Whether, when and how to come off a GLP-1 medicine is a decision for you and your prescriber, and OffRamp never advises on it. What you can do is walk in prepared. Ask what the evidence says about weight for someone like you, which health numbers to recheck, what weight change should prompt a call, what support there is for appetite, whether your muscle and strength are where they should be, whether any other medicines are affected, and when follow-up will happen.

Bring your weight trend, not just today's number. The rest of this article explains why each question matters.

Why this is a conversation, not a solo decision

People come off GLP-1 medicines for good reasons: cost, side effects, supply problems, reaching a goal, planning a pregnancy. The trials show why it deserves a plan rather than a quiet stop. A 2026 consensus statement from three European obesity organisations, published in The Lancet Diabetes and Endocrinology, describes decisions to start, pause or discontinue these medicines as shared decisions between patient and clinician that weigh the physical and psychological risks either way.

That framing is useful. You bring your goals, circumstances and data. Your prescriber brings your medical history and the options. Neither side has the whole picture alone.

Question 1: what happens to weight for someone like me?

The average answer is well documented. In the STEP 1 extension, people who stopped semaglutide regained about two-thirds of the weight they had lost within a year. In SURMOUNT-4, people switched from tirzepatide to placebo gained 14 percent over 52 weeks, while those who continued lost a further 5.5 percent.

Averages are not destinies, and the spread between people was wide. Asking your doctor how they read that evidence for your situation turns a scary statistic into a plan. Why people regain weight after stopping a GLP-1 covers the biology, and what happens when you stop Wegovy walks through the semaglutide trials in order.

Question 2: which health numbers should we recheck?

Weight is not the only thing these medicines move. The STEP 1 extension found that improvements in cardiometabolic risk factors, the heart and metabolic measures it tracked, reverted toward baseline for most of them a year after stopping. Ask which numbers matter for you, and when they should be checked again.

If you have type 2 diabetes, high blood pressure or another condition the medicine was helping, this question matters even more than the scale.

Question 3: what weight change should make me call you?

Agreeing on a number in advance takes the guesswork out later. Some people find a percentage easier than pounds. OffRamp's Regain Radar, for example, flags drift when your 7 day average sits 2 percent above your baseline for 7 days in a row, and raises an alert at 4 percent. Your doctor may suggest a different line for you, and theirs is the one to use.

The point is to decide now, while you are calm, what would count as a reason to get back in touch.

Question 4: what support is there for appetite and food noise?

As the medicine clears, appetite and food thoughts usually return over weeks. A 2025 joint advisory from four US obesity and nutrition societies lists registered dietitian counseling, group visits, telehealth and digital tools among the supportive strategies around GLP-1 treatment, and names nutrition for maintenance after stopping as an area that still needs research.

Ask whether a dietitian referral or a behavioural program is available to you. Insurance coverage varies, so it is worth asking early.

Question 5: are my muscle and strength where they should be?

Part of any large weight loss is lean mass. The same advisory recommends assessing muscle strength, function and body composition, and preserving muscle through resistance training and appropriate diet. Ask whether a strength or body composition check makes sense for you, especially if you are older or have lost a lot of weight quickly.

Ask too whether there is any reason your protein should be different from a general floor, for example if you have kidney disease.

Question 6: does this change anything about my other medicines?

A GLP-1 can affect blood sugar, blood pressure and how your stomach empties, so it may interact with how other treatments work for you. Only your prescriber and pharmacist can answer this, which is exactly why it belongs on the list. Bring a current list of everything you take, including supplements.

Question 7: when is follow-up, and what should bring me in sooner?

Leave with a date. A follow-up a few months after stopping lets your doctor see the trend and the health numbers together. Also ask which symptoms should bring you in sooner, so you are not left wondering whether something is worth a call.

What to bring to the appointment

A single weigh-in tells your doctor very little. A few weeks of morning weigh-ins and a 7 day average tell them a lot. That is why we built a doctor report into OffRamp instead of anything to do with doses. It exports a PDF with your medication name and last dose date as you logged them, your starting, goal and current 7 day average weight, the change since you started, your Regain Radar status, your daily protein floor, and a table of your weigh-ins.

Add your own notes on appetite, food noise, energy and side effects, and your question list. If you want to start weighing consistently before the appointment, how often to weigh yourself explains a routine that works. And if you are gaining while still on the medicine, why people gain weight on Ozempic is useful reading before you go.