What happens when you stop taking GLP-1 weight loss injections?

Weight loss injections, sometimes known as GLP-1s or by their brand names such as Ozempic, Wegovy or Mounjaro, are big business right now. They’re available through the NHS with certain stipulations, but can also be bought online, through pharmacies, and a growing number of outlets (not all of which are safe or reliable). They don’t work for everyone, and at some point, people may need or want to stop taking weight loss injections. It’s worth thinking about that before starting them, if possible, in order to make an informed decision.

This blog explores what can happen when you come off GLP-1 weight loss drugs such as Wegovy and Mounjaro. It’s for anyone taking or considering taking them, as well as therapists and other professionals who work with clients encountering weight loss injections. I'm an eating disorder and body image therapist, so this blog is focused on the psychological impact of stopping GLP-1 weight loss injections. I would always recommend psychological support before, during, and after taking these drugs, where possible.
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​For professionals, including counsellors and psychotherapists, there's a link to a training course on weight loss injections at the end of this blog!

​Why might people need or want to come off weight loss injections?

There are many reasons someone might need or choose to stop taking GLP-1s, including:
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• NHS limits – currently capped at 2 years due to lack of evidence for longer-term use, and to manage limited resources (according to NICE guidelines)
• Cost/financial changes
• Health reasons or side effects
• Values or personal choice, e.g. not wanting to stay on medication long-term
• Using them as a short-term “kick start”
• Supply issues

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​Weight gain when coming off GLP-1’s

When people stop taking weight loss injections, they often gain the weight back. A 2025 research paper showed that most return to their starting weight within 2 years of stopping GLP-1 drugs. These injections affect both muscle mass and fat loss, and when regaining weight, people can gain back more fat than muscle.

Other weight loss interventions (such as diets and bariatric surgery) inevitably involve weight regain too. This can lead to feelings of shame and failure. Mental health and self-esteem are often negatively impacted, and the risk of disordered eating increases. GLP-1 drugs are appetite suppressants so they can become part of a diet/binge cycle, involving continual cycles of shame and distress for clients. It keeps people trapped in diet culture and weight stigma, which can be a stressful and miserable experience.
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​The return of food noise

Many people worry about the return of “food noise” when stopping weight loss injections. But what is food noise, really?

Food noise can include:

• Anxious thoughts about eating or food
• Cravings
• Hunger
• Conflicting/battling thoughts – “I want ice cream” vs “I’m not allowed ice cream”
• Eating disorder thoughts
• Negative or critical self-talk around food

I often work with clients to unpack this noise, where it’s coming from and what’s influencing it. Some grew up with strict food rules or received love that felt conditional on appearance ideals. These early experiences can shape relationships with food and body shape/size.

For some, food noise is actual hunger. For many, food noise can be part of disordered eating. For those who binge eat, it can feel like a relentless hunger or cravings that won’t go away, but this can sometimes also be linked to restriction. An example of this is when somebody is “good” all day and then binges at night; in this sense, “good” is code for food restriction. Some people who binge eat may not be hungry and may "emotionally eat". In any of these cases, this benefits from therapeutic exploration and support.

I’ve written in more detail about food noise here.
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​Weight loss injections and disordered eating

GLP-1s are appetite suppressants. They encourage behaviours similar to disordered eating, as part of restriction. This may result in the onset of an eating disorder for some, or may worsen existing disordered eating. Some people experience such reduced hunger, they may become malnourished through not eating enough (remembering you can also be malnourished at a higher weight too). Often, what can be called “health” is more about striving for thinness at any cost - ironically, health being that cost in some cases. Weight loss injections are not about gaining health, they are about fast weight loss. Working on separating health from weight can be helpful for some people, redefining health on their own terms without the focus on weight loss or numbers on the scales. It’s also important to note that “health” isn’t attainable for everyone.

Weight loss injections mask hunger, cravings and food noise – they don’t help any underlying issues (e.g. trauma) and they don’t help improve relationships with food. They certainly do not help “treat” eating disorders – there is not yet enough research on this but I would anticipate when there is, it will show a highly detrimental effect. I’ve seen celebrities online say GLP-1’s can be used to “treat” binge eating but again this is not evidence-based and is more likely to exacerbate bingeing in the future.

Coming off GLP-1s can increase the risk of eating disorders and “compensatory” behaviours, e.g. feeling the need to “burn off” or “earn” food. Some people may turn to increased restriction or purging (e.g. vomiting or abusing other drugs such as laxatives) due to fear of weight gain or loss of control around eating. 
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​Fear of judgment from others

People who lose weight are often praised and validated by those around them. If they gain weight again, the thought of seeing those same people can feel humiliating and shameful.

This fear of judgment is something I often work on with clients in my practice. Many clients have a history of bullying or trauma, often from childhood. They carry a default assumption that others are thinking negatively about them. Many live surrounded by weight stigma and anti-fat biases. This can negatively impact mental health, self-esteem and self-worth.

When validation is gained purely from losing weight, any self-esteem from it is incredibly fragile because weight is so changeable, and the likelihood of weight gain is high. This leaves people incredibly vulnerable to mental health problems, disordered eating, body image problems and low self-worth. Self-acceptance needs to be worked on from within, from the “bottom up”, as superficial changes ultimately do not work. Self-acceptance may seem like hard work, but so is weight loss. It is possible to improve your relationship with food and your body, and it’s worth it in the long run.
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​Weight stigma and weight loss injections

Is the fear of weight gain really about weight itself, or more about the stigma and judgment around weight?

I might anticipate that it’s a fear of weight biases and fatphobia. Often people tell me they wouldn’t be bothered about their size, but everybody else seems bothered by it. This is weight stigma. We sadly live in a diet culture with a thin ideal that most of us have internalised, meaning it’s just become the norm.

Anti-fat bias can impact everyday life for people in larger bodies, who face personal and systemic discrimination. This includes not physically fitting into spaces like aeroplane seats or restaurant booths. Clothes may be harder to find. Exercise may not feel safe or accessible in public. Medical weight stigma is another issue - it stops people from seeking healthcare.

This may be a daunting idea for somebody coming off weight loss injections, having to potentially face weight biases again if gaining weight. It’s important to remember that this is not their fault. When people are mistreated due to their shape, size or appearance, we cannot expect the victim to change. When a bully picks on someone for being fat, the victim should not be told to become thin to make this stop - that only proves the bully right. The accountability is with the bully to change their behaviour, and for the culture which created these attitudes to change.

Bigger people have always existed and always will. Weight loss products come and go, and GLP-1 drugs are just the latest one. They are not a “cure” for fatness. That idea only deepens anti-fat bias and weight stigma, both of which are harmful to health.
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There is so much fear around the “obesity crisis” but I’m far more worried about the millions of people struggling with eating disorders, and the spike in disordered eating that is likely to follow the rise in popularity of weight loss injections.
 

Preparing to stop weight loss injections

Whether you're taking GLP-1 weight loss injections already or considering starting them, it helps to work on your relationship with food and body image. It can be helpful to have an exit plan, to be prepared for coming off them if or when you need to. If the idea of weight gain fills you with dread or fear, or you notice any thoughts about restricting food or compensatory behaviours (purging, over-exercise, etc), then it can be beneficial to access therapeutic support for this.

Ideally, the process of coming off weight loss drugs should be medically monitored. Therapy can be helpful to:
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• Understand your relationship with food
• Explore childhood experiences or trauma
• Understand disordered eating thoughts and food noise
• Prepare for possible changes in body shape and weight
• Explore the fear of weight gain
• Challenge negative thoughts about your body and eating
• Manage your inner critic
• Work on self-worth and body acceptance

 
Whether taking weight loss injections or considering stopping them, I help people at any stage to improve their relationship with food and body image. Get in touch for a free 15-minute consultation.
 

GET IN TOUCH

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​Weight loss injections training for professionals

This online self-paced training explores the intersections of neurodivergence, body image, eating behaviours, and the use of GLP-1 medications (such as Ozempic and Wegovy).

Presented by Bernie Wright, Lisa Smith, and Mel Ciavucco, this course offers insight into a rapidly evolving landscape — with practical guidance for supporting clients navigating weight stigma, disordered eating, and the physiological and emotional impact of weight loss drugs.

FIND OUT MORE HERE

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