Written by: Angela Derrick, Ph.D. & Susan McClanahan, Ph.D.
Date Posted: May 8, 2026 3:08 pm
If you are taking a GLP-1 medication like Wegovy or Zepbound, there is a good chance you have already thought about what happens when you stop.
Maybe your prescription costs more than your budget can sustain long-term. Maybe your insurance coverage is uncertain. Maybe you are simply wondering, with yourself or with your doctors, whether this is something you will need indefinitely, and what it means if circumstances change. Wherever you find yourself, any medication changes should be made under the guidance of a medical team.
For many people, those questions arrive with a particular kind of unease. Not just practical concern, but something more personal. Questions about hunger returning. About whether the progress you have made will hold. About what it would mean to navigate a transition you did not fully anticipate when you started.
Those questions are worth taking seriously, through thoughtful, informed attention, not dismissal or alarm.
At SpringSource: Eating, Weight & Mood Disorders, we work with people at every stage of the GLP-1 journey, including the stage that gets the least attention: what happens emotionally when the medication changes, pauses, or stops. This piece is for anyone navigating that territory, or who can already see it on the horizon.
Let us start with the reality that underlies these concerns, because they are not unfounded.
The research on weight regain after GLP-1 discontinuation is consistent. The STEP 1 trial extension found that one year after stopping semaglutide, participants regained approximately two-thirds of the weight they had lost during treatment. The SURMOUNT-4 trial found that in participants with obesity or overweight, withdrawing tirzepatide led to substantial regain of lost weight, whereas continued treatment maintained and augmented initial weight reduction.
It is also worth knowing that stopping these medications is common. A large 2025 study published in JAMA Network Open tracking more than 125,000 patients, found that nearly 65 percent of people using GLP-1 medications for weight loss without diabetes discontinued use within a year.
That means the majority of people currently taking these medications will stop at some point, and many will experience some degree of weight regain. Understanding this is a biological reality rather than a personal failing is an important starting point.
GLP-1 medications work in part by altering the brain’s appetite signaling. When the medication stops, those signals return. Hunger often comes back before the behavioral and emotional patterns that supported change on the medication have had time to become fully stable. Furthermore, people who rely primarily on medication alone may have fewer opportunities to build the practical behavioral strategies that support long-term change. When the medication stops, there can be a gap between the body’s new baseline and the habits needed to sustain it.
There is also some encouraging real-world nuance worth noting. A 2025 study published in AJMC found that many patients who stopped semaglutide or tirzepatide in real-world settings did not regain weight as rapidly as clinical trial outcomes suggested, particularly when tapering was gradual, and lifestyle support was in place. The picture is not uniform, and individual experience varies considerably.
For most people, some concern about weight changes after stopping a GLP-1 medication is understandable and proportionate. For others, particularly those with a longer history of complicated relationships with food, dieting, or their bodies, those concerns can grow into something that occupies more mental space than feels comfortable.
Some people describe checking their weight more frequently as a prescription end date approaches. Others describe eating less than they need because they are anticipating changes in hunger. Others describe a growing preoccupation with discontinuation that feels difficult to manage alone.
For many people, the concern is not just about weight. It reaches into questions of identity and control, and into what it means to change in a culture that is deeply invested in the size of your body. Therapy offers a place to untangle those layers, whatever ultimately happens with the medication.
Dr. Angela Derrick notes, “Although GLP1 medications reduce food preoccupation and enable physiological changes, in my clinical experience, they do not fully change how an individual sees themselves in relation to their body or food. These are often long-standing emotional patterns connected to history and identity and therefore require therapeutic support to shift in sustained ways.”
GLP-1 medications can produce significant physical change in a relatively short period of time. What they cannot do is keep pace with the psychological work of integrating that change.
When someone’s body changes, their sense of self often has to catch up. People describe being treated differently by those around them. They describe feeling more visible, more at ease, more recognized as the person they have always felt themselves to be. Others describe a more complicated response: a kind of grief over years spent in a body that felt harder to live in, or an unsettling awareness of how differently the world responds to them now, and what that says about the world.
All of this can become intertwined with questions about stopping the medication. If physical change brought certain things, the concern goes, what happens if things shift again?
That is not a question about pounds. It is a question about belonging, visibility, and self-worth. And it is the kind of question that responds well to therapeutic exploration rather than reassurance alone.
At SpringSource, we often see these concerns deepen in individuals who have come to associate the progress they made on GLP-1 treatment with a broader sense of agency in their lives. When that feels uncertain, the emotional response can be significant and worthy of attention.
What we often find in this work is that the concern about weight regain is really a concern about going back to feeling invisible, ashamed, or out of control. Those are the layers that therapy is best positioned to address, no matter what ultimately happens with the medication.
There is another dimension of this experience that deserves honest attention: the reality that access to these medications is genuinely inequitable, and that financial uncertainty around GLP-1 treatment is itself a meaningful source of stress.
The JAMA Network Open study noted that income was significantly associated with discontinuation rates, with lower-income patients more likely to stop treatment. Brand-name medications like Wegovy and Zepbound have list prices that can exceed $1,000 a month. Manufacturers offer discounts through programs such as LillyDirect and NovoCare, but even so, these medications remain expensive and difficult to sustain out of pocket indefinitely. Insurance coverage for weight loss remains inconsistent and frequently subject to change. Employer health plans often drop or restrict GLP-1 coverage with little or no warning. For many people, sustaining access long term involves real financial sacrifice.
We want to acknowledge something that does not always get named in clinical settings. For many people, the question of whether to stop a GLP-1 medication is not only emotional or behavioral. It is financial. That reality falls unevenly across income levels, and it is worth holding with the same seriousness as any other dimension of this experience.
Research is clear that behavioral and psychological support improves outcomes during GLP-1 treatment. What receives less attention is that this support may matter just as much, and in some ways more, during the maintenance phase and when navigating discontinuation.
The World Health Organization, in its updated guidance on GLP-1 medications, specifically named Intensive Behavioral Therapy as a necessary component of comprehensive care. Researchers who reviewed weight regain patterns noted that people who had built practical and psychological strategies during treatment tended to show more stable trajectories after stopping, compared to those who had relied primarily on medication alone.
At SpringSource, the work we do with people navigating GLP-1 maintenance and discontinuation includes several distinct threads.
Understanding and working with the concerns themselves. The questions that arise around stopping a GLP-1 medication are worth exploring, not avoiding. In therapy, we look at what those concerns are really about: what they reveal about a person’s relationship with their body, with control, and with their own sense of worth. That exploration is not about talking anyone out of legitimate concerns. It is about understanding them clearly enough that they do not have to drive decisions from the background.
Building a relationship with food that does not depend on medication. One of the most valuable things therapy can offer during this phase is support in developing a more intuitive, flexible, and compassionate relationship with food. GLP-1 medications can quiet food noise and reduce the urgency around eating, but they cannot teach someone to trust their hunger, to eat without shame, or to relate to food outside of a framework of control and monitoring. That learning happens over time, through a relational and therapeutic process.
Processing identity shifts with honesty and care. If your sense of confidence or belonging became attached to physical changes during GLP-1 treatment, that deserves thoughtful attention. Therapy offers a space to examine what genuinely shifted during treatment, what was always yours to begin with, and how to build a sense of self that feels stable regardless of what the scale says on any given day.
Attending to eating disorder risk during transitions. For people with any history of disordered eating, periods of medication change can be times of increased vulnerability. Hunger returning can activate restrictive patterns in some people. Changes in weight can increase shame and behavioral reactivity in others. Having a therapist who understands eating disorders during this period is a meaningful clinical safeguard.
Harm reduction during a difficult transition. At SpringSource, we bring a harm reduction lens to this work. We do not expect perfection during what is, for many people, a genuinely challenging transition. We work with people where they actually are, acknowledging the real biological, financial, and emotional pressures they are navigating, and helping them build whatever stability is possible from that starting point.
At SpringSource, we want people to know that needing support during medication transitions does not indicate any failure on your part. It means you are navigating something genuinely complex, and that navigating it alone is harder than it needs to be.
If you are thinking about stopping a GLP-1 medication, currently tapering, or already on the other side of discontinuation and finding it more complex than expected, a few things are worth remembering.
Weight changes, if they occur, are a known biological response to a medication that alters appetite signaling. They are not a measure of your effort, your character, or your worth.
The concerns you are carrying are not a sign that something is wrong with you. They are information about what this experience has meant to you, and what kind of support might be genuinely useful going forward.
The approaches that tend to serve people best in this transition are not the ones built on tighter rules or stricter monitoring. They are the ones that help build a more trusting, flexible, and sustainable relationship with food and with the body. That is the work that tends to last.
And whatever happens with the medication, your worth is not located in your body size or shape, even though the culture around us will suggest otherwise, often loudly. In our clinical experience and in the broader research on psychological well-being, that message is simply not true.
Whether you are considering starting or stopping a GLP-1 medication, currently tapering, or managing the aftermath of discontinuation, the emotional dimensions of that experience deserve the same thoughtful care as the physical ones.
At SpringSource: Eating, Weight & Mood Disorders, we provide specialized GLP-1 mental health support for people at every stage of the medication journey. Our approach is weight-inclusive, non-judgmental, and informed by decades of clinical expertise in eating disorders, mood disorders, and the psychological complexity of living in a body in a culture like ours.
We offer a free 15-minute consultation and would be glad to help you find the right level of support.
Call us at 224-202-6260, or fill out our contact form to explore next steps.
Recovery, and relief, are always within reach.
About SpringSource: Eating, Weight & Mood Disorders SpringSource is a clinician-owned practice specializing in eating disorders, weight-related concerns, and mood disorders across the lifespan. Founded by Dr. Susan McClanahan and Dr. Angela Derrick, both Ph.D. licensed clinical psychologists and Certified Eating Disorder Specialists with decades of leadership in the field, SpringSource provides evidence-based, weight-inclusive, and deeply individualized care. With offices in downtown Chicago and Northbrook and virtual therapy across Illinois, we are currently accepting new clients for individual therapy, GLP-1 mental health support, Higher Weight Support Group, DBT Group Therapy, and our hybrid Intensive Outpatient Program for Adults.
STEP 1 Trial Extension — Semaglutide weight regain after discontinuation Wilding et al. (2022), Diabetes, Obesity and Metabolism https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/
SURMOUNT-4 Trial — Tirzepatide weight regain after discontinuation Aronne et al. (2024), JAMA https://pubmed.ncbi.nlm.nih.gov/38078870/
SURMOUNT-4 Post Hoc Analysis — Cardiometabolic effects of weight regain Horn et al. (2025), JAMA Internal Medicine https://pmc.ncbi.nlm.nih.gov/articles/PMC12645400/
Systematic review and meta-analysis — Pooled weight regain across GLP-1 studies MedCentral / Obesity Reviews summary https://www.medcentral.com/endocrinology/obesity/weight-maintenance-after-glp-1-ra-withdrawal-exposes-critical-research-gaps
JAMA Network Open — Discontinuation rates among 125,000+ patients Rodriguez et al. (2025) https://pmc.ncbi.nlm.nih.gov/articles/PMC11786232/
Real-world weight regain is less rapid than clinical trials suggest Gasoyan et al. (2025), AJMC https://www.ajmc.com/view/weight-regain-after-glp-1-discontinuation-is-less-rapid-in-real-world-hamlet-gasoyan-phd
NPR Health — Many employer health plans have dropped or restricted GLP-1 coverage for weight loss Lupkin (2026), NPR https://www.npr.org/2026/04/22/nx-s1-5794613/health-insurance-wegovy-zepbound
We provide in-person therapy in Northbrook and Chicago, with telehealth therapy available throughout Illinois.
© 2026 SpringSource: Eating, Weight & Mood Disorders | Designed by 800Commerce
Serving: Chicagoland Area, Northbrook, Evanston, Arlington Heights, Glenview, Skokie, Palatine, Elgin, Cicero, Schaumburg, Des Plaines, Orland Park, and throughout Illinois