What happens to your weight when you stop a GLP-1? A real-world study of nearly 8,000 patients

Hamlet Gasoyan, DS, PhD, MPH, and colleagues at Cleveland Clinic's Center for Value-Based Care Research analyzed data from 7,938 adult patients in Ohio and Florida who had initiated injectable semaglutide (Ozempic/Wegovy) or tirzepatide (Mounjaro/Zepbound) for obesity or type 2 diabetes, then stopped within three to 12 months of starting. The study tracked what happened to their weight over the following year.

The 7,938 patients split into two groups: 6,184 treated with semaglutide and 1,754 treated with tirzepatide. The study was published in Diabetes, Obesity and Metabolism (doi:10.1111/dom.70660) in March 2026.

In the obesity group:

• Average weight loss before stopping: 8.4% of body weight
• Average weight change one year after stopping: +0.5% (patients kept most of the weight off, on average)
• 55% of patients gained weight in the following year
• 45% maintained or continued losing weight

In the type 2 diabetes group:

• Average weight loss before stopping: 4.4% of body weight
• Average weight change one year later: −1.3% (they continued losing weight, on average)
• 44% gained weight; 56% maintained or continued losing

Randomized trials typically remove all treatment and observe what happens. The STEP 1 extension trial — one of the most-cited studies on what happens after stopping semaglutide — found that participants regained most of the lost weight within a year. That finding is real.

The Cleveland Clinic study found different results — not because the biology is different, but because most patients didn't actually stop treatment entirely and stay stopped.

Within 12 months of discontinuing their initial medication:

• 27% switched to a different medication (including older obesity medications or switching between semaglutide and tirzepatide)
• 20% restarted their original medication
• 14% continued obesity treatment through lifestyle modification visits with dietitians or exercise specialists
• Less than 1% underwent bariatric surgery

As Dr. Gasoyan noted: 'Many patients do not give up on their obesity treatment journey, even if they need to stop their initial medication.'

The primary reason patients stopped in the first place was cost or insurance coverage loss, followed by side effects. Patients treated for type 2 diabetes were more likely to restart, likely reflecting more consistent insurance coverage for diabetes-related prescriptions.

For a broader evidence overview that includes the trial-based data, see weight regain after stopping a GLP-1: what the evidence shows.

This data is useful context, not reassurance. A few points to hold carefully:

• These patients were treated in a health system with ongoing clinical support. People who stop GLP-1s without continued medical engagement may fare differently.
• The average weight regain figure (0.5%) masks wide individual variation — 55% of obesity patients did gain weight.
• The better-than-expected outcomes appear largely attributable to treatment continuation in some form, not to biological adaptation after stopping.

If you're weighing whether to stay on therapy long term, see our piece on GLP-1 maintenance after weight loss.

• What happens beyond 12 months after stopping
• Whether these findings apply to people stopping for reasons other than cost or side effects
• Whether metabolic or cardiorenal benefits from GLP-1 therapy persist after stopping, even if weight is partially maintained
• The comparative effectiveness of the different post-discontinuation pathways patients took

• What is likely to happen to my weight and metabolic health if I stop?
• If I need to stop because of cost, are there any patient assistance programs or lower-cost alternatives?
• What would a planned discontinuation look like — is there a recommended tapering approach?
• If I stop and want to restart later, what's the process?
• Are there other obesity treatment options we should discuss before deciding to stop completely?

This study doesn't say stopping a GLP-1 is fine. It says that in a managed clinical population where patients had ongoing support and many didn't permanently stop treatment, outcomes were better than trial data predicts.

The practical message: if you need to stop your GLP-1, have an explicit plan with your clinician before your last dose. Not every outcome after stopping is regain — but the ones that go better tend to involve continued clinical engagement, not disengagement.

Medical disclaimer: This content is for educational purposes only and is not medical advice. Always consult a licensed healthcare professional before starting, stopping, or changing any treatment.

Sources

• Gasoyan H et al. Obesity treatments and weight changes in clinical practice after GLP-1 discontinuation. Diabetes, Obesity and Metabolism, March 2026. doi:10.1111/dom.70660. dom-pubs.onlinelibrary.wiley.com
• Cleveland Clinic newsroom, March 12, 2026. newsroom.clevelandclinic.org