Medical disclaimer. This page is for tracking and education only. It is not medical advice and it never recommends doses. Talk with your prescriber or care team before you change, lower, or stop any medication. Ozempic, Wegovy, Mounjaro, and Zepbound are named only to describe what readers search for.
If you are coming off Zepbound, the first step is to talk with your prescriber or care team. This page explains SURMOUNT-4 in plain words, what it can and cannot tell you, and what some people choose to track during a transition.
Start with your prescriber
Decisions about stopping, continuing, or changing tirzepatide belong to your prescriber or care team. If you are thinking about coming off Zepbound, ask them how they want to monitor your weight, appetite, energy, and any symptoms over time.
It can also help to ask what to watch for and when to check in. Some people like to bring a simple log to visits so the conversation is based on real patterns, not memory alone.
If eating feels hard, or food thoughts feel stressful, talk to a clinician. A steady plan and support can make follow-up easier to discuss.
SURMOUNT-4 in plain words
SURMOUNT-4 was a study of tirzepatide, the medicine sold as Zepbound and Mounjaro in different settings. In the trial, adults first completed 36 weeks of tirzepatide. After that, one group switched to placebo and the other group kept taking tirzepatide.
From week 36 to week 88, the placebo group gained 14.0% of body weight. The group that continued tirzepatide lost a further 5.5%.
In simple terms, the study found that after an initial response, outcomes differed between people who stayed on tirzepatide and people who switched off it. That does not tell any one person what their own path will be.
For a related read, see coming off Mounjaro and stop Wegovy weight regain.
What the trial does not tell you
The trial does not tell you what you should do with your medication. It does not set a taper, a stop date, or a substitute plan. Those are prescriber decisions.
It also does not predict how fast or how much any one adult may change after stopping. People differ in appetite, routines, health history, and support.
SURMOUNT-4 also does not tell you how to manage food, exercise, or body image during this time. If eating becomes stressful, a clinician can help you think through support options.
What to track
Tracking is not a treatment, but it can help you notice patterns during a transition. The app is planned to store data on the device with no account, and to let you export or delete everything.
- Weight trend over time, not single readings, with an adjustable regain band
- Appetite once a week, from 1 for quiet to 5 for loud
- Protein and fiber targets based on body weight
- Strength sessions logged as a simple record, with a goal of 2 to 3 sessions a week
- Taper notes if you want to record dose steps you typed in, without the app calculating, validating, or suggesting doses
Some people also like to note sleep, stress, or when hunger feels different. If eating feels hard, talk to a clinician before making changes to your routine.
Join the iOS waitlist from Get the app.
Key facts
- In SURMOUNT-4 (JAMA 2024), from week 36 to week 88 people switched to placebo gained 14.0% of body weight, while those who continued tirzepatide lost a further 5.5%. Source
Sources
Last updated: