Coming off Mounjaro or Wegovy. Why weight comes back and how to prepare
Many women don't know when, or whether, they'll stop their GLP-1 medication. Cost, supply, side effects and life all play a part. Whatever the reason, it helps to know what tends to happen next, so you can prepare while the medication is still on your side.
What the trials show
When people in the trials stopped their medication, most of them regained weight. A year after stopping semaglutide, participants had on average regained about two thirds of the weight they'd lost. In a tirzepatide trial, people switched to a dummy injection regained a substantial amount over the following year, while those who carried on kept losing.
That isn't a lack of willpower. These medications quieten appetite and the constant background chatter about food that many people call food noise. When the medication stops, appetite comes back, often quite quickly.
Why muscle matters here
If you lost muscle along with fat, you come off the medication with less of the tissue that helps your body handle food and energy. Weight that returns without strength training tends to return as fat. Keeping your muscle while you're on the medication is one of the best things you can do for life after it.
Prepare while the medication is helping
The time to build habits is while your appetite is quiet, not after it returns. These are the habits that tend to hold.
- Anchor meals. Three meals a day built around enough protein, at regular times. Regular protein-first meals help with fullness when appetite returns.
- Hard sets every week. Strength training two or three times a week, with the last reps of each set feeling genuinely hard.
- A rough-day minimum. The smallest version of your plan you'll do on a bad day, so one bad day doesn't become a bad month.
- A plan for food noise. Notice what sets it off and decide in advance what you'll do, for example a protein snack, a walk or a glass of water before you decide.
- A weekly check-in with yourself. Five minutes on a Sunday to ask what worked and what got in the way.
Talk to your prescriber
Whether, when and how to reduce or stop your medication is a decision for you and your prescriber, never something to change on your own. Some prescribers reduce the dose gradually. Ask what they recommend for you, and what support is available as your appetite changes.
The short version
- Most people regain weight after stopping GLP-1 medication. Appetite returning is biology, not failure.
- Protect your muscle while you're on it.
- Build your habits now, while the medication is helping.
Want help putting this into practice? The GLP-1 Graduate app is coming. Join the waitlist to hear first, or take the free Muscle Minimum Check today.
Sources
- Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide (STEP 1 extension). Diabetes, Obesity and Metabolism, 2022.
- Aronne LJ et al. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity (SURMOUNT-4). JAMA, 2024.
This article is education, not medical advice. Talk to your GP or prescriber about your own treatment.