Stopping Ozempic doesn’t always lead to major weight regain, according to a large new study.
As injectable GLP-1 medications become increasingly popular, one question continues to come up: What happens when people stop taking them?
A new Cleveland Clinic study involving nearly 8,000 patients suggests that, in everyday clinical practice, stopping semaglutide or tirzepatide does not typically result in major weight regain. Researchers found that many patients either resumed treatment later or switched to other weight-management approaches, helping them maintain much of their progress.
The study is among the largest real-world investigations to date exploring treatment patterns and long-term weight outcomes after discontinuing GLP-1 medications. The findings indicate that many patients were able to maintain relatively stable weight over the following year through alternative therapies and structured lifestyle interventions.
Published in Diabetes, Obesity and Metabolism, the research provides additional perspective on earlier randomized clinical trials. Those trials reported that patients who stopped semaglutide (sold under the brand names Ozempic/Wegovy) and tirzepatide (sold under the brand names Mounjaro/Zepbound) regained more than half of the weight they had lost within 12 months.
The study was led by Hamlet Gasoyan, DS, Ph.D., MPH, of Cleveland Clinic’s Center for Value-Based Care Research.
“Our real-world data show that many patients who stop semaglutide or tirzepatide restart the medication or transition to another obesity treatment, which may explain why they regain less weight than patients in randomized trials,” Dr. Gasoyan said.
Real-World Results After GLP-1 Discontinuation
The retrospective cohort study followed 7,938 adults with overweight or obesity in Ohio and Florida. Participants had started injectable semaglutide or tirzepatide for obesity or type 2 diabetes and then discontinued treatment within three to 12 months. Researchers tracked the treatments patients pursued afterward and monitored changes in body weight over time.
Although weight loss outcomes differed from person to person, the overall results showed meaningful reductions in body weight:
- Patients treated for obesity lost an average of 8.4% of their body weight before stopping treatment and regained an average of 0.5% one year later.
- Patients treated for type 2 diabetes lost an average of 4.4% of their body weight before discontinuation and lost an additional 1.3% over the next year.
- Among patients treated for obesity, 55% gained weight during the following year, while 45% either maintained their weight or continued losing weight.
- Among patients treated for diabetes, 44% gained weight, while 56% maintained or continued losing weight.
Why Patients Stop Ozempic and Similar Drugs
Previous research from the same team identified two leading reasons patients discontinue these medications: side effects and financial barriers, including high costs or insurance coverage limitations. Cost and coverage issues were the most common factor.
Researchers also found that patients taking the drugs for diabetes were more likely to restart treatment than those using them for obesity. The difference appears to be linked to more reliable insurance coverage for diabetes medications.
Alternative Weight Loss Treatments After GLP-1 Drugs
Many patients sought other forms of treatment during the year after stopping their initial GLP-1 medication.
- 27% switched to another medication (including older-generation obesity medications or switching between semaglutide and tirzepatide)
- 20% restarted their original medication
- 14% continued treatment through lifestyle modification visits with healthcare professionals such as dietitians or exercise specialists
- Less than 1% underwent metabolic and bariatric surgery
Ongoing Obesity Care Remains Important
According to the researchers, the findings highlight the value of continued, personalized support for people managing obesity, even after they stop a medication.
“Many patients do not give up on their obesity treatment journey, even if they need to stop their initial medication,” said Dr. Gasoyan. “In our future work, we will examine the comparative effectiveness of alternative treatment options for obesity in patients who discontinue semaglutide or tirzepatide, to help patients and their clinicians make informed decisions.”
Reference: “Obesity Treatments and Weight Changes in Clinical Practice After Discontinuation of Semaglutide or Tirzepatide” by Hamlet Gasoyan, Rebecca Schulte, Christopher B. Boyer, Nicholas J. Casacchia, W. Scott Butsch, Phuc Le, Ali Aminian, Marcio L. Griebeler, Bartolome Burguera and Michael B. Rothberg, 12 March 2026, Diabetes, Obesity and Metabolism.
DOI: 10.1111/dom.70660
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