Two different research questions
Research about withdrawal can help frame a conversation about ongoing care, but it does not provide a personal stopping plan. The studies below concern specific injectable trial treatments in adults without diabetes. They do not establish the outcome of every GLP-1 product, a compounded preparation or an individual telehealth program. Read the time points and denominators before comparing the numbers: a change measured from initial enrollment is different from one measured after a period of weight reduction.
STEP 1 extension: one year after withdrawal
The exploratory STEP 1 extension analyzed 327 participants from the original trial. Study treatment and lifestyle intervention stopped after week 68, with follow-up to week 120. The semaglutide group had lost an average 17.3% by week 68 and subsequently regained 11.6 percentage points, leaving an average net loss of 5.6% from the original baseline. The investigators described regain of roughly two-thirds of the prior loss. This was a selected extension subset, and stopping lifestyle support as well as medication limits what can be attributed to either change alone.
Source: Wilding et al.: STEP 1 trial extension, Diabetes, Obesity and Metabolism, 2022
SURMOUNT-4: randomized continuation or withdrawal
After 36 weeks of tirzepatide treatment, 670 participants were randomized to continue it or switch to placebo for 52 weeks. Their average reduction during the lead-in was 20.9%. From week 36 to week 88, the continued-treatment group lost another 5.5% on average, while the placebo group gained 14.0%, measured from week-36 weight. This randomized withdrawal comparison differs from simply observing people who elect to stop. It also concerns those who reached randomization after the initial treatment period, not every person who first enrolled.
Source: Aronne et al.: SURMOUNT-4 randomized clinical trial, JAMA, 2024
Why the percentages cannot be swapped
The 11.6-point STEP 1 regain is expressed relative to the original baseline; SURMOUNT-4’s 14.0% change uses weight at randomization after the lead-in. Adding or subtracting these figures as though they use the same starting point would mislead. To see the issue with simple hypothetical numbers, a change from 100 to 80 is a 20% reduction; a rise from 80 to 90 is a 12.5% increase from 80. The person remains 10% below 100. Always label which starting weight a percentage uses.
What these studies do not settle
Neither result tells you exactly what will happen to you, whether an individual should continue a medicine, or the right way to change a treatment plan. The studies do not compare every possible follow-up strategy after withdrawal. Avoid interpreting an average regain figure as either personal failure or an inevitable fixed amount. Discuss your circumstances and options with your prescribing clinician before making changes. If cost or access is becoming a problem, raise that while there is time to plan the next steps.
What to ask a service before enrolling
Ask how ongoing follow-up works, whether the clinician can discuss longer-term goals, and what happens if insurance or affordability changes. Clarify how to access records and contact the care team if you leave the subscription. These are questions about continuity of care, not reasons to accept an indefinite financial commitment without reading it. Compare the provider’s support and contract separately from trial outcomes. A program’s research citations do not answer whether its renewal charges, pharmacy arrangements or exit process fit your needs.
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Sources & scope
Sources checked October 12, 2026. This guide explains published information and consumer research questions; it is not a clinical evaluation.
- Wilding et al.: STEP 1 trial extension, Diabetes, Obesity and Metabolism, 2022
- Aronne et al.: SURMOUNT-4 randomized clinical trial, JAMA, 2024
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