In trials, the most effective way to keep weight off after semaglutide turned out to be continuing semaglutide. In STEP 4, people who continued the 2.4 mg dose lost a further 7.9 percent over the following 48 weeks. People switched to placebo regained 6.9 percent of their weight in that time. Below we collect what exactly happens to weight after treatment ends and what helps to keep the result.
What did STEP 4 show?
STEP 4 tested directly what continuing semaglutide gives compared with stopping it. It included 902 people with obesity, or overweight without diabetes. The results were published in 2021 in JAMA.
For the first 20 weeks everyone received semaglutide, 16 of which were spent increasing the dose to 2.4 mg. In that time participants lost an average of 10.6 percent. Then 803 people were randomly split into two groups for the next 48 weeks.
| STEP 4, weeks 20 to 68 | Continued semaglutide 2.4 mg | Switched to placebo |
|---|---|---|
| Change in body weight | loss of 7.9 percent | gain of 6.9 percent |
| Waist circumference | 9.7 cm less than on placebo | reference point |
| Systolic blood pressure | 3.9 mm Hg lower than on placebo | reference point |
| Stopped because of side effects | 2.4 percent | 2.2 percent |
The difference between the groups was 14.8 percentage points. People who continued treatment also rated their physical functioning better. Stops because of side effects were as rare at this stage as on placebo.
What happens to weight after stopping?
After semaglutide is stopped, weight gradually comes back, but not all of it within a year. This is shown most precisely by the STEP 1 extension, published in 2022. It covered 327 people who stopped semaglutide after 68 weeks of treatment and were followed for another year.
By week 68 these people had lost an average of 17.3 percent. In the following year without treatment they regained 11.6 percentage points. After 120 weeks from the start their weight was therefore still 5.6 percent lower than at the beginning. The authors sum this up as about two thirds of the lost weight returning within a year.
In the same period most of the improved cardiometabolic markers moved back towards their starting values. The researchers conclude that obesity is a chronic disease and that keeping the result requires continued treatment. This is the same conclusion that STEP 4 gives.
How fast does weight come back over the months?
According to a meta-analysis from September 2026, weight comes back at about 1 kg a month. The work combined six trials with 1776 participants who stopped semaglutide or tirzepatide. At the time of stopping, participants had lost an average of 15.35 kg.
- Pace: about 1.04 kg regained per month.
- Half of the loss: according to the model, it returns after about 7.5 months.
- Support: diet and exercise after stopping were linked to a slower return, although the result was imprecise.
- Size of the loss: the more someone had lost, the faster they usually regained weight.
The authors note that the data reach no further than 52 weeks, and later values are a model calculation. An earlier meta-analysis of eight trials from 2025 showed that the weight regained was proportional to the weight lost before. With semaglutide and tirzepatide it averaged 9.69 kg.
What happens to blood sugar and blood pressure after stopping?
Together with weight, other markers that improved during treatment also come back. A meta-analysis of 18 trials with 3771 participants, published in December 2025 in EClinicalMedicine, calculated this precisely. In people with obesity, weight rose by an average of 5.63 kg after stopping GLP-1 medicines, and glycated haemoglobin by 0.25 points.
Waist circumference, systolic blood pressure and fasting blood sugar also got worse. With semaglutide the regained weight averaged 8.21 kg, and with the older liraglutide 4.29 kg. Semaglutide worked more strongly, so after stopping it there was also more to regain.
The longer the follow-up after stopping, the more weight came back. With follow-up longer than 26 weeks it averaged 7.31 kg, with shorter follow-up 2.51 kg. The authors write that guidelines should cover not only starting treatment but also ending it and keeping the result.
Can you stay on a lower dose?
The Wegovy label provides two maintenance doses: 2.4 mg or 1.7 mg a week. No separate trial comparing weight maintenance on 1.7 mg and on 2.4 mg has been published for semaglutide.
Such a trial does exist for tirzepatide. In SURMOUNT-MAINTAIN, stepping down from the highest tolerated dose to 5 mg kept much more of the loss than stopping. We describe it in a separate guide on tirzepatide after the end of treatment. For semaglutide this question remains open.
What helps keep the result after treatment ends?
The strongest data say one thing: continuing semaglutide keeps weight better than any other approach tested in trials. Beyond that, the habits built during treatment matter. In all the STEP trials semaglutide was combined with a reduced-calorie diet and more physical activity.
- Regular weighing: the authors of the 2026 meta-analysis write that weight is worth checking early after stopping.
- Waist circumference: in STEP 4 it changed together with body weight, so it shows the direction of change well.
- Exercise and diet: were linked to a slower return of weight, although the data are still uncertain.
- A plan for after treatment: the same authors write about planning weight maintenance in advance.
Which measurements are worth taking and how often is described in the guide on how to measure peptide results. The course of weight loss during treatment itself is shown in the guide on semaglutide results.
How much does continuing semaglutide cost?
The cost of maintenance depends on the dose. A 3 mg vial of semaglutide costs 90 EUR in the shop. At 2.4 mg a week one vial lasts a week and two days, and a week costs 72 EUR. At 1.7 mg the vial lasts almost two weeks, and a week costs 51 EUR.
Supplies for a longer period are calculated in the guide on how long a GLP-1 vial lasts. Semaglutide 3 mg Bio-Peptide is in stock. All information about the molecule is on the semaglutide page.
The products in the shop are material for laboratory research, not the medicine Wegovy. The doses described above come from the label and the trials, and decisions about treating obesity are made by a doctor. The difference is explained in the guide on why semaglutide and tirzepatide are prescription-only.
Frequently asked questions
Does weight come back after stopping semaglutide?
In the STEP 1 extension, people who stopped regained 11.6 of the 17.3 percent lost within a year. After 120 weeks their weight was still 5.6 percent lower than at the start.
How to keep weight off after semaglutide?
In STEP 4, people who continued 2.4 mg kept their weight best. They lost a further 7.9 percent in 48 weeks, while the placebo group regained 6.9 percent.
How fast does weight come back after stopping?
A 2026 meta-analysis estimated the pace at about 1.04 kg a month. According to the model, half of the loss comes back after about 7.5 months.
Can you switch to a lower maintenance dose?
The Wegovy label provides a maintenance dose of 2.4 mg or 1.7 mg. No trial comparing weight maintenance on these two doses has been published.
How much does a week of maintenance at 2.4 mg cost?
With a 3 mg vial at 90 EUR, a week at 2.4 mg costs 72 EUR, and at 1.7 mg 51 EUR.
Sources
- Rubino D, Abrahamsson N, Davies M et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA, 2021, 325(14): 1414-1425. https://doi.org/10.1001/jama.2021.3224
- Wilding JPH, Batterham RL, Davies M et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022, 24(8): 1553-1564. https://doi.org/10.1111/dom.14725
- Kow CS, Thiruchelvam K, Ramachandram DS, Zaihan AF. Weight Regain Trajectories After Discontinuation of Semaglutide or Tirzepatide: A Reconstructed Aggregate-Data Bayesian Longitudinal Meta-Analysis. Endocrinology, Diabetes and Metabolism, 2026, 9(5): e70325. https://doi.org/10.1002/edm2.70325
- Berg S, Stickle H, Rose SJ, Nemec EC. Discontinuing glucagon-like peptide-1 receptor agonists and body habitus: A systematic review and meta-analysis. Obesity Reviews, 2025, 26(8): e13929. https://doi.org/10.1111/obr.13929
- Tzang CC, Wu PH, Luo CA et al. Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis. EClinicalMedicine, 2025, 90: 103680. https://doi.org/10.1016/j.eclinm.2025.103680
- Horn DB, Aronne LJ, Wharton S et al. Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN). The Lancet, 2026, 407(10545): 2305-2318. https://doi.org/10.1016/S0140-6736(26)00656-2
- U.S. Food and Drug Administration. Wegovy (semaglutide) injection, prescribing information, 215256s011. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf