The Long Game: What We Know (and Don’t) About the Long-Term Effects of Ozempic and Wegovy

Ozempic and Wegovy may offer short-term weight loss, but what about the long-term effects? Here’s what emerging research and real users are revealing.

They’ve been called miracle drugs.
They’ve been hailed as the end of obesity.
But Ozempic, Wegovy, Mounjaro, and similar GLP-1 medications are now raising a crucial question:

What happens after the weight comes off?

While many users report dramatic short-term results, long-term studies are still catching up. And for a growing number of women, the aftermath is more complicated than expected.

First, a Quick Recap: How GLP-1 Drugs Work

GLP-1 (glucagon-like peptide-1) receptor agonists help regulate blood sugar and reduce appetite. They slow gastric emptying, decrease food cravings, and increase insulin production. That’s great for people with Type 2 diabetes—and, as it turns out, highly effective for weight loss.

But these drugs were not originally designed for lifelong use by non-diabetic patients. And now that millions of people are taking them off-label for weight loss, we’re beginning to see what happens when the initial high wears off.

The Top Concerns About Long-Term Use

1. Muscle Loss

Several studies suggest that rapid weight loss on Ozempic often includes significant lean muscle loss, not just fat. That’s especially concerning for older women who are already at risk for sarcopenia (age-related muscle decline).

“You’re getting smaller, but you’re also getting weaker,” warns one clinical researcher. “That has long-term implications for mobility, balance, and overall health.”

2. Nausea, Fatigue, and Malnutrition

Many users report persistent side effects, including:

Nausea or vomiting
GI discomfort
Bloating and constipation
Fatigue or energy crashes
Inadequate calorie or nutrient intake

Some women report losing their appetite completely, even for healthy foods—leading to what some call a “numbness around eating” that feels unnatural or concerning.

3. Gallbladder Issues and Pancreatitis

Emerging research has linked GLP-1 drugs to increased risk of gallstones and pancreatitis, particularly in long-term or high-dose users. While rare, these conditions can be serious and sometimes require surgery.

4. Mental Health Effects

The emotional fallout of weight cycling (yo-yo dieting) is well documented—and Ozempic is proving no different. Coming off the drug can lead to rapid rebound weight gain, which may trigger:

Depression
Anxiety
Disordered eating behaviors
Body dysmorphia

Even while on the drug, some users report emotional numbness, loss of joy around food, or feelings of guilt for “needing a drug to be thin.”

5. Unknowns About Long-Term Organ Impact

Because GLP-1s are still relatively new to the weight loss market, long-term data is limited. Some researchers are now studying:

Potential effects on liver and kidney function
Changes in brain signaling related to appetite and reward
How these drugs interact with hormonal shifts in perimenopausal and postmenopausal women

Dependency and the “Forever Drug” Dilemma

The reality is: Most users regain the weight when they stop taking GLP-1 medications. That’s leading some doctors to suggest that users may need to stay on these drugs indefinitely—essentially making it a “forever drug.”

But is that realistic—or healthy?

For women especially, staying on a medication that suppresses natural hunger signals raises big questions about:

Fertility
Hormonal balance
Bone density
Mental health

A More Informed Approach

None of this is to say GLP-1 drugs don’t have a place. For some, they’re a life-saving tool. But women deserve the full picture—not just the Instagram version.

If you’re considering or currently using a GLP-1: