Keeping the Weight Off: Long-Term Success On and After a GLP-1

Most people regain much of their lost weight after stopping a GLP-1, so lasting success depends on a long-term plan. This guide covers what happens when you stop, whether you need the medication for life, and the habits that best keep weight off.

Will I regain weight if I stop taking my GLP-1?

Most likely, yes.

• Most people regain one-half to two-thirds of the weight they lost within 1 year of stopping semaglutide or tirzepatide. Improvements in blood sugar, blood pressure and other heart-health measures also fade (1).
• Example from the STEP 1 trial: people lost 17.3% of their body weight on semaglutide. Within a year of stopping, they regained 11.6 percentage points, leaving a net loss of about 5.6% (2).
• Across many studies: people regained about 21 lb (9.7 kg) on average after stopping semaglutide or tirzepatide, and about 5 lb (2.2 kg) after liraglutide. The more weight people lost, the more they regained, whether or not they followed lifestyle advice (3).
• The regained weight is mostly fat. Muscle lost during treatment may not fully come back. That means your body fat percentage can end up higher than before you started (4, 5).

Will I need to take this medication forever?

For many people, yes. The American Diabetes Association treats obesity as a long-term condition that tends to come back, like high blood pressure. Keeping the benefits usually takes ongoing treatment (1).

You and your prescriber decide together among these options (1):

• Continue at the lowest dose that still works.
• Take the medication on and off (intermittent treatment).
• Stop, with close monitoring of your weight.

Research on tapering down or on-and-off treatment is still limited.

Planning to come off your GLP-1? Try my free GLP-1 maintenance planner.

How can I maintain my weight loss and healthy habits long term?

• Stay very active. This is the most consistent predictor of keeping weight off. The recommendation is 200 to 300 minutes a week of moderate activity. In one analysis, people doing 300 or more minutes a week kept off about 11% of their weight, versus about 3% for those doing under 150 minutes (4).
• Borrow habits from people who kept weight off. The American Diabetes Association highlights habits from the National Weight Control Registry, a long-running study of people who lost weight and kept it off: at least 60 minutes of activity a day, regularly tracking your weight and eating, and a diet built on minimally processed, nutrient-rich foods. These have not yet been tested specifically in people stopping a GLP-1 (1).
• Exercise during treatment pays off after stopping. In a New England Journal of Medicine trial, people who exercised while taking liraglutide kept off the most weight. A year after stopping both, the exercise group had regained less weight and had less body fat than the medication-only group (6, 7).
• Sit less and build conscious control over eating. Part of why the combined approach worked was less time sitting and better control over eating habits (8).
• Keep strength training for life. It protects your muscle, bones and ability to do everyday tasks (9).

Where coaching can help

Several expert reviews point to the same gap. People on GLP-1s benefit from structured strength training that progresses over time, protein coaching, simple strength and fitness tests (grip strength, chair stands, 6-minute walk), and regular body composition checks. Most prescribers don't have time to provide this (9-11).

Knowledge is only half the battle

Knowing what to do is not the same as getting it done

This is the gap I built my coaching to fill: progressive strength training, protein coaching, simple fitness tests, and regular body composition check-ins, combined into one plan that fits your life.

This guide gives you the best evidence available, but research describes averages, and you are not an average. As a physician, I have worked with hundreds of people on GLP-1s. I combine the highest quality evidence with that experience and with your specific situation, preferences, and goals to build a plan that works for you, then adjust it as you go.

Book a free 30-minute callHow coaching works

This guide is for education only. Talk with your prescriber before changing or stopping your medication.

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More in the GLP-1 guide series

• How to Eat on a GLP-1
• Managing GLP-1 Side Effects
• Protecting Your Muscle on a GLP-1
• Is My GLP-1 Working?
• Why Isn't the Scale Moving?

References

1. American Diabetes Association Professional Practice Committee for Diabetes. 8. Obesity and weight management for the prevention and treatment of diabetes: Standards of Care in Diabetes–2026. Diabetes Care. 2026.
2. Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity & Metabolism. 2022.
3. Berg S, Stickle H, Rose SJ, Nemec EC. Discontinuing glucagon-like peptide-1 receptor agonists and body habitus: a systematic review and meta-analysis. Obesity Reviews. 2025.
4. Swift DL, Ross LM, Laddu DR, et al. Role of physical activity in obesity treatment and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. 2026.
5. Bhandarkar A, Bhat S, Kapoor N. Effect of GLP-1 receptor agonists on body composition. Current Opinion in Endocrinology, Diabetes, and Obesity. 2025.
6. Langland JT. GLP-1 agonists for obesity. JAMA. 2024.
7. Lundgren JR, Janus C, Jensen SBK, et al. Healthy weight loss maintenance with exercise, liraglutide, or both combined. The New England Journal of Medicine. 2021.
8. Jensen SBK, Janus C, Lundgren JR, et al. Exploratory analysis of eating- and physical activity-related outcomes from a randomized controlled trial for weight loss maintenance with exercise and liraglutide single or combination treatment. Nature Communications. 2022.
9. Mehrtash F, Dushay J, Manson JE. Integrating diet and physical activity when prescribing GLP-1s—lifestyle factors remain crucial. JAMA Internal Medicine. 2025.
10. Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society. The American Journal of Clinical Nutrition. 2025.
11. Sukurica E, Sengul GF, Uysal Cinar F. Weight loss or muscle loss? Cellular mechanisms and clinical strategies for preserving lean mass during GLP-1-based therapy. Diabetes, Obesity & Metabolism. 2026.