GLP-1s and the Weight Rebound Problem
After Stopping Weight-Loss Drugs, Pounds and Health Risks Return Quickly, Studies Find
What Happens After You Stop GLP-1 Weight Loss Drugs
A new study published in The BMJ finds that people who stop taking popular weight-loss medications like semaglutide and tirzepatide regain weight at a steady pace — about 0.4 kilograms (roughly one pound) per month — and most of the health benefits of the drugs fade within a year.
Researchers reviewed 37 studies with more than 9,000 participants and found that
“people on average regain weight at a rate of 0.4 kg/month after cessation of weight management medications, leading to a projected return to baseline weight after 1.7 years”.
They also reported that
“although weight loss resulted in improvements in HbA1c, fasting glucose, total cholesterol, triglycerides, systolic and diastolic blood pressure, all markers returned to baseline within 1.4 years of treatment cessation”.
In other words, once people stop taking the drugs, most of the progress on blood sugar, blood pressure, and cholesterol disappears too.
Faster Regain Than With Diet and Exercise
The researchers compared weight regain after drug treatment with that following lifestyle and behavioral weight-loss programs, such as diet and exercise plans. They found that the pounds came back faster after medications than after behavior-based programs.
“Weight loss with weight management medications was 3.2 kg greater than that with behavioural weight management programmes, but monthly weight regain was significantly faster after medication than after behavioural programmes by 0.3 kg/month.”
By contrast, people in behavioral programs tended to regain weight more slowly:
“body weight after behavioural programmes was predicted to return to baseline 3.9 years after the end of treatment, compared with 1.7 years after medication.”
Why It Happens
A separate BMJ editorial explained that while GLP-1 drugs can help many people lose significant weight, they are “no magic bullets for treating obesity.”
“After an average of 39 weeks’ treatment, cessation led to 0.4 kg/month weight regain, resulting in a body weight that would return to baseline values in less than two years.”
The commentary noted that the findings “cast doubt on the notion that GLP-1 receptor agonists are a perfect cure for obesity,” adding that common reasons for stopping the medications include “high costs, side effects, and the inconvenience of injections.”
Lasting Benefits and Healthier Habits
Still, the editorial emphasized that temporary weight loss may still offer health benefits for people with obesity. It cited the Diabetes Prevention Program trial, where participants
“achieved 5-7% weight loss through a structured healthy lifestyle intervention. Even though the lifestyle intervention group eventually regained weight, the cumulative incidence of developing diabetes was lower in the lifestyle intervention group compared with the placebo group.”
But for most people, the best long-term strategy may be to combine medication with sustainable lifestyle changes. As the BMJ editorial concluded:
“Healthy dietary and lifestyle practices should remain the foundation for obesity treatment and management, with medications such as GLP-1 receptor agonists used as adjuncts.”
The Bottom Line
GLP-1 drugs can be powerful, but their benefits fade once treatment stops. Keeping the weight off, and protecting heart and metabolic health, likely requires ongoing changes to diet, activity, and long-term support.