Will I Regain Weight After Stopping Semaglutide or Tirzepatide?

Clinic patient education · Evidence checked 3 October 2026

Learn about Dr. Fowad Shahzad’s clinical focus and professional background.

Weight can increase after semaglutide or tirzepatide is stopped. This is a reason to plan follow-up, not a certainty that every person will regain all the weight they lost. Two important withdrawal studies help explain the risk, but their group averages cannot predict an individual’s result or determine the right treatment duration.

Energy balance matters, but it is shaped by biology as well as behaviour. After weight loss, appetite can increase and energy expenditure can fall, making maintenance harder. Hunger may become more noticeable when appetite-suppressing treatment ends. NIDDK explains why regain is not an individual failing. It can also occur after bariatric surgery. Food intake remains relevant, but reducing regain to willpower alone misses these influences and the need for ongoing support.

What happened after semaglutide was stopped?

The STEP 1 extension followed 327 adults from the original trial for a year after treatment ended. Participants did not have diabetes. In the semaglutide group, average weight loss was 17.3% by week 68. Over the following year, participants regained 11.6 percentage points, leaving average weight 5.6% below the starting level. This represented roughly two-thirds of the previous loss.

Both semaglutide treatment and the trial’s structured lifestyle intervention ended at week 68. The extension was exploratory, so it does not isolate medication withdrawal from withdrawal of that support. It also does not mean everyone regained two-thirds, or that their eventual weight would follow the same pattern indefinitely.

What happened after tirzepatide was stopped?

In SURMOUNT-4, 670 adults without diabetes who completed an initial 36-week tirzepatide period were randomly assigned to continue treatment or switch to placebo. They had lost an average of 20.9% before this comparison began. During the next 52 weeks, weight increased by 14.0% in the placebo group, while those continuing tirzepatide lost a further 5.5%. Lifestyle counselling continued in both groups.

The 14.0% figure is a change from body weight at randomisation, not 14% of the weight previously lost. The withdrawal group remained an average of 9.9% below its original starting weight at week 88. These figures should not be compared directly with STEP 1 as a test of which medicine is better: the study designs, treatment periods and support differed.

What should a maintenance plan include?

NIDDK guidance explains that treatment duration depends on benefits and side effects, and that healthy eating and physical activity remain important after medication stops. NICE recommends maintenance support for people stopping weight-management medicines. These principles support a planned review; they do not mean that every patient must continue the same prescription indefinitely.

Before a planned change, discuss why treatment is ending, what alternatives are suitable and when follow-up should occur. Agree how to monitor weight and relevant health measures, and which changes should prompt an earlier appointment. Diabetes treatment needs its own review because neither withdrawal study above included people with diabetes. Do not use the trial percentages to change a diabetes prescription yourself.

A practical plan should fit food preferences, work and family routines, physical ability and finances. Ask what nutrition and activity support can continue, rather than relying on an extreme diet. NICE’s maintenance recommendations emphasise sustainable habits, self-management and ongoing support. Discuss monitoring in a way that also protects wellbeing, particularly if eating or weighing has become distressing.

These trials do not show that biotin, iron, vitamin D or magnesium prevents regain. They also do not establish a personal tapering or restarting schedule. If cost, side effects or supply problems make stopping likely, raise this early with the prescriber so that the next step is planned. Regain should lead to reassessment and support, without blame or a promise that one strategy will prevent it.

Discuss your treatment plan in Lahore

For an appointment with Dr. Fowad Shahzad, Zain and Wajid both arrange Lahore bookings from 08:00 to 23:00 Pakistan time. Confirm the consultation time, venue and fee before travelling; these are reception hours.

Call Zain: 0333 8288400 · WhatsApp Zain

Call Wajid: 0319 4631615 · WhatsApp Wajid

See all booking options and verified clinic locations. Johar Town consultations are by prior appointment, with Zain as the primary booking contact. Use reception messages for appointment arrangements; urgent symptoms need urgent medical care.

General information for adults, not an individual prescription or dosing plan. Suitability, contraindications and the complete information for the exact authorized product need review with your clinician.