Do Weight-Loss Injections Like Ozempic Actually Work Long Term?

Here’s a balanced, well-supported article on weight-loss injections such as Ozempic (semaglutide) and whether they really work long term. No fluff — just what the science shows.

Weight-loss injections (especially GLP-1 receptor agonists like semaglutide) have gotten a lot of attention. Early data are very promising. But “long term” means different things, and there are still some open questions. Let’s dig into what is clear, what is still uncertain, and what that means in practice.

What We Know from the Evidence

1. Strong, consistent weight loss while on treatment

Multiple randomized controlled trials (RCTs) show that semaglutide leads to substantial weight loss (often 10-15% of body weight or more) in people with obesity, especially when combined with diet/exercise interventions.  

2. Good durability over 1-2 years for many

Several real-world observational studies show that the weight loss achieved at 6 or 12 months is largely maintained through 24 months in people who stay on treatment.  

3. Steeper losses compared to older drugs

When compared to other options (e.g. liraglutide) or in people with obesity vs. with just diabetes, semaglutide tends to produce stronger, more durable effects—especially when adherence is good.  

4. Dose and persistence matter

Higher therapeutic doses and continuing treatment (vs stopping) are associated with greater and more sustained weight loss. Adherence is a strong predictor of how well people maintain or improve weight loss over time.  

5. Safety profile is reasonable in many

In trials with follow up of ~1-2 years and observational studies, most side effects are mild to moderate (gastrointestinal symptoms are common early) and many people tolerate the medication well.  

What the Evidence Doesn’t Yet Fully Resolve

1. What happens if the drug is stopped

If someone discontinues semaglutide or similar drugs, weight regain is common. The body tends to revert toward its previous weight unless lifestyle changes are strong and sustained. Some improvement in metabolic markers may persist, but a lot of the weight loss effect can be lost. There is less data on long-term outcomes post-discontinuation.  

2. Longer than 2‐3 year follow-ups are limited

While there are studies showing maintenance up to ~2 years, data beyond that (3-5 years plus) are less abundant. That makes it harder to fully understand very long-term durability, side effects over many years, or whether the effect gradually wanes.  

3. Variation among individuals

Not everyone responds the same. Factors like baseline weight/BMI, presence of diabetes, dose, how consistently the drug is used, lifestyle (diet, activity), and possibly other health conditions affect both how much weight is lost and how well it is kept off.  

4. Cost, access, side effects, and burdens

Even though semaglutide is generally safe, there are side effects (nausea, digestive issues, sometimes more serious risks that are still being studied). Also, cost and insurance coverage for long-term use are important practical barriers. These non-clinical issues can affect whether someone can stay on treatment long enough to see lasting benefit.

What “Long Term Success” Looks Like in Practice

Putting together what we do know, long-term success with weight-loss injections tends to mean:

• Starting treatment with a realistic target (often 10-20% weight loss over 1-2 years)

• Staying on the medication (ongoing treatment rather than stopping early)

• Combining with lifestyle changes (diet quality, physical activity, possibly behavioral support)

• Monitoring for side effects and adjusting dose as needed

• Having a plan for maintenance (how to manage once you reach a plateau or your goal, how to adjust if stopping is considered)

Bottom Line

Yes — weight-loss injections like Ozempic (semaglutide) do really work long term, provided they’re used continuously, in adequate dose, and along with exercise and lifestyle changes. The loss is significant, and many people maintain much of that loss over 1-2 years.

They’re not risk-free, and stopping or inconsistent use tends to lead to partial or full regain of weight. The evidence beyond 3 years is still growing, so while the current results are encouraging, there’s still more to learn.