Stopping a weight-loss drug: does the weight come back?

Does the weight come back when you stop?

In most trials yes, at least partly. A meta-analysis published in 2026 included 37 studies and 9,341 participants. After stopping, weight rose by a mean of 0.4 kg a month, and all measured cardiometabolic markers were projected to return to baseline in about 1.4 years [5]A.

In the same analysis weight came back faster after stopping a medicine than after a behavioural programme ended, by 0.3 kg a month on average, regardless of how much weight had been lost [5]A.

Older medicines were included too. Figures for the newest GLP-1 drugs come from the drug-specific trials below.

Semaglutide (Wegovy, Ozempic): the STEP 1 extension and STEP 4

In the STEP 1 extension, 327 participants were followed for a year after 68 weeks of semaglutide and lifestyle treatment ended. The semaglutide group had lost a mean of 17.3%. Within a year 11.6 percentage points of it, about two thirds, came back, leaving a net loss of 5.6% from the start. Most cardiometabolic markers also moved back towards baseline. The extension analyses were exploratory [1]A.

In STEP 4, 803 adults who had taken semaglutide for 20 weeks and lost a mean of 10.6% were randomly assigned to continue or switch to placebo. Over the next 48 weeks those who continued lost a further 7.9%, and those switched to placebo regained 6.9% [2]A.

Read more: Semaglutide (Ozempic, Wegovy)

Tirzepatide (Mounjaro): SURMOUNT-4 and SURMOUNT-MAINTAIN

In SURMOUNT-4, 670 adults who had lost a mean of 20.9% on tirzepatide over 36 weeks were randomly assigned to continue or switch to placebo. Over 52 weeks those who continued lost a further 5.5%, and those switched to placebo regained 14.0%. Of those who continued, 89.5% kept at least 80% of their earlier weight loss, against 16.6% of those switched [3]A.

In SURMOUNT-MAINTAIN, 378 adults were randomly assigned after 60 weeks of tirzepatide to continue at the maximum tolerated dose, lower the dose to 5 mg or switch to placebo. At week 112 weight was a mean of 21.9%, 16.6% and 9.9% below baseline. In the placebo group 67% received rescue tirzepatide after regaining at least half of the lost weight [4]A.

Both trials were funded by the maker of tirzepatide, Eli Lilly [3, 4]A. The Mounjaro label maintenance doses are 5, 10 and 15 mg; the prescriber chooses the dose [6].

Read more: Tirzepatide (Mounjaro)

Does exercise help keep the weight off after the medicine?

In the Danish S-LiTE trial, 195 adults first lost a mean of 13.1 kg on an 8-week low-calorie diet. They were then randomly assigned for a year to an exercise programme, liraglutide 3.0 mg, both combined, or placebo. At one year the combination group weighed 9.5 kg less than the placebo group, and body-fat percentage fell about twice as much as with exercise or the medicine alone [8]A.

In the follow-up one year after treatment ended, people who stopped liraglutide regained 6.0 kg more than those who stopped the exercise programme. More people from the combination group than from the liraglutide-only group kept a weight loss of at least 10% [9]A.

The trial was small, used liraglutide rather than newer drugs, and 109 people took part in the follow-up [8, 9]A.

Read more: Liraglutide (Saxenda)

What do the labels say about stopping?

The indication of Wegovy and Mounjaro is weight management, which covers both losing weight and keeping it off [6, 7]. The Wegovy package leaflet says not to stop the medicine without talking to your doctor [7].

The Saxenda label has a stopping rule: treatment is stopped if weight has not fallen by at least 5% after 12 weeks on the 3.0 mg daily dose [10]. With Wegovy in adolescents, treatment is stopped and re-evaluated if BMI has not fallen by at least 5% after 12 weeks [7].

Read more: Cost of long-term treatment and reimbursement in Finland

Stopping before pregnancy

According to the labels, semaglutide is stopped at least two months and tirzepatide at least one month before a planned pregnancy, because they leave the body slowly [6, 7]. Liraglutide is stopped if pregnancy is wanted or occurs [10].

Read more: Pregnancy, contraception and other side effects