For all the hype surrounding weight loss injections, including Ozempic and Mounjaro, the elephant in the slimming room remains: what happens when you stop taking the injections?
Wellness coach Rachael Sacerdoti shares her expert advice for life after Ozempic, Mounjaro and more…
"There's no denying weight loss injections such as Ozempic have revolutionised the slimming world," Rachael begins, before cautioning: "But as anyone with an eye on this landscape knows, just like fad diets, the real challenge isn't losing the weight – it's keeping it off when the prescriptions end.
"I'm seeing more and more women panicking about what happens next," says Rachael, whose health programme So Simple guides women through healthy weight loss and lifestyle changes. "They've had fantastic results but haven't built the foundations to maintain them."
Coming off weight loss medication isn't as simple as flicking a switch, Rachael warns. "Your body has been operating under completely different rules. When those hunger signals come roaring back – and trust me, they will – you need serious strategies in place.
"The medication buys you time, but it's what you do with that time that determines whether you'll still be wearing the same jeans six months later."
Coming off Ozempic in midlife
"For women navigating midlife, the stakes of the post-Ozempic transition are even higher," Rachael cautions. "Perimenopausal and menopausal women face a perfect storm of metabolic challenges that the medications temporarily mask. When hormonal fluctuations meet declining muscle mass and the return of a suppressed appetite, it's a recipe for rapid weight regain.
Keeping weight off post-Ozempic
Rachael’s non-negotiable advice for maintaining your new weight, no matter what weight loss method you follow, is strength training at least three times weekly, "No exceptions," she insists.
1. Strength training
It's not simply about how you look, Rachael warns. "Weight loss injections can torch muscle alongside fat, which destroys your metabolic rate. Each pound of muscle lost makes maintaining results exponentially harder once you stop."
We need to maintain our muscle if we want to ensure our weight loss is sustainable, as muscle is crucial for fat loss. "Every bit of muscle you gain is essentially a little fat-burning furnace that works around the clock. It's your insurance policy against regain."
2. Protein
Rachael’s second commandment is ensuring you eat enough protein, recommending a minimum of 100g daily. This straightforward guideline becomes crucial during the transition phase between finishing your weight loss injections and returning to pre-injection life.
"When pharmaceutical appetite control disappears, protein becomes your best defence. It keeps you fuller longer, preserves muscle and burns more calories during digestion than anything else."
3. Midlife advice
"Women coming off weight loss injections in midlife need to be particularly strategic about their approach," Rachael adds. "The hormonal shifts of midlife can reduce muscle protein synthesis by up to 20%, meaning you're fighting an uphill battle unless you're deliberately counteracting it.
"The women in their 40s and 50s who maintain their results are religious about progressive strength training and hitting higher protein targets – often 120-130g daily rather than the standard 100g. I've also found that this group benefits most from tracking metabolic age markers rather than scale weight alone - when these women see their biological age improving despite perimenopause, it creates a motivation that outlasts any medication."
The blind spots
Having guided hundreds of women through weight loss journeys, Rachael highlights five crucial factors most people completely miss when it comes to Ozempic and other weight loss injections.
1. Rewired taste buds
"Nobody talks about how these medications temporarily rewire your taste buds," she says. "I've had clients who suddenly couldn't stomach their favourite takeaway while on Ozempic. That's your golden opportunity to retrain your palate toward whole foods."
Rachael recommends keeping a 'taste journal' during medication use and the tapering period. "When you document how your food preferences shift, you can identify danger zones before old cravings blindside you."
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2. The psychological elements
There's also a psychological element few discuss relating to weight loss drugs. "These medications give many women their first real sense of control around food. When that vanishes, there's often an emotional adjustment period that catches people completely off-guard. We help clients develop specific mindfulness practices and trigger management strategies before they ever taper off."
3. Sleep patterns
Optimise and perfect your sleep patterns before stopping medication to maintain results, Rachael recommends. "Poor sleep destroys your hunger hormones, but the medication masks this effect. Once you stop, those disruptions hit you like a freight train unless you've already fixed them."
4. Keep going out
Don't waste the appetite suppression by hiding at home. Instead, use this time to master restaurant ordering, dinner party navigation and drinks management without relying on the medication's help. These social skills become priceless when you're no longer getting pharmaceutical support.
5. Don't use medication as a crutch
"These medications aren't the enemy or the saviour – they're simply a tool. The question isn't whether they work; it's whether you're using them as a crutch or a catalyst."
For those serious about maintaining their results, Rachael’s message is clear: "Start strength training and upping your protein intake now, not when you're already tapering off. The habits that will save you six months from now are the ones you're building today."
