Keep weight off after stopping Mounjaro: Practical tips

The active ingredient in Mounjaro, tirzepatide, works by mimicking the effects of 2 hormones that regulate appetite, food cravings, and blood sugar levels. They are:

1. Glucagon-like peptide 1 (GLP-1).
2. Glucose-dependent insulinotropic polypeptide (GIP).

When you stop using Mounjaro, your body experiences a shift in these hormonal signals, which can lead to increased hunger and food cravings. For these reasons, many people find it challenging to maintain their weight loss when they stop their medication.

Return of food noise

Mounjaro works by reducing your appetite, which can also help with food noise, snacking, and overeating. However, it will only help reduce this until you stop taking it. After Mounjaro is stopped, food noise comes back, and some people report that it feels stronger than before. While there’s no evidence that Mounjaro makes your appetite come back stronger, having your appetite reduced for an extended period of time could make it harder to manage when it comes back, especially if you struggled with this before.

As Mounjaro also slows digestion, this will go back to normal, meaning you will not feel as full between meals as you did before. This can feel very sudden for some people, but there are things you can do to help manage this, such as:

• slowly reducing your dose rather than coming off Mounjaro at the highest maintenance dose – so the appetite change does not feel as sudden or intense
• staying on a maintenance dose, which involves taking a dose that keeps you at your goal weight without losing more, but still provides the benefits of Mounjaro, like a lowered appetite, management of blood sugar levels, and slowed digestion
• eating food that can mimic a similar effect of slowed digestion, including plenty of protein, fibre, and healthy fat – these can keep you feeling fuller for longer between meals

Gastrointestinal rebound symptoms

Some people report that they get gastrointestinal (stomach and digestive system) symptoms after stopping Mounjaro. This may be a bodily reaction to stopping the treatment, or could be due to diet changes or increased eating. It’s important that you stick to your diet and exercise plan after stopping Mounjaro, and if there are any foods that you want to reintroduce, you do so slowly.

For instance, some people do not eat a high-fibre diet on Mounjaro due to side effects, but when you’re no longer taking a medication that keeps you fuller, fibre is a very important part of maintaining weight and helping with hunger. However, eating more fibre, or eating more than you did before, could lead to gas and bloating.

Nausea and stomach discomfort are also reported by some people after coming off Mounjaro. This is usually mild and temporary, and it helps to eat little and often, drink plenty of water, and avoid foods that could make this worse, like spicy, high-fat, or rich foods. As most people cut out alcohol while on Mounjaro, if you do drink after stopping treatment, make sure to do this very slowly, or you may also get stomach upset, nausea, or vomiting. This is because your alcohol tolerance will be lower.

‘Mounjaro blues’

‘Mounjaro blues’ is a term created by some users who noticed that taking Mounjaro improved their mood and energy levels. Because of this, stopping Mounjaro may make you feel more tired or even cause changes in mood. This is likely due to Mounjaro’s effect on blood sugar, as it helps to regulate blood sugar dips.

When you stop Mounjaro, your blood sugar will start to fluctuate more naturally, so you may notice that you feel more tired or sluggish than before. However, losing weight and eating well can also help with managing your blood sugar levels, so not everyone will get these symptoms after stopping Mounjaro, and some people may have healthier blood sugar levels than before starting treatment.

You can help manage blood sugar dips that may affect your energy and mood by:

• getting enough sleep – at least 7 to 9 hours every night
• staying active – although it can feel more difficult at first, keeping active has a positive effect on your mood and energy levels in the long-term
• eating slow-release carbs, which help to keep your energy levels steady – whole grains, oats, and legumes are great choices

“In some cases, the ‘Mounjaro blues’ could be connected to an increase in appetite and food noise, which can lead to feelings of frustration, irritation, and low mood, especially if you’re struggling to stick to a healthy lifestyle.

Speaking to a doctor or therapist is recommended, especially if food noise is very strong or linked to emotional eating. They can help you find ways to manage and other coping techniques not centred around food.” Dr Kathryn Basford

Some people will regain weight after stopping Mounjaro injections because of the changes that take place in the body.

Results from clinical trials

Data from a randomised controlled trial suggests that without making long-term changes to your lifestyle, weight gain is likely when you stop taking Mounjaro.

In the trial, 670 participants received a once-weekly Mounjaro injection at their maximum tolerated maintenance dose of either 10 or 15mg. After 36 weeks, the average weight loss in the group was around 21%.

From here, the participants were randomly assigned to 1 of 2 groups to continue receiving Mounjaro or to receive a placebo to investigate what happens to weight loss when Mounjaro is stopped.

After 52 weeks, the results showed that:

• the group who continued Mounjaro treatment lost a further 5.5% of their body weight
• those assigned to the placebo group regained 14%

Over a total of 88 weeks, the Mounjaro group lost on average 25% of their body weight compared to almost 10% in the group that stopped Mounjaro part way through and then went on a placebo.

Although losing one tenth of your initial body weight is a significant achievement, the trial results indicate that stopping Mounjaro treatment increases the likelihood of putting weight back on.

Another more recent study looking into the effects of stopping weight loss treatment found that people often return to their baseline weight within 1.7 years on most weight loss medications, and just 1.5 years after taking Mounjaro or Wegovy. The study suggests that weight loss medication like Mounjaro should be a long-term obesity treatment, rather than a short-term one.

Though more research is pointing to Mounjaro being used as a long-term treatment for obesity, people stop taking Mounjaro for a variety of reasons, such as:

• they’ve reached their weight loss goals – stopping Mounjaro because you’ve lost enough weight is the most common reason to stop taking it, but you can also stay on a maintenance dose to maintain your weight if you and your doctor agree it’s suitable and safe
• financial reasons – Mounjaro is mainly accessed privately, as the NHS have very strict criteria on prescribing it, so some people may not be able to keep paying for treatment
• pregnancy – you cannot take Mounjaro if you are pregnant, and some people use Mounjaro to lose weight before pregnancy, which can improve fertility levels
• for surgery – if you’re due to have surgery, it’s usually recommended to stop treatment, at least for a few weeks or more, depending on the surgery and recovery time
• side effects – like all medications, Mounjaro can cause side effects and for some people, these may not go away or are severe, making Mounjaro unsuitable

If you want to stop taking Mounjaro, it’s important you discuss this with your doctor first. If you still want to lose weight but Mounjaro is not working out for you for any reason, they may recommend a different type of weight loss medication. You can stop Mounjaro straight away, or you can choose to reduce your dose slowly before stopping, though this is not clinically required and is more of a preference to help manage appetite changes.

When you stop taking Mounjaro, it can remain in your system for 25 to 30 days. So, if you are stopping because you are experiencing side effects, it can take a little while for them to subside completely. During this time, it’s important to carry on with your diet and exercise changes to maintain your weight loss.

When you first start taking weight loss injections like Mounjaro, following healthy habits, and a diet and exercise plan are typically part of the prescribing criteria to help you boost your results and reach your weight loss goals.

These healthy habits can stand you in good stead when you want to stop Mounjaro treatment. Weight maintenance, with or without medication, is challenging, but there are several things you can do to help you keep the weight off after Mounjaro treatment.

Mindful eating

During Mounjaro treatment, you alter your diet to enhance your results. It can be easier to make such lifestyle changes during your treatment because the medication suppresses your appetite, helping you to transition into life without weight loss medication. To maintain weight loss, you’ll still need to follow a healthy diet plan, rather than going back to how you were eating before you started taking Mounjaro.

It’s unlikely that any particular foods will exactly mimic the effects of Mounjaro, but certain nutrients can help to keep you feeling fuller for longer:

Dietary fibre

Research shows that dietary fibre reduces the risk of heart disease and obesity and keeps you fuller for longer.

Soluble fibre sources like oatmeal, carrots, flax seeds, and black beans also:

• reduce cholesterol
• increase the production of important molecules by the good bacteria in your gut
• may reduce the amount you eat at mealtimes

Protein

Protein is another food group important for weight loss because it can help regulate your calorie intake and energy metabolism. Some evidence suggests that increasing protein intake can promote fat loss while retaining muscle mass.

A high protein diet also increases how much energy your body uses to digest, absorb, metabolise and store nutrients, also known as the thermic effect of food (TEF). Between 20 and 30% of protein’s calories are used for digestion. So, you’ll burn more calories when you digest protein which might help increase weight loss.

Foods like legumes and beans are good sources of protein and fibre.

Exercise regularly

Regular physical activity is recommended for everyone as part of a normal, healthy lifestyle, but it is also essential for weight management and weight loss.

The NHS recommends that all adults aged 19 to 64 should aim to complete either:

• 150 minutes of moderate-intensity activity
• or 75 minutes of intense or vigorous exercise each week

A small study involving 26 obese women found that a combination of a low-calorie diet and high-intensity interval training (HIIT) had an appetite suppressing effect.

Another study found that a combination of aerobic and resistance training reduces intermuscular fat by 41% and visceral fat by 36% in older (65 years and up) obese adults.

Taking care of your emotional wellbeing

Losing weight isn’t just about the physicality of the process but also understanding what, why, and how we eat. Understanding this may help to identify potential causes of overeating or other unhelpful eating habits. This will help you to address these triggers and plan how you are going to overcome them.

For example, approximately 40% of people will increase their food intake when they feel stressed. If stress-eating has been a factor in your weight gain, knowing how to combat stress with other strategies will help you overcome this in the future. Ways to combat stress include:

• exercising more – this boosts natural feel-good hormones and can also get your mind off whatever is bothering you
• choosing more nutrient-dense foods – a healthy diet leads to a healthier mind
• staying hydrated – keeping hydrated helps keep our body working as it should and may help regulate hormone levels associated with stress
• finding healthy distractions like meditation, mindfulness, or yoga

Set realistic goals

When you stop taking Mounjaro, it is important to set realistic goals. Setting targets that are impossible or put you under lots of stress and pressure will negatively impact your weight loss goals and can lead to an increase in stress-eating and a decrease in motivation.

Start with small achievable milestones, like:

• aiming to complete 150 minutes of moderate exercise per week over 4 to 5 days
• walking to work each day instead of driving or using public transport
• swapping unhealthy snacks for nutrient-dense alternatives such as a piece of fruit, trail mix, or vegetable sticks with low-fat dips

Treat underlying health conditions

Obesity can increase the risk of several other health conditions, such as type 2 diabetes, high blood pressure, heart disease, and some types of cancer (like breast and bowel). Therefore, it is important to look after your health and address any additional or underlying medical conditions that may have an impact on your weight loss journey such as (but not limited to): hypothyroidism, arthritis, metabolic diseases. An awareness of any underlying health conditions will enable you to figure out how best to approach your weight loss journey once your treatment with medication has ended.

Equally, when you stop weight loss treatment, it’s important to discuss any current medications you take with your doctor. That’s because some can affect your body weight and metabolism, including those used to treat:

• diabetes
• high blood pressure
• psychiatric disorders
• depression

Get support

An effective way to help you keep weight off after Mounjaro is to let your support network know that you are stopping treatment. By involving your friends and family in your journey, you’ll be motivated to succeed. They can even help you further by joining in with your exercise activities or avoiding offering you unhealthy foods and drinks.

There are also support networks available for weight loss, both online and in your local area. You may find you need support for some of the triggers for unhealthy habits, and there will be options available to help, including:

• local support groups and services
• counselling

If you’re worried about regaining weight, taking a Mounjaro maintenance dose could be a solution. The Mounjaro maintenance dose is a long-term dose that you can take to maintain your current weight, still getting all the benefits of Mounjaro, like a reduced appetite, improved energy levels, feelings of fullness, and stable blood sugar levels, but without further weight loss.

You can take any dose as a Mounjaro maintenance dose and start maintenance just before or as you reach your goal weight. Your doctor will check in regularly – it’s important to let them know if you start to lose or put on any weight, so they can adjust your maintenance dose. You should still follow your diet and exercise plan and work on maintaining your weight through your lifestyle, so you are prepared if you do decide to stop Mounjaro later on.

However, Mounjaro is a long-term weight loss medication, and there are currently no restrictions on how long you can take it as long as you:

• do not develop any allergies or conditions that make Mounjaro unsuitable
• are not trying to get pregnant
• are not having ongoing or serious side effects

How long does Mounjaro stay in your system?

Mounjaro can stay in your system for around 25 to 30 days, though by day 5, the medication has reduced by half in your body. This means by day 5, the effects will begin to fade, and without another injection, you’re not likely to feel any effects after a few weeks, even if there are traces in your body for around a month.

Can you just stop taking Mounjaro?

Yes. It’s safe to just stop Mounjaro, without reducing your dose or going on a maintenance dose. However, if you’re worried about weight regain and food noise, speak to your doctor about reducing your dose gradually so your appetite comes back slowly, or taking a maintenance dose for longer until you’re ready to stop.

Will I get withdrawal symptoms when I stop taking Mounjaro?

No, Mounjaro is not addictive and does not cause withdrawal symptoms. You might get other symptoms from stopping, such as temporary stomach pain or gastrointestinal side effects, as your body adjusts. However, these should not be confused with withdrawal symptoms.

Why am I still losing weight after stopping Mounjaro?

As Mounjaro can stay in your system for around a month, you may still feel some of its effects for a few weeks after stopping. So, you may still be losing weight because your appetite and blood sugar are still being managed by Mounjaro.

You may also be losing weight after stopping Mounjaro if you’re continuing with your diet and exercise plan, or if you’ve increased your physical activity. Mounjaro helps you lose weight, but it’s not the cause, so if you’re still following healthy lifestyle changes, you can still lose weight after stopping Mounjaro.

Is it harder to maintain weight after Mounjaro than "normal" weight loss?

Maintaining weight loss is difficult, whether you lose weight with or without Mounjaro. Studies show that people taking Mounjaro may regain their weight within 1.5 years of stopping. However, studies into people losing weight “normally” (without weight loss medication) show that:

• 30 to 35% of lost weight is regained within 1 year
• 50% of people return to their baseline weight by year 5
• only 1 in 6 people maintained a weight loss of 10% or more for 1 year, at any point in their lives

After getting help with medication, maintaining weight can feel more of a sudden change, as your food noise and appetite come back. Maintaining weight after losing it “normally” is also difficult, even though appetite and food noise are not altered by medication.

As appetite, behaviour, and long-term healthy lifestyle changes are difficult for many people to manage long-term, on or off medication, obesity is classed as a long-term health condition, and medications to treat it are also long-term. Maintaining weight is just as important as losing it to keep the benefits that come with a lower weight, like improved blood sugar, heart health, energy, and overall health.