No end date in the labels
The Indications and Usage section of each label gives no number of months after which treatment ends. The weight-management labels instead describe two goals together: bringing excess weight down and keeping that reduction over the long term, always alongside a reduced-calorie diet and more physical activity [1][2][3][5].
The diabetes labels, such as Ozempic® and Mounjaro®, describe use alongside diet and exercise to improve blood sugar control, and Ozempic® also lists reducing the risk of heart events and of kidney decline in certain adults [4][18]. MedlinePlus puts it plainly for semaglutide: the medicine helps control diabetes and weight but does not cure either, and it should not be stopped without talking to your doctor [7].
Long term, with review points
“Long term” in a label does not mean “regardless of results”. Several documents name a point at which response is checked, and they do not agree on the timing.
| Document | Who | When | What the document says | Source |
|---|---|---|---|---|
| Saxenda®, US label | adults | 16 weeks after starting | stop if less than 4% of starting weight has been lost | [3] §2.2 |
| Saxenda®, US label | ages 12 to 17 | 12 weeks on the maintenance dose | stop if BMI has not fallen by at least 1% | [3] §2.2 |
| Saxenda®, EU SmPC | adults | 12 weeks on 3.0 mg a day | stop if less than 5% of starting weight has been lost | [15] §4.1 |
| Saxenda®, EU SmPC | children 6 to 11 and adolescents | 12 weeks on 3.0 mg or the highest tolerated dose | stop and re-evaluate if BMI or BMI z score has not fallen by 4% | [15] §4.1 |
| Wegovy®, EU SmPC | adolescents 12+ | 12 weeks on 2.4 mg or the highest tolerated dose | stop and re-evaluate if BMI has not fallen by at least 5% | [16] §4.1 |
| Wegovy®, Canadian monograph | adolescents 12 to 17 | 12 weeks on 2.4 mg or the highest tolerated dose | reassess whether to continue | [17] §4.2 |
| Wegovy®, Zepbound®, Foundayo™, US labels | adults | not stated | no numeric response threshold; maintenance dose chosen by response and tolerability | [1][2][5] §2 |
What the NIDDK says about duration
The NIDDK, part of the US National Institutes of Health, describes obesity as a chronic disease. It gives its own rule of thumb for weight medicines: when the full dose has been taken for 12 weeks and the loss is still under 5% of starting weight, a health care professional will probably advise stopping [6].
It also notes that liraglutide, semaglutide and tirzepatide are among six medicines the FDA has approved for long-term weight management, that eating and activity habits may need to continue for years or even a lifetime, and that some weight is likely to come back after a weight medicine is stopped [6].
How long the main trials lasted
| Trial or program | Medicine | Length | Source |
|---|---|---|---|
| Weight trials (Studies 2–6) | Wegovy® injection | 68 weeks | [1] §14.2 |
| 7.2 mg trials (Studies 8–9) | Wegovy® injection | 72 weeks | [1] §14.2 |
| Tablet weight trial (Study 7) | Wegovy® tablets | 64 weeks | [1] §14.2 |
| Weight trials (Studies 1–2) | Zepbound® | 72 weeks | [2] §14.1 |
| SURMOUNT-4 (Study 4) | Zepbound® | 88 weeks in total | [2] §14.1; [10] |
| Sleep apnea trials | Zepbound® | 52 weeks | [2] §14.2 |
| Weight trials (Trials 1–2) | Foundayo™ | 72 weeks | [5] §14 |
| Weight trials; subgroup with abnormal glucose | Saxenda® | 56 weeks; 160 weeks | [3] §14.1 |
| SELECT, heart outcomes | semaglutide 2.4 mg | mean exposure 34.2 months, mean follow-up 39.8 months | [8] |
| FLOW, kidney outcomes | Ozempic® 1 mg | median follow-up 41 months in the label, 3.4 years in the paper; early stopping was recommended at a planned interim analysis | [4] §14.3; [9] |
The longest results on treatment
- SELECT, analysed for weight: in people without diabetes who had heart disease, weight on semaglutide kept falling for about 65 weeks and then held. At 208 weeks the average change was −10.2% against −1.5% on placebo, and stopping the study drug was more common on semaglutide [11].
- SURMOUNT-1 at three years: the 1,032 participants who had prediabetes as well as obesity stayed on their assigned dose for 176 weeks. Their weight changed by −12.3%, −18.7% and −19.7% on 5, 10 and 15 mg, against −1.3% on placebo, and 1.3% against 13.3% developed type 2 diabetes. The authors reported no new safety signals; the trial was funded by Eli Lilly [12].
- STEP 5: over 104 weeks, average weight changed by −15.2% with semaglutide 2.4 mg and −2.6% with placebo; 77.1% against 34.4% kept at least a 5% loss. Digestive events were reported by 82.2% and 53.9% [13].
- Saxenda® over 160 weeks: in the subgroup with abnormal blood sugar, 28% on liraglutide and 14% on placebo were known to have at least a 5% loss at week 160, but only 50% and 43% had a weight recorded then. Stopping the study drug reached 47% and 55% [3].
Why trial length is not a limit
A trial length tells you how long the medicine was studied in a controlled way, not how long it may be used. People in real life may continue for longer or stop sooner.
It also means the labels contain more evidence about the first one to four years than about later years, and the longest trials report averages from people who stayed in. That is a fair question to raise with your prescriber, especially if you are planning many years ahead.
When the labels say to stop or pause
- Suspected pancreatitis: the labels say to stop the medicine if pancreatitis is suspected, and the Wegovy® Medication Guide describes severe stomach pain that will not go away, sometimes reaching the back [1].
- A serious allergic reaction: the Medication Guide asks you to stop and get medical help straight away if the face, lips, tongue or throat swell, or if breathing becomes difficult [1].
- Pregnancy: the Wegovy®, Zepbound®, Saxenda® and Foundayo™ labels say to stop when a pregnancy is recognised, and the Wegovy® and Ozempic® labels ask for semaglutide to be stopped no later than 2 months ahead of a planned pregnancy, since it stays in the body for a long time [1][2][3][4][5].
- Not tolerating the dose: the Saxenda® label says to stop in adults who cannot tolerate 3 mg, and in young people who cannot tolerate 2.4 mg [3].
- Your prescriber may also stop or change treatment for other reasons, such as side effects or other illnesses.
What happens if treatment ends
In the STEP 1 extension, people who had lost 17.3% on semaglutide over 68 weeks regained 11.6 percentage points within a year of stopping, leaving a net loss of 5.6%; most heart and metabolic measures also moved back towards where they started [14]. In SURMOUNT-4, weight changed by −5.5% with continued tirzepatide and +14.0% after the switch to placebo over 52 weeks [10]. The article on stopping a GLP-1 goes through these studies in detail.
Because stopping changes things, the labels and MedlinePlus treat it as a conversation with your prescriber rather than a decision to make alone [7].
Wegovy®, Ozempic® and Saxenda® are registered trademarks of Novo Nordisk A/S. Zepbound® and Mounjaro® are registered trademarks and Foundayo™ is a trademark of Eli Lilly and Company. PepLabo is not affiliated with or endorsed by Novo Nordisk or Eli Lilly.
When to get help
| Sign | Who to contact | How fast | Source |
|---|---|---|---|
| Swelling of the face, lips, tongue or throat, or difficulty breathing, after a dose | Emergency services (911 or your local number); stop the medicine | Emergency | Wegovy® Medication Guide [1] |
| Severe stomach pain that persists, with or without nausea or vomiting | Your prescriber, right away; stop the medicine | Today | Wegovy® Medication Guide; label section 5.2 [1] |
| A positive pregnancy test while on a weight-management GLP-1 | Your prescriber | Today | Wegovy®, Zepbound®, Saxenda® and Foundayo™ labels, section 8.1 [1][2][3][5] |
| Questions about how long to continue, or about a planned pregnancy | Your prescriber | At your next appointment | MedlinePlus; Wegovy® label section 8.3 [1][7] |