What the evidence says about stopping a weight loss injection

What does stopping mean here?

Stopping means ending the injections. That might be your choice, a planned review, or because the medicine is not suitable for you. NICE, which advises the NHS, treats semaglutide (Wegovy) and tirzepatide (Mounjaro) differently. The points below are taken from NICE guidance. They are not an instruction for you, and they are not a HaleWell treatment plan.

What does NICE say about semaglutide?

NICE technology appraisal 875 recommends semaglutide as an option for weight management, including weight loss and weight maintenance, alongside a reduced-calorie diet and increased physical activity in adults. It recommends it only if it is used for a maximum of 2 years, and within a specialist weight management service providing multidisciplinary management of overweight or obesity.

It also sets who it is for: at least one weight-related comorbidity, and a body mass index of at least 35.0 kg/m2, or a body mass index of 30.0 kg/m2 to 34.9 kg/m2 where the person meets the criteria for referral to specialist weight management services in NICE’s guideline on overweight and obesity. Use a lower body mass index threshold, usually reduced by 2.5 kg/m2, for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds.

NICE says to consider stopping semaglutide if less than 5% of the initial weight has been lost after 6 months of treatment. This is NHS guidance, and it includes a commercial arrangement with the company. It is not a description of how a private clinic must run.

What does NICE say about tirzepatide?

NICE technology appraisal 1026 recommends tirzepatide as an option for managing overweight and obesity, alongside a reduced-calorie diet and increased physical activity in adults, only if they have an initial body mass index of at least 35 kg/m2 and at least one weight-related comorbidity. Use a lower body mass index threshold, usually reduced by 2.5 kg/m2, for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds. The recommendation also says the company provides it according to the commercial arrangement. That is an NHS funding point, not a HaleWell rule.

The review is different from semaglutide. NICE says that if less than 5% of the initial weight has been lost after 6 months on the highest tolerated dose, decide whether to continue treatment, taking into account the benefits and risks of treatment for the person.

NICE’s practical guide says to calculate, at the start, what a 5% loss from the person’s initial weight is in kilograms, and to explain that the medicine may be stopped if that loss is not reached in the timeframe. The appraisal itself still frames the 6-month point as a decision, not an automatic stop.

What if the weight comes back?

NICE’s practical guide says the possible duration of tirzepatide treatment, if weight is lost, could be long term, and that a person can choose to stop at any time. If they choose to stop, NICE says to explain that without a continued reduced-calorie diet and increased physical activity, stopping the medicine is likely to lead to weight regain.

In the committee discussion of that same appraisal, NICE records expert evidence about semaglutide and the STEP 1 trial: around two thirds of the weight lost while on treatment is regained within the first year after stopping. That is NICE’s record of what its clinical experts explained. It is not a figure from a HaleWell patient.

What will HaleWell not do?

HaleWell Clinic is a UK online medical weight-loss clinic. A UK-registered prescriber decides whether treatment is clinically appropriate. Medicine is supplied by Halewell Clinic Limited. Pharmacy GPhC registration is in progress, and no registration number is shown until it exists. This page is not a consultation.

It will not tell you to stop a medicine you are already taking. If you are in treatment, speak to the clinician who prescribed it before you change the dose or stop. If you have not started, you can join the HaleWell waitlist. Joining is free. It does not guarantee that a medicine will be prescribed.

What should I ask before I stop?

Ask the prescriber what support continues if you stop, including a reduced-calorie diet and physical activity, and when you would be reviewed. Ask whether the 6-month review in the NICE guidance applies to the medicine you are taking, and what 5% of your own starting weight is in kilograms.

Short answers

Does NICE say everyone should stop at 6 months?

No. For semaglutide, NICE says consider stopping if less than 5% of the initial weight has been lost after 6 months. For tirzepatide, NICE says decide whether to continue if less than 5% has been lost after 6 months on the highest tolerated dose. Both recommendations sit alongside diet and activity, and both depend on the person.

Will the weight stay off if the injections stop?

NICE says that stopping tirzepatide without a continued reduced-calorie diet and increased physical activity is likely to lead to weight regain. Its committee discussion also records expert evidence that, after semaglutide, around two thirds of the weight lost is regained within the first year.

Can this page tell me to stop?

No. This is general information from HaleWell Clinic. A decision to stop belongs with you and the clinician who prescribed the medicine. Treatment is only offered if it is clinically appropriate.