Stopping GLP-1 therapy leads to regain of most lost weight and reversal of cardiometabolic improvements.
- Current status
- EstablishedEvidence stable · Discontinuation
- Why
- STEP 1 extension (exploratory, n=327): one year after stopping semaglutide, participants regained two-thirds of their prior weight loss, and cardiometabolic improvements reverted towards baseline for most variables. SURMOUNT-4 (randomized withdrawal of tirzepatide): weight rose 14.0% after switching to placebo, ending 9.9% below starting weight; it reports no cardiometabolic outcomes. Implies indefinite treatment is needed to maintain effects.
- What would change it
- Evidence that intermittent or tapered dosing maintains benefits.
- Linked studies
- 2 · 2 supports
- Last updated
- Oct 19, 2026
The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.
01The evidence
The evidence, sorted by what it shows
Supports (2)
- Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical TrialRandomized trial · 2024 · Study tier 1 · Different population · Benefit · Industry funded
SURMOUNT-4 randomized withdrawal in adults with obesity or overweight without diabetes: after 36 weeks of tirzepatide (mean loss 20.9%), switching to placebo gave a 14.0% weight gain from week 36 to 88 vs a further -5.5% with continued tirzepatide; the placebo group stayed 9.9% below starting weight (25.3% with tirzepatide). The abstract reports no cardiometabolic outcomes.
- Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extensionRandomized trial · 2022 · Study tier 2 · Different population · Harm direction · Industry funded
STEP 1 extension, n=327 exploratory.
02History
How this assessment has changed
- EstablishedOct 19, 2026 · Evidence stable
Owner decision 2026-10-18 on IN-061 (claims audit): recommended options accepted (IN-061.35). Status unchanged; rationale corrected to match the audited links.
- EstablishedSep 13, 2026 · Evidence stable
initial curated status