Keeping the Weight Off After Medication: How to Help Patients Prevent ‘Semaglutide Rebound’

Tape measure wrapped around weight loss medication – preventing rebound weight gain

Wegovy, Ozempic and GLP1- inhibitors have arguably become the most popular medications in the modern world. But are they designed to be used long-term?

A study published in the Journal of the American Medicine Association (JAMA)*1 investigated more than 800 obese or overweight patients. It found that continuing to subcutaneously inject 2.4mg of semaglutide weekly after completing 20 weeks of semaglutide treatment can further reduce weight.

It also improved other health indicators, like physical functioning and systolic blood pressure, in the subsequent 48 weeks compared with switching to a placebo.

‘Many patients are seeing weight-loss medications as a lifelong strategy,’ says Dr Jason Winnett, Bariatric and Laparoscopic Surgeon from the Winnett Specialist Group.

However, other patients prefer to stop taking medications completely when they reach their weight-loss goals. This can lead to rebound weight regain, which can be frustrating.

If your patients want to discontinue GLP-1s, here are some tips to help.

1. Understand why patients stop taking medication

Actively listen to patients’ motivations for stopping medication (such as side effects, cost, family concerns).

‘Do not try to persuade,’ says Dr Winnett, ‘but provide safety data and rebound rate research results to help patients make informed decisions.’

Use the conversation as an opportunity to explain that obesity is a chronic condition, and stopping medication marks a transition, not the end of treatment. Framing weight management as a shared, long-term plan can help patients feel supported and prepared for the next phase of care.

2. Go slow and low

The 2024 European Congress on Obesity (ECO)*2 reported on a Danish study involving 2,246 patients, finding that those who tapered off semaglutide slowly kept the lost weight off for at least six months.

‘It also found that significantly lower doses of the drug are as effective for weight loss as higher ones, irrespective of BMI,’ says Dr Winnett.

According to Dr Henrik Gudbergsen, the researcher who presented the Danish study: ‘A patient’s appetite returns when they stop taking the drug, and if they stop taking it suddenly, they may find it hard to resist their cravings.

‘However, if they stop slowly, and have expanded their awareness and understanding of healthy lifestyle behaviours and eating habits, their hunger and satiety will be more manageable, making it easier for them to maintain a healthy weight.’

Mr Winnett adds that in his own practice, he has commonly seen patients maintain their weight long-term after tapering off semaglutide. ‘Of course I have seen the reverse too, but when there is dietetic, psychological and physician oversight, there is a much better chance of success.’

For those who do experience rebound weight gain after weight-loss medication, surgery may be an option. Discuss with your specialist or contact the Winnett team.

3. Use metaphors to educate patients

It’s important to emphasise that obesity is caused by multiple factors, such as genetics, physiology, and neurohormonal regulation. Use common language and metaphors to help patients understand the physiological mechanisms behind rebound weight gain.

‘For example,’ says Dr Winnett, ‘weight loss is like stretching a rubber band. The harder you stretch it, the easier it is to bounce back without changing the structure of the rubber band. If your lifestyle doesn’t fundamentally change, the rebound will be very fast.’

4. Establish a ‘behaviour template’

One of the most effective tools for long-term weight maintenance is helping patients clearly identify and preserve the habits that led to their success.

Ask patients to review key behaviours (including what they eat, when they eat, how they exercise) during their weight management journey. Organise successful habits into a written template and, during follow-up appointments, remind them to maintain these habits.

5. Educate patients about exercise

A 2024 study by researchers from the University of Copenhagen*3 shows that exercise in conjunction with tapering helps prevent rebound weight gain.

The study found that one year after stopping liraglutide (another GLP-1 weight-loss drug for weight loss), participants who did not exercise regained 6kg of their lost weight.

Conversely, participants who had used liraglutide and maintained a regular exercise routine after discontinuing the drug regained only 2.5kg.

The study found that ‘Body weight and body composition were maintained one year after termination of supervised exercise, in contrast to weight regain after termination of treatment with obesity pharmacotherapy alone.’

Dr Winnett recommends encouraging your patients to ‘just get moving’: ‘at least 30 minutes of exercise per day, five times per week, including ideally two or three sessions of weight-bearing exercise a week.’

6. Establish multidisciplinary support

Long-term success is more likely when patients have a supportive team behind them. A dietitian can help with meal planning and nutrition goals. A psychologist can address emotional eating, binge behaviours, and self-blame. A GP or specialist provides medical oversight and supports behaviour change.

Establishing a multidisciplinary care team ensures patients receive support on all fronts (physical, emotional, and behavioural), making weight maintenance more sustainable.

7. Schedule follow-ups and provide reassurance

Dr Winnett says, ‘It’s a good idea for GPs to follow up within 1 month of stopping medication or if the weight gain is more than two or three kilograms. Regular contact helps patients feel supported and allows early intervention if weight starts to increase.’

He recommends patients use the Body Roundness Index (BRI) to measure their body and also urges doctors to keep verbally encouraging patients, even when the scale doesn’t move in the desired direction.

‘Remind patients that some rebound is not a failure,’ Dr Winnett says. ‘Rather, it is a normal part of chronic disease management. Also, encourage patients to return to their GP or specialist clinic without fear or shame. Continue to convey the message: “You are not alone.”’

Help your patients prevent ‘semaglutide rebound’ weight gain

As GLP-1 medications like semaglutide become increasingly common, GPs are key to helping patients navigate life after treatment. Rebound weight gain is a real risk, but with slow tapering, structured lifestyle changes, and a supportive care team, it can be minimised.

By checking in early, reinforcing helpful behaviours, and normalising setbacks, you can make a lasting difference in your patients’ weight maintenance journey.

If you’re seeking specialist support, contact the Winnett Specialist Group. We’re here to assist with referrals, medication planning, and long-term weight management strategies.