Stopping a GLP-1 medicine: what happens to your weight?

Made with AI tools and overseen by an Australian GP · Updated 8 November 2026

The awkward truth that social media skips: these medicines treat weight while you take them. Stop, and appetite usually comes back, and so does much of the weight.

Quick answer: Most people regain weight after stopping. A year after stopping semaglutide, people in the STEP 1 extension had regained about two-thirds of the weight they’d lost. In SURMOUNT-4, people switched from tirzepatide to placebo regained 14% of their weight in a year, while those who continued kept losing. Plan any stop with your doctor.

What the trials found

• STEP 1 extension (semaglutide): people lost 17.3% of their weight over 68 weeks. One year after stopping, they’d regained 11.6 percentage points, leaving them 5.6% below their starting weight.
• STEP 4 (semaglutide): after 20 weeks on treatment (10.6% lost), people who continued lost a further 7.9% over 48 weeks. Those switched to placebo regained 6.9%.
• SURMOUNT-4 (tirzepatide): after 36 weeks (20.9% lost), people who continued lost a further 5.5% over a year. Those switched to placebo regained 14.0%.
• In SURMOUNT-4, 89.5% of people who stayed on tirzepatide kept at least 80% of their weight loss, versus 16.6% on placebo.

Health benefits fade too

• In the STEP 1 extension, improvements in blood pressure, blood fats and blood sugar mostly drifted back towards where they started once semaglutide stopped.
• If you have diabetes, your blood sugar may rise again, so your doctor may need to adjust your other treatment.

Why it happens

• Obesity is a long-term (chronic) condition. The trial authors concluded that ongoing treatment is needed to keep the weight and health gains.
• Regain after stopping isn’t a willpower failure. It’s what the medicine stopping looks like.
• One caveat: in the STEP 1 extension, the lifestyle support also stopped at the same time.

If you’re thinking of stopping

• Talk to your doctor first, so you can plan follow-up checks of weight, blood pressure, blood sugar and cholesterol.
• Keep up strength training and protein: muscle helps you stay strong whatever the scales say. See muscle loss and protein.
• Planning a pregnancy? There are minimum gaps before trying to conceive. See pregnancy and contraception.

See your GP before stopping if you take a GLP-1 medicine for type 2 diabetes, so your blood sugar plan can be adjusted. Get urgent help (000 in Australia, or your local emergency number) for very high blood sugar with vomiting, drowsiness or confusion.

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Evidence and more information

• Wilding et al, Diabetes, Obesity and Metabolism 2022: STEP 1 trial extension, weight regain after stopping semaglutide
• Rubino et al, JAMA 2021: STEP 4, continuing versus stopping semaglutide
• Aronne et al, JAMA 2024: SURMOUNT-4, continuing versus stopping tirzepatide
• Wilding et al, NEJM 2021: STEP 1, semaglutide 2.4 mg for weight management (weight loss, side-effect and gallbladder rates)

Updated 8 November 2026. General education, not personal medical advice, and not a recommendation for any medicine. Whether a medicine suits you depends on your health and other medicines, so talk to your doctor or pharmacist.

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