Stopping Semaglutide? Here’s How to Keep the Weight Off (in 6 Steps)

How to avoid rebound weight gain after semaglutide

Semaglutide has become a global phenomenon, not just as a weight-loss drug but also for its wider range of health benefits.

According to a 2024 study in the New England Journal of Medicine, weight loss was not the only upside of the medication. The study of 3,533 participants with Type II diabetes found that the risk of a primary event was 24% lower in the semaglutide group than in the placebo group.

The research also showed that the chances of a major cardiovascular event were 18% lower in the semaglutide group, after tracking patients for more than three years.*1

However, other large studies have found that when people stop using semaglutide, weight often simply piles right back on.

Melbourne Bariatric and Endoscopic Surgeon Dr Jason Winnett says, ‘The treatment of obesity is not like taking paracetamol to treat a cold, or an infection where you take antibiotics and you’re done. Obesity is a chronic disease, just like high blood pressure and diabetes. It often requires long-term treatment, sometimes for life.

‘At the same time, we are certainly seeing more people being able to taper off medications without gaining too much rebound weight, particularly if tapering is slow and there is a comprehensive and holistic multidisciplinary approach to diet, exercise and the weight-loss mindset.’

Here are 6 key steps Dr Winnett recommends to avoid rebound weight gain after taking semaglutide.

1. Stop semaglutide usage gradually

According to a study from the European Congress on Obesity(ECO)*2, conducted in Denmark with 2,246 participants, patients who tapered off semaglutide gradually were able to keep their lost weight off for at least six months.

‘Furthermore,’ Dr Winnett says, ‘it found that lower doses of the drug were as effective for weight loss as higher ones.’

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.’

2. Track your diet

Controlling your diet is the most effective way to maintain your weight, and there are many methods, such as the Mediterranean diet or intermittent fasting.

Dr Winnett says, ‘The Mediterranean diet emphasises minimally processed fruits, vegetables, legumes, nuts, and whole grains. It contains moderate amounts of yogurt, cheese, poultry, and fish. Olive oil is its primary cooking oil.

‘Intermittent fasting is also effective. A common intermittent fasting plan might restrict eating to between 7am and 3pm, with the remaining 16 hours spent fasting.’

3. Introduce weight-bearing exercise

A 2024 study by researchers in 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 says the bottom line is 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.’

4. Adjust your expectations

‘Managing expectations is important, and we must realise that medication is an “accelerator” for weight loss,’ says Dr Winnett.

‘Stopping medication is not the end, but the starting point of self-management. You still have to do some work.’

For some patients, surgery may be a better long-term solution. Others may simply need to stay on the medication long term.

‘Obesity is a chronic disease, and just as patients stay on medication for other long-term conditions, such as blood pressure or depression, we’ve seen some patients stay on obesity medications for life while others are able to taper.’

5. Track your weight

Weighing yourself once a week is a simple habit that can help you stay aware of gradual weight changes.

You can use the newer Body Roundness Index (BRI) to measure your weight every week and record it. This means measuring your weight, waist circumference, and hip circumference every week. The BRI can be an effective alternative to the Body Mass Index (BMI), which only factors in weight and height (weight [kg]/ height [m²]).

‘Unlike the older BMI, the BRI better distinguishes between muscle and fat,’ says Dr Winnett. ‘For instance, athletes with high muscle mass are often classified as overweight or obese on the BMI when they are not.’

It’s important to remember, though, that BMIs and BRIs don’t tell the whole story, and that that number on the scales is not as important as your overall improvement in health.

6. Seek support

‘The patients who fare best are those who reach out early to their care team for help,’ says Dr Winnett. ‘Health professionals are not only helpers on the weight loss journey, but importantly, they are also listeners to help patients and answer questions. So never be afraid to ask!’

Seeking help from your GP, surgeon, dietitian, psychologist, or specialists like us at Winnett Specialist Group can help you stay on track and prevent small setbacks from becoming long-term challenges.

Prevent ‘semaglutide rebound’ weight gain

Semaglutide has helped thousands achieve meaningful weight loss, but keeping that weight off after stopping the medication is where the real work begins. Rebound weight gain after semaglutide is common but not inevitable. With a gradual taper, consistent exercise, dietary awareness, mindset support, and expert guidance, it’s possible to maintain your progress for the long term.

Learn about weight loss medications to explore sustainable weight management plans and personalised care to suit your lifestyle. Long-term success isn’t about perfection; it’s about having a plan and the right team behind you.