I'm an MD and Here's Why Patients Who Lose Weight Fastest on Ozempic Are the Ones Who Regain It

Patience is golden—especially when it comes to a successful weight-loss journey. While there are many different paths to choose from that can help you reach your endgame, there are some helpful common facts that you should be mindful of.

First and foremost, it's important to choose lifestyle changes that are sustainable—meaning habits you can easily keep up with long after you reach your weight-loss goal. Another fact? Regular exercise—specifically resistance training—is a must in order to create a calorie deficit and maintain lean muscle mass. Tracking your progress is a really helpful step to keep you on track.

But one tidbit that may surprise you has to do with the patience we spoke of earlier. Patients who lose weight fastest on Ozempic are the ones who are more likely to regain it. So speed may help you win the race, so to speak, but not for the long run. We spoke with Dr. Alexander Zuriarrain, MD, FACS, board-certified physician, quadruple-board-certified surgeon at Zuri Plastic Surgery & HYDROLOGY, who works extensively with patients on medically guided weight-loss programs, including GLP-1 therapies—to learn why.

GLP-1 medications are effective because they engage multiple pathways involved in metabolism and appetite.

"They slow gastric emptying, enhance feelings of satiety, and act on the brain's appetite centers to reduce food cravings," Dr. Zuriarrain says. "In addition, they help regulate blood sugar and insulin response, which can reduce fat storage. This combination creates a powerful physiologic shift that makes it easier for patients to sustain a caloric deficit without the constant struggle of hunger."

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Weight loss is unique for each individual—even when taking GLP-1 medication. According to Dr. Zuriarrain, the rate at which patients lose weight depends on various factors, such as degree of insulin resistance, baseline metabolic rate, lifestyle habits, and body composition.

"Patients with higher levels of visceral fat or metabolic dysfunction often see more rapid initial results," Dr. Zuriarrain adds. "Adherence to nutrition, protein intake, resistance training, and dosing consistency also play a significant role. There is also a genetic component that influences how individuals respond to these medications."

Fast weight loss can cause a reduction in resting metabolic rate and the loss of lean muscle mass. This leads to "metabolic adaption," where your body torches fewer calories at baseline.

"Additionally, hormonal signals that regulate hunger—such as ghrelin—can increase after weight loss, driving appetite back up," Dr. Zuriarrain explains. "If patients have not built sustainable habits during the process, weight regain becomes much more likely once the medication is reduced or discontinued."

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It's important to keep in mind common mistakes during your weight-loss journey. Dr. Zuriarrain says one of the most common pitfalls is not consuming sufficient protein, which further contributes to muscle loss and a slower metabolism. Another is opting for low-calorie or low-nutrient diets that won't be sustainable in the long-term.

"Patients may also under-hydrate or neglect resistance training, both of which are critical for preserving lean body mass," Dr. Zuriarrain says. "Sustainable weight loss with GLP-1 therapy requires a structured approach that includes adequate protein, strength training, and gradual lifestyle integration—not just appetite suppression alone."

For more healthy tips to navigate life after Ozempic, check out I'm a Doctor and These 4 Mistakes Cause Rebound Weight Gain After Stopping Ozempic.