Recent evidence suggests tapering off semaglutide is promising for maintaining weight loss, particularly when paired with diet and exercise coaching.

A common, ongoing concern and question for patients taking a GLP-1 like semaglutide is whether the weight they lost while on a GLP-1 will return once they stop. While research does suggest that weight gain after stopping a GLP-1 can occur,¹  slowly tapering off semaglutide can help patients maintain weight loss. A recent study² that investigated tapering off semaglutide found that once a patient’s goal weight was achieved, the average weight loss during the nine-week tapering period was 2.1 percent.

Tapering Off Semaglutide: A Cohort Study

In a cohort study² of 2,246 adults (BMI = 33.2 kg/m² and median weight of 97kg), semaglutide doses were tailored for individual patients to minimize side effects. The starting dose was 0.25 mg once weekly and then increased to a maximum dose of 2.0mg for Ozempic® and 2.4 mg for Wegovy® across 16 weeks. The average maximum dose of semaglutide for weight loss was 0.77 mg. When it was time to increase the dose, patients received only the lowest effective dose. For patients who maintained a > 0.5 percent weight loss relative to their body weight, their dose remained the same — it was not increased.

At 64 weeks (n = 359), an average weight loss of 14.8 percent was observed. At 76 weeks (n = 185), an average weight loss of 14.9 percent was observed. In addition to semaglutide, patients also received diet and exercise coaching. Of the original 2,246 participants, 353 (BMI 31.5 kg/m² and M_weight = 92 kg), tapered off semaglutide once they reached their goal weight. The dose was reduced across nine weeks and the patients continued to received diet and exercise coaching. During these nine weeks, the average weight loss was 21 percent. Of the 353 patients, 240 tapered semaglutide to zero. Data available at the 26-week mark for 85 of these patients showed their weight was stable, with an average weight loss of 1.5 percent after tapering semaglutide to zero. Forty-six of the 240 patients did restart semaglutide after tapering to zero; their average weight gain after stopping semaglutide was 1.3 percent.

Coupling Diet & Exercise Coaching with a GLP-1

There is early evidence to suggest that patients can benefit from diet and exercise coaching when tapering off semaglutide — and while taking the medication. These results confirm that successful weight loss requires a multi-prong approach wherein patient benefits are optimized with lifestyle changes when coupled with a pharmacological intervention. While GLP-1 medications are effective for weight loss, they may not be a long-term solution for many patients because of their cost and side effects. (A dietary beverage such as Biocare, which is designed specifically for patients taking a GLP-1, helps reduce the common side effects of the medication while providing essential daily nutrition.)

Working with patients to implement sustainable lifestyle changes can help them maintain their GLP-1 supported weight loss. Once patients’ appetites return after tapering off semaglutide, having the tools and information to make healthy food choices can increase their chances of keeping the weight off. Scientifically formulated meal replacements can help patients not only ensure their RDAs for micro- and macronutrients are met and but also that caloric goals are met. Health care professionals should talk with patients about lifestyle changes that include physical activity and dietary changes. Supplementing an active lifestyle and healthy eating habits with a scientifically formulated meal replacements offer patients a greater chance of keeping the weight off once they taper off semaglutide or other GLP-1 medications.

Source(s):

1 Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension

2 Weight loss maintained with slow taper of semaglutide