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While GLP-1 drugs like Ozempic, Wegovy, and Zepbound have reshaped weight management and diabetes control, research shows that many patients stop taking them after a year.
Research has shown that stopping these medications can lead to potential rebound risks, ranging from rapid weight regain to loss of cardiovascular protection.
Dr. Frank Dumont, internal medicine physician and executive medical director of Virta Health in San Francisco, spoke with Fox News Digital about why patients stop taking GLP-1, the potential risks and how to maintain progress afterward.
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Why do patients quit
Some patients may stop taking GLP-1 medications due to medical problems or side effects, while others prefer not to continue taking medications long-term, Dumont said.
Common side effects include nausea, vomiting, constipation and diarrhea.
“Those kinds of things can become bothersome enough that people have trouble eating enough food to be well nourished,” he told Fox News Digital. “It is important to work with your doctor to decide whether or not it is appropriate to continue taking the medication.”
Other serious side effects, such as acute pancreatitis, would result in immediate discontinuation of the medication.
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“We know it’s quite rare, but if the pancreas is involved, it’s not a good thing,” Dumont said. “It can be very serious. It can even be life-threatening.”
Some GLP-1 medications carry a warning about thyroid tumors based on animal studies, although the risk in humans remains unknown.
“When people take GLP-1 drugs, they lose weight, but they tend to lose both fat mass and lean muscle mass.”
These medications should not be used by people with a personal or family history of medullary thyroid carcinoma or a condition called multiple endocrine neoplasia syndrome type 2 (MEN 2).
Dumont outlined six potential risks that patients may face after stopping a GLP-1.
No. 1: Return of hunger and cravings
The most immediate side effect patients notice after stopping a GLP-1 is the return of intense cravings and a strong appetite spike, often called “food noise,” according to Dumont.
Many patients assume they can treat GLP-1 as a short-term prescription, taking the drug to reach a weight or blood sugar goal and then stopping, the doctor noted.
Hunger and cravings generally increase after stopping a GLP-1, the doctor explained. (iStock)
However, major medical organizations, including the American Medical Association (AMA) and the Obesity Medicine Association, classify obesity as a chronic disease that generally requires ongoing management.
“Unless you’ve significantly changed what you’re doing in terms of the types of foods you’re eating, it’s likely you’ll go back to the same foods you were eating before, and hunger and cravings will increase,” Dumont said.
No. 2: Weight regain
According to Dumont, it’s typical for GLP-1 users to regain weight after quitting smoking.
In the STEP 1 trial extension, participants regained about two-thirds of the weight they lost within a year of stopping semaglutide and lifestyle interventions.
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In the SURMOUNT-4 trial of tirzepatide, patients who switched to a placebo after 36 weeks of treatment regained more than half of the weight they lost over the following year, even when receiving diet and exercise counseling.
“It’s so devastating for people who felt like they finally found a solution that would work,” Dumont said.
No. 3: Modification of biomarkers
Biomarkers — which are measurable indicators of what’s happening inside the body, like blood sugar, blood pressure, and cholesterol levels — tend to improve when taking a GLP-1, which is beneficial for people with prediabetes or diabetes.
When a GLP-1 is shut down, these markers can reverse if not countered by a change in diet, according to Dumont.
Early trials showed that people regained more than two-thirds of the weight lost while taking a GLP-1 within a year of stopping the drug. (iStock)
Improvements in fatty liver disease may also fade after stopping treatment, the doctor said.
“We know that these medications can help reduce some steatotic or fatty liver diseases,” he noted. “And when you stop taking medication, if you go back to eating like you used to, those numbers tend to get worse.”
No. 4: Deterioration of body composition
Weight loss while taking GLP-1 medications can include muscle loss, raising concerns about long-term body composition and physical function, according to Dumont.
“When people take GLP-1 drugs, they lose weight, but they tend to lose both fat mass and lean muscle mass,” he told Fox News Digital.
In a body composition study of tirzepatide, approximately 25% of the weight lost was lean mass, which includes muscle and other non-adipose tissue. The remaining 75% was fat.
Dumont expressed concern that patients who regain weight after stopping treatment may not completely replace the muscle they lost.
Studies have linked GLP-1 to a reduced risk of chronic diseases like cardiovascular disease and stroke. (iStock)
“So there is a slight reduction effect if someone is on and off these medications, where they lose fat and muscle, stop the medication, gain fat back, take the medication again, and lose fat and muscle,” he added.
The doctor emphasized that muscle preservation is important for metabolism, injury prevention and daily activities.
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No. 5: Effects on mental health
In addition to the physical consequences, Dumont stressed that stopping a weight-loss medication can have serious consequences on mental health.
Many patients have spent years following diets and programs without lasting success, often viewing GLP-1 as a final solution, according to the doctor.
In addition to the physical consequences, the doctor noted that stopping a weight loss medication can have serious consequences on mental health. (iStock)
When the medication doesn’t work for them — coupled with a history of weight loss setbacks — experiencing “regression on all fronts” can be “really devastating from a mental health standpoint,” Dumont said.
“It can make you feel discouraged and feel like you don’t have the control you thought you did,” he added.
No. 6: Loss of health protection
An observational study published in BMJ Medicine found that adults with type 2 diabetes who stopped GLP-1 treatment had a higher risk of major cardiovascular events than those who continued. Longer periods without treatment were associated with higher risk.
Dumont noted that the issues of stopping GLP-1 go well beyond weight, highlighting the broader risk of losing metabolic benefits.
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By taking a GLP-1, decreased inflammation and improved cholesterol and blood sugar levels help reduce the risk of major events like heart attacks and strokes, the doctor said.
“But again, if you stop treatment and you haven’t changed the way you’re eating, then all of these numbers can get worse… and that can then increase the risk of these bad things happening – things that can be devastating from a quality of life perspective, but can also shorten your life,” he warned.
“GLP-1 is not the only solution,” explains the doctor. “This needs to be combined with…a way of eating that will work for you in the long term and allow you to successfully come off the medication if you need to.” (iStock)
Make your progress last
According to Dumont, achieving metabolic goals and making lasting lifestyle changes can help patients maintain their progress after stopping GLP-1.
“We actually have published, peer-reviewed data showing that you can actually stop one of these medications when you reach your metabolic goals,” he said.
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The Virta-affiliated observational study examined selected patients with type 2 diabetes as part of a structured nutrition program. Therefore, the results may not apply to all GLP-1 users.
The doctor recommends adopting sustainable eating habits before stopping GLP-1.
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“GLP-1 is not the only solution,” he said. “This needs to be combined with…a way of eating that will work for you in the long term and allow you to successfully come off the medication if you need to.”
Dumont recommended working with the prescribing clinician on a plan to stop treatment and then monitoring weight and blood sugar.
Gn Health
