When someone stops using GLP-1 medications, the biological and behavioral changes that helped with weight loss begin to reverse. Unfortunately, many people experience significant weight regain, often rapidly.

Weight Regain Is Common and Often Substantial

One of the most consistent findings across clinical trials is the return of weight after GLP-1 medications are stopped. In the STEP 1 extension trial, participants who discontinued semaglutide regained an average of 11.6% of their body weight within a year. This represented roughly two-thirds of the weight they had previously lost. Their net weight loss, a year after stopping, dropped from nearly 15% to just about 5%.

Real-world data backs this up. A 2024 analysis of over 20,000 patients using GLP-1 drugs found that 17–18% of users regained all the weight they had lost—and sometimes even more—within a year of discontinuation. Meanwhile, about 56% managed to maintain some or all of their weight loss. While that’s encouraging, it still means that nearly half of patients saw partial or full reversal of their progress.

Hunger and Cravings Return in Full Force

One of the primary benefits of GLP-1 medications is how they suppress appetite and reduce “food noise”—the constant thoughts about food that many people with obesity experience. When the medication is stopped, hunger hormones such as ghrelin surge back, increasing cravings and making portion control more difficult. Many individuals report a dramatic increase in appetite and find themselves eating more than they intended, despite wanting to stay on track.

Experts often note that the return of these intense cravings can feel overwhelming. Without the medication, it takes more conscious effort and external support to manage hunger cues and stay within a calorie deficit.

The Body Actively Tries to Regain Lost Weight

The human body is biologically wired to maintain a certain “set point” weight. When weight is lost—especially rapidly, as it often is with GLP-1 medications—the body responds by slowing metabolism, increasing hunger, and conserving energy. This phenomenon is well-documented and is one reason why people tend to regain weight after successful diets or drug therapies.

One meta-analysis found that patients who lost 8–16 kilograms on GLP-1 drugs typically regained 6–9 kilograms within a year after stopping. The body views weight loss as a threat to survival, and its hormonal and neurological responses are designed to encourage weight regain.

Health Improvements Also Regress

The benefits of GLP-1 medications go beyond weight. While on treatment, many patients see improved blood sugar control, lower blood pressure, better lipid profiles, and reductions in markers of inflammation. But these benefits are closely tied to weight loss. When the weight returns, so do the health risks.

In the STEP trial, patients with prediabetes who had reversed their condition while on semaglutide relapsed within a year of stopping treatment. Blood pressure and cholesterol levels also crept back toward their pre-treatment baselines. Although some markers, such as inflammation levels, remained slightly improved, most of the cardiometabolic gains diminished along with the weight loss.