Jump to: What the study found | Why real-world results differ from trials | What patients did after stopping | What this means if you’re considering stopping | Limitations to keep in mind | Take home message
A new study of nearly 8,000 patients who stopped taking Ozempic, Wegovy, or Mounjaro found that weight regain was far less severe than clinical trials have suggested.1
Patients treated for obesity lost an average of 8.4% of their body weight before stopping, and regained just 0.5% of that weight one year later. Those treated for type 2 diabetes actually continued losing weight after stopping their treatment.1
These findings, published in Diabetes, Obesity and Metabolism in March 2026, challenge the widely reported narrative that stopping GLP-1 medications inevitably leads to regaining most of the weight you’ve lost.
These results highlight that there’s a difference between how we behave in a research setting and the real world.
People don’t just stop and do nothing. Most stay engaged with their weight management in some form, whether that’s restarting medication, switching to an alternative, or working with healthcare professionals on lifestyle changes.
Important safety information: Semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro) are prescription-only medications. This article is for informational purposes only. Always consult your prescriber before stopping, switching, or adjusting any medication.
What the study found
Researchers at the Cleveland Clinic analysed electronic health records from 7,938 adults in Ohio and Florida who started injectable semaglutide or tirzepatide for obesity or type 2 diabetes and then stopped the medication within 3 to 12 months.1
The headline findings:
- Patients treated for obesity lost an average of 8.4% of body weight before stopping, and regained an average of just 0.5% one year later
- Patients treated for type 2 diabetes lost an average of 4.4% before stopping, and lost a further 1.3% over the following year
- In the obesity group, 45% continued to lose weight or maintain their weight after stopping
- In the diabetes group, 56% continued to lose weight or maintain their weight after stopping
To put this into context, the two major clinical trials on this topic suggested that most people who stop taking weight-loss medications regain the weight they lost within a year.
In the STEP 1 extension trial, participants who stopped semaglutide regained around two-thirds of their lost weight within a year.2
In SURMOUNT-4, only 17% of those who stopped tirzepatide maintained at least 80% of their weight loss.3
So why is there such a large gap between what happened in trials and what happened in real-world clinical practice?
Why real-world results differ from clinical trials
The lead researcher, Dr Hamlet Gasoyan from Cleveland Clinic’s Center for Value-Based Care Research, pointed to two main reasons for the difference.1
First, patients in clinical trials tend to lose more weight before stopping. Trial participants typically stay on medication longer and reach higher doses, so when treatment is abruptly withdrawn, the rebound is sharper.
In the Cleveland Clinic cohort, patients had lost less weight before discontinuation, which may have made their results easier to maintain.
Second, clinical trials are designed to isolate the effect of one medication. When a trial stops the drug, all treatment (including any lifestyle support they were receiving) effectively stops. In real life, that’s rarely what happens.
Patients continue to pursue weight management through other means, such as switching medications, pausing and restarting GLP-1 therapy later, or engaging in structured lifestyle changes with healthcare professionals.
In other words, the trials measure what happens when treatment is abruptly cut off. Real life measures what happens when people adapt.
What patients did after stopping
One of the most useful findings from this study is the breakdown of what patients actually did within 12 months of stopping their initial GLP-1 medication:1
- 27% switched to a different medication, including older obesity medications or swapping between semaglutide and tirzepatide
- Around 20% restarted the same medication they had originally been prescribed
- 14% continued their treatment through lifestyle modification visits with dietitians, exercise specialists, or other healthcare professionals
- Less than 1% had bariatric surgery
Combined, more than half of patients pursued some form of continued weight management after stopping their initial prescription. This is significant because it suggests that, for many people, stopping one medication doesn’t mean giving up on treatment entirely.
The most common reason for stopping in the first place was cost or insurance issues, not a decision to discontinue treatment.4
Side effects were the second most common reason, and those patients tended to stop earlier in their treatment.
It’s worth noting that this study was conducted in the U.S., where insurance coverage for obesity medications is inconsistent and often denied.
In the UK, the cost barrier differs (most people pay privately for GLP-1 weight-loss treatment), but the principle remains the same: people who stop medication often do so for practical reasons, not because they’ve chosen to abandon treatment.
What this means if you’re considering stopping
This study doesn’t suggest that stopping GLP-1 medication is risk-free.
In the obesity group, 55% of patients did regain some weight after stopping.1 And the averages mask significant individual variation; some people regained substantially more than others.
What it does suggest is that the outcome after stopping isn’t predetermined.
People who stayed engaged with some form of support, whether through medication adjustments, professional lifestyle guidance, or both, tended to fare better than the alarming trial headlines would predict. This aligns with what we see at Second Nature. Taking the medication on its own is unlikely to support lasting weight loss.
To lose weight and keep it off, it’s essential to develop sustainable habits and a healthier lifestyle that will support a lower weight in the long term, whether you continue on medication or eventually come off it.
If you’re thinking about stopping or have already stopped, the most important step is to have a plan.
Speak to your prescriber about your options, and consider whether structured support from a dietitian or health coach could help you maintain your progress.
For a deeper look at why weight regain happens after stopping and what you can do about it, see our full guides on weight regain after stopping Mounjaro and weight regain after stopping Wegovy.
Limitations to keep in mind
No single study settles a question like this, and there are a few important caveats.
This was a retrospective observational study, not a randomised controlled trial.
The researchers analysed health records rather than controlling treatment conditions, so we can’t draw firm causal conclusions about why patients maintained their weight.
The study population was drawn from a single health system in Ohio and Florida, so the results may not fully generalise to other settings, including the UK.
There was also significant individual variation in outcomes. The averages look reassuring regarding weight regained, but some patients regained considerably more weight than others.
The study doesn’t yet identify which factors predict who will maintain weight and who won’t, though the research team has indicated this is their next area of investigation.
Take home message
The Cleveland Clinic study of nearly 8,000 patients provides some reassurance that stopping GLP-1 medications doesn’t inevitably lead to regaining all the weight you’ve lost.
In real-world practice, average weight regain was far smaller than clinical trials suggested.
The reason for the difference comes down to what happens after stopping.
In trials, treatment is cut off completely. In real life, most people continue managing their weight through medication switches, restarts, or structured lifestyle support.
The key takeaway is that if you stop taking weight-loss medication, it’s important to plan for how you’ll maintain the weight loss in the long term.
People who stayed engaged with some form of weight management support had better outcomes than those who didn’t.
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
References
- Gasoyan, H., et al. (2026). Obesity treatments and weight changes in clinical practice after discontinuation of semaglutide or tirzepatide. Diabetes, Obesity and Metabolism.
- Wilding, J.P.H., et al. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553-1564.
- Aronne, L.J., et al. (2024). Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial. JAMA, 331(1), 38-48.
- Gasoyan, H., et al. (2025). Reasons for discontinuation of obesity pharmacotherapy with semaglutide or tirzepatide in clinical practice. Obesity, 33(12), 2296-2303.
