GuideWhat Happens When You Stop Taking GLP-1: Trial Data
In this guide
This article is for information only and is not medical advice. Talk to your prescriber or a qualified professional.
What happens when you stop taking GLP-1 medicine? In clinical trials, people who stopped regained much of the weight they had lost. After the semaglutide 2.4 mg STEP 1 trial, participants regained about two-thirds of their weight loss within a year of stopping. In SURMOUNT-4, adults who switched from tirzepatide to placebo gained a mean 14.0% in body weight over 52 weeks, while those who continued lost a further 5.5%. These are group averages from studies, not predictions for you. Whether to continue, stop or change a medicine is a decision for you and your prescriber.
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What happens when you stop taking GLP-1, trial by trial
Two randomized withdrawal studies answer this question most directly. Each one stopped the medicine in some participants and compared them with people who did not.
STEP 1 extension (semaglutide 2.4 mg)
In STEP 1, adults with obesity, or with overweight and a weight-related condition, and without diabetes took semaglutide 2.4 mg once weekly or placebo for 68 weeks, along with a lifestyle program. The extension followed 327 participants for 52 more weeks after treatment stopped. According to the published paper, the injections and the structured lifestyle intervention both ended at week 68.
- From week 0 to week 68, mean weight loss was 17.3% with semaglutide and 2.0% with placebo.
- By week 120, the semaglutide group had regained 11.6 percentage points of the lost weight and the placebo group 1.9 percentage points.
- That left a net loss from week 0 to week 120 of 5.6% in the semaglutide group and 0.1% in the placebo group.
- The authors report that improvements in cardiometabolic measures seen on semaglutide reverted toward baseline for most variables by week 120.
The authors summarize this as regaining two-thirds of prior weight loss one year after withdrawal. The paper is Wilding and colleagues, Diabetes, Obesity and Metabolism, 2022.
SURMOUNT-4 (tirzepatide)
SURMOUNT-4 enrolled 783 adults with obesity, or overweight and a weight-related complication, without diabetes, at 70 sites in 4 countries. Everyone took tirzepatide for 36 weeks, with the dose rising to a maximum tolerated 10 mg or 15 mg. At week 36, 670 participants were randomly assigned to keep taking tirzepatide or switch to placebo for 52 more weeks. The lead-in produced a mean weight reduction of 20.9%.
| Measure | Continued tirzepatide | Switched to placebo |
|---|---|---|
| Change in weight, weeks 36 to 88 | Down 5.5% | Up 14.0% |
| Change in weight, weeks 0 to 88 | Down 25.3% | Down 9.9% |
| Kept at least 80% of the lead-in weight loss at week 88 | 89.5% | 16.6% |
The paper is Aronne and colleagues, JAMA, published online December 2023. The authors concluded that withdrawing tirzepatide led to substantial regain of lost weight, while continued treatment maintained and added to the initial reduction.
A wider look: the 2026 meta-analysis
A systematic review and meta-analysis in the BMJ by West and colleagues pooled 37 studies and 9,341 participants who had stopped weight management medication. It covered medicines in general, not only GLP-1s. Average treatment lasted 39 weeks and average follow-up 32 weeks. The reported average rate of weight regain was 0.4 kg per month (95% confidence interval 0.3 to 0.5). Cardiometabolic markers were projected to return to baseline within 1.4 years. Regain was faster after stopping medication than after stopping behavioral weight management programs, by 0.3 kg per month.
What these results can and cannot tell you
- They are averages. Individual results varied around those means. The STEP 1 extension reports standard deviations of 7.7 and 8.9 percentage points for the key figures, so some people regained more and some less.
- They describe a clean stop. Both trials ended treatment outright to compare with a control. Neither was built to test gradual dose reduction or to say what is the best way to stop.
- The populations are specific. SURMOUNT-4 randomized only people who had completed 36 weeks of tirzepatide at their maximum tolerated dose. The STEP 1 extension stopped lifestyle support at the same time as the medicine.
- The doses matter. STEP 1 studied semaglutide 2.4 mg. Ozempic is also semaglutide, but its label tops out at 2 mg and is for adults with type 2 diabetes, so these figures are not a statement about Ozempic. SURMOUNT-4 studied tirzepatide, the active ingredient in both Zepbound and Mounjaro.
- They do not tell anyone to stop or stay on. That depends on health, goals, side effects, access and more, and only a prescriber who knows you can weigh them.
What the labels say about stopping
The prescribing information addresses stopping in specific safety situations. For example, the Wegovy label says to discontinue if pancreatitis is suspected. The Wegovy and Ozempic labels say to discontinue at least 2 months before a planned pregnancy, and the Ozempic label gives the long washout period for semaglutide as the reason. If one of those applies to you, talk to your prescriber. Do not rely on a general article.
When to call a clinician
Contact your prescriber if you are thinking about stopping, if you have already stopped and your weight, blood pressure or blood sugar numbers are moving, or if you stopped because of side effects.
The Medication Guides for Wegovy, Ozempic and Zepbound say to stop the medicine and call your healthcare provider right away for severe stomach pain that will not go away, with or without vomiting. Get medical help right away for signs of a serious allergic reaction, such as swelling of the face, lips, tongue or throat, or trouble breathing or swallowing.
If you are asking what to expect, how to maintain weight after stopping a GLP-1 covers the general lifestyle principles from consensus sources. Our guides to protein on a GLP-1 and muscle loss on a GLP-1 cover other things people ask about during treatment.
Questions to bring to your prescriber
These are prompts for a conversation, not advice.
- What is the plan if I stop, and who will follow up?
- Which measurements should we track, and how often?
- Are there health reasons that change the timing for me?
- If I have side effects, what are my options besides stopping?
Frequently asked questions
Can you stop taking Ozempic?
Whether and how to stop is for you and your prescriber to decide. The Ozempic label addresses stopping in some safety situations, such as at least 2 months before a planned pregnancy. The trial data in this article are for semaglutide 2.4 mg and for tirzepatide, not for Ozempic.
What happens when you stop taking Mounjaro or Zepbound?
Mounjaro and Zepbound contain tirzepatide. In SURMOUNT-4, adults who switched from tirzepatide to placebo had a mean weight gain of 14.0% over 52 weeks, and 16.6% of them kept at least 80% of their earlier weight loss, compared with 89.5% of those who continued.
What happens when you stop taking Wegovy?
Wegovy contains semaglutide. In the STEP 1 extension, participants who stopped semaglutide 2.4 mg regained a mean 11.6 percentage points of weight over 52 weeks, about two-thirds of what they had lost.
How fast does weight come back?
In the 2026 BMJ meta-analysis of weight management medicines, the average was 0.4 kg per month after stopping. Individual rates vary, and that average is not specific to GLP-1 medicines.
Keep your own record
If you have questions about what is changing, a record helps your prescriber see it. Dosinha’s weight log, shot log and side-effect check-ins are free, and you can share what you notice at your appointments. It does not prevent weight regain, and it does not tell you what to do about your medicine. It helps you notice patterns. Try the free tools.
Sources
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022.
- Aronne LJ, et al. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial. JAMA, published online December 2023.
- West S, et al. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ, 2026.
- DailyMed. Wegovy prescribing information and Ozempic prescribing information. Novo Nordisk, labels posted 2026.
This article is for information only and is not medical advice. Talk to your prescriber or a qualified professional.