KeptComing off Mounjaro or Zepbound
- Mounjaro and Zepbound are both tirzepatide. Zepbound is the version approved for weight management.
- In SURMOUNT-4, people switched to placebo regained 14% of body weight over 52 weeks, on average.
- About 46% of that group still kept at least a 10% loss from where they started.
- Appetite usually returns over the first few weeks. A gain line and a food-noise plan help most in that window.
Mounjaro and Zepbound contain the same medicine, tirzepatide. If you're stopping, cutting down or taking a break, here's what the main study found, and how to give yourself the best chance of keeping your loss.
What SURMOUNT-4 found
In SURMOUNT-4, 783 adults took tirzepatide for 36 weeks and lost about 21% of their body weight on average. Then 670 of them were randomly split: half stayed on tirzepatide and half switched to placebo for a year.
- The placebo group regained 14% of their body weight on average.
- The group that stayed on lost a further 5.5%.
- Even so, about 46% of the placebo group still kept at least a 10% loss from where they started.
Like the semaglutide trials, SURMOUNT-4 stopped the medicine at once, so it shows what happens with no plan in its place. It doesn't tell us how well structured habits work after stopping, and it didn't test tapering.
When appetite comes back
Tirzepatide is taken weekly and wears off over a few weeks. Many people describe hunger and food noise coming back in that time, often before the scale moves. If tirzepatide quieted food noise a lot for you, expect a noticeable change, and plan for it.
A maintenance plan for after tirzepatide
- Record your starting point: your 7-day average in the week you stop.
- Set a line, for example 3 lb above it, and decide what you'll change when you cross it.
- Weigh most mornings and judge the weekly average, never a single day.
- Write a plan for loud food-noise moments while you're calm.
- Keep protein at each meal and two or three short strength sessions a week.
- Act early: one small change for two weeks as soon as your average crosses the line.
The full routine is in how to keep weight off after a GLP-1.
Tapering, side effects and restarting
Questions about tapering, symptoms after stopping, or restarting belong with your prescriber. We don't give advice on doses or medication decisions.
Common questions
Do you gain weight after stopping Mounjaro or Zepbound?
On average, yes. In SURMOUNT-4, people switched from tirzepatide to placebo regained 14% of their body weight over a year. About 46% still kept at least a 10% loss from where they started.
Can you keep weight off after coming off Mounjaro?
Many people keep a meaningful loss. Weighing most mornings, judging your weekly average, setting a gain line and acting early, planning for food noise, and keeping protein and strength training in your week are the habits most linked to maintenance.
Should I taper off Zepbound?
That's a decision for you and your prescriber. SURMOUNT-4 stopped tirzepatide at once and did not test tapering. Kept doesn't give advice on doses.
Sources
- Aronne LJ et al. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity (SURMOUNT-4). JAMA, 2024. Link
- West S et al. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ, 2026;392:e085304. Link
- Wing RR, Phelan S. Long-term weight loss maintenance. American Journal of Clinical Nutrition, 2005;82(1 Suppl):222S-225S. Link