Do I have to take weight loss medications like semaglutide for life?
If some patients can see remission of diabetes and control of hypertension without medications, why are we assuming that we cannot do the same with obesity? I constantly see people stating the opposite — including insurance companies (I wonder why? That’s a rhetorical question!)
I always educate patients about the need for lifestyle modifications, especially when starting their first blood pressure or diabetes medication. Combining treatment with changes like increased physical activity, eating healthier and improving bad habits can help patients come off medication in the future. It’s important to remember that just because obesity is a chronic condition does not mean the only solution is lifelong chronic medication use. Lifelong management for a chronic disease can also come in the form of monitoring, education and a form of accountability (the scale is to obesity, like AA is to alcohol addiction).
While more robust data is needed in obesity medicine, especially strong data comparing weight regain purely with and without continued lifestyle modifications in the absence of medications, we can in the meantime extrapolate some data about what we know of patients with hypertension and/or diabetes. We know some patients with these diagnosis can come off medications and stay off. So let’s take a look at that data and try to make a science and evidence based educated guess for people on weight loss medications.
Who can stop medications?
Lifestyle changes are key: Patients who adopt healthy habits, such as regular exercise, reducing processed sugars and reducing salt intake, have a much better chance of controlling blood pressure and diabetes without medication.
Underlying causes matter: If your high blood pressure was caused by a reversible factor (e.g., sleep apnea or stress), addressing the root cause can improve your chances.
Early intervention helps: If your blood pressure is well-controlled early on, you may be more likely to come off medication.
Recent diagnosis: If you are a newly diagnosed patient with diabetes then you are more likely to achieve remission.
Weight loss: Losing 5-15% of your body weight can significantly improve blood sugar levels and blood pressure.
What does the research say?
Success rate: Studies show that around 15-40% of patients who make significant lifestyle changes can successfully stop taking their blood pressure medications. Overall, studies estimate that 10-30% of patients can come off diabetes medications with the right approach.
Relapse risk: Stopping medication doesn’t guarantee permanent success. Regular monitoring is crucial, as some patients may need to resume treatment later.
The role of bariatric surgery: For patients with obesity, bariatric surgery has shown dramatic success, with up to 80% remission in some cases.
DiRECT study findings: A structured low-calorie diet helped nearly 46% of patients achieve remission within a year, enabling them to stop medications.
I firmly believe that in obesity medicine, lifestyle modifications are the cornerstone of success— not just for weight loss but for reclaiming health and reducing dependency on medications. We can work on putting the power back in your hands; by embracing sustainable changes like a balanced diet, regular physical activity, and stress management, you can take control of your journey. For many, this means the possibility of coming off medications and paving the way for a healthier, medication-free future. The choice is yours, and every small step counts toward lasting change.
Remember, it is okay to “fall off the wagon,” we’ve all been there.
If you’re interested in a weight-loss program and want to schedule a free, 10-minute consultation or an appointment with our obesity medicine board-certified doctor, book one below.
