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Cosmos Study

Many Patients Maintain Weight Loss a Year After Stopping Semaglutide and Liraglutide

January 23, 2024
Dual-Team Study
Team A:Kersten Bartelt, RNChris Mast, MDJoe Deckert, PhD
Team B:Matthew Gracianette, MDBrendan Joyce

Key Findings

  • More than half of patients are able to maintain weight loss achieved while on semaglutide or liraglutide even a year after discontinuing the medication.
  • However, a portion of patients who stop taking either medication experience weight regain, with 18.7% of liraglutide users and 17.7% of semaglutide users regaining all the weight they had lost or more. 

In a previous study, we demonstrated that patients using the recommended weight loss dose of semaglutide for 60 weeks achieved weight loss of 8-11% of their initial body weight.1 However, clinical trials have shown weight gain after discontinuation of semaglutide.2,3 Because of this, we aimed to further investigate the effects on weight after discontinuing semaglutide or liraglutide. 

We studied 20,274 patients who were prescribed semaglutide and successfully lost at least five pounds while on the medication. We aimed to assess their weight change one year after discontinuation. We found that 17.7% of these patients regained all the weight they had lost or even exceeded their initial weight. However, a majority (56.2%) of patients either remained around the same weight they were at when stopping the medication or continued to lose additional weight. 

Figure 1
Proportion of Patients by Weight Change After Stopping Semaglutide
Proportion of Patients by Weight Change After Stopping Semaglutide
Figure 1. The proportion of patients by amount of weight regained or lost after stopping semaglutide.

Similarly, we studied 17,733 patients prescribed liraglutide who achieved a weight loss of at least five pounds while on the medication. Among this group, 18.7% experienced complete weight regain or surpassed their initial weight. However, 55.7% of these patients either remained around the weight they were at when stopping the medication or continued to lose additional weight. 

Figure 2
Proportion of Patients by Weight Change After Stopping Liraglutide
Proportion of Patients by Weight Change After Stopping Liraglutide
Figure 2. The proportion of patients by amount of weight regained or lost after stopping liraglutide.

Original Publication Date: January 23, 2024
Last Updated: May 16, 2024

These data come from Cosmos, a collaboration of 236 Epic health systems representing more than 227 million patient records from 1,301 hospitals and more than 28,600 clinics from all 50 states and Lebanon. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson. 

  1. Little D, Deckert J, Bartelt K, Ganesh M, Stamp T. Weight Change With Semaglutide. Epic Research. https://epicresearch.org/articles/diabetes-drug-helps-with-weight-loss-in-both-diabetics-and-non-diabetics. Accessed on November 17, 2023. 
  2. Wilding, John P..H., et al. “Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension.” Diabetes, Obesity, and Metabolism, vol. 24, no. 8, Pharmacology and Therapeutics, August 2022, pp. 1553-1564. https://doi.org/10.1111/dom.14725. 
  3. Rubino, Domenica, et al. “Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults with Overweight or Obesity.” JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.3224. https://jamanetwork.com/journals/jama/article-abstract/2777886.