A new analysis suggests that people who stop taking Ozempic-like medications may retain only about 25% of the weight they initially lost, even up to a year after discontinuing treatment. While that may sound encouraging at first glance, there’s a significant caveat: researchers still don’t know how much of that sustained weight loss comes from fat versus muscle.

This uncertainty points to a largely overlooked issue surrounding medications such as semaglutide and tirzepatide, which are widely prescribed for type 2 diabetes and weight management. Emerging evidence indicates that between 40% and 60% of the weight lost during treatment may actually come from lean muscle mass rather than body fat — raising concerns about long-term health outcomes.

Although it’s well established that many patients regain weight after stopping these medications, what remains unclear is the composition of that regained weight. If most of the regained weight is fat, while muscle mass is not fully restored, patients could end up with a worse body composition than before starting treatment.

Medical researcher Brajan Budini of the University of Cambridge, one of the study’s lead authors, emphasized this risk: “If the regained weight is disproportionately fat, individuals may ultimately be worse off in their fat-to-lean mass ratio, which can have serious health implications.”

To better understand this pattern, researchers conducted a systematic review of 48 studies examining weight regain after discontinuing GLP-1 medications. However, many of these studies had limitations, including short follow-up periods and inconsistent methodologies. As a result, the team narrowed their analysis to six high-quality randomized controlled trials involving more than 3,200 participants.

These studies tracked patients for up to 52 weeks after stopping treatment and revealed a consistent trend: weight regain tends to happen quickly at first, then gradually slows over time. On average, individuals regained about 60% of the weight they had lost within one year.

Using this data, researchers modeled longer-term outcomes and found that weight regain appears to plateau after roughly 60 weeks, eventually stabilizing after patients regain around 75% of their lost weight. However, the reasons behind this pattern are still not fully understood.

Some experts believe that these medications may temporarily help patients develop healthier eating habits or trigger physiological changes, such as shifts in hormone regulation or brain pathways linked to appetite. Even so, these benefits may not be enough to fully prevent weight regain once the drugs are discontinued.

Another concern is that newer, more potent medications may accelerate overall weight loss without adequately preserving muscle mass. This means patients could lose weight more quickly — but not necessarily in a healthy or sustainable way.

Because of these risks, researchers suggest that treatment strategies should go beyond medication alone. Gradually tapering off the drugs, rather than stopping abruptly, may help reduce rapid weight regain. Additionally, patients are strongly encouraged to adopt long-term lifestyle changes, including balanced nutrition and regular exercise, to help preserve muscle mass and maintain results.

“Relying solely on medication is not enough,” said co-author Steven Luo. “Patients need proper guidance on diet and physical activity to build habits that will support their health even after they stop taking these drugs.”

Ultimately, while Ozempic-like medications can be highly effective for weight loss, this research underscores the importance of understanding their long-term impact — and the need for a more comprehensive, sustainable approach to managing weight.