Adults with Diabetes on GLP-1s Maintain Weight Loss in Second Year

Adults with type 2 diabetes who maintain continuous use of GLP-1 receptor agonists largely preserve their first-year weight loss into a second year of treatment, according to research published in August 2026 by Epic Research. Among patients who stayed on medications like semaglutide and tirzepatide, a significant portion either maintained their weight or achieved additional reductions, though medication discontinuation rates and regain patterns varied between the two drugs.

Two-Year Weight Trajectories for Semaglutide Users

For patients taking semaglutide—marketed as Ozempic and Wegovy—weight loss achieved in the first year remained stable for many who continued treatment. According to Epic Research data tracking 38,621 U.S. adults with diabetes who stayed on GLP-1 therapy continuously for at least a year and lost a minimum of five pounds, 70.2% of semaglutide users held steady one month past the one-year mark, while 15.9% continued to lose weight. By the two-year mark, 37.7% of semaglutide patients maintained their weight loss and another 35.4% continued losing weight.

Weight regain increased gradually over the second year among semaglutide patients. At one month past the one-year threshold, 13.9% of semaglutide users had regained at least a quarter of their initial weight loss. That proportion climbed to 26.9% by the end of the second year. Furthermore, 4.6% of semaglutide patients experienced a full return to their baseline weight by the two-year checkpoint, according to the Epic Research findings.

Comparing Tirzepatide and Semaglutide Outcomes

Patients prescribed tirzepatide—marketed as Mounjaro and Zepbound—demonstrated higher consistency in retaining first-year weight loss and lower overall regain rates compared to semaglutide users. Epic Research reported that at one month past the one-year mark, 81.0% of tirzepatide patients held steady, with only 7.3% having regained at least a quarter of their initial loss.

At the two-year mark, 47.3% of tirzepatide patients maintained their weight loss and 38.6% continued to shed pounds. Meaningful weight regain—defined as regaining at least 25% of the first-year loss—reached 14.2% for tirzepatide users at two years, while fewer than 2% (1.6%) returned to their full baseline weight. Analysts note that these tracking metrics exclusively reflect individuals who remained on active prescriptions without gaps exceeding 60 days, biasing the dataset toward patients who successfully tolerated and responded to the therapies.

Clinical Context and Long-Term Expectations

Glucagon-like peptide-1 receptor agonists serve dual clinical functions in managing type 2 diabetes and supporting weight reduction. Because metabolic adaptations in diabetes can make sustained weight management challenging, tracking second-year outcomes provides clinicians and patients with empirical benchmarks for long-term treatment planning. The Epic Research findings indicate that while long-term continuity on GLP-1 medications helps the majority of responders sustain or extend weight loss, a notable minority experiences partial or full weight regain despite remaining on the drug regimen.