Right now, an estimated 2.5 million people in the UK are using weight loss jabs – but as soon as they stop, the food noises return. And so does the weight. To find out why, I spoke to leading experts Dr Max Pemberton & Dr Courtney Raspin, who showed me their step-by-step tools for stopping weight loss injections for good
Words: Amy Dowrick | Images: Shutterstock
A new study has revealed it takes on average just 18 months for GLP-1 users to return to their pre-treatment weight after stopping – but why is this the case?
“This is why diets fail so spectacularly,” says Dr Pemberton & Dr Raspin, who have over 40 years of experience between them in researching eating disorders. “You’re not weak; you’re fighting a biological system designed to get you back to the weight it thinks you should be, because it’s where you’ve been for years.”
To get a better understanding, I asked them to share their step-by-step tools for users of GLP-1s to come off the medication once and for all, from changing your relationship with food to understanding hunger and fullness.
How to come off weight loss jabs
According to Dr Pemberton & Dr Raspin, stopping too soon could be your biggest mistake.
“Don’t go from full dose to nothing,” they say. “Reduce gradually down by one dose level at a time and find what we call the sweet spot: the lowest dose that holds your weight stable.” This is what they call the ‘maintenance dose’.
“The maintenance phase allows your body to recalibrate and accept your new lower, weight as normal,” they say. “If you use this window properly, older pathways genuinely fade. Only then should you think about stopping.”
Maintaining your weight
Regular eating
“One of the problems with these medications is that you simply don’t feel hungry, so it’s tempting to skip meals entirely,” they say. “Don’t. Your body still needs fuel whether it’s shouting for it or not.”
Dr Pemberton & Dr Raspin recommend three meals a day, roughly at the same times, with a small snack if you need one. “This matters enormously when you come off the medication because your body has to relearn hunger and fullness signals, and it can only do that if you’re eating on a predictable schedule rather than grazing chaotically,” they add.
Protein
When you lose weight quickly, you don’t just lose fat – you also lose muscle. So, Dr Pemberton & Dr Raspin suggest piling on the protein.
“It’s the one thing we find ourselves saying to women in their 40s and 50s who are navigating perimenopause and menopause alongside weight loss, because the hormonal changes at this stage make muscle loss even more pronounced,” they say.
“Muscle loss at this stage of life is a disaster, and not just aesthetically,” they add. “It matters for your metabolism, your bone density, and your long-term mobility.”
They suggest aiming for around 1.2 to 1.6 grams of protein per kilogram of body weight a day, spread across every meal.
Strength training
You need to protect your muscle mass as you lose weight as you age – so sticking to cardio just won’t cut it.
“Two or three short sessions a week of resistance work, even with light dumbbells at home, will make an enormous difference to how your body holds its shape and how robust you feel in 10, 20, 30 years’ time,” they say. “You don’t need a gym membership or a personal trainer. You need consistency.”
Sleep
“Sleep is probably the most underrated weight management tool in existence,” says Dr Pemberton & Dr Raspin. “Chronic sleep deprivation ramps up hunger hormones, blunts the prefrontal cortex, and makes emotional eating far more likely.”
“If your coping strategy for a difficult week has always been a bottle of wine and a family bag of crisps in front of the telly, that pattern will reassert itself the moment the medication stops quietening your brain,” they add.
Instead, go for a walk, have a bath, phone a friend, journal, or try breathing exercises – whatever doesn’t involve the fridge.
Here’s why you should try walking for weight loss
Emotional support
Don’t underestimate the people around you – isolation and emotional eating are deeply intertwined.
“When we’re alone with difficult feelings, food becomes the easy companion,” says Dr Pemberton & Dr Raspin. “The patients who do best in the long run are the ones who have rebuilt, or protected, their social lives alongside their physical health.”
“The people you spend time with shape your habits more than you’d think,” they add. “If your social life has revolved around big meals out, you may need to gently reshape some of those rituals or find friends who are happy to meet for a walk or a coffee instead.”
What to avoid
According to Dr Pemberton & Dr Raspin, the habits that got you there are the habits that keep you there – and stopping them doesn’t mean you’ve graduated.
“The classic trap is treating the end of medication as the end of the work”, they say. “Someone stops the jab, feels fine for a few weeks, quietly stops weighing themselves because they’re confident, stops journalling because they feel they’ve got it cracked, and six months later they come back having regained most of what they lost.”
They also suggest avoiding the return to diet culture. “Restriction is exactly what sent your body into starvation mode and ramped up food noise in the first place,” says Dr Pemberton & Dr Raspin.
Instead, go back to basics, with regular meals, food journalling and checking in with yourself emotionally.
“Catch a wobble early and it stays a wobble. Ignore it for six months and it becomes a relapse,” they add. “One bad weekend does not undo a year’s work, but if you tell yourself, it does, you’ll eat your way into proving it true.”
Maintenance
“The life you’re maintaining after the medication is categorically different from the life you had before it,” says Dr Pemberton & Dr Raspin. “You’re not the same person who started this journey. You’ve rebuilt your relationship with food, you understand your emotional triggers, you have tools you didn’t have before.”
They see maintenance as a skill you’ve learned – and while the first few months off medication require the most attention, the habits then become increasingly automatic.
For more information, worksheets and downloadable weight-tracker, go to www.theweightlossprescription.com. The Weight Loss Prescription by Dr Max Pemberton and Dr Courtney Raspin (Thorsons, £16.99) is out now, and is available online here.
