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Stopping a GLP-1

People stop GLP-1 medicines for all sorts of reasons: cost, side effects, pregnancy plans, reaching a goal, a supply problem. The trials that studied stopping are clear about what tends to happen next — and that is exactly why it is worth planning with a prescriber rather than doing abruptly on your own.

By the Cafeity teamUpdated 3 min read

The short answer

In trials that stopped treatment, much of the lost weight returned within a year. In the STEP 1 extension, people who stopped semaglutide regained about two-thirds of the weight they had lost over the following year.1 In SURMOUNT-4, people switched from tirzepatide to placebo after 36 weeks regained an average of 14% of body weight over the next 52 weeks, while those who continued lost a further 5.5%.2 The medicines leave the body over weeks — semaglutide is present for about 5 to 7 weeks after the last dose — so appetite returns gradually.3 Whether and how to stop is a decision to make with your prescriber.

Bar chart of two stopping trials: in the STEP 1 extension, weight fell 17.3% on semaglutide by week 68 but was only 5.6% below the start a year after stopping; in SURMOUNT-4, weight fell 20.9% in a 36-week tirzepatide lead-in, and people who continued lost a further 5.5% while those switched to placebo regained 14%.
Averages from the STEP 1 extension and SURMOUNT-4. Trial averages, not predictions for anyone.

What the trials found

Two trials that tested stopping treatment.
TrialDesignWhat happened after stopping
STEP 1 extension (semaglutide 2.4 mg)Treatment stopped at week 68; followed for a further yearParticipants had lost 17.3% by week 68, regained 11.6 percentage points by week 120, and ended 5.6% below their starting weight — about two-thirds of the loss regained. Cardiometabolic improvements also reversed towards baseline.
SURMOUNT-4 (tirzepatide)36 weeks of tirzepatide, then randomised to continue or switch to placebo for 52 weeksAfter a 20.9% loss in the lead-in, those switched to placebo regained 14% of body weight; those who continued lost a further 5.5%.

Sources: STEP 1 extension; SURMOUNT-4.12

The STEP 1 extension authors concluded that the findings confirm obesity is a chronic condition and suggest ongoing treatment is needed to maintain the improvements; the SURMOUNT-4 authors concluded that continuing tirzepatide maintained and added to the initial loss, while withdrawing it led to substantial regain.12 These are averages: some people keep more of the loss, some less.

How the medicine leaves the body

Semaglutide has a half-life of about a week and remains in the circulation for about 5 to 7 weeks after the last dose; tirzepatide's half-life is about 5 to 6 days.34 So the effects on appetite and the gut fade over weeks rather than stopping overnight. See semaglutide and tirzepatide.

Planning it with your prescriber

No label sets out a tapering schedule, and deciding how to come off is a clinical decision. Useful things to raise:

  • Why you want to stop, and whether there are alternatives — a different dose, a different medicine or form.
  • What will support eating, activity and weight afterwards, and how often you will be reviewed.
  • Other medicines that may need reviewing as weight or appetite changes — blood pressure and diabetes medicines especially.
  • Timing around surgery or a planned pregnancy — semaglutide's label advises stopping at least 2 months before a planned pregnancy.3

After stopping

Keeping the record going through the transition is the most useful thing you can do: weight as a trend, appetite and food noise as they return, and eating. It turns "it all came back" into a clear picture that you and your prescriber can act on early.

Keeping a record of it

Cafeity keeps working without a medicine on the record: the weight trend, appetite, food noise and eating continue on the same timeline, so the months after stopping are as visible as the months on treatment.

Cafeity weight screen showing a smoothed trend weight of 115.6 kg, down 5.5 kg since last week, with the note "Based on your recent rate. Not a prediction."
The smoothed trend, with or without a medicine.
Cafeity "Your week, understood" screen: Ora explains that everything is calculated from your own log, offers questions such as "When are my symptoms worst?", and shows the week's protein, energy, water, weight trend, symptom days and a note that protein was 80 g under target.
Patterns from your own log.

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Common questions

What happens when you stop a GLP-1?
In the trials, appetite and weight tended to return: about two-thirds of the lost weight within a year after stopping semaglutide, and a 14% regain over a year after switching from tirzepatide to placebo.12
Should I taper off a GLP-1?
The labels do not describe a tapering schedule; how to stop is a decision to make with your prescriber.
How long do GLP-1 effects last after stopping?
The medicine clears over weeks — semaglutide is present for about 5 to 7 weeks after the last dose — so its effects fade gradually.3

Sources

  1. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension Wilding JPH et al. Diabetes, Obesity and Metabolism 2022;24:1553–1564
  2. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity (SURMOUNT-4) Aronne LJ et al. JAMA 2024;331(1):38–48
  3. Semaglutide injection and tablets for weight management — US prescribing information DailyMed, US National Library of Medicine, version published 30 June 2026
  4. Tirzepatide injection for weight management and obstructive sleep apnoea — US prescribing information DailyMed, US National Library of Medicine, version published 2 September 2026

Written by the Cafeity team from the sources listed here. Figures from prescribing information are quoted as the label states them; trial results are averages from those trials, not predictions for any one person. This page has not yet been reviewed by a clinician — see the editorial policy for how pages are researched and corrected.