Why Most People Regain Weight After Stopping GLP-1 Drugs

What the New British Medical Journal Review Really Shows

GLP-1 receptor agonists such as semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro, Zepbound) have changed obesity treatment. Many people are losing significant weight, often for the first time in years.

But a new systematic review published in the British Medical Journal confirms what those of us who work inside real weight-loss outcomes have been seeing for years:

Weight loss created through appetite suppression does not sustain itself when the drug is removed unless the body and behavior systems are rebuilt.

This matters because a large percentage of people do not remain on these medications long-term due to side effects, cost, access, or personal choice.

So the real question is not whether GLP-1s work.

It is what happens when the medication stops.

Key Findings From the BMJ Review

1. Weight Regain Begins Quickly After Stopping

Across clinical trials, participants who discontinued weight-loss medications began regaining weight at a consistent pace.

The average rate of regain was approximately 0.4 kg per month after stopping treatment.

Based on this observed rate, researchers projected that body weight would return to pre-treatment levels in roughly 1.5 to 1.7 years for many individuals if medication was not continued.

In some cases, participants regained more weight than they had originally lost.

2. Regain Was Faster Than After Diet and Exercise Alone

One of the most important findings was that weight regain occurred significantly faster after stopping medication than after ending traditional lifestyle-based interventions.

This tells us something critical.

The body was not relearning regulation.
It was being pharmacologically controlled.

Appetite signaling was altered, but muscle systems, intake skills, behavior structure, and metabolic defenses were not rebuilt.

3. Health Improvements Also Reversed

As weight returned, many of the cardiometabolic improvements seen during treatment also diminished, including blood pressure, cholesterol, and blood glucose markers.

This reinforces what long-term coaching work shows clearly.

Obesity is not a weight problem.

It is a regulation problem.

4. Many People Do Not Remain on GLP-1s Long-Term

Real-world data show that a large proportion of individuals discontinue GLP-1 medications within the first year due to gastrointestinal side effects, financial burden, or loss of coverage.

This makes sustainability the central issue.

Not access.
Not dosage.
Sustainability.

What Years of Coaching Inside This Problem Has Shown

After coaching women for years, including many who have lost weight with GLP-1 medications and many who have never touched them, the pattern is always the same.

Weight loss happens when intake is controlled.

Weight regain happens when the body was never taught how to regulate without enforcement.

This is not a motivation problem.

It is a missing-skill and missing-system problem.

Every long-term success I have seen, regardless of method, shared the same foundations:

• Eating was structured and skill-based
• Muscle was protected and developed
• Behavior systems were installed
• Identity shifted from dieting to regulation

This is the gap medication does not fill.

And it is the exact domain my work is built around.

The Governing Law of Body Change

There is a law that applies to every method of fat loss.

Whatever removes the weight must also maintain the weight.

If the process that created the body is not something that can be lived with, structured, and sustained, the body will eventually adapt back.

This body that God has blessed us with is governed by adaptation.

If you do not train to keep it strong, it adapts by getting weaker.
If you do not regulate intake, it adapts by storing fat.

This is not failure.

This is physiology.

How to Build a Body That Can Maintain Weight Loss

With or Without GLP-1 Medication

My work focuses on building what medications cannot:

• Metabolic resilience
• Eating skill
• Muscle preservation
• Behavioral structure

These are what allow weight loss to remain stable after appetite suppression is reduced or removed.

Long-term maintenance depends on three foundational systems.

1. Eating as a Skill

Not restriction.
Not rules.
Not cycles.

Skills.

Intake awareness.
Meal structure.
Hunger interpretation.
Environmental control.

These are what allow regulation to continue when the drug is gone.

2. Training the Body to Defend Muscle

Muscle is metabolic tissue.

It governs resting energy expenditure, glucose disposal, insulin sensitivity, mobility, and aging resilience.

Without resistance training and progressive overload, weight loss shifts toward metabolic decline, which accelerates regain risk.

3. Behavior Systems, Not Motivation

Motivation starts change.

Systems sustain it.

Structure, accountability, feedback loops, identity reinforcement, and psychological skill-building are what convert temporary success into permanent outcomes.

These are learned once.

They are practiced for life.

Ready to Build That Foundation?

The 21-Day Reset

The 21-Day Reset was built to install the exact foundations medications do not:

• Eating structure
• Intake awareness
• Training consistency
• Regulatory skills
• Behavioral momentum

It is designed to help women build a base that supports fat loss now and stability later, whether GLP-1s are part of the journey or not.

Click the link below to join the next 21-Day Reset.

Join The Next 21-Day Rest

Want Personalized Coaching?

My 1-on-1 coaching is designed for women who are either using GLP-1 medications or coming off them and want to build a body and lifestyle that no longer depend on pharmacological control.

Inside private coaching we focus on:

• Personalized nutrition systems
• Muscle-centered training strategy
• Metabolic protection
• Psychological habit architecture
• Long-term maintenance design

Click the link below to apply for 1-on-1 coaching.

Apply For Coaching

Final Perspective

GLP-1 medications can assist weight loss.

They cannot replace the process of building a body that knows how to regulate itself.

Sustainability is not found in appetite suppression.

It is built through skills, structure, training, and behavioral alignment.

God Bless. Let's Work. 

References

Shi, Q., Wang, Y., Hao, Q., et al. (2025). Trajectories of weight change after discontinuation of anti-obesity medications: systematic review and meta-analysis. British Medical Journal.

University of Oxford. (2026). Stopping weight-loss drugs linked to faster weight regain.

Rubino, D., et al. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance. JAMA.

Wilding, J. P. H., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine.