Stopping weight loss drugs regains weight

8 min read – fact checked

(Disclaimer: Not medical advice, consult your prescribing practitioner before making any decisions)

Recent systematic review and meta-analyses (1,2) suggests that cessation of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in adults with obesity and/or diabetes is commonly associated with clinically meaningful weight regain and deterioration in cardiometabolic markers (fig.1), including glycaemic control, blood pressure, and waist circumference. These findings suggest that the metabolic benefits of GLP-1RA therapy are largely treatment-dependent, a pattern consistent with other chronic disease pharmacotherapies rather than curative interventions.

GLP-1RAs are demonstrably effective in achieving significant short-term weight loss and metabolic improvement, and they play an important role in the management of severe obesity and poorly controlled diabetes. However, real-world data indicate high rates of treatment discontinuation, particularly within the first one to two years of use (2) as i’ve previously evidenced on my social feeds (fig.2) – PS: follow me on my social feeds by clicking on my social links at the end of this page.

Discontinuation appears to be multifactorial, with contributors including gastrointestinal side effects (3), treatment cost and access, patient expectations, and tolerability over time. These attrition rates raise important questions regarding long-term acceptability and adherence for a substantial proportion of patients.

Beyond physical side effects, emerging clinical observations suggest that appetite suppression may also have psychosocial implications for some individuals. Reduced hunger and altered food reward can change how patients engage with social eating situations, potentially affecting quality of life, social participation, and personal identity (4). While these experiences are not yet well quantified in large trials, they represent an important area for further research and should be considered during patient counselling and shared decision-making.

Current evidence increasingly supports the view that, for many individuals, GLP-1RA therapy functions as a long-term or ongoing treatment to maintain weight loss, rather than a short-term intervention. Although dose titration and use of the lowest effective dose may improve tolerability, long-term outcomes following discontinuation remain inconsistent, and weight regain is common. As with other chronic therapies, this underscores the importance of transparent discussions with patients regarding expected treatment duration, benefits, risks, and alternatives.

Finally, there is growing concern regarding loss of fat-free mass (muscle) during GLP-1RA-induced weight loss, particularly in older adults or those with pre-existing sarcopenia or osteoporosis. This highlights the need for concurrent strategies such as exercise, adjust dietary intakes, other long-term lifestyle support and need for nutritional screening to reduce the risks of long-term adverse outcomes (4). Ongoing research is needed to better define the balance of benefits and risks over extended periods and to identify which patients are most likely to achieve sustainable outcomes.

A far safer and potentially equally effective alternative is my natural weight loss & detox programme, which has been empirically evidenced to sustainably reverse pre-diabetes, insulin resistance, obesity, BMI, and waist-to-hip ratio (fig 3-5), as discussed in my recent blogpost HERE.

If you wish to participate in my weight loss & detox programme, visit my website to learn more and sign up before the end of the year – prices will increase as from the 1st January 2026, so make sure you sign up before then via this webpage HERE.

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