Regaining weight after stopping a GLP-1 medication is a commonly reported side effect — but going off the drug may also result in the loss of other health improvements, as well.
“These findings further cement the idea that GLP-1 medications are meant to be taken indefinitely, just like any other chronic disease medication for other chronic diseases,” says Spencer Nadolsky, DO, an obesity medicine doctor in Portage, Michigan and founder of the online obesity clinic Vineyard. Dr. Nadolsky was not involved in the study.
What the Study Found
The team analyzed health data from about 300 participants who had obesity and at least one weight-related complication (most were female and were 47 years old on average). The participants had taken tirzepatide for 36 weeks and experienced both weight loss and cardiometabolic improvements like decreases in waist size, blood pressure, and LDL “bad” cholesterol. The study was funded by the maker of Zepbound, Eli Lilly.
Researchers found that most participants (82 percent) experienced at least a 25 percent weight regain a year after going off the GLP-1.
In addition, those who regained more weight post-Zepbound had a more significant reversal of heart and metabolism benefits they achieved while on the drug — including waist size, blood pressure, LDL cholesterol, and blood sugar levels — than those who maintained their weight loss.
What Typically Happens When You Stop a GLP-1 Medication?
This new analysis took the data further by categorizing the different levels of weight loss or regain with cardiometabolic health outcomes.
“The participants that regained the most amount of weight have the most significant reversal of cardiometabolic benefits,” says Dr. Nadolsky. People who kept the weight off were able to mostly maintain the metabolic improvements Zepbound helped them achieve, with the exception of blood pressure, he says.
The study authors recommend future research to dig deeper into better strategies for weight reduction maintenance post-GLP-1, noting that the current study limitations include a lack of detailed lifestyle measures — like whether participants kept up with exercise and positive diet changes — that could add to the depth of the findings.
“It would be nice to see the difference in lifestyle in those various categories of who didn’t regain that much weight versus those who regained the most along with the various cardiometabolic markers like blood pressure changes,” adds Nadolsky.
How to Keep Weight Off if You Stop Taking a GLP-1
High prices for GLP-1 weight loss drugs have been a persistent barrier for many people who would otherwise want to stay on GLP-1s.
“Obviously, the direct pricing with the manufacturers could help someone at least stay on a very low dose and spread it out further if needed to save money. You can use non-GLP-1 medications that are generic and cheaper, like phentermine and topiramate, as well,” says Nadolsky.
If you lose access to your GLP-1, talk to your doctor, Nadolsky recommends. “Lifestyle may not be enough, but you can try your best. If needed, you may want to look into non-GLP medicines, along with maybe a low-dose spread out beyond one week at a time.”
