Most who stop semaglutide or tirzepatide restart or switch, study finds

Adults who stop taking injectable semaglutide (sold as Ozempic, Wegovy and Rybelsus) or tirzepatide (Mounjaro and Zepbound) often restart the drug or begin a different obesity treatment, and their average weight a year later changes little, according to a study published in the journal Diabetes, Obesity and Metabolism ^[1].

The study reviewed electronic health records from a large health system in Ohio and Florida covering January 1, 2021, through June 30, 2025. It included 7,938 adults who started injectable semaglutide or tirzepatide for obesity or type 2 diabetes between 2021 and 2023 and stopped the medication within 3 to 12 months. The average age was 55.7 years and 63.8% were female. In the study's definition, a patient had discontinued if more than 90 days passed between running out of a supply and the next fill ^[1].

In the year after stopping, 19.6% restarted the same medication and 35.2% received an alternative obesity treatment. That included 27.4% who started a different medication, 13.7% who had a lifestyle modification visit with a health professional and 0.6% who had metabolic and bariatric surgery. Patients could fall into more than one of those groups, so the figures do not add up to 100% ^[1].

Weight outcomes were measured two ways. Before stopping, patients treated for obesity had lost an average of 8.4% of their body weight, and patients treated for type 2 diabetes had lost an average of 4.4%. From the point of discontinuation to one year later, the average change was +0.5% (95% confidence interval 0.0% to 1.0%) for the obesity group and -1.3% (95% CI -1.6% to -1.0%) for the type 2 diabetes group ^[1].

The averages hide large differences between individuals. The authors described "considerable individual-level variability" in weight change after stopping. The analysis of individual variation included 3,810 patients, and the weight-trajectory analysis included 6,634. The median patient in the study had weight measurements recorded in 7 separate months ^[1].

Why it matters for patients

Weight regain after stopping a GLP-1 drug is often described as inevitable. In this group of patients, the average change over the following year was small — a gain of about half a percent for people treated for obesity. But that average is a mix. Some patients regained a substantial amount of weight and others did not, and the study reports only the average plus the observation that results varied widely, not the size of those swings ^[1].

The averages also reflect what happened after stopping, not just the effect of stopping. About one in five patients restarted the same drug and about one in three began some other obesity treatment. Patients who restarted or switched would be counted in the average alongside those who stopped treatment entirely, so the overall figure describes a group in which many people were still being treated in some form ^[1].

The study did not report why patients stopped their medication in the first place — whether cost, side effects, supply problems or a decision with their clinician played a role. It also measured weight and subsequent treatments, not health outcomes such as heart events, blood sugar control or quality of life. And the findings come from one health system's records, so they may not reflect patients in other settings. The paper discloses that several authors have financial ties to Novo Nordisk, Eli Lilly and other companies, including one author employed by Novo Nordisk ^[1].

What has not been reported

The study does not include data on the reasons for discontinuation, patient insurance status or out-of-pocket costs, and no information has been disclosed on how these results compare with people who never started a GLP-1 medication. The authors also did not report separate weight outcomes for semaglutide compared with tirzepatide. Whether the patterns seen here hold for newer drugs in this class, including oral options, has not been reported ^[1].