After months and months of touting the virtues of Glucagon-Like Peptide-1 Receptor Agonists, GLP-1’s, medical researchers have turned their focus instead to what happens to patients after they stop taking these drugs. I have written about this feature before, but the subject has almost become an obsession with medical writers. There has been overwhelming, blind acceptance of these drugs because of the significant weight loss they cause, and the American public’s perpetual concern over obesity and the need to lose weight. GLP-1’s do work, and in my opinion reached the status of “wonder drugs.” But patients have painted themselves into a corner from which GLP-1’s will not let them escape.
The “corner” to which I refer is the inescapable regaining of weight once a patient is no longer taking a GLP-1. Regaining weight is a real concern for patients because it happens universally when the drugs are not taken. Fifty percent of obese patients discontinue a GLP-1 within a year of starting it, so regaining weight affects a lot of patients. They stop because of cost, the inconvenience of giving oneself a shot daily or weekly, or they experience adverse effects. But stopping always results in weight gain and loss of the cardiometabolic benefits afforded by GLP-1’s. In fact, after stopping terzepatide and semaglutide, the return to baseline weight takes an average of 1.7 years with a monthly regain average of 0.4 kg (.88 lbs).
In another research setting, a study evaluated 1776 patients who lost an average of 14.7 kg (32.34lbs). When they stopped the GLP-1 drug, they regained an average of 9.9 kg (22 lbs) with an average monthly gain of 0.8 kg (1.76 lbs).
Cardiometabolic benefits, which include fasting blood sugar (FBS), HbA1c, diastolic blood pressure, Total Cholesterol (TC) and Triglyceride (TG), are lost much sooner with stopping GLP-1’s. In fact, these tests, which are measures of the control of diabetes, can revert to baseline levels almost immediately. One doesn’t cure diabetes, but merely controls it through replacement of insulin or the addition of other biochemical stimuli. The average time to return to baseline weight takes 1.4 years, but as mentioned, some parameters change much faster.
Obesity is “a chronic relapsing condition” as is seen by the “yo-yo” ups and downs of peoples’ weight. A person can gain 30 pounds, go on a diet, lose it, only to gain it back. GLP-1’s perpetuate that cycle, unless they are taken continuously.
The “Greater weight loss tends to result in faster weight regain.” “People return to their baseline weight and lose all cardiometabolic benefits in less than 2 years after stopping semaglutide or terzepatide….GLP-1’s should not be relied on as a magic cure for treating obesity.” A healthy diet and lifestyle practices should be practiced to maintain one’s weight. Time will tell what to expect from GLP-1’s. We know they work, and we know they have many drawbacks. It’s very possible, however, that these problems can be corrected so GLP-1’s don’t have negative stigma hounding them. The last paragraph of my reference says “it’s incredibly important we look at…..the data….look at what happens in the longer term.”
Dr. G’s Opinion: I believe in these drugs. They are really no different than insulin in that to maintain control they have to be taken in perpetuity. If the cost comes down, that won’t be an issue. Nobody balks at taking insulin every day. Why should they with GLP-1’s?
Reference: Tucker, ME. Weight Regain, Health Benefit Loss Rapid When GLP-1’s stopped Medscape 2026 January 8.
