LONDON, February 28, 2024 — If you’ve lost weight with Ozempic, Wegovy, or Zepbound, prepare for a likely return to your starting point. A new analysis reveals people typically regain their lost weight within 18 months of stopping these popular medications, a timeline significantly faster than previously thought.
Weight Regain is Rapid After Stopping GLP-1 Drugs
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The study, published Wednesday in the British Medical Journal, underscores the challenge of maintaining weight loss even with powerful pharmaceutical interventions.
- People on semaglutide or tirzepatide—the drugs behind Ozempic, Wegovy, and Zepbound—regain about 22 pounds within a year of stopping treatment.
- Across 13 weight-loss medications, individuals are projected to return to their baseline weight in roughly 20 months.
- Cardiometabolic health markers, like blood pressure and cholesterol, also revert to pre-treatment levels about 17 months after stopping medication.
- Exercise and dietary changes are crucial for sustaining weight loss after discontinuing these drugs.
Researchers analyzed 37 studies encompassing 9,300 participants using 13 different weight-loss medications. While previous estimates suggested weight regain on semaglutide or tirzepatide would take two to three years, this analysis puts the timeframe at just 18 months. This finding, according to researchers, highlights the need for a long-term strategy beyond medication.
These Drugs Aren’t a Cure, But a Tool
“What was particularly striking in our data was just how fast it was regained,” said Sam West, a physiology researcher at Oxford University and co-author of the study, in a phone interview Thursday. The analysis showed individuals lost approximately 33 pounds during treatment but saw about 22 pounds creep back on within the first year after stopping.
Giles Yeo, a professor of genetics at Cambridge University specializing in food intake, wasn’t surprised by the findings. “Many people forget that GLP-1s are drugs like any other,” he explained in a phone interview Thursday. “And like most drugs, with the exception of vaccines, they typically only work when you’re on them.” He drew a parallel to blood pressure medication: “When your blood pressure is normalized, no one ever says, ‘Gee, I’m going to now stop taking my pill.’ Because what happens if you stop is, almost immediately, your blood pressure will become abnormal again. Now, clearly it takes longer to regain weight, but the same is going to be true for these weight-loss drugs.”
Limitations and Future Research
Yeo cautioned that the study had limitations. Only a small fraction of the reviewed studies focused specifically on semaglutide, one of the most widely prescribed weight-loss drugs. Furthermore, the available trial data didn’t extend beyond 12 months, meaning the longer-term projections are estimates. He anticipates more comprehensive long-term data will emerge as more people use these medications.
The review also found that, on average, people regain weight about four times faster after coming off weight-loss medication than they do after completing a behavioral weight-loss program, such as a diet. In addition to weight, cardiometabolic health markers—including blood pressure and cholesterol—return to pre-drug levels around 17 months after stopping all weight-loss drugs.
Maintaining Loss: A Shift in Focus
The findings underscore the difficulty of maintaining weight loss after stopping these injections. A 2022 study, for example, showed participants regained about two-thirds of their lost weight roughly a year after discontinuing weekly semaglutide injections—consistent with the new review’s averages.
As millions of Americans use GLP-1s, scientists are increasingly focused on strategies for weight maintenance. Studies indicate that as many as half of users discontinue the drugs within a year due to cost, side effects, or other reasons. Pharmaceutical companies are now exploring ways to use these drugs for weight maintenance, potentially through lower doses, fewer injections, or oral formulations.
How to Slow Weight Regain
Weight-loss medications work by suppressing hunger, but that suppression doesn’t address the underlying biological drive to eat. “When you lose weight, your body naturally fights against it by suppressing how many calories you burn and increasing your hunger drive,” West said. When the medication stops, those cravings often return with a vengeance. “Those are ultimately going to drive weight regain if you’re not able to control those feelings,” he added.
However, these medications can create an opportunity to establish more sustainable habits. A 2024 study found that people who exercised while on weight-loss drugs maintained more weight loss after stopping the medication than those who didn’t exercise. Yeo suggests viewing these drugs as a tool to build healthier lifestyles—creating new habits, recipes, and routines—that can be sustained even after stopping the medication. “I’m not saying this is easy, but you now have a set of tools…that you can just call upon when the going gets tough.”
