GLP-1 weight rebound: How to Prevent Weight Regain after stopping Mounjaro & Wegovy

Wegovy and Mounjaro are both powerful tools, helping those struggling with obesity to lose weight. When goal weight has been reached, stopping weight loss injections seems like the logical next-step, but what happens now?

Data from clinical trials suggests patients are at a real risk of weight regain after discontinuing Wegovy or Mounjaro treatment. Referred to sometimes as GLP-1 weight rebound, this can undo all the hard work and money that was invested into treatment to begin with.

Here we’ll look at how to come off weight loss injections in a way that reduces the risk of weight regain, and help you keep the weight off for good.

What happens when you stop Wegovy or Mounjaro

Both treatments work through the common GLP-1 hormone pathway, with Mounjaro additionally activating the GIP hormone. When these satiety hormones are activated, gastric emptying slows and both food noise and appetite reduce.

Once treatment is stopped, GLP-1 and GIP levels naturally return to pre-treatment levels. This triggers an increase in ‘food noise’ and appetite. Furthermore, because the medication is no longer slowing the rate of gastric emptying, the stomach digests food quicker, making you feel hungry much sooner after a meal compared to when you were on the treatment.

This can all lead to an increased food intake and therefore weight gain.

The data: what clinical trials say about weight regain

The amount of weight regained after stopping each treatment was observed in clinical trials and summarised below:

	Wegovy	Mounjaro
Clinical trial reference	STEP 4 extension	SURMOUNT-4
Observed weight regain	67% (two-thirds)	25%
Follow up period	1 year	1 year

It can be seen after a year of stopping treatment, weight regain ensues due to an increased appetite, increased blood sugar levels and lowered feelings of fullness.

Additionally, metabolic and cardiometabolic benefits, such as lowered blood pressure, improved cholesterol and reduced inflammation - were also reversed slightly.

These findings suggest that treatment and/or lifestyle changes made whilst on treatment, need to be continued to ensure continuous benefit.

Stopping Wegovy/Mounjaro and weight gain.

Both Wegovy and Mounjaro activate hormones that influence gastric emptying, hunger and appetite. To work effectively, treatments are prescribed with an emphasis on sustainable lifestyle changes.

After stopping therapy, levels of these hormones return to pre-treatment levels, as do the effects they cause. In other words, hunger and appetite return to normal and stomach empties at its usual rate, further increasing hunger.

Unless lifestyle changes are maintained, the return in hunger and appetite results in weight gain. This is why clinicians at Quick Meds focus on helping patients build sustainable habits they can stick to even after treatment has stopped.

How do I come off Wegovy/Mounjaro safely to prevent regain

You can technically stop treatment ‘cold turkey’ without any dangerous withdrawal symptoms. However, to ensure effectiveness for long term health, it's recommended to incorporate a post-treatment maintenance plan.

Based on our real-world experience with patients at Quick Meds, and knowledge of how hunger and appetite returns after treatment cessation, we advise:

• Gradually tapering down.
• A slower, step down approach can help you to adjust to life without medication
• Maintaining lifestyle modifications
• Whilst reducing the dose, stick to sustainable lifestyle changes.

It's best to think of the treatment as a transitional period to learn more about yourself. Most of us are conditioned to have 3 square meals (or more) daily and to ‘clean the plate’ - regardless of fullness levels.

The treatment serves as learning more about the eating patterns and portion sizes required for each individual. Learning to eat when the body needs nutrition and to stop when it's telling you it's had enough, is vital to ongoing success.

Individuals who can then continue to implement this after stopping treatment are less likely to regain weight.

Proven strategies to prevent weight regain

1. Slowly taper off the medication
2. to allow your body to adjust to not being on treatment
3. Protect your muscles
4. It's common for patients to lose muscle whilst on treatment. This can lower metabolic rate encouraging the body to keep weight on/regain weight.
5. To prevent this, ensure you are eating plenty of protein during and after treatment for lean muscle mass preservation and to keep metabolism high.
6. Prioritise ‘volume eating’
7. As the medication is no longer slowing gastric emptying, you may feel hungry much sooner.
8. Eat plenty of low calorie but high-volume foods, like leafy greens, cruciferous vegetables and legumes to physically trigger fullness
9. Resistance training
10. 2 or more sessions of weight training can help to boost metabolic rate
11. Continuous monitoring
12. Use the tapering down period to assess ‘food noise.’
13. Ensure lifestyle habits are in place before moving to the lower dose.

Is weight maintenance possible?

Weight maintenance is possible but it's important to shift from seeing the medication as a ‘cure’, to a bridge to a healthier lifestyle. According to NICE, patients coming off weight-loss treatments should have a structured lifestyle plan for at least 1 year to avoid weight regain and include:

Phase	Strategy	Action
Downward taper	Slowly reduce the dose over a few months	Monitor how you feel on the lower doses. If hunger returns, slow the reduction further.
Metabolism	Protect muscle/metabolic rate	Protecting muscle mass helps maintain your metabolic rate. Eat sufficient protein and perform resistance training
Fullness	Volume eating	Fill your plate with low-calorie ‘bulk’ to physically trigger the feeling of fullness. Leafy greens, cruciferous vegetables and legumes are good options.
Monitoring	The regain trigger	Weigh yourself regularly. If you are regaining, book in for a review with a clinician to discuss strategies to minimise this

Remember, there's no official Wegovy/Mounjaro tapering schedule. Work with your provider to discuss what's right for you based on your individual needs.

At Quick Meds, our clinicians are trained to provide tailored advice that respects your nutritional needs and cultural background. By working closely with you at each stage, we offer one-to-one care to help you build healthier eating habits towards a lasting change.

The key to maintenance is making lifestyle changes that are sustainable long term. If changes are viewed as temporary, weight regain is much more likely.

Sustainable habits lead to sustainable results.

When to speak to your pharmacist

Stopping your medication is a clinical decision that you should manage with professional guidance. At Quick Meds, we recommend speaking to us:

1. When you are reaching your goal weight
2. When you’re close to your goal weight, get your ‘taper-down’ plan in place. This can be different for each individual. Our clinicians can help tailor the plan for you
3. If food noise returns
4. If you start to taper down and food noise returns, speak to us for strategies to slow this down.
5. If you experience a weight regain
6. Clinical trials show weight regain is most likely in the first 12 months after stopping treatment.
7. If you notice a weight creeping back, book a review to determine the reason and work on strategies to minimise this.

At Quick Meds, As a GPhC regulated pharmacy, at Quick Meds, you can be assured you are in safe hands. Consult our pharmacists at any time to discuss your ongoing treatment, tapering plan and maintenance strategies.

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