How to avoid weight regain after GLP-1s, according to a dietitian

GLP-1 medications may have revolutionized the way people lose weight, but maintaining that change in body composition still presents challenges.

When people come off anti-obesity drugs, “weight regain happens to the majority”, explains Dr Linia Patel, women’s health dietitian and performance nutritionist.

“If we’re looking at obesity as a chronic condition, these medications are designed to be used for life and you’re not actually meant to come off them,” the author of new book Life After Weight-Loss Medication, tells Fit&Well.

“The challenge is that around 50% of people don’t stay on them because they are self-funded. The drugs become too expensive, or they reach their goal weight and think they don’t need them anymore. Also, people tend not to like staying on medication long-term.”

Patel urges people who regain weight after stopping GLP-1s to show themselves compassion, because it’s not a failure—it’s a “physiological response”. But she also encourages people to “get in the driver’s seat” and work with their biology to keep the weight off.

I asked Patel what people can do, and she shared these three tips for weight maintenance post-GLP-1s.

1. Make lifestyle changes while using GLP-1s

Patel says one of the big mistakes people who take GLP-1s make is only focusing on weight loss, rather than thinking ahead to the maintenance phase.

“They don’t realize that these medications are powerful and are so effective, but as soon as you come off them, your appetite, digestion and food noise is likely to change.

“People who are effective at keeping the weight off have leveraged the power of the drugs while they are on them by using the headspace to focus on new behaviours and making meaningful lifestyle changes.”

The dietitian suggests using your time on GLP-1s to focus on learning healthy recipes and building non-food-related coping strategies, so you're less likely to reach for unhealthy snacks when you stop the medication.

2. Establish a food routine

GLP-1s help to reduce appetite, so you need to make a concerted effort to eat even when you don’t feel hungry.

Patel suggests adopting the pinned eating method. Rather than relying purely on hunger cues, you pin breakfast, lunch and dinner to set times to establish a routine.

“You’re not going to want to eat as much as you did before, but you have to eat because that really is important in terms of getting the nutrients in and protecting that precious muscle mass,” she says.

“Pinned eating is about almost setting yourself an alarm to eat at certain times, and making sure you have three square meals or liquid calories like soups and smoothies, which are easier to get in when you’re not hungry.”

If you transition off the appetite-suppressing drugs, you can then stick with this established eating pattern.

3. Combine protein and fiber

Protein and fiber are particularly important when you are taking GLP-1 medications, says Patel, because they address two of the biggest challenges people face.

The first issue is muscle loss. Protein helps maintain lean muscle mass as you lose weight and, alongside resistance training, can help preserve or build strength. The more muscle you have, the more calories you burn at rest, supporting weight maintenance.

The second is digestive issues. Fiber supports a healthy digestive system, helping to prevent constipation (a common side effect of the drugs)

Both protein and fiber are naturally filling, so they will help you maintain your new weight.

“[Protein and fiber] work together to keep you feeling full and nourished,” says Patel.

Meals like Greek yogurt with berries and chia seeds, chicken with vegetables and quinoa, or eggs with wholegrain toast and avocado provide both nutrients at once.

Patel also cautions against cutting out any food groups entirely.

“I’ve got so many clients who end up [with] low iron, or with their hair falling out, and that’s all a result of not nourishing themselves,” she says.

Instead, she advises adopting a balanced approach—including protein, healthy fats, complex carbohydrates, fruits, vegetables and fiber-rich foods—to support long-term health, energy levels, digestion, and sustainable weight loss while on GLP-1 medications.

Life After Weight-Loss Medication is out now