People who stop taking popular weight-loss drugs regain weight rapidly and see heart and diabetes risks return within two years, a review of more than 9,000 adults published Wednesday in The BMJ found.
Review Tracks Weight Regain After GLP-1 Drugs Are Stopped
GLP one Weight Loss Drug: Weight Returns Quickly After Stopping Them, Review Finds
People who discontinued weight-loss medications regained weight significantly faster than those who stopped diet or exercise programs, according to the analysis led by researchers at the University of Oxford.
The review examined randomized trials and observational studies involving more than 6,000 adults who used GLP one weight loss drug, or older weight-loss medications, compared with about 3,000 people enrolled in behavioral weight management programs.
After stopping medication, participants regained an average of 0.4 kilograms per month, adding back roughly 10 kilograms, or twenty-two pounds, within the first year. Most studies did not track patients beyond that point.
“What we found particularly shocking was just how fast weight was regained after people stopped taking medication,” said Sam West, a postdoctoral researcher at Oxford and lead author of the review.
Researchers also used modeling to estimate long-term effects. They found that markers linked to diabetes and heart disease, including high cholesterol and elevated blood pressure, likely returned to pre-treatment levels in under two years.
Medication Users Regain Weight Faster Than Diet Groups
GLP one weight loss drug medications, such as semaglutide and tirzepatide, sold under brand names including Ozempic, Wegovy and Mounjaro, have surged in popularity for treating obesity and type 2 diabetes.
However, about half of people with obesity stop taking these drugs within one year, previous studies suggest. High cost and gastrointestinal side effects are among the most common reasons for discontinuation.
The review found that people who stopped weight-loss medications regained weight almost four times faster than those who stopped behavioral programs, including structured diets and exercise plans.
Participants in behavioral programs, ranging from group-based plans like Weight Watchers to meal replacements such as soups and shakes, also regained weight after stopping. But the pace of regain was far slower.
West said one explanation may be that diet and exercise programs often teach coping skills to manage hunger. Medication users, by contrast, may lose those hunger-suppressing effects abruptly when treatment ends.
“It’s not clear why people regain weight faster after stopping medications because it hasn’t been studied in depth,” West said. “But once the drug is removed, people still live in the same food environment.”
Experts Call for Support Beyond Prescriptions
Experts not involved in the review said the findings highlight the limits of medication-only approaches to obesity.
Dana Small, a professor at McGill University who studies metabolism and the brain, said GLP one weight loss drug, remains valuable but should not be viewed as a standalone solution.
“Once people stop taking weight-loss medications, the hunger-curbing effects are gone, but ultra-processed foods are still everywhere,” Small said. “We need weight-loss maintenance strategies and real efforts to change the food environment.”
The review also found that patients who received additional support during treatment, such as nutrition guidance from dietitians, tended to lose more weight initially.
Questions remain about how best to help patients who want or need to stop medication, said Dr. Melanie Reichert, who has consulted for companies that make weight-loss drugs.
“For individuals who consider stopping the medication, what does that support look like?” Reichert said. “We really don’t know those answers yet.”
Reichert said she is optimistic about improved access to treatment, including lower-cost options, pill-based medications, and insurance-backed behavioral programs. Reducing stigma around obesity, she added, is also critical to long-term health.
The authors said understanding weight regain is essential, given the ongoing risks of diabetes and heart disease associated with excess weight.
