Maintaining Weight Loss After GLP-1 Medications
Medications such as Mounjaro (tirzepatide) and Wegovy (semaglutide) have transformed obesity treatment by targeting appetite regulation and insulin signalling. For many patients, they enable meaningful weight loss where previous strategies have failed. However, a common concern arises when treatment stops: how to avoid regaining the weight. Fear not as Dr Catherine demystifies the process that patients experience as they reduce their dose and gives useful strategies to compensate.
Why Weight Regain Happens After Stopping GLP-1s
Weight regain is not a failure of willpower. It is a predictable biological response. Appetite hormones increase, energy expenditure falls, and the brain strongly defends its previous “set point”. Understanding this physiology is the first step in countering it.
From Appetite Control to Environment Control
GLP-1 medications reduce hunger automatically. Once they are withdrawn, relying on hunger cues alone is rarely sufficient. Instead, the goal should be to design an environment that makes healthy choices the default.
This includes:
Eating regular, structured meals to avoid reactive eatingPrioritising protein and fibre at every meal to blunt appetite signals Keeping ultra-processed foods out of sight (or out of the house entirely)
Think less about resisting temptation and more about removing the need to resist.
Preserving Muscle to Protect Metabolism
During rapid weight loss, some loss of lean muscle is almost inevitable. Muscle mass is metabolically active; losing it reduces resting energy expenditure and makes regain more likely.
Resistance training two to three times per week is one of the most effective anti-regain strategies. It need not be extreme — progressive, consistent strength work is sufficient. Adequate protein intake (often higher than expected) is equally important.
Patients who maintain muscle tend to maintain weight.
Planning for the Return of Hunger
A key psychological mistake is expecting appetite to remain suppressed after stopping medication. When hunger returns, it can feel alarming or discouraging.
Instead, treat hunger as data, not danger.
Simple strategies include:
Using volume foods (vegetables, soups, salads) to eat larger portions without excess calories. Eating slowly and deliberately to allow satiety signals to registerAccepting mild hunger between meals rather than reacting urgently to it.
This reframing reduces panic-driven eating.
Psychological Ownership After Medication
Some patients unconsciously attribute their success entirely to the drug, which undermines confidence once it is stopped. In reality, most people have already developed better habits during treatment — they simply discount them.
A useful psychological exercise is to write down:
What you eat differently now
How your relationship with food has changed
What behaviours you would keep even if weight were irrelevant
This reinforces agency and continuity.
Long-Term Monitoring Without Perfection
Weight regain is easiest to reverse in its earliest stages. Regular but emotionally neutral monitoring (for example, weekly weights or monthly measurements) allows timely course correction.
The aim is not perfection, but responsiveness.
At Winchester GP, we emphasise that weight management is a long-term physiological and psychological process, not a temporary intervention. With thoughtful planning, lifestyle structure, and the right mindset, it is entirely possible to maintain the benefits achieved with GLP-1 medications — and to do so with confidence rather than fear.
We will be here to support you both on and off medication.