Going off your GLP-1? Here’s a blueprint for your last 30 days

While GLP-1s were intended to be a long-term medication, that doesn’t always happen. Maybe your insurance dropped its coverage, you’ve reached your goal weight and want to see how you do without it, or your prescription ran out. Whether you’re choosing to stop your GLP-1 or not, it can be stressful — and that’s where planning your last 30 days on your GLP-1 can make all the difference. Strategic preparation can set you up for success before you take your last dose, helping you maintain weight loss after medication, so you can stop your GLP-1 without going back to square one. (Remember this isn’t medical advice — you should speak with your prescribing clinician before tapering or stopping any medication.)

Key Takeaways

• Losing access to a GLP-1 — whether due to financial barriers, high out-of-pocket costs, dropped insurance coverage, or severe side effects  —  is common but manageable with the right plan.

• Don’t just stop suddenly if you can help it: First exhaust coverage options and then talk to your clinician about tapering.

• Your appetite and food noise will return over weeks to months after stopping, and if you have type 2 diabetes, your blood sugar levels may drift back up as well.

• Hitting your protein and fiber targets, meal planning, getting regular movement, and tracking your habits are the strategies that can support weight maintenance.

• Members who stayed engaged with Weight Watchers after discontinuing their medication continued to see results.

If you have to (or want to) wind down your GLP-1 journey, your care team can help you figure out the next steps together. Even though GLP-1s are supposed to be a long-term medication, certain things can get in the way, like the cost; perhaps your insurance coverage changed or your current plan stopped covering it.

Not only is this normal, it’s actually the biggest reason people quit taking GLP-1s. In one study published in Obesity, nearly half of people living with obesity stopped taking GLP-1s either because of out-of-pocket costs or because they lost insurance. Another analysis in JAMA Network Open found that the more people pay out of pocket, the more likely they are to stop taking the medication. 

For some people, the side effects — which usually include nausea, vomiting, constipation, and diarrhea — get to be too much; in that same Obesity paper, 15% of people stopped their GLP-1 because they couldn't tolerate the side effects. And some people just don’t want to take a medication forever.

If you’re nervous about stopping your GLP-1, that’s understandable. Research has found that people taking GLP-1s regain roughly two-thirds of their weight loss within about a year of stopping GLP-1s, which is why creating a maintenance plan matters before coming off the medication. With the help of your clinician and time to plan, it’s possible to maintain your weight loss results in the long run.

Once you learn you might not get a refill of your GLP-1, get in touch with your clinician and insurance coordinator. If your coverage has been denied by your insurance, you can ask your clinician to submit additional medical documentation or make a case for why this specific medication is necessary. Or, if you get your insurance through your workplace, your HR department might be able to help you find a workaround, too. This is where the Weight Watchers Med+ program is a great resource: Your care team includes an insurance coordinator who can help maximize your insurance coverage.

You can also research manufacturer savings programs. Each individual drug has its own medical and insurance eligibility, cash-pay discounts, and applications, so you'll have to do your homework for the exact medication. But if you’re down to shop around, you can also check with other pharmacies to get their cash prices for GLP-1s, since they may have different pricing if you’re paying out-of-pocket.

For patients who can no longer afford their medication, whether due to a lapse in insurance or higher out-of-pocket costs, “I would talk about other medications that are more affordable,” says Dr. Robert Kushner, M.D., a professor of medicine and medical education at Northwestern University’s Feinberg School of Medicine in Chicago.

Your care team at Weight Watchers can help you find less-expensive alternatives, such as non-GLP-1 oral medications.

If you’re choosing to stop your GLP-1 or can no longer afford it, always talk to your clinician before you taper down or stop the medication. Tapering off a GLP-1 means just scaling things back, the reverse of how you probably ramped up during your first few months on the medication.

Right now, the evidence for why tapering seems to work is still TBD. But researchers know definitively that stopping the medication suddenly doesn’t work well. “In all of the drug trials that we've conducted where, at the end of the trial, every one of them has stopped the drug immediately, people start regaining their weight fairly quickly,” says Kushner. 

So the opposite approach — don’t stop the drug suddenly and instead taper off it slowly — may work better. Why, exactly? For one, easing off your GLP-1 might help keep the food noise and appetite from returning in full force all at once. “The idea is that you slowly take the training wheels off,” Kushner says. And early signs show that it can be effective: Research has found that people who gradually lowered their dose to nothing over the course of nine weeks (on average) were able to maintain a stable body weight for the first 26 weeks after tapering completely off.

On top of that, a study in The Lancet found that people who lowered their tirzepatide dose to 5 mg (the second-lowest dose) and stayed on it maintained more of their weight loss — even though they did regain some — than those who stopped altogether. Importantly, this was a fixed lower maintenance dose, not a taper down to zero, so it speaks more to staying on a low dose than to tapering off. “If you lower the dose, you can hold onto some of that weight loss, but not all of it,” Kushner says.

To taper, talk to your clinician, who may recommend one of two approaches that makes the most sense for you: lowering the dosage while keeping the same schedule, or keeping the same dosage while reducing how often it's taken. Kushner, for example, suggests some patients move from weekly shots to shots every 10 days. The evidence is anecdotal, but “whether it's habitual or they just feel like they still have control, patients are able to maintain the behaviors for those extra days,” he says.

While you’re still on your GLP-1, “double down on your eating and health behaviors as much as you can,” says Kushner. “You want to be in as much control as possible.” At this point, you’re still experiencing all the benefits of the GLP-1, like the reduction in food noise, decreased appetite, and extended feeling of fullness, so it’s a good moment to create and anchor your strategies for weight maintenance.

First, make sure your nutrition is on point. That includes hitting your protein goals, which can ensure they don’t fall by the wayside as you start feeling hungrier and add more food to your plate. Fiber is also essential to keep you feeling full — it’s not a natural alternative to a GLP-1, per se, but by taking up space in your gastrointestinal system, it can help you stay full for a longer period of time. 

If you’re not yet tracking your meals, now’s the time to start. “You may want to track your nutrition and plan your meals out carefully,” says Kushner. That way, you can continue the eating patterns and meal structures that you had on a GLP-1 for as long as you possibly can — even once your cravings and appetite return.

It’s also a good time to log your workouts. “Keep your physical activity and exercise habits in line with what you've been doing all along,” says Kushner. You might need to move more once you go off the medication — either extend your walks, for instance, or up the intensity when you’re lifting — in order to maintain. It’s easier to plan that now versus when you’re trying to convince yourself to go to the gym.

If you need help, the Weight Watchers GLP-1 Success Program can help make tracking your nutrition, exercise, and beyond a habit. That way, when you stop your GLP-1, you’ll feel confident and prepared. In fact, 80% of GLP-1 Success members say they’re learning sustainable eating behaviors on Weight Watchers that they’ll rely on even after their GLP-1 treatment is complete.*

First, a quick refresher on how a GLP-1 leads to weight loss: It reduces your appetite, stabilizes your blood sugar, helps you feel fuller faster and for longer periods of time, and quiets food noise (the constant churn of thoughts about food).

Not surprisingly, once you actually stop the medication, those actions in your body will wind down. So “you'll have more food noise and your appetite will increase,” says Dr. Sabina Kobylinski-Tognazzini, D.O., a clinician with Weight Watchers Med+. That said, it may take weeks for the medication's effects to wear off completely. For example, tirzepatide has a half-life of five days. “That means half of the drug is gone in five days — and then after another five days, half of that,” Kushner explains. “So it takes several weeks before you have no drug in you.” And if you taper, the off-ramp might be even more gradual.

If you’re worried about weight regain after GLP-1s, that’s understandable. First, know that everyone is different. And while you might not want to step on a scale, whether out of fear or avoidance, it’s important to weigh yourself. “I know some people don't like to do that, but that's how you maintain your weight loss,” says Kobylinski-Tognazzini. “You really need to self-monitor and be honest about your weight so that you can see what’s changing.”

Instead of feeling bad about any uptick in your weight, take it as information you can use to plot out your next moves. You can even set up a “trigger” weight — say, five to 10 pounds above your goal weight — that merits a talk with your clinician about your next steps.

Whatever the reason you’re stopping your GLP-1, take some comfort in this: Lots of people do it. In one study of people taking GLP-1s for weight loss, more than half had stopped the medication after a year. (And after two years, that number rose to 72%.) 

The good news: Weight Watchers can help guide you through this transition. Being off the medication can feel isolating, but with the WW community, you can connect to others in a similar situation. “So if you're having an issue, you don't feel like you're all alone out there,” says Kobylinski-Tognazzini. Plus, you can hear tips about what’s worked for other members to get ideas to try, in addition to social support.

Weight Watchers also offers expert guidance for the after-medication phase, with access to clinician guidance to help you taper, and meetings with our Registered Dietitians to help you set up your nutrition for when your appetite and cravings ramp back up. 

If you’ve lost access to your GLP-1 because of the cost, know that you have options: You can figure out your coverage with the help of your clinician and insurance coordinator, or, in some cases, switch to an alternative that might also be effective for you. If you don’t have any success with that (or just want to stop your GLP-1 for whatever reason), you can work with your clinician to taper the drug, which may help lower your chances of regaining weight. Your appetite and food noise will return after a few weeks or months, so it’s important to lean on your healthy weight-maintenance habits, like tracking your meals, exercising regularly, and focusing on balanced nutrition — the exact system that Weight Watchers has in place — to maintain your results down the road.