Rebound weight gain after stopping GLP-1 RAs

Stopping weight loss drugs is followed by weight regain and reversal of beneficial effects on heart and metabolic health markers such as high cholesterol and high blood pressure, finds a study published by The BMJ.

It shows that the average rate of weight regain is 0.4kg/month after stopping treatment, with weight and risk markers for diabetes and heart disease predicted to return to pre-treatment levels in less than two years.

It also finds that the rate of weight regain after stopping weight loss drugs is almost 4 times faster than after diet and physical activity changes, irrespective of the amount of weight lost during treatment.

The development of highly effective weight management medications such as glucagon-like peptide-1 (GLP-1) receptor agonists including semaglutide and tirzepatide has transformed the treatment of obesity.

Yet it is estimated that around half of people with obesity discontinue GLP-1 drugs within 12 months.

‘This evidence suggests that despite their success in achieving initial weight loss, these drugs alone may not be sufficient for long term weight control,’ say the researchers.

A linked editorial states: ‘People taking GLP-1 receptor agonists should be aware of the high discontinuation rate and the consequences of cessation of medications. Healthy dietary and lifestyle practises should remain the foundation for obesity treatment and management, with medications such as GLP-1 receptor agonists used as adjuncts.

West S, et al. BMJ 2026;392:e085304

https://www.bmj.com/content/392/bmj-2025-085304