In trials, most people regained a large share of the weight they lost after stopping tirzepatide (Mounjaro) or semaglutide (Wegovy). Appetite typically returns within weeks, weight comes back gradually over months, and blood pressure, blood sugar and cholesterol improvements also reverse. There is no established taper schedule. Options include continuing, moving to a lower licensed dose, switching to another treatment such as the Foundayo tablet, or a planned stop with a strong maintenance plan. Agree the plan with your prescriber before you stop.
SURMOUNT-4: tirzepatide
In SURMOUNT-4, adults took tirzepatide for 36 weeks and lost an average of about 20% of their body weight. They were then randomly assigned either to continue tirzepatide or to switch to placebo for a further 52 weeks. Those who continued lost a further 5.5% on average. Those who switched to placebo regained about 14% of their body weight over the same period.
SURMOUNT-4: adults first lost about 20% of body weight on tirzepatide over 36 weeks, then continued or switched to placebo for 52 weeks. Group averages; individual results vary.
STEP 1 extension: semaglutide
In the STEP 1 extension, people who stopped semaglutide 2.4mg after 68 weeks and were followed for a further year regained about two thirds of the weight they had lost, and improvements in several cardiometabolic markers moved back towards where they started.
2026 BMJ meta-analysis
A 2026 meta-analysis published in the BMJ pooled studies of weight-loss medicines and reported that weight returned at an average of around 0.4kg per month after stopping, and that, on average, all the weight lost was likely to be regained in under two years. It also found that markers such as blood pressure and cholesterol moved back towards baseline. These are averages across studies, and individual results vary widely.
| Trial / analysis | Medicine | What happened after stopping |
|---|---|---|
| SURMOUNT-4 | Tirzepatide (Mounjaro) | About 14% of body weight regained over 52 weeks (placebo group); continuers lost a further 5.5% |
| STEP 1 extension | Semaglutide 2.4mg (Wegovy) | About two thirds of lost weight regained within a year; cardiometabolic markers drifted back |
| BMJ meta-analysis (2026) | Several weight-loss medicines | Average regain about 0.4kg a month; lost weight likely fully regained in under two years |
Important
These are group averages from clinical trials and pooled analyses. Some people regain less, some more, and results depend on what you do after stopping. The figures are for planning, not predictions.
Obesity is a chronic, relapsing condition, not a lack of willpower. GLP-1 based medicines work by acting on appetite, fullness and food reward in the brain and gut. While you take them, hunger is quieter and meals are more satisfying. When the medicine leaves your system, those signals return to where they were. Your body, which has lost weight, also tends to push back with increased hunger and reduced energy expenditure, so the starting point is not neutral. See how the medicines work in our guides to how Foundayo works and what the Wegovy pill is.
- Appetite usually increases over the weeks after the last dose, as the medicine wears off
- Food noise, the constant thinking about food that many people lose on treatment, can return
- Portion sizes tend to creep up unless you deliberately plan them
- Habits built while appetite was suppressed may not yet be automatic
Weight is not the only thing that changes. In the trials, improvements in blood pressure, blood sugar (HbA1c), cholesterol and waist circumference partly or largely reversed in the months after stopping, in line with weight regain. If you took the medicine for type 2 diabetes or prediabetes, blood sugar can rise again, so you should have a monitoring plan with your clinician. See our guides on Mounjaro and type 2 diabetes and Foundayo and type 2 diabetes.
| Option | What it means | Things to consider |
|---|---|---|
| Continue long term | Remain on your current maintenance dose | Keeps the benefit; ongoing cost; regular reviews. See Mounjaro maintenance and Wegovy pill long-term use |
| Move to a lower licensed dose | Step down under prescriber guidance | Some people maintain well on a lower dose; discuss at review. See the Mounjaro and Wegovy dose schedules |
| Switch to another treatment | For example from an injection to a tablet | Different side effects and cost; needs a prescriber plan. See switching from injection to Wegovy pill and Foundayo vs Mounjaro |
| Planned stop | Come off with a maintenance plan in place | Regain is likely on average; monitoring is important. See maintaining after Wegovy and after Foundayo |
| Stop for a defined reason | Pregnancy, surgery, side effects, cost | Plan the timing and what comes next |
There is no established tapering protocol for these medicines in the UK licence, and no evidence that taking tiny doses helps you come off more smoothly. If you want to reduce, the safe route is a prescriber-led step to a lower licensed dose.
Switching treatments
Some people consider switching rather than stopping, for example moving from an injection to the tablet Foundayo (orforglipron) or the Wegovy pill. Early trial data in people who had lost weight on injectable medicines suggest that switching to orforglipron largely maintained their weight loss. This is a decision for you and your prescriber, and is not the same as stopping with nothing in its place. Our pill or injection comparison, Wegovy pill vs injection and decision guide cover the differences.
Making a Stop PlanIf you decide to stop, the weeks and months afterwards matter. These habits have the best support and cost nothing.
| Habit | Why it helps |
|---|---|
| Prioritise protein at every meal | Supports fullness and helps preserve muscle |
| Keep up resistance training | Helps maintain muscle mass when weight changes |
| Plan meals and portions | Replaces the appetite control the medicine provided |
| Weigh weekly | Catches regain early, before it becomes large |
| Agree a trigger point | For example, a set weight gain at which you will call your prescriber |
| Keep reviews booked | Continued support improves outcomes |
Our nutrition guide and calorie deficit calculator help with meal planning, and our muscle preservation guides for Mounjaro, Wegovy, the Wegovy pill and Foundayo cover protein and strength training. If your weight stalls rather than regains, see the Mounjaro, Wegovy and Foundayo plateau guides.
If you stop and later want to restart, do not simply return to your previous dose. After a break the body is no longer used to the medicine, and jumping back to a high dose can bring severe nausea and vomiting. Prescribers usually advise restarting at a lower dose and titrating up again. For Foundayo, if you have missed seven days or more, contact your prescriber before restarting. For injections, follow the guidance for missed doses in the patient leaflet and speak to your prescriber if more than a dose or two has been missed. See our missed Mounjaro dose guide and missed Wegovy pill dose guide, and the dose schedules for the Wegovy pill and Foundayo. If nausea returns, our nausea guide helps.
| Situation | What to do |
|---|---|
| Short gap (a missed dose or two) | Follow the missed-dose advice in your leaflet and speak to your prescriber if unsure |
| Gap of a week or more (Foundayo) | Contact your prescriber before restarting |
| Long gap on any medicine | Prescriber review You will usually restart at a lower dose and build up again |
These medicines are not recommended during pregnancy and should be stopped in advance of trying to conceive. Semaglutide (Wegovy) should be stopped at least two months before a planned pregnancy, and your prescriber will advise on timing for tirzepatide and orforglipron. Mounjaro can also reduce the effectiveness of oral contraceptive pills, which is covered in our Mounjaro and the contraceptive pill guide. If you become pregnant unexpectedly, stop the medicine and contact your prescriber or midwife.
Stopping Because of Side EffectsIf side effects are the reason, there may be options short of stopping, such as slower titration, a lower dose or practical measures. Our guides on nausea and constipation set these out, and the side effects guides for Mounjaro, Wegovy and Foundayo explain what is expected. Seek urgent help for severe abdominal pain, persistent vomiting or signs of an allergic reaction, and tell your prescriber if you stop for these reasons.
Stopping Because of CostIf cost is the reason, talk to your prescriber first. A lower licensed dose or a different treatment may be possible. Compare the total cost over your whole course using our guides on Mounjaro costs, Wegovy cost and whether it is worth it for Mounjaro or Wegovy.
Stopping Before SurgeryStopping before an operation is a separate decision made with your surgical and anaesthetic team. Current UK guidance does not recommend automatic stopping for everyone, so do not stop on your own. Tell your team and follow their written instructions.
The bottom line
Stopping is allowed and sometimes the right call, but it should be a plan, not a drift. Expect appetite to return, put your maintenance habits in place before the last dose, and agree a monitoring point with your prescriber. Talk it through with our team via our weight loss consultation, or browse the full guide library.
Thinking About Coming Off Treatment?
Our GPhC-registered pharmacy team can help you plan a safe step-down, switch or stop, with a maintenance plan built around you.
Start Your Free Online Consultation → Use code SWITCH10 if you're switching from another provider Happy Pharmacy is a GPhC-registered pharmacy (No. 9013192) — Superintendent Pharmacist: Palvinder Deol — Rated 4.8★ Excellent on Trustpilot- 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;331(1):38-48.
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24:1553-1564.
- BMJ Group. Stopping weight loss drugs linked to weight regain and reversal of heart health markers (2026 meta-analysis press release).
- Mounjaro® (tirzepatide) UK Summary of Product Characteristics, electronic Medicines Compendium (emc).
- Wegovy® (semaglutide) UK Summary of Product Characteristics, including pregnancy and discontinuation, emc.
- Foundayo® (orforglipron) UK Summary of Product Characteristics, emc.
- NICE. Tirzepatide for managing overweight and obesity (TA1026).