How long would you need to jab yourself...and contend with the cost? Two MDs specializing in weight loss and endocrinology share how it works.
About the experts
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Highlights
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When it comes to weight-loss medications, a January 2025 study published in the American Medical Association’s JAMA Network Open reported that 54% of people stop taking GLP-1 medications, such as Ozempic or Wegovy, within one year; while 72.2% discontinue by two years.
Jennifer Brown, MD, a physician certified in obesity management, confirms this pattern as an observation in her practice. “About half of people taking GLP-1s for weight loss stop within a year, usually because of the cost, side effects, or their unwillingness to stay on the medication long-term,” she explains.
The study’s researchers noted that people without type 2 diabetes have higher discontinuation rates (nearly 65% after one year) compared to those with diabetes (46.5% after one year). This makes sense, as many of the drugs in this class are specifically indicated for long-term type 2 management.
Ahead, Dr. Brown and another physician specializing in obesity management, Meena Malhotra, MD, unpack what patients should know before going off a GLP-1.
The real reasons people quit
If you’re thinking about stopping, then you already know it can get complicated fast. Side effects are the most common reason people quit, accounting for 28.2% of cases, according to a 2025 report from Truveta Research. Cost is another major hurdle—especially since many insurance plans don’t cover these medications for weight loss alone, leaving you to pay hundreds or even thousands a month out of pocket.
But there’s a deeper issue at play. “Many patients, and even some healthcare providers, still have the idea that being overweight is a short-term problem that has a quick fix,” Dr. Brown says. In reality, obesity is recognized by the U.S. Centers for Disease Control and Prevention (CDC) as a common, serious, and costly chronic disease. Just as other chronic conditions like diabetes and hypertension call for ongoing management, obesity can, too.
What really happens when you stop
Lost in the fanfare around these groundbreaking interventions is the part that perhaps few people readily talk about: what happens when you stop taking GLP-1 medications? According to the landmark STEP 1 trial published in Diabetes, Obesity and Metabolism, people who stopped semaglutides regained about two-thirds of their weight within one year. That said, outcomes vary widely from person to person.
A 2024 Epic Research study involving more than 20,000 patients found that about 18% regained all their weight or more after stopping such medications. On the flip side, more than half of people either maintained their weight loss or continued losing weight. The rest fell somewhere in between. The study also found that for every one percentage point of weight gain after stopping, the likelihood of restarting the medication increased by 2.3% to 2.8%.
Navigating these notions, Dr. Brown says the decision to quit, and when, can come with some struggle. “Some patients do get upset if they have to stop their GLP-1 because of side effects or insurance coverage issues, because they know how quickly they can regain weight,” she says.
So, what’s the solution? The key is using these drugs as a tool to build better habits, not as a magic cure-all. “A lot of my patients use GLP-1s as a short-term therapeutic tool while they work on nutrition, strength, and gut health—the habits that make the results last,” Dr. Malhotra explains. When you establish healthy weight loss habits during your time on the medication, you’re giving yourself a better chance at keeping the weight off.
Doctors’ cautions about “cycling”
Both Dr. Brown and Dr. Malhotra say it’s fairly common for people to stop and restart taking these medications. “Many people cycle on and off GLP-1s,” Dr. Brown says. “They lose significant amounts of weight, then stop taking the medication. Within a few months, they have regained weight and start back on a GLP-1.”
Dr. Malhotra agrees, saying that some of her patients might come off the medication, then restart it if they notice appetite or insulin issues returning.
But is cycling on and off actually a good idea? Not so fast, says doctors, warning the practice can come with real health risks. Research has shown that weight cycling—repeatedly losing and gaining weight—can increase your risk of heart attack, muscle loss, and regaining more fat than muscle when the weight comes back.
There’s also a practical problem to consider: When you restart a GLP-1 after being off for two weeks or more, your body has readjusted, so jumping back to your previous dose can trigger severe gastrointestinal side effects. These medications were designed for long-term continuous use, not for stopping and starting around life events—though that doesn’t mean you can’t stop if you need to, just that cycling repeatedly isn’t ideal for your health.
Only a small percentage of patients view these medications as a long-term solution. “In my experience, some patients—around 20%—realize obesity is a chronic disease and plan to stay on medication long term,” Dr. Brown says. Dr. Malhotra sees similar patterns: “Around a quarter of my patients end up staying on a lower ‘maintenance’ dose long term, particularly those with more advanced insulin resistance or type 2 diabetes.”
For these patients, staying on the medication isn’t giving up—it’s smart management. Think about it this way: “If a patient with hypertension stops taking their medicine, their blood pressure goes up,” Dr. Brown explains. “The same thing happens when a patient stops taking their weight loss medication—their weight goes back up.”
Experts weigh in about stopping
Whatever your reason, if you need to stop taking a GLP-1, the most important thing—after talking with your healthcare provider for personalized advice and recommendations—is to do it gradually, according to Dr. Malhotra. “Yes, always taper,” she says. “I never have patients stop suddenly, it’s important to give the body time to readjust.” She typically lowers the dose gradually or extends the time between doses, depending on the medication.
During the tapering period, Dr. Malhotra doubles down on other healthy habits. “We focus on blood sugar stability, protein intake, hydration, and resistance training,” she explains. “This prevents rebound hunger or fatigue once the medication is out of the system.”
But here’s the reality check—successfully stopping without regaining weight is rare. “I have had a handful of patients who were able to gradually stop taking GLP-1s without regaining weight, but this is not typical,” Dr. Brown says. There’s currently no evidence-based protocol that guarantees you’ll keep the weight off after discontinuing these medications.
The truth about “microdosing”
You’ve probably heard people talking about taking tiny “microdoses” to maintain their results without staying on the full medication dose. According to Dr. Brown, “Microdosing has not been shown to be an effective strategy.” However, Dr. Malhotra has a different take based on her practice: “Microdosing can be very helpful for maintenance once someone has stabilized their habits and body composition.”
This highlights just how personalized this treatment needs to be for individual patients. Dr. Malhotra’s approach focuses on using lower doses once you’ve already established strong lifestyle habits, while Dr. Brown emphasizes that effective obesity management typically requires a therapeutic dose that actually works. The takeaway? What works for one person might not work for another, which is why working with a doctor who knows your specific situation is so important.
Does it matter which medication you’re taking?
When it comes to stopping GLP-1 use, does it matter if you’re on Ozempic, Wegovy, Mounjaro (tirzepatide), compounded semaglutide, or the oral form, which is emerging? (We also tried a probiotic that can lead to similar effects as a GLP-1 drug.)
A little bit, the experts say, but maybe not as much as you’d think. The same general principles apply across the board. “Yes, it’s the same for all types of GLP-1s, including oral forms,” says Dr. Brown. “They all basically work in the same way.”
Dr. Malhotra points out some small but noteworthy differences: “Tirzepatide works on two hormonal pathways, so I tend to taper that a bit slower. With compounded semaglutide, consistency and purity can vary, so we move more cautiously. The oral form tends to clear the system faster, so adjustments can happen more quickly—but even then, I recommend a gradual step-down so metabolism has time to recalibrate.”
The bottom line
If you’re considering discontinuation, you might be wondering how other people have handled it emotionally. Just like outcomes, reactions are case-by-case. “Many patients are resistant to taking lifelong medication for weight management, so they’re very unhappy when they realize there’s no easy way to stop taking GLP-1s without weight regain,” Dr. Brown says.
The experience may not be as negative with the certain precautions. Dr. Malhotra finds that when patients prepare properly, the experience can actually be empowering. “Many feel proud because they’ve learned how to eat and move in a way that supports their body,” she says. “But it’s also normal to feel a little anxious about whether the progress will remain.” She says this is why she puts such an emphasis on preparation before tapering as a way of helping the transition off the medications be smooth and sustainable.
What matters most is having a plan that works for your life. Work closely with your healthcare provider to figure out what’s sustainable for you, and remember this important truth: obesity is a chronic condition, just like diabetes or high blood pressure. Sometimes chronic conditions need ongoing treatment. There’s no shame in needing medication to manage your health—what matters is finding an approach that helps you feel your best.
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