The Off-Ramp: A 12-Week, Evidence-Based Plan for Stopping or Stepping Down GLP-1 Weight-Loss Medication

Most people who take a GLP-1 medicine for weight eventually stop, pause or change it, and the best trials show that, on average, much of the weight comes back within a year. This book is for the moment you realise it is your turn: it helps you plan the transition deliberately, with your prescriber, instead of simply running out.

Who it is for

Adults taking, or about to stop, semaglutide (Wegovy, Ozempic, Rybelsus), tirzepatide (Zepbound, Mounjaro), liraglutide (Saxenda) or oral orforglipron, whether because of cost, coverage ending, side effects, supply problems, pregnancy plans or a time limit on treatment.

What you will do with it

• Run a two-minute self-check that tells you which chapters matter most for you
• Decide with your prescriber whether to stop, step down or stay, using a decision tree and a conversation script
• Prepare in the two weeks before your last dose, then follow a 12-week plan with a minimum and a full version of every week
• Set green, amber and red regain thresholds, each with an action decided in advance, including when to ask about restarting

What is inside

• What really happens to appetite and weight when you stop
• Stop, step down or stay: making the decision
• The first 12 weeks, week by week, including the hunger that returns
• Eating to stay full, with practical protein guidance
• Keeping your muscle, with strength protocols for beginners and for people who already lift
• Your situation: cost and coverage, type 2 diabetes, pregnancy plans, age 65 and over, eating to cope
• Troubleshooting and questions, plus a "Find your page" index
• Printable tools: pre-last-dose checklist, plan agreement for your appointment, 12-week tracker, protein planner, strength log and threshold card
• 151 cited sources, with weaker evidence labelled as such

What you receive

• PDF edition: fixed-page layout that keeps the tables, worksheets and diagrams as designed; best for printing the tools.
• EPUB edition: reflowable text for compatible e-readers and reading apps. Tables and worksheets are easiest to use in the PDF.

Both files are delivered as downloads after purchase.

Please note

This book is general education, not medical advice, and the author is not a medical professional. Do not stop, start, reduce or space out doses without talking to your prescriber, especially if you have diabetes, take glucose-lowering or blood-pressure medicines, are pregnant or planning a pregnancy, or have a history of an eating disorder. The plan does not promise that you will keep all the weight off; where the evidence is thin, for example on tapering, the book says so plainly. Evidence was checked to 10 November 2026.