Weight regain
Also called: rebound weight gain
Clinical reviewer: Jacob Moore, MD · Last checked September 24, 2026
What is weight regain after stopping GLP-1?
Weight regain is the return of lost weight after a GLP-1 medication is stopped, a pattern seen across trials. In the STEP 1 extension, participants who stopped semaglutide regained two-thirds of their prior weight loss. In SURMOUNT-4, stopping tirzepatide led to substantial regain, while continued treatment maintained the loss. A meta-analysis found regain was proportional to the original amount lost.
How much weight do people regain after stopping?
The STEP 1 trial extension followed 327 participants for a year after treatment was withdrawn; those on semaglutide had lost 17.3% of body weight by week 68 versus 2.0% on placebo, then regained 11.6 percentage points and 1.9 percentage points respectively by week 120, leaving net losses of 5.6% and 0.1% [1]. The authors describe this as participants regaining "two-thirds of their prior weight loss" [1]. In SURMOUNT-4, a 36-week tirzepatide lead-in produced a mean 20.9% reduction; among 670 participants then randomized, those switched to placebo gained 14.0% from week 36 to 88, while those continued on tirzepatide lost a further 5.5% [2].
Why do people regain weight after stopping?
A 2026 narrative review notes that stopping is associated with substantial weight regain, "60%-90% within one year," attributing this to biological adaptations such as reactivation of orexigenic pathways and adaptive thermogenesis [3]. A separate meta-analysis of 8 randomized trials and 2372 participants found weight regain was "proportional to the original weight loss," at 2.20 kg after liraglutide and 9.69 kg after semaglutide or tirzepatide [4]. The same review notes tapering strategies for stopping have not been validated [3].
Frequently asked questions
Does everyone regain the same amount of weight?+−
No. A meta-analysis found regain was proportional to the original amount lost, averaging 2.20 kg after liraglutide and 9.69 kg after semaglutide or tirzepatide.
Is weight regain just about diet and exercise?+−
A 2026 review describes biological causes too, linking regain to adaptations such as reactivation of orexigenic pathways and adaptive thermogenesis.
Related terms
Sources
- Wilding JPH et al. Weight Regain and Cardiometabolic Effects after Withdrawal of Semaglutide, The STEP 1 Trial Extension. Diabetes Obes Metab, 2022.
- Aronne LJ et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity, The SURMOUNT-4 Randomized Clinical Trial. JAMA, 2024.
- Shah E et al. Clinical Management of Weight Regain and Cardiometabolic Consequences After Discontinuation of GLP-1 Receptor Agonists. Diabetes Obes Metab, 2026.
- Berg S et al. Discontinuing glucagon-like peptide-1 receptor agonists and body habitus, A systematic review and meta-analysis. Obes Rev, 2025.
This entry is for education and is not medical advice. Talk with a licensed clinician about your own situation before starting, stopping, or changing any treatment.
