What happens when you stop weight-loss injections?

If you are thinking about stopping weight-loss injections, or you already have, you have probably read two kinds of advice. One says the weight will all come back. The other says you will be fine if you are disciplined. Neither is accurate, and neither helps you prepare.

I am a clinical psychologist, and this is what I tell people about the psychological side of stopping.

What usually comes back

Hunger, and often quickly. For many people appetite returns within weeks rather than months. It can feel abrupt rather than gradual.

Food noise. The running commentary about what to eat, when, and whether it was allowed. For some people this is the harder half, and it can arrive a little after the hunger does.

Some weight, for most people. In the large trials, most people regained a substantial part of the weight they had lost in the year after stopping. But averages hide wide variation. Some people regained very little.

Why it can feel stronger than before

After weight loss, the body pushes back. Appetite regulation shifts upward and energy use falls. The medication was sitting on top of that push.

Take it away and you are not simply back where you started. You are back where you started, with a body that would like the weight back. That is physiology, not a failure of willpower.

The first fortnight

The first two weeks after the effect fades are usually the hardest. Appetite is loud, and whatever routines you built feel flimsy. Many people reach the same conclusion at this point: none of it worked, and it was all the medication.

That conclusion is drawn at the worst possible moment. Your routines are being tested under full load for the first time. Give them longer than a fortnight before you judge them.

What helps

Keep a rhythm of eating. Eat at regular points in the day, whether or not you feel hungry. Structure is the thing most likely to still be standing in six months.

Eat enough. The pull to compensate by eating less backfires. It produces more hunger and, often, eating that gets away from you.

Expect the noise, and name it. Predicted things are much less frightening than unpredicted ones.

Know what food was doing for you. If eating used to soothe you or switch things off, that need is still there. It will ask again when appetite returns.

Tell one person. Not for accountability. So someone knows this is a hard stretch.

Talk to your prescriber first. Ask about tapering, and agree in advance what would happen if you needed to go back on.

Going back on is not failure

For some people the right answer is to restart. That is a clinical decision, made with your prescriber, and it is not a relapse. If it happens, you are adding the medication back to a foundation you have built, which is a much better position than the first time.

Preparing properly

Most people stop with no plan, because nobody gives them one. My course, When the Noise Stops, has a whole part on the decision to stop and another on the landing afterwards: the first fortnight, telling hunger from noise, and what to do when weight moves. You can start there even if you have already stopped.

Find out about When the Noise Stops →

This article is general information, not medical advice. Decisions about your medication belong to you and your prescriber.