 2021.
    
13. Wilding, J.P.H., Batterham, R.L., 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.