Evidence-BasedClinical Research

Stopping GLP-1 Medications: What Happens Next?

Thinking about stopping Ozempic, Wegovy, or Mounjaro? This guide covers what the research shows about weight regain, realistic expectations, and evidence-based strategies for maintaining your weight loss after stopping GLP-1 medications.

~2/3

Average weight regained within 1 year of stopping

1-2 weeks

Time for appetite effects to wear off

Varies

Individual outcomes differ significantly

What the Research Shows

Clinical trials have studied what happens when people stop GLP-1 medications. The results provide important context for your expectations:

STEP 1 Extension Study
Semaglutide (Wegovy) 2.4mg
  • 68-week treatment: -17.3% body weight
  • 1 year after stopping: regained +11.6%
  • Net retained: ~5.7% weight loss
SURMOUNT-4 Study
Tirzepatide (Mounjaro)
  • 36-week treatment: -20.9% body weight
  • Stopped group: regained +14%
  • Continued group: lost additional -5.5%

Important context: These are average results from clinical trials. Individual outcomes vary significantly. Some participants maintained most of their weight loss, while others regained more than average. Your results will depend on many factors including genetics, lifestyle changes, and metabolic adaptations.

Why Weight Regain Happens

Weight regain after stopping GLP-1 medications isn't about willpower - it's biology. Understanding why it happens can help you prepare:

Appetite Regulation Returns to Baseline

GLP-1 medications work by reducing appetite signals in the brain. When you stop, these appetite signals return to their pre-treatment levels. This isn't a sign of failure - your brain is simply returning to its natural set point.

Metabolic Adaptation

After weight loss, your body burns fewer calories than someone who was never overweight (metabolic adaptation). This means you may need to eat less than expected to maintain your new weight. This effect persists whether you lose weight with medication or without.

Obesity as a Chronic Condition

Medical research increasingly views obesity as a chronic metabolic condition that requires ongoing management, similar to high blood pressure or diabetes. Just as blood pressure medications need to continue to work, weight loss medications may need long-term use for sustained effect.

Timeline: What to Expect After Stopping

Week 1-2

Appetite Returns

Hunger and cravings begin to increase as medication leaves your system. Food noise may return.

Week 3-4

Medication Cleared

Most of the medication has cleared from your body. Full appetite typically restored.

Month 1-3

Weight Stability Test

Critical period where lifestyle habits determine whether weight stays stable or begins increasing.

Month 3-12

Long-term Trajectory

Most weight regain occurs in this period if it's going to happen. Studies show average regain of 2/3 of weight lost.

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Evidence-Based Maintenance Strategies

If you decide to stop GLP-1 medication, these strategies can help maximise your chances of maintaining weight loss:

Nutrition
  • Maintain portion sizes developed during treatment
  • Prioritise protein (aim for 1.6g per kg body weight)
  • Continue eating slowly and mindfully
  • Plan meals in advance to avoid impulsive choices
  • Limit ultra-processed foods and sugary drinks
Physical Activity
  • Aim for 150-300 minutes moderate activity per week
  • Include resistance training 2-3 times weekly
  • Increase daily movement (walking, stairs)
  • Find activities you enjoy and can sustain
  • Consider working with a personal trainer
Behaviour & Mindset
  • Weigh yourself regularly (weekly minimum)
  • Set a 'intervention weight' threshold
  • Maintain sleep hygiene (7-9 hours)
  • Manage stress (linked to weight regain)
  • Stay connected with support systems

The "Intervention Weight" Strategy

One practical approach is to set an "intervention weight" - a threshold that triggers action before significant regain occurs:

  1. 1
    Set your intervention weight - typically 3-5kg above your ending treatment weight
  2. 2
    Weigh yourself weekly - same day, same time, same conditions
  3. 3
    If you hit your intervention weight: intensify lifestyle efforts immediately or contact your prescriber about restarting medication
  4. 4
    Don't wait - catching regain early is much easier than reversing significant weight gain later

When to Consider Restarting Medication

It's not a failure to restart GLP-1 medication. Consider it if:

Signs You May Benefit from Restarting

  • Weight regain approaching or exceeding your intervention threshold
  • Return of weight-related health problems
  • Struggling with appetite despite best efforts
  • Quality of life significantly impacted

What Restarting Looks Like

  • Usually restart at lowest dose (like first time)
  • May escalate faster if previously tolerated well
  • Side effects usually milder than initial start
  • May consider long-term maintenance approach

Alternative Approaches to Stopping

Dose Reduction (Maintenance Dose)

Some prescribers suggest reducing to a lower maintenance dose rather than stopping completely. Research on this approach is limited, but it may help some people maintain weight loss with fewer side effects and lower cost than full doses.

Cyclical Use

Some people use GLP-1 medications periodically - taking breaks and restarting when needed. While not extensively studied, this may be practical for some situations. Discuss with your prescriber whether this approach might suit you.

Long-term Continuous Treatment

Current evidence suggests continuous long-term use provides the best weight maintenance. Like treating other chronic conditions, ongoing medication may be the most effective approach for many people. This is increasingly viewed as a legitimate long-term treatment option.

Setting Realistic Expectations

  • Some weight regain is normal - Don't view any regain as complete failure. Even maintaining a portion of your weight loss provides health benefits.
  • Individual results vary enormously - You may do better or worse than average. The studies show wide ranges of outcomes.
  • Lifestyle changes help - While they may not fully prevent regain, healthy habits provide real protection and other health benefits.
  • Restarting is always an option - Trying to maintain without medication is worthwhile, but don't struggle unnecessarily if it's not working.

Frequently Asked Questions

Related Guides

References & Sources

  • Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022.
  • Aronne LJ, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity (SURMOUNT-4). JAMA. 2024.
  • Hall KD, Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin North Am. 2018.
  • NICE Clinical Guideline: Obesity: identification, assessment and management (CG189).

Medical Disclaimer

This information is provided for educational purposes only and is not intended as medical advice. Decisions about stopping or continuing GLP-1 medications should be made in consultation with your healthcare provider based on your individual circumstances.

Last updated: December 2025

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