GLP-1 drugs are truly worthy of being called miracle drugs because of the massive societal impact they have had, and because of the American public’s desire to lose weight. Who doesn’t know someone who is on “the fat shot,” as these drugs were once known? They are incredibly popular and have fattened (pun intended) the profits of the pharmaceutical companies who have developed and sold them. The fact that these drugs are expensive and are administered as a weekly injection has not deterred patients from buying them and enjoying the results of taking them.
The one undeniable fact remains that when GLP-1 drugs are stopped, patients consistently regain weight and lose the cardio-metabolic benefits. GLP-1’s must be continued long term or the reason for taking them (to lose weight) is completely negated. Scientific study after study has proven this. A 2022 study funded by Novo Nordisk pharmaceutical company showed that one year after stopping semaglutide, the 327 study participants regained an average of two-thirds of the weight they had lost and blood pressure and lipid levels had returned to their previous values. And a 2026 study by Eli Lilly showed that reducing the dose of Tirzepatide can maintain weight loss in obese adults (keep them at the same weight), but discontinuing it caused significant weight regain.
In 2011, the early days for GLP-1’s, the New England Journal of Medicine published a study that showed “a 14% weight loss produced persistent changes in the nine appetite-regulating hormones which increased significantly and remained elevated for 1 year after weight loss” and promoted weight regain.
Another Novo Nordisk study reported that patients 45 years and older with pre-existing cardiovascular disease, a BMI of 27 or greater, and who were not diabetic, reported a 20% reduced risk of CV events after taking semaglutide.
Well, then, should GLP-1’s be considered long-term therapy? My answer is, “YES.”
It has been shown that if lifestyle changes are practiced strictly during weight loss, and if they become ingrained in the patient’s life routine, highly disciplined patients can maintain weight loss after stopping GLP-1’s. However, if the patient is severely obese, they should remain on GLP-1 if they can afford it.
GLP-1’s, and the resultant weight loss, improve self-esteem, appearance, and quality of life. Anyone prescribed a GLP-1 should also practice lifestyle changes. The chances for successful weight loss are greater if both are in use.
Other advocates recommend an individualized approach with dose reduction or very gradual discontinuation to help patients maintain their weight loss. But human nature being what it is, a lot of patients’ uncontrolled appetite will return and all will be lost. But there is no question that to maintain the weight loss you have achieved, the patient needs to continue a GLP-1. How long? At what dose? This is an individual decision based on trial and error. If you lost weight continually on 10 mg a week, your options are to continue 10 mg but take it every 8-10 days. OR reduce the dosage strength to 7.5 mg per week to keep weight at a baseline level.
There are three main situations that may necessitate discontinuation of a GLP-1:
Unaffordable cost—at $500 to $1000 per month, one must be serious about taking it and
make an effort to lose weight.
Lack of response—no weight loss or poor weight loss, ineffective at lowering blood sugar.
Complications during use—many side effects
Pancreatitis, reflux esophagitis, colitis, severe constipation
From personal experience, I can say that Zepbound slows just about every digestive activity. My stomach and lower intestinal activity slow to a snail’s pace. These problems manifest themselves by slowed swallowing and constipation which are annoying more than anything.
My recommendation is once started, a GLP-1 should be continued if tolerated and affordable. You will regain the lost weight if you don’t, and no one wants to spend their last days fighting to stay slim.
Reference: Castilhos W. Can obesity treatment with GLP-1 drug last Forever? Medscape.com, 2026. September 15.
