Weaning off a GLP-1? Tips for the transition

After a year of using a GLP-1 medication to lose weight, Abby was ecstatic to have shed more than 100 pounds. But she grew uneasy as she approached her target, wondering what happens when you stop a GLP-1 drug and how she could maintain her stellar results.

Research suggests Abby's concern about rebound weight gain is well founded. People who cease taking GLP-1 obesity drugs, which include semaglutide (Wegovy) and tirzepatide (Zepbound), typically regain an average of nearly a pound a month, ultimately gaining back all the weight they lost within two years, according to a review of 37 earlier studies.

The study's findings, published online Jan. 7, 2026, by BMJ, don't surprise Meghan Salamon, a dietitian at the Weight Center at Harvard-affiliated Massachusetts General Hospital.

"This is a medication that controls a disease, like any other. If someone has high blood pressure and takes medication to control it, their blood pressure would go back up if they were to come off that medication," Salamon explains. "GLP-1s act in the same fashion. Someone stopping these medications doesn't have the same control over their obesity, and their weight can increase."

What to expect

Nearly 12% of Americans - about one in eight - have used GLP-1 drugs for weight loss, according to a 2025 report from RAND, a nonprofit research organization. People who tap these blockbuster medications, which mimic a naturally produced hormone called GLP-1, lose an average of 15% to 20% of their body weight.

Even when people want to lose more weight, they may have strong reasons to discontinue use of a GLP-1. Intolerable side effects such as persistent nausea, vomiting, diarrhea, or fatigue top the list of common reasons why people may stop, Salamon says. But cost and access are also major issues.

When coming off a GLP-1, watch for increased hunger and "food noise" - persistent, intrusive thoughts about food - as well as a diminished ability to feel full with smaller portions.

"These medications are designed to slow your digestion and increase your feelings of fullness. So when you remove them, digestion speeds back up, and hunger signals become stronger," Salamon says. "Many people will feel hungry sooner after meals and will think about food more often. But these changes are expected, and they're biologically driven."

Sustaining progress

If you're anxious about stopping a GLP-1, ask your doctor if tapering off gradually, taking a lower dose, or using the drug intermittently is a better option (if that's financially possible), Salamon says.

Here, she offers tips for the transition.

Eat for fullness. The best way to accomplish this is to focus on these three nutrients:

• Protein, especially from in lean meat, poultry, fish, soy, and dairy products, is "incredibly important," Salamon says - not only because it helps maintain lean body mass, but because the body also burns significantly more calories digesting protein than it does carbohydrates and fats.
• Fiber is abundant in fruits, vegetables, nuts, seeds, and whole grains. Increasing your intake is one of the best ways to help mimic the effects of a GLP-1, Salamon says. Fiber - especially the soluble form found in the skins of fruits and vegetables - promotes fullness by "creating a jello consistency in the stomach," she says. "That helps to slow down digestion. It also helps push on the sides of the stomach, which signals our brain's natural GLP-1 hormone and makes us feel full. A great way to start is to make sure you have a fruit or a vegetable, or both, at every meal."
• Healthy fats, found in items such as fatty fish, olive oil, avocados, nuts, and seeds, "help create a comfortable satiety as well as slow down digestion, helping you feel fuller longer," Salamon says.

Eat on a consistent schedule. Ideally, eat a meal every three to five hours, Salamon says. "If you find your meals are farther apart, add a high-protein or high-fiber snack," Salamon says. "Skipping meals can lead to feelings of chaotic hunger, which can make you eat more than you should as well as make it more challenging to make healthy decisions."

Plan for hunger. Keep shelf-stable snacks in your purse or car. Items such as nuts, edamame, dried fruit, or protein bars provide a healthy option if hunger strikes.

Move for maintenance. Aerobic activity such as walking, cycling, or swimming burns calories, while strength training helps maintain or increase lean body mass, "which is one of the major drivers of our metabolism," Salamon says.

Prioritize slumber. Research suggests inadequate sleep can fuel hunger. "When we don't get enough sleep, we produce more ghrelin, which is known as the hunger hormone," she says.

Drink sufficient fluids. Dehydration - which is already setting in when we start to feel thirsty - can actually feel like hunger. "It can show up as a 'snacky' feeling, so we go look in the cupboard or fridge for something to eat even though our brain is asking for water," Salamon says.

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