Verbatim response from Perplexity
On GLP-1s, most people lose weight gradually at first, then more steadily over the first year; a realistic expectation is roughly 5%–15% of body weight in 6–12 months, with some medications and patients reaching 15%–25% after about a year.[12][15][2] It is often sustainable only while you keep taking the medication; when people stop, weight regain is common, and one large analysis found weight trajectories worsened after discontinuation, while the STEP 1 extension found people regained about two-thirds of lost weight within a year off semaglutide.[7][2]
A practical timeline looks like this:
- First month: some people notice weight loss by week 4 as doses are titrated up.[12]
- First 3 months: real-world data show some users average about 1.4% loss at 3 months, though responses vary widely.[14]
- 6–12 months: this is when most of the meaningful loss happens; clinical-trial averages are around 15%–19% for semaglutide/tirzepatide, with many patients losing at least 10% of starting weight.[1][7]
- After 12 months: weight loss usually slows or plateaus; many patients stabilize rather than continue dropping indefinitely.[7][2]
On sustainability:
- Yes, while on treatment: studies and reviews show GLP-1s can maintain weight loss over 104 weeks or longer if continued.[2]
- No, not reliably after stopping: multiple sources report substantial regain after discontinuation, including an average regain of nearly 2 pounds per month in one large 2026 analysis.[7]
- Best long-term results usually come from combining the drug with diet, activity, and behavior changes; medication alone produces less durable results in real-world use than in trials.[3][4][5]
If you want, I can also give you a med-by-med comparison of expected weight loss for Wegovy vs Zepbound vs Ozempic vs Mounjaro, and what a realistic month-by-month loss might look like for your starting weight.