Life
Weight-Loss Drugs: Short-Term Results or Long-Term Strategy?
4 min. read
Baptist Health South Miami Hospital
Medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have transformed the landscape of weight management, offering hope where traditional methods have stalled.
Both drugs work by mimicking gut hormones that regulate insulin release, slow digestion and reduce appetite, with the overall effect of making you feel full more quickly and for a longer time. Many patients diagnosed as clinically obese report double-digit weight loss when taking these drugs.
But what happens when you stop taking them?
David Motola, M.D., is a general surgeon with Baptist Health who has expertise in bariatric and minimally invasive surgery and whose clinical interests include both medical and surgical weight loss. He says recent studies offer the first real look at what happens when patients stop medical weight-loss treatment—and the findings are clear.
Obesity: An American Epidemic
America’s struggle with obesity is no longer a niche public health concern—it’s a defining feature of modern medical care. From primary care clinics to cardiology offices, excess weight influences daily clinical decisions.
The scope is staggering. Researchers report that the number of American adults living with obesity has more than doubled over the past three decades, reaching an estimated 107 million in 2023.
For decades, the prescription for obesity was simple but difficult: eat less, move more. While lifestyle changes remain the cornerstone of health, sustaining significant long-term weight loss through behavior alone is notoriously hard.
A New Era of Weight-Loss Treatment
Semaglutide and tirzepatide were originally approved by the U.S. Food and Drug Administration (FDA) for the treatment of type 2 diabetes. But what started as a treatment for blood sugar control revealed a profound secondary effect: substantial weight loss. Clinical trials consistently show double-digit percentage weight loss on average. In 2021, the FDA approved semaglutide for weight-loss management, followed by tirzepatide in 2023.
For patients with type 2 diabetes, these drugs offer a powerful two-for-one benefit, according to Dr. Motola.
“For these patients, medications such as semaglutide and tirzepatide are doing double duty,” he says. “They improve blood sugar control while also helping patients lose a meaningful amount of weight, which further reduces their long-term cardiovascular risk.”
Dr. Motola emphasizes the systemic impact of these treatments. “We’re not just treating a number on a scale,” he says. “We’re treating a chronic metabolic disease—obesity—that affects nearly every organ system in your body.”
In one trial, semaglutide was associated with a 20% reduction in major adverse cardiovascular events such as heart attack and stroke in people with excess weight or obesity and established cardiovascular disease.
Other Health Benefits of Weight-Loss Drugs
Beyond visible weight loss, these medications appear to offer life-extending benefits that are less immediately obvious, says Dr. Motola.
- Diabetes Remission: Studies have reported remission of type 2 diabetes in some patients after substantial weight loss.
- Improved Quality of Life: Improvements have been noted in sleep, acid reflux and bone density.
- Cancer Risk Reduction: Emerging evidence suggests reductions in long-term risks for certain cancers, including breast, endometrial and prostate cancer.
Because of their success in treating obesity, demand for these drugs has been unprecedented. In 2023 alone, nearly 26 million semaglutide and more than 6 million tirzepatide prescriptions were written in the U.S. These numbers are expected to be dramatically higher for 2025, underscoring a shift in how both patients and providers view obesity—not as a willpower failure but as a treatable medical condition.
Rebound Effect: What Happens When You Stop?
Despite the impressive before-and-after photos, however, the story doesn't end when the prescription runs out. Like diabetes or high blood pressure, obesity is a chronic disease with powerful biological drivers. When medication stops, those drivers often reassert themselves, Dr. Motola notes.
Recent data paints a clear picture of the "rebound effect":
- Semaglutide: In the STEP 1 extension trial, participants who stopped taking the drug regained about two-thirds of their lost weight within a year. By week 120, many cardiometabolic improvements had drifted back toward starting levels.
- Tirzepatide: In the SURMOUNT-4 trial, participants who switched to a placebo experienced significant weight regain—about 14%—during the follow-up period.
- General Trends: A broader analysis by the British Medical Journal found that after discontinuing weight-loss medications, people regained an average of nearly one pound per month, often returning to their starting weight within two years without additional support.
“At Baptist Health, we see that weight-loss medications can help control appetite while a person is taking them,” Dr. Motola says. “When the medication is stopped, the body often feels more hunger again, and that’s why weight can return.”
Moving Toward Long-Term Solutions
The data suggests that for many, these medications are not a temporary fix but a long-term maintenance therapy, much like medication for hypertension or high cholesterol. However, stresses Dr. Motola, medication isn't the only path.
“The most important thing is for people living with obesity to talk with their doctor. For some patients, medications are enough. For others, there are additional options such as bariatric surgery that can help achieve more lasting results and improve long-term health,” Dr. Motola explains. “We help patients review all of their options and find a treatment plan that works for their long-term health.”
Semaglutide and tirzepatide represent powerful, evidence-based tools in the fight against obesity and offer unprecedented benefits for heart health and metabolic stability, concludes Dr. Motola. Yet, as the research shows, they work best when understood not as a short-term sprint but as part of a comprehensive, lifelong commitment to health.
Click here for more information about weight-loss surgery options at Baptist Health South Miami Hospital.
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David Alexander Motola, MD
David A. Motola, M.D., is a board-certified general surgeon at Baptist Health. He is trained to manage a broad spectrum of surgical conditions affecting most areas of the body. He has expertise in bariatric and minimally invasive surgery and performs robotic surgery to address abdominal wall hernias, hiatal hernias, gallbladder disease and other foregut issues. His clinical interests include both medical and surgical weight loss.
After earning his medical degree at New York Medical College in Valhalla, N.Y., Dr. Motola completed a five-year general surgery residency and a bariatric surgery fellowship at Orlando Regional Medical Center. During his fellowship, he was a general surgeon at Orlando Health South Seminole Hospital and Orlando Health Dr. P. Phillips Hospital.
Dr. Motola is a member of numerous professional organizations, including the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery. He has conducted research in his specialty, published his work in medical journals and presented at national symposiums.
Dr. Motola believes that health is much more than lab values and diagnostic images. He addresses a patient's health from a holistic standpoint – physical, mental, emotional and spiritual. He meets his patients where they are and treats them as if they were a loved one.
Dr. Motola is fluent in English and Spanish. When he is not in the clinic or operating room, he spends his time in the gym maintaining his fitness, in the garden tending to his plants and in his study building Legos. He also enjoys traveling and culinary pursuits.
