Stopping a GLP-1: what comes back, and what staying on costs
In clinical trials, people who stopped got most of the weight back within a year. In the STEP 1 extension, they regained two-thirds of what they had lost. Staying on has a price too. In year one that runs $1,788 (with auto-refill) to $5,637, depending on the drug.
Two cash programs to check.
No insurance needed.
- Strut Health$149 a month, with auto-refillcompounded semaglutideCheck price →Semaglutide shot or lozenge, then a health questionnaire
- Shed$199 a monthcompounded semaglutideCheck price →Every medication is listed with a starting price
What clinical trials found when people stopped
| Trial | Before stopping | After stopping | Those who stayed on |
|---|---|---|---|
| STEP 4, April 13, 2021 | 803 people lost 10.6% in 20 weeks on semaglutide 2.4 mg, the Wegovy shot | Gained back 6.9% of their weight over 48 weeks on a placebo | Lost 7.9% more |
| SURMOUNT-4, January 2, 2024 | 670 people lost 20.9% in 36 weeks on tirzepatide 10 or 15 mg, Zepbound | Gained back 14.0% over 52 weeks on a placebo. 16.6% kept at least 80% of their loss | Lost 5.5% more. 89.5% kept at least 80% |
| STEP 1 extension, May 19, 2022 | 327 people lost 17.3% in 68 weeks on semaglutide 2.4 mg, the Wegovy shot | A year later, 5.6% below where they started: two-thirds of the loss was back | Everyone stopped in this part of the trial |
In the extension's averages, someone who started at 220 pounds was 38 pounds lighter at week 68, and 12 pounds lighter a year after stopping. At NovoCare's price for the shot, those 68 weeks cost $5,933. That is $156 for each pound at week 68, and $494 for each pound still off a year later.
What staying on costs, year one and year two
At the lowest cash price we track for each drug. Compounded semaglutide is a pharmacy-made version that is not FDA-approved and is not Wegovy or Ozempic. Compounded tirzepatide is a pharmacy-made version that is not FDA-approved and is not Zepbound or Mounjaro. The makers sell weekly shots in four-week boxes, so a year is 13 four-week boxes, and programs bill by the month.
| Drug, dose and price | Year one | Year two |
|---|---|---|
| Compounded semaglutide at Strut Health $149 a month, with auto-refill | $1,788 | $1,788 |
| Compounded tirzepatide at Strut Health $149 a month, with auto-refill | $1,788 | $1,788 |
| Wegovy pill, 25 mg at NovoCare $149 at 1.5 mg, $199 at 4 mg, $299 at 9 and 25 mg | $3,338 | $3,588 |
| Wegovy shot, 2.4 mg at NovoCare $349 at every dose up to 2.4 mg | $4,537 | $4,537 |
| Zepbound, 5 mg at LillyDirect $299 at 2.5 mg, $399 at 5 mg | $5,087 | $5,187 |
| Zepbound, 10 or 15 mg at LillyDirect $299 at 2.5 mg, $399 at 5 mg, $449 at 7.5 mg and up | $5,637 | $5,837 |
Where year one costs less than year two, it's because the first doses are priced lower. At NovoCare the 7.2 mg Wegovy HD shot is $399 a month, $5,187 a year, above the 2.4 mg price in the table. The weight loss calculator puts each drug's trial result beside what it cost.
Where the price jumps with the dose
The makers' steps are in the table above. These programs charge more at higher doses:
| Program and drug | A month | Extra a year |
|---|---|---|
| Sam's Club Member Health, Zepbound | $399, or $699 at higher doses | $3,600 |
| LifeMD, Zepbound | $498, or $698 at higher doses | $2,400 |
| CVS MinuteClinic, Zepbound | $428, or $528 at higher doses | $1,200 |
| Walgreens Weight Management, Zepbound | $448, or $548 at higher doses | $1,200 |
| Ro Body, Zepbound | $548, or $598 at higher doses | $600 |
Shed ($199 a month) and Henry Meds ($297 a month) charge the same for compounded semaglutide at every dose.
Coming back after a break
Your prescriber decides where you restart. The Wegovy label says to restart the climb at a lower dose after 2 or more missed doses in a row, and doesn't name the dose. The Zepbound label says nothing about restarting. If you start again at the lowest dose, this is the climb back:
| Back to | How long | What the climb costs |
|---|---|---|
| Wegovy pill, to 25 mg at NovoCare | 90 days | $647 |
| Wegovy shot, to 2.4 mg at NovoCare | 16 weeks | $1,396 |
| Zepbound, to 5 mg at LillyDirect | 4 weeks | $299 |
| Zepbound, to 10 mg at LillyDirect | 12 weeks | $1,147 |
| Zepbound, to 15 mg at LillyDirect | 20 weeks | $2,045 |
The first doses cost less at LillyDirect and NovoCare, so a restart doesn't cost more a month. This page gives no advice on lowering or stopping a dose.
More on staying on
- Maintenance doses by drug, from the FDA labels
- Restarting after a break: what your old program charges now
- Switching programs without a gap in your prescription
- Can't afford it anymore? Read this before you stop
- Every program's price, cheapest first
Frequently asked questions
What happens when you stop taking a GLP-1?
How much does it cost to stay on Zepbound for a year?
What does it cost to restart a GLP-1?
Sources
Evidence checked September 28, 2026
Every figure above is taken from the document beside it, the FDA label or the trial that produced it, so you can read the source instead of trusting us. No clinician reviews these pages. What that means.
5 documents
- STEP 4: stopping semaglutide after 20 weeksSTEP 4, Rubino D et al. JAMA 2021;325(14):1414-1425
- SURMOUNT-4: stopping tirzepatide after 36 weeksSURMOUNT-4, Aronne LJ et al. JAMA 2024;331(1):38-48
- The STEP 1 extension: a year after stopping semaglutideSTEP 1 extension, Wilding JPH et al. Diabetes Obes Metab 2022;24(8):1553-1564
- Wegovy dose climb and what the label says about restartingFDA prescribing information for Wegovy, injection and tablets (DailyMed, revised June 2026)
- Zepbound dose climbFDA prescribing information for Zepbound (DailyMed, revised August 2026)
