If you’re curious about weight loss medications—or you’re already taking one—let’s begin with this: there’s nothing wrong with you. Wanting support with your health doesn’t mean you’ve failed. It doesn’t mean you lack willpower. And it certainly doesn’t mean you’ve taken an “easy way out.”

The conversation around medications such as Ozempic, Wegovy and Mounjaro has been loud, polarised and often unhelpful. What’s frequently missing is calm, compassionate education about what happens after the initial weight loss—especially when someone stops the medication.

That’s why Episode 157 of The Eating For You Podcast focused on a key topic that many people are quietly worried about:

Weight regain after stopping weight loss medications.

In this blog, I’ll compare what the research suggests about weight regain after stopping medication versus weight regain after lifestyle and behavioural programs, and I’ll add the part that often gets overlooked: body composition—your balance of muscle and fat.

Why weight regain needs more attention

When we only talk about weight loss, we unintentionally set people up to feel like they’ve “failed” if the weight comes back. But the reality is this:

Regain can be a predictable biological response—especially when biological support is removed.

In Episode 157, I discussed a systematic review published in November 2025 examining weight regain after stopping weight loss medications in adults with overweight or obesity. The review included data from just under 9,500 participants across 20 weight loss medications.

Systematic reviews report averages, so individuals will vary. Some people maintain their losses after stopping medication. But averages matter because they tell us what is likely for many people.

First: how modern weight loss medications work (brief refresher)

Medications like Ozempic, Wegovy and Mounjaro are often described as GLP-1 receptor agonists (and some medications act on multiple appetite pathways). The core effect for many people is:

• • Appetite suppression
    
    
  • Appetite regulation
    
    
  • Hormonal changes that reduce hunger
    
    
  • Feeling fuller sooner, so you eat less
    

What these medications don’t automatically do:

• • Preserve muscle (lean body mass)
    
    
  • Guarantee you’ll meet your nutrient needs
    
    
  • Teach skills for emotional or stress eating
    
    
  • Build a more peaceful relationship with food long-term
    

And that matters—because for long-term health, how you lose weight can influence how you regain it.

The missing conversation: weight is not the same as health

Weight is simply a number on a scale. It doesn’t tell the full story of health and wellbeing. 

What matters more is body composition: your lean body mass (muscle) and your fat mass—and the type and location of fat.

A quick, non-judgemental reframe:

• • Subcutaneous fat sits under the skin (the “pinchable” fat).
    
    
  • Visceral fat sits deeper, around the organs, and is more metabolically active.
    

Visceral fat can contribute to metabolic risk because it releases fatty acids and inflammatory factors into the circulation. But the goal is not to label bodies as “good” or “bad.” Every adult has both kinds of fat. The question is about relative amounts and overall health—not pass/fail.

Also important: someone in a smaller body can still have elevated visceral fat, especially with:

• • Ageing and menopause
    
    
  • Chronic stress
    
    
  • Long periods of inactivity
    
    
  • Lower lean muscle mass
    

Why muscle matters 

Muscle (lean body mass) supports:

• • Strength and balance (risk of falls as we age)
    
    
  • Independence and mobility
    
    
  • Blood sugar regulation (especially relevant for type 2 diabetes)
    
    
  • Metabolic resilience
    
    

In the podcast I used an analogy:

If you lose weight without protecting muscle, it can be like going from a V8 engine to a 4-cylinder engine. With less muscle, your body may need less “fuel” to maintain weight, and it can become harder to maintain a lower weight long term.

Rapid weight loss—with or without medication—can reduce lean body mass. Risk increases when:

• • Protein intake drops too low for your needs
    
    
  • Resistance training isn’t part of your routine
    
    
  • Side effects reduce appetite and energy
    
    

If weight loss comes at the cost of muscle, weight may return—but with a different composition: more fat and less muscle. And that shift can raise metabolic risk even if the number on the scale looks similar.

Why people stop weight loss medications (real-world reasons)

In Episode 157 I covered several reasons people discontinue medication—many of which have nothing to do with motivation:

Side effects
Common side effects are gastrointestinal: nausea, reflux, constipation, fatigue. There may also be mood changes and low energy for some people.

The “hidden” side effect
In trying to manage discomfort, people may:

• • Skip meals
    
    
  • Eat less protein
    
    
  • Move less because energy is low
    These are understandable responses—but they can increase muscle loss risk.
    

Cost
In Australia, costs can be substantial depending on medication and dosage—often around $150 to $700 per month (with subsidies for eligible people with type 2 diabetes).

Belief it’s short-term
Some people assume they’ll use medication temporarily, rather than as a longer-term treatment.

Plateaus and disappointment
When weight loss slows, people may feel discouraged—even though plateaus are common with many interventions.

What the research suggests about weight regain after stopping medication

In the systematic review discussed in Episode 157, the reported average regain pattern suggested many participants returned toward baseline (pre-medication) weight within about 1.7 years, averaging roughly 0.4 kg per month of regain.

The review also noted that cardiometabolic markers (including HbA1c, fasting glucose, cholesterol, triglycerides and blood pressure) tended to return toward pre-medication levels as well.

The key takeaway is not “medications don’t work.” The takeaway is:

When medication is removed, biological support is removed. Appetite rebounds—and regain can follow.

This is not about laziness, weakness, or failure. It is a biological response to changing signals around hunger, fullness and energy balance.

And if someone hasn’t had support to rebuild hunger/satiety awareness or manage stress eating habits, those patterns can return quickly.

Weight regain after lifestyle/behavioural programs: what’s different?

Now let’s compare this with lifestyle and behavioural programs.

In Episode 157, I discussed systematic reviews of behavioural weight management programs.

These programs vary widely: exercise programs, structured meal plans, partial or total meal replacements, and behavioural change interventions.

What those reviews broadly suggest is:

• • Weight regain can occur after programs end
    
    
  • But regain is often slower when people retain access to ongoing support and resources
    
    
  • Regain can be quicker when weight loss was more rapid (possibly linked to lean mass loss)
    

One key difference highlighted in the medication vs program comparison:

Medication cessation: average return toward baseline by ~1.7 years

Behavioural programs: regain more like ~5 years on average
And cardiometabolic improvements were often maintained over that longer period.

This is a meaningful distinction—not because programs are “better,” but because programs may leave people with:

• • Skills
    
    
  • awareness
    
    
  • routines
    
    
  • strategies to adapt when life changes
    

Why skills matter more than willpower

Lifestyle and behavioural programs (especially those that are mindfulness-based and non-diet) can help people develop:

• • Eating awareness (noticing hunger, fullness, satisfaction)
    
    
  • Flexible, nourishing routines that fit real life
    
    
  • Support for emotional/stress eating
    
    
  • Movement habits that feel achievable and sustainable
    
    
  • A mindset shift away from “all-or-nothing” eating
    

When you have skills, you have something to return to—even years later—when a new driver for eating shows up (stress, grief, menopause, injury, fatigue, changing schedules).

That’s why in my Foundations Mindful Eating Program, clients retain access to the resources long-term—because behaviour change isn’t a one-and-done event. Life happens, bodies change, and support matters.

Can medication and lifestyle support work together?

Yes—there is emerging evidence that medication alongside lifestyle and eating habits support can lead to healthier habits and better long-term outcomes.

If medication is part of your care plan, it’s worth asking your healthcare team:

• • Is this recommended as temporary support or long-term treatment?
    
    
  • What is the plan to protect lean body mass?
    
    
  • How will we support nourishment, not just appetite reduction?
    
    
  • What support is in place for emotional eating, stress, and routines?
    

This combination approach can help protect muscle, improve metabolic health, and reduce the proportion of fat regain.

The question I want to leave you with: is stable weight a realistic goal?

This is one of the most important reflections from Episode 157:

Is it appropriate—or even realistic—to expect your body weight to stay the same long term, especially with:

• • Ageing and menopause
    
    
  • Injury or illness
    
    
  • Changing activity levels
    
    
  • Shifts in work, stress and sleep
    

Bodies change. Weight can fluctuate. Body composition can shift. The goal doesn’t need to be “freeze your weight in time.”

What if the real goal is:

• • metabolic health
    
    
  • physical strength
    
    
  • emotional wellbeing
    
    
  • and the ability to support your body through change
    

Long-term health and happiness isn’t about perfect control. It’s about building habits and self-trust that hold steady through life’s seasons.

A Calmer Way Forward

If you’re ready to explore a calmer, non-judgemental approach to eating that supports your body through change, you’re welcome to book a free 30-minute Mindful Eating Strategy Call. 

It’s a chance to talk through what you’ve tried, what’s not working anymore, and what might support you next.

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Because you don’t need more pressure. You need practical support, compassion, and a plan that fits your real life.

Important note: This is general information only and not personal medical advice. If you’re using medication, please work with your doctor and seek personalised support. You are most welcome to reach out to me for nutrition and eating habit support.