Long-Term Outcomes and Maintenance Studies

Short-term studies demonstrate how GLP-1 receptor agonists such as semaglutide, tirzepatide, and liraglutide lead to significant weight loss over a few months.

Long-term research now provides a clearer picture of what happens after the first year of treatment. These findings help clinicians and patients understand how to maintain results and protect long-term health.

Several extended studies have examined the durability of GLP-1 therapy. Participants who continued treatment for 68 to 104 weeks maintained most of their initial weight loss and continued to see improvements in blood pressure, cholesterol, and blood sugar for the duration of treatment.

Key trials and sources

• STEP 5 Trial (Semaglutide 2.4 mg, 104 weeks): Participants maintained a mean weight reduction of around 15 percent, with improvements in metabolic and cardiovascular markers. [doi.org/10.1056/NEJMoa2208609]
• SURMOUNT-1 Extension (Tirzepatide, up to 88 weeks): Demonstrated continued weight loss and metabolic benefits through nearly two years of treatment. [doi.org/10.1056/NEJMoa2206038]
• SCALE Maintenance Study (Liraglutide, 56 weeks): Showed sustained weight reduction.[doi.org/10.1001/jama.2015.1833]
  

These studies confirm that the benefits of GLP-1 therapy are not temporary, provided treatment and lifestyle adjustments continue.

When medication is withdrawn, several studies have observed partial weight regain within 6 to 12 months. For example, a follow-up to the STEP 1 trial found that participants regained roughly two-thirds of the weight they had lost after discontinuation. [doi.org/10.1001/jama.2022.10879]

This highlights the chronic nature of obesity and the importance of long-term management, whether through continued medication, behavioural support, or both.

Long-term data show that GLP-1 receptor agonists do more than support weight loss. They improve a range of health markers that persist over time:

• Reduction in HbA1c and fasting glucose
• Lower triglycerides and LDL cholesterol
• Decrease in systolic blood pressure
• Reduced waist circumference and visceral fat
• Improvement in sleep apnoea symptoms and liver enzymes

Cardiovascular outcome studies, such as SUSTAIN-6 and REWIND, have shown reduced rates of major adverse cardiac events among patients treated with GLP-1 analogues. [doi.org/10.1056/NEJMoa1611925], [doi.org/10.1056/NEJMoa1901118]

These findings reinforce the role of GLP-1 drugs in broader metabolic health beyond weight reduction.

Long-term studies have not revealed new safety concerns beyond known side effects such as nausea or gastrointestinal symptoms.

Rates of pancreatitis, gall bladder problems  and other serious events remain very low. Continued surveillance and pharmacovigilance programmes monitor these outcomes globally.

Patients who are monitored regularly and adhere to dose guidance show excellent tolerability over multi-year use.

Medication alone is rarely sufficient for lifelong weight stability. People who pair GLP-1 treatment with lifestyle and behavioural strategies experience the best long-term outcomes.

Advice from Laura Reed, Health Coach:
“Our most successful patients treat the medication as a bridge, not a finish line. Over time, they transition to habits that sustain the same routines—structured eating, hydration, physical activity, and accountability.”

Maintenance may include:

• A lower, long-term maintenance dose
• Continued nutrition and behavioural coaching
• Regular monitoring of weight, blood pressure, and biomarkers
• Early reintroduction of treatment if weight regain exceeds safe limits

Studies such as SURMOUNT-4 and STEP-6 evaluate  the benefit of extending treatment beyond two years, explore whether GLP-1s can be safely continued for chronic use similar to antihypertensives or lipid-lowering drugs.

Emerging data suggest that long-term therapy may improve not only weight but also life expectancy, organ function, and quality of life.
Future research will help determine optimal duration and step-down strategies for sustained results.

Evidence confirms that GLP-1 medications are safe and effective for sustained weight loss and improved metabolic health.
Continuing treatment under clinical supervision, combined with structured behavioural support, offers the best chance of keeping weight off for the long term. Stopping abruptly often leads to weight regain, underscoring the importance of ongoing follow-up and maintenance planning.

You can complete an online health assessment if you would like to explore whether GLP-1 treatment may be clinically appropriate for you – start the assessment.

Dr Abby Hyams completed her medical training in Bristol and has been a GP for 19 years, spending many of those as a partner in an NHS practice in Hemel Hempstead. She has a particular passion for supporting patients with weight loss and promoting positive behaviour change, helping individuals build sustainable habits that improve their long-term health and wellbeing.

This article is for general information only and should not be used for the diagnosis or treatment of medical conditions. Medic Spot Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.

There is no guarantee of a specific weight loss medication being prescribed. Clinicians will review your online questionnaire alongside other independently validated medical information about you and will recommend the most appropriate weight loss treatments for you based on your answers. In some cases, the clinicians may contact you for additional information. See Terms of Service for more information.