What happens when you stop taking Zepbound?

If you stop using Zepbound for weight loss or obstructive sleep apnea (OSA), you will most likely regain much of the weight you have lost or you may lose the beneficial effects for OSA over time. The improvement in apnea in people with OSA is most likely related to body weight reduction with Zepbound.

In 88-month long weight loss studies with Zepbound, people who stopped treatment after 36 months regained 14% of their body weight, compared to a 25% weight loss in those who stayed on the medicine.

In 1-year long obstructive sleep apnea (OSA) studies, Zepbound significantly improved the apnea-hypopnea index (AHI), a tool that measures the severity of disrupted breathing in OSA. Patients with OSA also lost an average of 45 to 50 pounds during treatment, which may directly have beneficial effects in OSA.

Related: How does Zepbound help treat sleep apnea?

Obstructive sleep apnea (OSA) is a serious breathing disorder that can be common in people with obesity or overweight. It is characterized by a collapse of the upper airway during sleep and can cause pauses in breathing, shallow breathing, disturbed sleep and low blood oxygen. Snoring, fatigue and excessive daytime sleepiness are key symptoms of OSA.

Speak with your doctor before you stop using Zepbound. Obesity or being overweight and obstructive sleep apnea are chronic (long-term) health conditions that often require long-term medical treatment. Your healthcare provider may suggest that you switch to another medicine, adjust your dose, or add changes to your exercise and diet routine to help control weight gain.

If you are having trouble getting Zepbound (tirzepatide) at the pharmacy due to a drug shortage or cost issues, your healthcare provider may be able to recommend other treatments or money-saving options. Eli Lilly, the manufacturer, may be able to offer copay assistance or patient financial help, if you qualify.

Will I regain the weight I lost if I stop Zepbound?

Studies have shown that weight regain is common when weight loss treatments like Zepbound are discontinued. Most patients will need to remain on treatment to improve or maintain their current level of weight loss.

The Phase 3 SURMONT-4 study evaluated 783 people with obesity or overweight but without type 2 diabetes. Mean body weight for patients at the start of the study was 107.3 kg (236 lbs). The objective was to look at the effect of tirzepatide on maintaining weight loss over time, when used alongside diet and exercise.

The researchers sought to determine what the average percent change in weight over the year. They also looked at the number of people at the end of the year who kept off at least 80% of their weight loss

All of the patients received Zepbound given subcutaneously once a week for 36 weeks (9 months), along with diet and exercise. Doses were increased slowly up to a maximum of a 10 mg or 15 mg dose.

After 36 weeks, 335 patients continued treatment with Zepbound injections for an additional year (52 weeks), and 335 patients took a placebo (inactive) shot during this time.

Results

• In the first 36 weeks, people using Zepbound lost an average of about 21% of their weight.
• Over the next year, people who continued on Zepbound had an additional weight loss of 5.5%, on average, while those taking the placebo shot had a weight regain of 14%, a statistically significant difference (P < .001), which means the results did not happen just by chance.
• On average, over the 1 year and 9 month period (88 weeks) people taking Zepbound had a 25.3% weight loss and those using the placebo shot had a regain of 9.9% of their weight.

In addition, close to 90% of those receiving Zepbound at week 88 had kept off at least 80% of the weight they lost in the first 36 weeks, compared to about 17% of the placebo group, also a significant difference.

Related questions

• Ozempic Side Effects to Watch For
• Zepbound Vs Mounjaro: Complete Comparison Guide for Weight Loss and Diabetes Treatment
• Why am I not losing weight on Mounjaro?

Common side effects

The most common side effects were stomach-related and occurred more frequently with Zepbound than placebo. During the first 36 weeks these included nausea (36%) diarrhea (21%), constipation (21%) and vomiting (16%). Most stomach-related side effects were reported as mild-to-moderate and decreased and leveled-off over the 88-week treatment period.

In the first 36 weeks, 7% of patients dropped out of the study due to stomach-related side effects.

How long has Zepbound been on the market?

In November 2023, the U.S. Food and Drug Administration (FDA) approved Eli Lilly’s Zepbound (tirzepatide), a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist for weight loss. But Lilly’s Mounjaro, which also contains tirzepatide, was first approved for blood sugar control in adults with type 2 diabetes in May 2022.

Zepbound is indicated for weight loss in adults with obesity or who are overweight and have weight-related medical conditions like high blood pressure, type 2 diabetes, heart disease or high lipid levels. In December 2024, it was also approved to treat obstructive sleep apnea in adults with obesity.

How does Zepbound cause weight loss?

Zepbound works by activating the receptors for the incretin hormones GIP and GLP-1 to slow down the movement of food through your digestive tract. This action decreases your appetite and lengthens the amount of time you feel full after eating.

Zepbound is given as a subcutaneous (under the skin) injection once a week into the stomach area, thigh, or upper arm using a pre-filled pen. Zepbound is available in 6 strengths - 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg) - and comes with 4 single-dose pens per carton.

Approval studies for Zepbound

FDA approval for Zepbound was based on results from the 72-week, Phase 3 SURMOUNT studies.

• In SURMOUNT-1, people without type 2 diabetes taking Zepbound 15 mg lost an average of 48 lbs, and those taking 5 mg lost an average 34 lbs. (compared to 7 lbs. on placebo, an inactive treatment).
• In SURMOUNT-2, people with type 2 diabetes taking Zepbound 15 mg lost an average of 34 lbs. and those on the 10 mg dose lost an average of 30 lbs. compared to 7 lbs. on placebo.

In these studies, the most common side effects were nausea, diarrhea, vomiting, constipation, stomach area pain, heartburn, injection site reactions, tiredness, allergic reactions, belching / burping, and hair loss.

Zepbound also carries a Boxed Warning for the risk of thyroid C-cell tumors, as with other incretin mimetics.

What about Ozempic - will I regain weight if I stop Ozempic?

Weight regain seems to be common with other incretin mimetics when treatment is stopped, as shown in studies with semaglutide (Ozempic, Wegovy).

In studies with semaglutide, patients who stopped treatment still had an overall weight loss of 5.6% of their original weight after 52 weeks, but the placebo group was close to their original starting weight.

Learn more: What happens when you stop taking Ozempic?

Finally, remember, it’s hard to lose weight. Obesity or overweight are medical conditions and not a failing of willpower. And regaining weight after initially losing it can take a toll on your mental health. Keep your mind strong by staying active, eating healthfully, maintaining your social circles, getting enough sleep and talking to a trusted partner or healthcare provider when needed.

This is not all the information you need to know about tirzepatide (Zepbound) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.