What is most fascinating about Ozempic isn’t the weight loss. It’s the psychological revolution it has triggered.

Something extraordinary is happening to people who’ve spent years, even decades, locked in a mental war with food. Again and again, I hear the same phrase from the medicalised weight-loss army: the “food noise” has stopped.

But what happens when the jabs stop? A recent report in The Times suggested that patients may need a full year of support after coming off Ozempic. I’d say that’s the bare minimum. Because once the food noise returns, so does the weight.

Some patients plan to taper off gradually, while others hope to stay on a maintenance dose indefinitely. But for many, going off the drug brings a risk of “Ozempic rebound” — the return of weight and cravings. Sustaining weight loss typically requires lasting lifestyle changes, as most users report a surge in appetite once the injections stop.

Yet there are also accounts from people who say their cravings never returned, even after discontinuing the medication. If true, this raises a critical question: are these drugs doing more than suppressing appetite in the short term? Could they be reshaping long-term behaviour and not just altering brain chemistry?

Some slim people seem oddly irked by Ozempic. We’ve long treated body weight as a reflection of character. Thinness is seen as discipline, virtue, self-control. Obesity is framed as a moral failure — greedy, lazy, slobbish. Katie Hopkins once tried to prove how easy it is to lose weight by deliberately gaining it. She had to force herself to eat, found the whole process unpleasant and difficult, and eventually, after much effort, she gained weight.

But for a whole cohort of people, the reverse is true. They live in a near-constant state of hunger, tormented by a 24/7 food soundtrack. And still the weight piles on.

Ozempic challenges this old narrative. Suddenly, it’s not about willpower or virtue — it’s about biology. And the implications go far beyond individual weight loss. The potential public health benefits are huge: lower rates of diabetes, heart disease, and even some obesity-related cancers. This could be the next statin or thalidomide. We don’t know yet, which is why we need to think very carefully about how we are using these drugs.

That’s because we still have no quality research to show what happens in the long term. And already, serious concerns are emerging. The death of North Lanarkshire nurse Susan McGowan, 58, last September is believed to be the first in the UK officially linked to weight-loss medication. And across the country, regulators have now received reports of more than 100 deaths potentially linked to drugs such as Ozempic, Wegovy, and Mounjaro — though these cases remain unconfirmed and may involve other contributing health factors.

There are also countless reports of people self-medicating online. Singer Avery recently revealed on Instagram that she developed osteoporosis at 30 after taking a weight-loss drug without a prescription. “I DO have an eating disorder, and I did NOT get Ozempic from a doctor. It is very easy to get,” she said.  Online self-medication isn’t new. What’s new is how easy it has become, and how little scrutiny there seems to be.

The real question now is not just what happens next, but how we support people when the drugs wear off, stop working, or begin to cause harm.

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Stella O’Malley is a psychotherapist and bestselling author. She is Founder-Director of Genspect, an international organisation that advocates for a healthy approach to sex and gender.

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