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What happens if you stop Zepbound?

Came off the drug
+14%

body weight gained over the 12 months after stopping

Stayed on it
-5.5%

over the same 12 months, in the same trial

No clinician has reviewed this page. Every clinical statement on it is drawn from the FDA label or the trial cited beside it, and every price carries the date it was verified — but that is sourcing, not medical review, and the two are not the same thing. What we do and do not check · Who checked the price

What happens if you stop taking Zepbound?

The label for Zepbound carries Study 4 on the label (NCT04660643), an 88-week randomised withdrawal trial: everyone was put on the drug for 36 weeks, and the 670 who reached the maintenance dose were then randomly assigned either to keep taking it or to switch to placebo for 52 weeks without being told which. It is the only design that measures stopping rather than never starting. They had lost 20.9% of body weight during the run-in, the figure the label states. Over the year that followed, the group that stopped gained 14% and the group that carried on lost a further 5.5% — 19.5 points of body weight between the same people, decided by nothing but whether the drug continued. In kilograms: 22.1 kg lost, 11.9 kg of it back, which is 54% of the loss rather than the two-thirds a straight division of the two percentages would suggest.

Weight was not the only thing that came back

The same table in the label follows what else the drug had moved. Each row is the change over the 12 months after randomisation, in the two arms.

MeasureOn the drugAfter stoppingStaying on
Waist circumference(cm)-17.8+7.8-4.3
Systolic blood pressure(mmHg)-11.2+8.2+2
Diastolic blood pressure(mmHg)-5.1+3.2-0.7
Pulse(bpm)+5-5.2-2.1
HbA1c(%)-0.5+0.30

Read the blood-pressure rows against the column beside them: the drug had taken systolic pressure down and stopping gave most of that back, in people who by then weighed less than when they started. The pulse row runs the other way — it rose on the drug and fell when the drug stopped.

What this trial cannot tell you

Of the 783 people who started, 14.4% stopped before the randomisation at week 36, adverse events being the commonest reason. Only those still on the drug at week 36 entered the comparison, so these figures describe people who had already tolerated it for eight months.

What it means for the price

Every page on this site prices a year, because a monthly figure hides the titration months. This trial is the reason the year is the wrong unit too. At $449 a month at maintenance, a second year is $5,388 and a fifth year is $26,940 — and the trial says the alternative to paying it is not keeping the result.

What a year of Zepbound actually costs, step by step →

Where the price on this page comes from

  1. [1] Zepbound self-pay pricing, LillyDirectprimary
  2. [2] FDA prescribing information for ZEPBOUNDprimary

Where the trial figures come from

FDA prescribing information for ZEPBOUND, section 14.4primary

Questions

Do you regain everything after stopping Zepbound?
Not all of it, on this trial. Over the 36 weeks on the drug the average person went from 107.3 kg to 85.2 kg, a loss of 22.1 kg. In the 12 months after stopping they put back 11.9 kg, which is 54% of what they had lost — so roughly 46% of the loss was still there at the end. Note that the two percentages on this page are measured against different weights, and dividing one by the other overstates the regain.
Does that mean Zepbound has to be taken forever?
The trial does not answer that and neither does this page: it measured one year off the drug in people who had been on it for 8 months, and it was not designed to test whether anything else — a slower taper, a lower maintenance dose, a different diet — changes the shape. What it does establish is that stopping is not a neutral event, which is the assumption a monthly price invites.
What does that do to the cost?
It changes what the yearly figure is. Zepbound is $449 a month at maintenance here, and a first year comes to $5,637 once the titration steps are priced and the thirteen fills a 28-day month bills are counted. If the weight comes back when the drug stops, that is not a one-off cost to reach a goal; it is $5,388 a year for as long as the result is wanted. Every comparison on this site prices a year. This trial is the reason to multiply it.
Who was in this trial?
Of the 783 people who started, 14.4% stopped before the randomisation at week 36, adverse events being the commonest reason. Only those still on the drug at week 36 entered the comparison, so these figures describe people who had already tolerated it for eight months.

Everything on Zepbound

Last updated 2026-09-02 — the label version this page quotes. Read and dated by Alex Seot.