What happened a year after people stopped semaglutide?

The short answer

Participants regained about two-thirds of the weight they had lost during treatment. On average, they still weighed less than when they started. This was a follow-up of a smaller group from STEP 1—not a prediction that everyone will regain the same amount.

The question behind the study

Losing weight is one question. Keeping it off after treatment ends is another. John Wilding and colleagues followed participants for a year after the STEP 1 treatment period ended to see what happened next.

The analysis included 327 adults with overweight or obesity who did not have diabetes. They had completed 68 weeks of semaglutide or placebo alongside lifestyle support. At week 68, both the trial medicine and the structured lifestyle program stopped.

What the numbers mean

In the semaglutide group, average weight loss was 17.3% at the end of treatment. A year later, average weight remained 5.6% below the starting level. The researchers reported that participants regained 11.6 percentage points of body weight during that follow-up. These rounded results come from the study’s analyses; they need not add up exactly.

That is where the “two-thirds regained” headline comes from. It does not mean that participants gained two-thirds of their total body weight. It means they regained roughly two-thirds of the weight previously lost.

The average also hides differences between people. Among participants with a weight measurement at the final visit, 48.2% of the former semaglutide group remained at least 5% below their starting weight.

What this tells us about the weight-loss journey

A maintenance plan matters as much as the initial weight-loss phase. This study helps explain why a plan that ends when the scale reaches a target may leave an important question unanswered: what will support maintenance afterward?

The finding also shifts the conversation away from treating regain as a personal failure. In this group, regain was common after the treatment program ended, even after substantial initial loss.

What the study cannot settle

This was an exploratory follow-up, not a new randomized comparison of different ways to stop treatment. Participants were selected from certain sites and had completed the initial treatment period, so they were not identical to everyone who originally enrolled. The follow-up stopped at one year; it cannot tell us where weight would settle several years later.

Because structured lifestyle support ended too, the study cannot isolate the effect of stopping the medicine from the effect of stopping that support. It did not test a taper, a lower maintenance dose, or a specific replacement treatment.

A useful question to take away: “If my treatment changes or stops, what is our plan for maintaining the progress?”