What Happens After Stopping Semaglutide or Another GLP-1
People stop GLP-1 medicines for many reasons. Some reach the weight they wanted. Others stop because of side effects, cost, or plans for a pregnancy. Whatever the reason, it helps to know what usually happens next so you can plan for it.
When people stop semaglutide or tirzepatide, the weight they lost tends to come back over time. The NIH says you will probably regain some weight after you stop a weight management medicine.[1] In one trial, people regained about two-thirds of the weight they had lost within a year of stopping semaglutide.[2] That is not a personal failure. These medicines help while you take them, and their effects fade once you stop.
Why Weight Comes Back
Semaglutide and tirzepatide slow how fast the stomach empties and can lower appetite.[3][4] When you stop, those effects wear off. The researchers who followed people after stopping semaglutide said their results show obesity is a long-term condition, and that ongoing treatment is needed to keep the benefits.[2]
What the Trials Found After Stopping
| Trial | Before stopping | After stopping |
|---|---|---|
| Semaglutide, one-year follow-up | Average loss of 17.3% of body weight after 68 weeks | Regained about two-thirds of that within a year. Still 5.6% below starting weight on average[2] |
| Semaglutide, switched to placebo | Average loss of 10.6% over 20 weeks | Gained 6.9% over the next 48 weeks, while those who continued lost a further 7.9%[5] |
| Tirzepatide, switched to placebo | Average loss of 20.9% over 36 weeks | Gained 14.0% over the next 52 weeks. Still 9.9% below starting weight overall[6] |
In each trial, people kept some of the loss on average, though results varied from person to person.[2][5][6]
What Happens to Other Health Measures
Weight is not the only thing that changes. In the semaglutide follow-up, most of the gains in heart and metabolic health measures faded back toward where they started after people stopped.[2]
GLP-1 Treatment With Clinician Review
Answer a short questionnaire. A licensed clinician reviews your health history before prescribing compounded semaglutide or tirzepatide.
Planning to Stop
Stopping is your decision. These steps can make it smoother:
- Planning a pregnancy. Stop semaglutide 2 months before you try to get pregnant.[3] For tirzepatide, the NHS advises stopping at least 4 weeks before.[7] We do not treat anyone who is pregnant.
- Stopping gradually. The NHS advises not stopping tirzepatide suddenly, and says the dose may be lowered step by step instead. Stopping suddenly can affect blood sugar in people with type 2 diabetes.[7] If you have diabetes, speak with the doctor who manages it first.
- Healthy habits. The NIH notes that weight management medicines work best alongside healthy eating and activity.[1] Those habits are worth keeping up whether or not you stay on a medicine.
- Questions about your plan. Send us a message through your secure online account before you stop.
Staying on Treatment Long Term
Some people choose to stay on a GLP-1 medicine such as compounded semaglutide or tirzepatide. The NIH says a prescriber may advise staying on it long term if you have lost enough weight and have no serious side effects.[1] In the tirzepatide trial, 89.5% of people who kept taking it held on to at least 80% of their weight loss. Among those switched to placebo, it was 16.6%.[6]
Neither path is the wrong one. Knowing the evidence helps you choose with clear expectations.
FAQ
Will I gain all the weight back after stopping semaglutide?
Not necessarily all of it. In one trial, people regained about two-thirds of their lost weight in the year after stopping. On average, they still weighed 5.6% less than when they started.[2]
Should I stop a GLP-1 all at once?
The NHS advises against stopping tirzepatide suddenly, and a gradual lowering of the dose may be suggested.[7] Send us a message through your secure online account before you stop. If you have type 2 diabetes, speak with the doctor who manages it first, because stopping can affect your blood sugar.[7]
Is stopping tirzepatide different from stopping semaglutide?
The pattern is similar. In a tirzepatide trial, people switched to placebo regained much of their weight within a year.[6]
Can Starfish.com help if I want to start a GLP-1 again?
Yes. You can request compounded semaglutide or tirzepatide through our online questionnaire, and a licensed clinician reviews your answers before prescribing.
Explore GLP-1 Treatment
A licensed clinician reviews your answers and, if treatment is right for you, issues a prescription within 1 to 2 hours. Your medication is mailed to you.
References
- National Institute of Diabetes and Digestive and Kidney Diseases. “Prescription Medications to Treat Overweight & Obesity.” https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
- Wilding JPH, et al. “Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension.” Diabetes, Obesity and Metabolism, 2022. https://doi.org/10.1111/dom.14725
- U.S. National Library of Medicine, MedlinePlus. “Semaglutide Injection.” https://medlineplus.gov/druginfo/meds/a618008.html
- U.S. National Library of Medicine, MedlinePlus. “Tirzepatide Injection.” https://medlineplus.gov/druginfo/meds/a622044.html
- Rubino D, et al. “Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial.” JAMA, 2021. https://doi.org/10.1001/jama.2021.3224
- Aronne LJ, et al. “Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial.” JAMA, 2024. https://doi.org/10.1001/jama.2023.24945
- NHS. “Tirzepatide: a medicine to manage type 2 diabetes and treat obesity.” https://www.nhs.uk/medicines/tirzepatide/
