What Happens When You Stop?

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This is the question everybody has and most places avoid answering.

I'll answer it directly, and then explain why the answer is the reason this programme is built the way it is.

The short answer

When you stop, you'll typically regain one to two kilograms.

That's water weight. It's expected, it's normal, and it's fine. Don't panic when the scale moves in the first fortnight — it isn't fat returning, and it isn't a sign that everything is unravelling.

After that, you find out something real: whether the lifestyle you've built is genuinely sustainable.

That's the honest situation. Not a threat, not a sales line. It's simply where the programme has been heading the entire time.

Why I'm not going to dress this up

I could tell you that the results are permanent and let you find out otherwise. Plenty of marketing does exactly that.

But look at what actually happens with this class of medication when it's handed out without a programme around it. Someone injects for a year, loses a great deal of weight, stops — and regains most of it. That's a well-documented pattern, and it's not because the medication doesn't work. It works precisely as designed. It suppresses appetite while you're taking it.

So if nothing else changes — if your eating patterns, your protein intake, your activity, your sleep, and your understanding of your own hunger signals are all exactly the same as before — then removing the appetite suppression returns you to the conditions that produced the original weight.

You rented a result rather than building one.

Which brings me to the thing I actually believe, and it's a personal position as much as a clinical one.

Why I don't keep people on this indefinitely

I'm not one of those people who can eat whatever they want without consequence. If I stop paying attention for a few weeks, I gain a few kilos. So I've spent my adult life in the gain-lose cycle, and I know from the inside that losing weight is not the hard part. Lots of things will make you lose weight.

Not gaining it back is the hard part. And almost nothing on the market is designed for that.

So a programme that keeps you injecting forever isn't solving your problem. It's converting your problem into a monthly cost, and taking whatever risk the medication carries for as long as you're on it, indefinitely.

That's why we have a de-escalation phase. That's why bloods are repeated three months after the programme ends rather than at the finish line. And it's why the weekly conversations are so heavily about eating patterns and hunger signals rather than dosing.

What the programme does to prepare you for stopping

Every phase is designed backwards from this moment.

The signal work. During adaptation we spend serious time helping you distinguish actual hunger from the other things that feel like it — the four o'clock reward-seeking, the emotional reach, the habitual mealtime that isn't driven by need. That skill doesn't disappear when the medication stops. It's the single most portable thing you'll take out of this.

Food knowledge. Reading nutrition labels properly. Recognising calorie-dense foods. Identifying high-protein options and replacing your household staples with them. Knowing which foods work as a reliable fallback when you're struggling. None of that requires a prescription to keep using.

Protein and resistance training. If you finish the programme having preserved your muscle, your metabolic rate is in far better shape than someone who crash-lost the same weight. Muscle is metabolically active tissue — protecting it is protecting your future capacity to maintain.

Sleep. Still working after you stop.

The habits themselves, reinforced deliberately during de-escalation rather than left to chance.

By the time the medication tapers off, the intention is that what's holding your weight is everything else — the wings, in the analogy I use, rather than the engine.

The three-month follow-up

We follow up three months after you finish. Both bloods and a conversation.

Two reasons. The first is that it tells us whether the metabolic improvement held — which is the actual outcome we were after, more than any weight figure.

The second is that it catches drift early. Three months out is when people can start slipping without noticing: protein intake creeps down, resistance training becomes fortnightly, then monthly, then a thing you used to do. Caught early, that's a conversation and an adjustment. Caught at eighteen months, it's starting over.

Come to that appointment even if things are going badly. Especially then. I'd much rather see someone who's regained four kilos and is embarrassed about it than have them avoid us for a year.

If someone genuinely struggles

Sometimes people come off and find it harder than expected.

In that case we can consider a lower dose to let the body adjust more gradually — a gentler taper rather than a return to full treatment.

I want to be clear that this is rarely needed. It's not the expected path and I'm not offering it as a comfortable escape hatch. But it exists, and if you need it, that's a clinical decision rather than a personal failure.

What I'd ask is that you come and discuss it rather than quietly sourcing medication somewhere else. Which happens, and it's the worst version of this — back on treatment, no monitoring, no titration, nobody watching your muscle mass or your bloods.

The honest framing

Here's how I'd like you to think about the end of the programme.

The six months isn't the treatment. The six months is the training.

You're using a period of suppressed appetite to build things that are difficult to build when you're constantly hungry — new eating patterns, a protein habit, a resistance training routine, better sleep, and a working understanding of your own signals. The medication makes that window possible. It isn't the point of the window.

If you go through six months and come out with a lower number and no new habits, you've had a temporary result. If you come out with the habits, the weight is a side effect of something more durable.

That's the difference between the two outcomes, and it's largely determined by how you spend the six months rather than what happens after them.

One more thing about the cycle

If you've lost and regained weight before — several times, maybe — you may be reading this expecting the same ending.

I'd say two things.

First, the previous attempts probably failed for identifiable reasons, and those reasons are usually not "insufficient willpower." Constant hunger makes new habits nearly impossible to establish. That's a large part of what the medication is doing here: creating conditions where change is actually achievable.

Second, going through the cycle before is not evidence you'll go through it again. It's evidence that whatever you did before didn't include the part that makes it stick. That's a fixable problem.

I'd know. I've been round that cycle plenty of times myself.

Klinik Dr Tan, Lot 27, Ground Floor, Block D, Lintas Square, Kota Kinabalu. WhatsApp 017-234 7328. Appointments preferred.

Book a consultation with Dr. Tan — Book Online or WhatsApp 017-234 7328.

简要说明

我是陈医生，亚庇 Lintas Square 的 Klinik Dr Tan。

这是每个人都想问、多数地方避而不答的问题。

简短答案：停药后通常会回升1–2公斤，那是水分，属正常，不必惊慌，那不是脂肪回来了。之后你才会知道一件真实的事：你建立起来的生活型态是不是真的可持续。

为什么我不粉饰这一点：这类药物在没有配套的情况下发出去，众所周知的模式是——打一年、掉很多、停药、胖回去。那不是因为药没效，而是因为药完全照设计运作：服用期间抑制食欲。如果其他什么都没变（饮食模式、蛋白质、活动、睡眠、对自己饥饿讯号的理解），拿掉食欲抑制，就回到了当初造成体重的条件。你是租来一个结果，不是建立一个结果。

为什么我不让人长期用药：我自己就不是怎么吃都不胖的人，几个星期不留意就会胖几公斤，所以我这辈子都在「胖—瘦—胖」的循环里。我从内部知道：减重不难，不复胖才难，而市面上几乎没有东西是为后者设计的。让你一直打针的计划并没有解决你的问题，只是把你的问题变成每月的开销，同时无限期承担药物的风险。

计划如何为停药做准备（每个阶段都是从停药那一刻倒推设计的）：

• 讯号辨识：分辨真正的饥饿和其他像饥饿的东西（下午四点想要奖励、情绪性进食、时间到了的习惯）。这项能力停药后不会消失，是你带走的最重要的东西。

• 食物知识：看营养标签、辨认高热量密度食物、找出高蛋白选项、替换家中主食、知道哪些食物是可靠的备用选择。这些都不需要处方。

• 蛋白质与阻力训练：保住肌肉，代谢率就比同样减重却流失肌肉的人好得多。肌肉是代谢活跃的组织，保住肌肉就是保住将来维持的能力。

• 睡眠，以及减量期刻意强化的所有习惯。

三个月后的追踪：抽血加上面谈。一是确认代谢改善有没有维持住（这才是真正的成果）；二是及早发现偏移——蛋白质摄取慢慢下降、阻力训练变成两周一次、一个月一次、然后变成「以前会做的事」。三个月发现，是一次对话和调整；十八个月才发现，就是重来一次。

即使状况不好也请来。尤其是状况不好的时候。 我宁可见到一个胖回四公斤、觉得不好意思的人，也不希望他一整年都避开我们。

如果真的很吃力：可以考虑较低剂量让身体更缓慢地适应。这很少需要，不是预设路径。但如果需要，那是临床决定，不是个人失败。请回来讨论，而不是自己去别处买药——那是最糟的版本：又开始用药，却没有监测、没有剂量调整、没有人看着你的肌肉量和血液指标。

最诚实的框架：这六个月不是治疗，这六个月是训练。 你是在利用一段食欲被抑制的时间，去建立那些在长期饥饿状态下几乎不可能建立的东西。药物创造了这个窗口，但药物不是窗口的目的。六个月后只剩下一个较低的数字而没有新习惯，那是暂时的结果；带着习惯出来，体重只是更持久的东西的副产品。

关于那个循环：如果你以前减了又胖过好几次——第一，之前失败通常有可辨认的原因，而那些原因通常不是「意志力不足」；持续的饥饿几乎让人无法建立新习惯，这正是药物在这里所做的事：创造出改变真正可行的条件。第二，经历过循环不代表你注定再经历一次，而是代表你之前做的事缺了让它固定下来的那一部分。那是可以解决的问题。

我知道，因为我自己也在那个循环里转过很多次。

Klinik Dr Tan，Lot 27, Ground Floor, Block D, Lintas Square, Kota Kinabalu。WhatsApp：017-234 7328。

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