Safely stopping GLP-1 medication

There are many reasons you might consider stopping GLP-1 therapy. Maybe you’re experiencing uncomfortable side effects, or the cost is unsustainable. Whatever the reason, you’ll want to work with your care provider to develop an exit plan.

Here, we’ll cover the main points to consider when going off GLP-1 therapy and what to expect.

What happens when the drug leaves your system?

GLP-1s work by suppressing the hunger hormone ghrelin. They also slow down your digestion, making you feel fuller for longer. As the drugs leave your system, ghrelin levels rise. You’ll start to feel hungrier more often and will likely have more thoughts of food (aka “food noise”). 

As a result, weight regain is likely. In fact, clinical trials show that people who stop cold turkey may regain two-thirds or more of their lost weight within 10 to 12 months. Carefully planning any changes with your care provider can help you limit weight regain. 

Tapering off GLP-1s is key 

One approach may be to taper off GLP-1s rather than quitting all at once. Options include gradually reducing or stretching out your doses. These approaches give you and your doctor a chance to monitor how your hunger, weight and metabolic markers respond. 

New research suggests that tapering slowly off the medications can help you maintain your weight loss. In one study, people who slowly tapered off the meds over the course of nine weeks were able to continue losing weight during the tapering period. What’s more, they kept the weight off six months later. 

Alternate methods to maintain weight loss 

During GLP-1 treatment, you have an opportunity to make lifestyle changes without the distractions of food noise and hunger. These lifestyle changes are crucial to keeping the weight off after GLP-1 therapy: 

Nutrition 

You know it’s important to balance calories in with calories out. On the food side of the equation, that means focusing on satiety. Nutrient-dense, high-fiber foods and protein help to keep you full on fewer calories. Choose legumes, lean meat, low-fat dairy, fruits, vegetables and whole grains. These mimic the effect of GLP-1s by keeping you feeling fuller for longer. 

Physical activity 

The best exercise is the one you enjoy and, therefore, do. Find activities you like and make them a regular part of your routine. Adding resistance training twice a week to your weekly workouts is also important for maintaining muscle mass. Muscle mass is often lost during weight loss. Resistance training can help you preserve and enhance your muscles. 

Lifestyle factors 

Mental tools to cope with stress and boost resilience are invaluable when stopping GLP-1s. They can help you deal with food cravings, find the motivation to maintain food and exercise routines, and face challenges that arise. Avoiding all-or-nothing thinking is a helpful way to stay on track. For example, if you overeat at one meal, keep moving forward and manage your portions better at the next one. Or squeeze in small bouts of movement even when you can’t make time for a long workout. Each of these steps contributes to better outcomes. Good-quality sleep and stress management are also important factors in keeping hunger hormones at bay. 

Other tools 

If lifestyle changes alone are not enough to maintain weight loss, your doctor may recommend you try a lower-cost anti-obesity medication, such as metformin or naltrexone/bupropion. Or they may suggest you use GLP-1s intermittently.   

Summing it up

No matter your reason for going off GLP-1s, it’s important to plan with your doctor. It is possible to safely wean yourself while maintaining your weight loss. Going off the medication could mean a return of appetite, cravings and weight gain. Monitor your weight and symptoms and be prepared with a game plan of how to address challenges that arise. Remember: Obesity is a chronic condition, and changes to your medications and management are part of the process, not a personal failure.