Hormonal
Discontinuation of GLP-1 receptor agonists leads to significant weight regain (approx. two-thirds of lost weight) and loss of cardiometabolic benefits, driven partly by a surge in ghrelin.
If you stop taking GLP-1 medications, you will likely regain most of the weight you lost. This is a physiological response (ghrelin surge), not a failure of willpower. To maintain weight loss, you must either stay on the medication indefinitely or switch to a more durable intervention like surgery.
the STEP and SURMOUNT-4 trials demonstrated that upon discontinuation, patients regained approximately two-thirds of lost weight, with cardiometabolic benefits disappearing... weight regain after GLP-1 RA cessation is in part due to a surge of ghrelin, which stimulates the patient’s appetite and contributes to weight regain.
Why this rating
Based on randomized clinical trials (STEP, SURMOUNT-4).
Source
Great Debates: Undergoing the Knife versus Pill-Popping—The Comparative Efficacy and Cost-Effectiveness of Bariatric Surgery and GLP-1 Receptor Agonists in the Management of Obesity
Paul J. Brosnihan et al. · The American Surgeon · 2025
DOI 10.1177/00031348251337145
More from this paper
- Bariatric surgery (sleeve gastrectomy, gastric bypass, duodenal switch) provides superior long-term total weight loss (23.4%–40.7%) compared to GLP-1 receptor agonists (up to 25.3% with tirzepatide).Good
- GLP-1 receptor agonists are cost-effective for expanding access to obesity treatment, particularly for patients ineligible for or hesitant about surgery, and can serve as a bridge to surgery or adjunct for post-surgical regain.Moderate
Related findings · Hormonal
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