What is already known on this topic The development of highly effective weight management medications (WMMs) has transformed the treatment of obesity Real world observations estimate that around 50% of people with obesity discontinue WMMs within 12 months A previous systematic review quantified and compared the rate of weight regain with behavioural weight management programmes (BWMPs) What this study adds People on average regain weight at a rate of 0.4 kg/month after cessation of WMMs, leading to a projected return to baseline weight after 1.7 years Although weight loss resulted in improvements in HbA 1c , fasting glucose, total cholesterol, triglycerides, systolic and diastolic blood pressure, all markers returned to baseline within 1.4 years of treatment cessation The rate of weight regain after the cessation of WMMs was faster than after the cessation of BWMPs, independent of the amount of weight lost during treatment Ethics statements Ethical approval Not required

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