How Long Can You Stay on Zepbound for Weight Loss? Stay Plan

You can stay on Zepbound for weight loss for many years. The FDA approved it as a long-term, chronic weight management medication. Key clinical trials lasted 72 weeks, and follow-up data shows people using it effectively for over three years.

However, stopping often leads to weight regain; one 2025 study found 82% of people regained a significant amount of weight within a year of stopping. Your personal treatment length will be decided with your doctor.

Key Takeaways

• Zepbound (tirzepatide) is an FDA-approved medication for chronic weight management, meaning it is intended for long-term use to help you lose weight and keep it off.
• Clinical trials show people can safely use Zepbound for up to 88 weeks (about 20 months), with emerging data supporting its effectiveness for over three years.
• Weight regain is common if you stop taking Zepbound. One analysis found 82% of people regained at least 25% of lost weight within a year of discontinuing the medication.
• The recommended starting dose is 2.5 mg once weekly, which is gradually increased over several months to a maintenance dose of 5 mg, 10 mg, or 15 mg weekly.
• Insurance coverage often requires prior authorization and is typically approved for 6-month periods initially, with renewal depending on continued need and weight loss progress.

How long can you take Zepbound for lasting weight loss results?

You can take Zepbound for as long as you and your doctor decide it is safe and effective. The FDA approved it specifically for chronic weight management. This means the medication is designed to be a long-term part of your health plan, similar to how you would manage high blood pressure or cholesterol.

The clinical trials that led to Zepbound’s approval lasted 72 weeks (about 16 months). An extension of one trial showed that people who continued treatment maintained significant weight loss for 176 weeks, or just over three years. While long-term safety data continues to be collected, the evidence clearly supports using Zepbound for multiple years to sustain weight loss and its associated health benefits.

What if you stop taking Zepbound?

Stopping Zepbound usually leads to weight regain. Research shows that most people will see their appetite and weight return to previous levels after the medication leaves their system.

One 2025 analysis of the SURMOUNT-4 trial found that 82% of participants regained at least a quarter of the weight they had lost within one year of stopping the drug. This weight regain often comes with a reversal of health improvements in areas like blood pressure and cholesterol levels.

When to start and how long to stay on Zepbound: crafting your weight loss journey

Your journey with Zepbound begins with a conversation with your doctor. Typically, you may be a candidate if you have a body mass index (BMI) of 30 or higher, or a BMI of 27 or higher with a weight-related health condition like high blood pressure or type 2 diabetes.

The dosing schedule is gradual to help your body adjust. Your treatment will likely follow these steps:

• Month 1-4: You will start with a weekly injection of 2.5 mg. Your doctor will increase the dose every 4 weeks, moving to 5 mg, then 7.5 mg, then 10 mg.
• Month 5 and beyond: The goal is to find the most effective dose you can tolerate. The recommended maintenance doses are 5 mg, 10 mg, or 15 mg once a week.

How long you stay on Zepbound is personal. Your doctor will consider your weight loss progress, how well you tolerate any side effects, and your ability to maintain a healthy lifestyle. Many people find they need to continue the medication long term to maintain their results.

Insurance coverage questions: how long can Zepbound be approved for weight loss?

Insurance coverage is a major factor for long-term Zepbound use. Most plans that cover weight loss medications require prior authorization before they will pay for the prescription.

This approval is not permanent. Insurance companies review coverage periodically. For example, UnitedHealthcare's 2025 policy grants an initial 6-month approval for Zepbound. To get coverage renewed for another 12 months, you typically must show you are continuing to lose weight or maintain a significant weight loss, often defined as at least 5% of your starting body weight.

Tips for navigating coverage:

• Talk to your doctor's office. They are experienced in submitting the necessary paperwork and documenting your medical need.
• Contact your insurance provider directly. Ask about your plan's specific criteria for covering Zepbound.
• Explore manufacturer savings programs. Eli Lilly offers a savings card that may reduce your cost if you have commercial insurance.

From start to maintenance: planning the length of your Zepbound treatment

A successful Zepbound plan has three phases.

1. The Start-Up and Titration Phase (Weeks 1-20)

This initial period is about getting your body used to the medication. You begin with the lowest dose to minimize side effects like nausea. The dose is increased every 4 weeks until you reach a dose that effectively controls your appetite and supports steady weight loss.

2. The Active Weight Loss Phase (Months 6-12)

During this time, you are on a stable, effective dose. Combined with a reduced-calorie diet and increased physical activity, this is when most people see the most significant weight reduction. Clinical trials show the greatest weight loss often occurs between 36 and 52 weeks.

3. The Long-Term Maintenance Phase (Year 2 and Beyond)

The goal here is to preserve your hard-won results. You continue your maintenance dose to help manage appetite and metabolism. Data shows that continuing Zepbound is highly effective at preventing weight regain. This phase can last for years, as obesity is managed as a chronic condition.

What's the ideal duration for Zepbound to maximize weight loss benefits?

The ideal duration balances maximum weight loss with long-term sustainability. Research indicates that weight loss continues to increase for up to 72 weeks on Zepbound. For many, the most dramatic changes happen in the first 9-12 months.

However, "ideal" isn't just about losing the most weight. It's about losing enough weight to improve your health and then maintaining that new, healthier weight. Therefore, the ideal duration for many people is indefinite, as long as the medication is working and side effects are manageable.

Stopping treatment once you hit a goal weight often leads to backsliding. The 2025 SURMOUNT-4 analysis is a powerful reminder that the biological drivers of obesity often persist, making continued treatment necessary to maintain benefits.

Long-term Zepbound use: when to re-evaluate your plan and next steps

Even with a long-term plan, your situation can change. It’s important to have regular check-ins with your doctor to assess if Zepbound is still the right choice for you.

Consider re-evaluating your plan if:

• Your BMI falls below 27 and you no longer have any weight-related health issues.
• Your weight loss has stalled for 12 weeks or more despite being on a stable dose.
• You experience persistent or severe side effects that affect your quality of life.
• Changes in insurance or cost make continuing the medication unsustainable.

If you and your doctor decide to stop Zepbound, do not quit abruptly. Create a transition plan that focuses intensely on the lifestyle habits you built. Be prepared for your appetite to return and work with a dietitian or health coach to manage it. Remember, the healthy eating and exercise habits you developed are just as important as the medication was.