What Are the Clinical Considerations After Discontinuing a GLP-1 Receptor Agonist?
GLP-1 receptor agonists (GLP-1RAs), such as semaglutide, liraglutide, dulaglutide, and tirzepatide, have helped numerous patients lose weight, improve glucose control, and reduce cardiovascular risk factors. As more individuals begin transitioning off these medications, many are seeking guidance on how to maintain their progress—especially when it comes to keeping the weight off!
People discontinue GLP-1RAs for many reasons. Insurance coverage may end, making the out-of-pocket cost unsustainable. Others experience side effects such as nausea, vomiting, constipation, or diarrhea that make continued use difficult. Whatever the reason, having a plan is essential.
So, how do you maintain weight loss after stopping a GLP-1RA?
Expect physiological changes—and know they’re normal.
Appetite & Satiety:
Increased hunger due to loss of delayed gastric emptying,
Diminished satiety response.
Weight Gain:
If no structured maintenance plan is implemented, many regain lost weight within 12-24 months.
Glycemic control:
Potential increases in fasting glucose and A1c.
Cariometabolomic markers:
Possible increases in blood pressure, triglycerides, and LDL cholesterol.
Focus on a structured eating plan.
Prioritize protein at every meal to support satiety and muscle maintenance.
Add high-fiber foods—such as vegetables, berries, legumes, and whole grains—to help regulate blood sugar and keep you feeling full.
Establish consistent meal times and patterns to avoid grazing and overeating.
Stay well-hydrated throughout the day to support appetite regulation and digestion.
Commit to physical activity. Being consistent in activity helps stabilize metabolism, mood, and appetite.
Aim for regular exercise, including walking, stretching, and resistance training.
Strive for at least 150 minutes/week of moderate-intensity aerobic activity.
Address emotional and behavioral eating.
For many patients, this is the biggest challenge after stopping the medication. Consider meeting with a nutritionist, health coach, or therapist to build long-lasting habits and coping strategies.
Suggested Monitoring Schedule after Discontinuation.
Weigh weekly at home or in the clinic.
If diabetic or pre-diabetic, check your fasting glucose and A1c level 3 months after discontinuation.
Monitor blood pressure at regularly scheduled office visits.
Recheck liver enzymes, and may need a liver ultrasound to monitor Nonalcoholic Fatty Liver Disease (NAFLD).
Stay connected with your healthcare provider!
Regular visits help monitor weight trends, glucose goals, and overall health. Your provider can also adjust your plan or add new strategies as needed.
Coming off a GLP-1 agonist is a transition—not an ending. With the right structure, support, and expectations, you can maintain the progress you’ve worked hard to achieve.