Two things, in order. What happens if you stop: on average, people who stopped or were switched to placebo regained about half to two-thirds of the weight they had lost within about a year (STEP 1 extension, STEP 4, SURMOUNT-4), shown here as study examples applied to your weight, not a prediction. Then how maintenance works: a calorie range that allows for the slower metabolism some weight-reduced bodies show, and five habits linked with keeping weight off.
STEP 1 extension (semaglutide 2.4 mg, a subset of 327 people): after 68 weeks people were 17.3% below their starting weight on average. At week 68 the drug and the trial's lifestyle program both stopped. One year later they had regained about two-thirds of that loss, ending 5.6% below their starting weight. This study had no group that kept taking the drug.
STEP 4 (semaglutide 2.4 mg): everyone took semaglutide for 20 weeks and lost about 10.6%, then half were switched to placebo. Over the next 48 weeks the placebo group gained 6.9% of their week-20 weight and those who stayed on lost a further 7.9%. Diet and activity counselling continued for everyone throughout.
SURMOUNT-4 (tirzepatide 10 or 15 mg, 670 adults randomized): after 36 weeks of tirzepatide people were about 20.9% below their starting weight. Over the next 52 weeks those switched to placebo gained 14.0% of their week-36 weight, and those who stayed on lost a further 5.5%. Measured from the start of the trial, that is 9.9% below starting weight with placebo and 25.3% below with tirzepatide. Lifestyle counselling continued throughout.
All three point the same way for semaglutide and tirzepatide: on average, weight comes back after the drug stops. These medications treat the condition while you take them. Sources: Wegovy and Zepbound prescribing information (§14); Wilding et al., Diabetes Obes Metab 2022; Rubino et al., JAMA 2021; Aronne et al., JAMA 2024.
What the trials do not tell you
They do not show regain is inevitable for you. In STEP 4 and SURMOUNT-4, people switched to placebo kept receiving the trial's diet and activity counselling and still regained weight on average; in the STEP 1 extension the drug and the lifestyle program stopped together. None of these trials tested a dedicated maintenance plan after stopping, so they cannot tell you what such a plan would do. Individual results varied widely.
Observational work on people who kept large losses off without drugs, best known the National Weight Control Registry, consistently finds high physical activity, regular self-weighing and consistent eating patterns. That is association, not proof. None of those studies were in people coming off a GLP-1.
The figures above are group averages from those trials: a reference point, not a prediction for you.
They also cannot say what a lower dose would do, and this page does not model it. Dose is a decision for your prescriber.
How maintenance works
Obesity medicine treats this like blood pressure, not a course of antibiotics. Many people stay on a maintenance dose long term, some step down with their prescriber, and some stop and hold with structure; all legitimate. The trials compared stopping with continuing; they did not test structured maintenance plans after stopping.
Maintenance calorie range (allowing for metabolic adaptation)
Some studies find that a body which has lost weight burns fewer calories than the formula predicts, by up to about 15% in small metabolic-ward studies (Leibel et al., NEJM 1995), but this varies a lot between people, and the formula itself has an error for any one person. So the calculator shows a range, not a single number. Your weekly average weight over three weeks is the real test; adjust with your clinician or a dietitian.
Five habits linked with keeping weight off in observational studies
1. A trigger weight
Pick a number 3–5 lb above where you settle and weigh weekly. Cross it two weeks running → act: tighten protein, log for a week, talk to your prescriber.
2. Resistance training, twice a week
Resistance training may help preserve or build strength and lean mass while your weight changes. Two 30-minute sessions a week with compound lifts or machines is a common starting point.
3. Protein stays where it was
1.2–1.6 g per kg of goal weight still matters after the scale stops moving. Protein gives the most satiety per calorie, and appetite comes back when the drug goes.
4. Steps, not "cardio"
People in the National Weight Control Registry report about an hour a day of moderate activity, mostly walking (self-reported, observational). A daily step count of a few thousand more than you do now is a practical rule of thumb, not a tested threshold.
5. Watch liquid calories; pick a meal pattern you can keep
Drinks with calories tend to be less filling than the same calories from food. Most people in the National Weight Control Registry report eating breakfast, but a randomized trial that told people to eat or skip breakfast found no difference in weight (Dhurandhar et al., Am J Clin Nutr 2014). Use whatever meal timing keeps your hunger manageable.
Stepping down the dose
Some prescribers taper (e.g. 2.4 → 1.7 → 1 mg over months) or stretch the interval. Data is early, and neither label gives a taper schedule; the idea is to let appetite return gradually once the habits above are in place. Not something to do alone.
Set the habits up now: the weekly habit tracker covers these and saves on your device. Eating for maintenance is the "stopped" setting on the meal planner.
This is an arithmetic tool built on published group averages, not medical advice or a prediction for any individual. It is not a reason to stop, continue, or change a prescription; that decision belongs with your prescribing clinician, and stopping is something to plan with them, not alone. Trial populations differ from any one person, and regain varies widely.
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