Quitting your weight-loss shot? What keeps the weight off

GLP-1 drugs like semaglutide and tirzepatide have changed how people talk about weight loss. Plenty of people don't stay on them for life, though. The cost adds up, the side effects wear on them, or they simply hit their goal. That's when the question few people ask at the start shows up: what happens once you stop?

In September 2026, Women's Health ran a guide on keeping the weight off after quitting these drugs, and the doctors it quoted agreed on one point: the hunger comes back. Below is how much weight tends to come back with it, how fast, and what changed the outcome in a trial that followed people for a full year after treatment ended.

The weight comes back, and it comes back fast

A meta-analysis by West and colleagues at the University of Oxford, published in the BMJ in January 2026, pooled 37 studies covering 9,341 adults with overweight or obesity who had stopped a weight-loss drug. On average, they'd been treated for 39 weeks and were then followed for 32 weeks.

Once the drug was gone, weight crept back at about 0.4 kg (roughly 0.9 lb) a month. That doesn't sound like much. It just doesn't stop. The gains in blood sugar, blood pressure and cholesterol were projected to slide back to where they started within 1.4 years.

Faster than after a diet

The same review compared that rebound with what happens after people finish a weight-loss program built on diet and habits, with no medication. After the drugs, weight returned 0.3 kg a month faster, and that gap held no matter how much weight people had lost in the first place.

The authors land on caution. Using these drugs short term, without a broader plan for managing weight, comes at a cost once they're withdrawn. That isn't the same as saying the drugs don't work. It means their effect leaves when they do, and what lasts is whatever you built around them.

A trial that checked back a year later

What the meta-analysis can't tell you is how to keep it from happening. That's where a University of Copenhagen trial comes in, published in 2021 in The New England Journal of Medicine.

Adults with obesity and without diabetes first lost an average of 13.1 kg on an eight-week low-calorie diet. Then came a year of randomly assigned plans. Some did a moderate-to-vigorous exercise program, some took a daily injection of liraglutide (a drug from the same family as semaglutide), some did both, and the rest got a placebo. By the end of that year, exercise plus the drug had held on to the weight loss best.

Once everything stopped, the exercise still showed

The more telling part came later. In 2024, Jensen and colleagues reported in eClinicalMedicine how people were doing a year after treatment ended, and 109 participants came back to be measured.

Over that year with no treatment at all, people who'd taken only the drug regained 6.0 kg more than people who'd done only the supervised exercise. And compared with the drug-only group, those who'd combined drug and exercise had lost 5.1 kg more since randomization, with body fat 2.3 percentage points lower. The authors' summary: weight and body composition held steady a year after supervised exercise ended, which wasn't the case after stopping the drug alone.

What these studies don't tell us yet

Start with who was studied. The Danish trial enrolled adults aged 18 to 65 with obesity, and the drug was liraglutide, not semaglutide or tirzepatide. It's reasonable to expect exercise to help the same way with those, but nobody has measured it.

Then there's size. Only 109 people made it to the final follow-up, split across four groups, so the numbers come with wide margins of error. And there's funding: the trial was paid for by Helsefonden and the Novo Nordisk Foundation, and several authors report ties to Novo Nordisk, the company that makes liraglutide.

The meta-analysis has its own limit. Follow-up was short, 32 weeks on average, so how far the rebound goes after that is estimated with models rather than observed patient by patient. Any one person may do better or worse than the average.

One more caveat, raised by Danish science journalists when the trial came out: in the study's own graphs, every group regains some weight after treatment ends, including the people who exercised. Exercise didn't erase the rebound. It made it a lot smaller.

If you're on one of these drugs, start training now

The takeaway is about timing. Exercise isn't something to save for the day you come off the drug. You start while you're still on it. In the Danish trial, what made the difference was a year of exercise done during treatment. Strength work also matters for another reason, which we cover in what happens to your muscle when you lose weight fast.

Pick a routine you can actually keep: moderate-to-hard cardio plus strength sessions, several days a week. In the trial it was supervised, and that counts for a lot, because someone expecting you makes it harder to skip. If getting started is the hard part, here's how to build a gym habit that lasts.

If you train at Gym Triple X, two strength days and one or two cardio days fit into a normal week. When and how to stop the drug is your doctor's call. One of the doctors Women's Health spoke with advises against quitting cold turkey and suggests talking with your doctor about tapering the dose instead.

Coming off a treatment without losing what you've gained is easier when someone is watching your weeks from the outside. If that sounds useful, a personal trainer on the Costa del Sol can see you through that stretch.