- GLP-1 medications work by reducing hunger, which leads to weight loss.
- When you stop taking GLP-1s, your appetite goes back up and weight can come back.
- Stopping and restarting involves talking to your health care team and gradual weaning.
GLP-1 medications like Ozempic, Wegovy and Zepbound are well-known for their powerful weight-loss benefits. However, while around 12% Americans use them and they are intended to be taken long-term, the majority stop taking them within a year.
“There are several reasons someone may not take a GLP-1 consistently, including cost, inconsistent access, manufacturer shortages or loss of coverage,” says Gretchen Zimmermann, M.B.A., RD, CDCES, CSOWM. Some may also hope that weight-loss results will be sustained without it.
But what actually happens when the medication is stopped? If you need to stop and restart a GLP-1, here’s what to consider and how to do it safely.
How GLP-1 Medications Work
Short for glucagon-like peptide-1, GLP-1s such as Ozempic have been around for over 20 years and were initially used to treat diabetes.
GLP-1s mimic a gut hormone that suppresses appetite and increases insulin secretion, lowering glucose (i.e., blood sugar) levels. Through these two main actions, GLP-1s can make it easier to stay in a calorie deficit to lose weight, while also improving metabolic health.
“The main way GLP-1 medications work for weight loss is at the gut to make you feel full and at the brain to make you less hungry,” says Carolynn Francavilla, M.D., MFOMA, DABOM. In doing this, GLP-1s send clear signals that you’re full, making it easier to eat less.
Many people taking GLP-1s report reduced appetite, less stress around eating and a significant suppression of “food noise,” described as constant, intrusive thoughts about food. These benefits and changes in eating habits can be life-changing for many people, but may not last if the medication is stopped.
What Can Happen If You Don’t Take a GLP-1 Consistently
Here are a few things you may expect if you don’t take a GLP-1 consistently.
Appetite Increase
When coming off a GLP-1, you’ll likely experience an increase in appetite. How quickly and how profoundly this occurs can vary from person to person.
“When levels of GLP-1 drop, the effects of the medication will start to wear off. It can take about five to seven weeks for it to wear off completely, so you may not experience this right away,” says Ana Reisdorf, M.S., RD. This is one reason why GLP-1s are intended to be a long-term treatment whenever possible, as the effects can wear off once you discontinue use.
Weight Regain
Weight regain is common after stopping GLP-1s, as appetite increases and the body tries to return you to your previous weight. Reisdorf says without the medication’s effects, calorie intake will gradually increase, and research shows that most people regain about two-thirds of what they lost within one year of stopping.
A phenomenon called metabolic adaptation occurs after weight loss, in which your metabolic rate (the number of calories you burn at rest) decreases to a greater extent than expected based on your new weight. This means fewer calories need to be consumed and a higher daily calorie burn (i.e., more exercise) may be needed to prevent weight regain.
Blood Sugar May Go Up
Since GLP-1s improve insulin resistance, inconsistent use can diminish their blood sugar–lowering benefits for those with diabetes.
“GLP-1s require consistent administration to sustain results, and inconsistent use can lead to wide variations in blood glucose levels,” says Chhaya Makhija, M.D., DipABLM. This may be especially important to monitor if you have diabetes, which is why Makhija recommends monitoring your blood sugar levels and consulting your prescribing physician.
Emotional Challenges
Coming off a GLP-1 may also lead to frustration if appetite and food noise return. In addition, fear of weight regain can occur when the medication is no longer suppressing your appetite, which can make some people feel defeated. Supportive behavioral strategies and professional help can be incredibly helpful in these cases.
Tips for Stopping or Restarting a GLP-1
If you need to stop and restart your GLP-1, here is how you can do it most safely.
How to Safely Stop a GLP-1
- Consult with your physician. Reisdorf recommends consulting with your health care provider when you’re ready to restart your GLP-1. Many doctors, including Francavilla, advise restarting at the lowest dose, as jumping back to your previous dose can cause more severe side effects, like nausea and vomiting. This allows your body and digestive system to readjust to the medication and can minimize the risk of side effects. The dose is then typically increased gradually every three to four weeks based on tolerance and your prescriber’s recommendations.
- Monitor for side effects. Side effects such as nausea, vomiting or constipation may occur when restarting a GLP-1, so it’s important to pay attention. Talking with your doctor or a registered dietitian who understands how to manage GLP-1-related side effects can help you proactively prepare for them. While they may not always occur, they are more likely to do so when first restarting a GLP-1 or when increasing the dose. “Just like when you first started, you need to give your GI system time to adjust again,” adds Reisdorf.
- Maintain healthy lifestyle habits. Zimmermann emphasizes the importance of maintaining healthy lifestyle habits, such as choosing nutrient-dense foods, hydrating and staying active. She says smaller, well-balanced meals throughout the day, such as lean protein and fiber-rich vegetables, make it easier to stay nourished and comfortable as your body readjusts to being on a GLP-1. “A goal of 150 to 300 minutes per week of moderate activity, such as brisk walking, along with strength training twice a week can be highly beneficial for maintaining weight,” she adds.
Meal Plan to Try
Simple 7-Day GLP-1-Friendly Meal Plan for Beginners, Created by a Dietitian
Our Expert Take
While GLP-1s are designed for long-term use, stopping and restarting them is possible with the right plan and support. Because appetite, weight and blood sugar levels may change when GLP-1s are paused or resumed, working closely with your health care team can help you navigate these transitions safely and most effectively.
