Healthline News RSS Feed – Read More

• A new study has found that people regain weight within 2 years of stopping a GLP-1 drug.
• Metabolic improvements also tend to fade within that time, researchers found.
• Experts advise that slowly tapering off the medication is better than quitting abruptly.
• It’s also important to incorporate supportive changes in diet, exercise, and lifestyle for long-term weight management.

Many people looking to lose weight and improve their health turn to medications like semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound). 

As noted by the authors of a recent review published in The BMJ, glucagon-like peptide-1 (GLP-1) drugs can help patients lose between 15% and 20% of their body weight.

However, their findings indicate that despite the success of these medications, people who stop them tend to regain quickly, returning to their original weight within an average of 1.7 years.

During that timeframe, people also experience a reversal of the cardiometabolic health benefits seen while on the medications.

The researchers suggest that a “more comprehensive” approach may be needed in order to achieve lasting weight loss with GLP-1s.

Assessing weight management after GLP-1s

The team of researchers conducted a review of the available evidence to determine the amount of weight people regain when they stop taking GLP-1 medications.

They additionally wanted to examine how they compare to when people lose weight via diet and exercise.

To answer these questions, they searched for and combined results from all available studies to get an overall picture. Altogether, data from 37 studies involving 9,341 adults with overweight or obesity were included.

The studies included randomized controlled trials (considered the gold standard), non-randomized trials, and observation studies. All participants tested the medications for a minimum of 8 weeks, and were followed for at least 4 weeks after ceasing treatment.

Medications included popular GLP-1s, such as semaglutide, tirzepatide, and liraglutide, as well as other anti-obesity medications, including orlistat. Some studies combined drug treatments with behavioral supports such as diet and exercise.

For comparison purposes, the research team utilized data from a prior review of behavioral weight management programs and employed statistical models to estimate the average rate at which individuals regained weight after discontinuing medication.

They also examined changes in blood sugar levels, cholesterol, and blood pressure to determine if participants maintained the improvements they experienced while on the medication.

Most people regained all their weight after GLP-1s

When they reviewed the data, they found that people lost an average of 8.3 kilograms (about 18 pounds) while they were using medication.

However, once they stopped treatment, they regained their lost weight at a rate of about 0.4 kilograms (nearly 1 pound) per month. And, within an average of about 1.7 years, most had regained all of their weight.

They additionally noted that newer drugs like semaglutide and tirzepatide were associated with an even faster rate of regain: about 2 pounds per month with a return to baseline in about 1.5 years.

When the researchers compared weight regain after stopping medication to weight regain following the cessation of behavioral weight management programs, people generally lost less weight with behavioral techniques. However, weight regain was slower, at approximately 0.1 kilograms (one-quarter pound) per month.

Furthermore, it took approximately 3.9 years for them to return to their starting weight.

The study also examined various markers of metabolic health, including blood sugar (HbA1c and fasting glucose), cholesterol, triglycerides, and blood pressure. While these values had improved on the medications, they gradually returned to their original levels within around 1.4 years.

The team also found no clear evidence that the continuation of behavioral supports after quitting weight loss drugs helped slow down the regain.

According to the study authors, their findings show that while GLP-1 medications can provide tremendous benefits, those benefits may only last as long as you are using them.

While behavioral programs may provide smaller results to GLP-1s, weight loss may be more sustainable.

Tapering off GLP-1s can help your body adjust

“Stopping GLP-1 medications often reveals something we don’t talk about enough: the drug was doing part of the physiological work that lifestyle alone may not yet be prepared to sustain,” said Flávio Mitidieri Ramos, MD, MSc, director of EndoDiagnostic Advanced Treatment for Obesity.

According to Ramos, who wasn’t involved in the study, GLP-1s suppress appetite and food noise, but the body adapts to them over time.

“When the medication is reduced or stopped abruptly, hunger signals, reward pathways, and metabolic efficiency tend to rebound,” he told Healthline. “Weight regain is not a personal failure; it is a predictable biological response.”

Ramos added GLP-1s should almost never be stopped without a gradual taper, both by reducing the dose and by extending the interval between dosing.

“This gradual step-down allows the brain, gut, and metabolic system time to recalibrate,” he explained.

Ramos further noted the importance of close follow-up during this phase.

“This is not about rushing off the medication, but about preparing the physiology for the next step,” he said.

It involves eating structure, protein intake, movement, and behavioral awareness so that the patient is able to manage appetite and weight with each lower dose.

Tips for long-term weight management

Brian Parana, a health and nutrition coach, shared how he assists clients as they exit treatment with GLP-1s. Prana wasn’t involved in the study.

“The first actionable step is rebuilding eating structure before appetite fully returns,” he told Healthline.

“I have clients move to three planned meals per day, each built around a clear protein anchor.” According to Parana, protein increases satiety and slows digestion during a time when hunger signals can often overshoot. It also supports the preservation of muscle mass.

“Strength training should also be introduced or reinforced before stopping GLP-1s,” he advised, adding that many lose muscle along with fat, especially if they are not doing strength training. “Muscle tissue plays a major role in daily calorie burn and glucose regulation,” said Parana.

Regular movement is another key piece of the puzzle. “Walking improves insulin sensitivity, helps regulate appetite hormones, and lowers stress, all of which matter more once appetite suppression is removed,” he said.

Parana said that sleep and stress management must also be addressed, since lack of sleep and chronic stress raise cortisol, a hormone that drives cravings and fat regain. “Simple routines like consistent bedtimes, morning light exposure, and reducing late-night screen use make a measurable difference in appetite control,” he said.

Finally, Parana suggested viewing GLP-1s as a bridge rather than your final destination. “Clients who treat the medication as time to practice eating structure, movement, and recovery habits are far more successful long term than those who rely on appetite suppression alone,” he said.

Adding to these tips, Ramos advised that you ultimately need to be realistic, keeping in mind that obesity is a chronic, relapsing condition. As such, some individuals may require ongoing medical treatment to achieve success.

“The goal should not be to come off GLP-1s at any cost, but to integrate medication, behavior, and physiology in a way that patients can actually sustain in real life,” he said.