Countless people have found success losing weight with the help of GLP-1 drugs. The gratification that comes with goals accomplished can give way to uncertainty if and when it comes time to wean off medication.
For many people, GLP-1s provide safe, meaningful weight loss. However, cost often drives people to ask about stopping them, not necessarily because their disease is “cured,” says Dr. Benjamin Duffy, an obesity medicine specialist and director of the ThedaCare Weight Wellness Solutions program.
GLP-1s 101
GLP-1s are a group of medications that include drugs like Ozempic and Wegovy (semaglutide) along with Zepound and Mounjaro (tirzepatide). They were designed to help manage blood sugar and glucose levels in people with type 2 diabetes. Later, they were also discovered to slow digestion and suppress appetite. This can help people eat less, and therefore help treat obesity.
ThedaCare Weight Wellness Solutions offers the support of a whole team, including an obesity medicine specialist. This physician can help determine if a GLP-1 is a good option for a person, how long they should stay on it, and what support and treatments or medications they may need after stopping the drug.
Potential for Regain
“In Wisconsin, the average amount of time a person takes GLP-1s is seven months,” Dr. Duffy says. “After that, they often discontinue the drug or switch to a lower, maintenance dose.”
Some early studies suggest that a portion of patients may hold their weight loss for a time after stopping, but many will see weight regain if they stop with medication. That’s because obesity is not a temporary problem, but rather a chronic, lifelong disease, Dr. Duffy says.
“Like blood pressure or cholesterol disorders, most patients will need some form of ongoing treatment,” he continues. “That might mean staying on GLP-1s long-term or transitioning to another medication strategy. Trying to stop these medications too soon, or for the wrong reasons, can carry real risks.”
Medical Oversight
In a monitored setting, Dr. Duffy likes to see people on GLP-1s lose 1 to 2 pounds per week. At the same time, his team works with individuals on diet and lifestyle changes. If weight loss is too rapid in the beginning, it can cause unpleasant side effects. These can include hair loss, saggy skin and loss of muscle mass.
If a person abruptly stops GLP-1s, they may regain between 50% and 80% of the weight they lost. This is because the medication suppresses the appetite and metabolism. A sudden halt causes a spike in appetite while metabolism lags behind — a perfect storm that can cause rebound weight gain.
Dr. Duffy and his team take a more measured approach.
“We help people taper off their treatment dose over about two months so that as their appetite slowly increases, so does their metabolism,” he says. “We can use oral medications to suppress appetite during this phase, too, and it’s proven to be very successful.”
Body Composition Beyond BMI
Individuals in the ThedaCare Weight Wellness Solutions program start with a complete body composition analysis. This measures their muscle mass and notes the position and types of fat deposits in their body.
“Patients may come to us with a goal weight or BMI (body mass index) in mind,” Dr. Duffy says. “We help them set an overall metabolic goal that emphasizes building muscle mass so they gain health as they lose weight. It’s not just about a number on a scale — it’s so much more than that.”
Coaching for Success
Allie Hatley, a health coach with the ThedaCare Weight Wellness Solutions team, ramps up her support for patients as they begin to wean off GLP-1s.
“We want these changes to feel realistic and sustainable, not overwhelming,” she says. “A person should feel supported and not alone.”
Starting with weekly or biweekly meetings, people may work with the health coach to learn about:
- Victories beyond the scale, including recognizing the health benefits that come from weight loss and how feeling better can help people live more fulfilling lives.
- Embracing an active lifestyle, both exercise and beyond. All kinds of movement have merit. These can include completing home chores, running errands and having energy to pursue hobbies.
- How to handle out-of-the-ordinary situations or other high-risk circumstances, like going on vacation, dining out or holiday celebrations.
- Challenging negative thought patterns that people have been conditioned to believe.
Bottom Line
“GLP-1s can be life-changing, but they are not a cure,” Dr. Duffy says. “Obesity is a lifelong disease, and most patients will need ongoing treatment. That could be continuing a GLP-1, transitioning to another medication, or leaning on a full care team. The key is staying connected to expert support and recognizing that health is a journey, not a finish line.”
There’s no universal experience for people who come off a GLP-1, and setbacks and weight regain are common. Dr. Duffy likens obesity to cancer, a condition that requires more intensive treatment at the outset, followed by close monitoring over the longer term.
“There can be flare-ups, like injuries that prevent exercise or new prescriptions that cause weight gain,” he says. “Our team is here if we need to intervene.”
Hatley also reminds people that setbacks should not cause guilt or shame.
“Let’s shift into curiosity mode and treat it as a slip-up, not a defeat,” she says. “I always say, if you have a flat tire, you fix the tire. You don’t slash the other three. Let’s make that fix and keep going.”
