After stopping tesamorelin therapy, many individuals gradually regain visceral abdominal fat and may lose some of the metabolic benefits achieved during treatment, as the stimulation of the growth hormone (GH) and insulin-like growth factor-1 (IGF-1) pathway decreases after therapy termination [1-7]. What is described as the effects of tesamorelin discontinuation shows that the benefits associated with the therapy are strongly linked to its continuation.
Tesamorelin works by stimulating the pituitary gland to release the body's natural growth hormone, which then increases IGF-1 production and helps to reduce visceral fat, improve lipid profile, and support metabolic functions [1-3]. After treatment discontinuation, GH and IGF-1 activity gradually returns to levels closer to baseline, reducing the metabolic effects that help control abdominal fat accumulation.
Some of the most important data regarding tesamorelin discontinuation come from long-term clinical trials conducted by Falutz J and colleagues. In a 52-week extension study published in the journal AIDS (2008), participants who continued tesamorelin therapy maintained a reduction in visceral abdominal fat of approximately 18%, whereas those who discontinued treatment regained visceral fat relatively quickly after the end of therapy [1]. The researchers concluded that maintaining the reduction in abdominal fat requires continued treatment.
Similar results were presented in pooled analyses of Phase III trials by Falutz J and colleagues (2010). Participants continuing tesamorelin maintained improvements in visceral adipose tissue (VAT), waist circumference, and triglyceride levels, while discontinuation of the treatment was associated with a gradual reversal of some of these benefits [2]. These findings suggest that tesamorelin does not permanently alter fat distribution. Instead, it affects metabolic pathways only when therapy is active.
Studies on liver fat also suggest that continuing therapy may be important for maintaining effects. Stanley TL et al. (2019) observed a significant reduction in liver fat and slower progression of liver fibrosis over 12 months of tesamorelin therapy in individuals with HIV-associated non-alcoholic fatty liver disease (NAFLD) [3]. Fibrosis refers to scarring of the liver. Although long-term effects after discontinuing treatment are less well-studied, the mechanism of action of tesamorelin suggests that some benefits may disappear once GH–IGF-1 stimulation ceases.
Regaining fat after stopping tesamorelin is thought to be related to the fact that the underlying causes of visceral fat accumulation often remain present. In HIV-associated lipodystrophy, factors such as antiretroviral therapy, insulin resistance, chronic inflammation, impaired fat tissue signaling, and reduced natural GH secretion can continue to promote abdominal fat deposition even after temporary improvement achieved during treatment [1–5].
Importantly, discontinuing tesamorelin does not appear to cause classic withdrawal symptoms characteristic of some medications. Instead, the main effect observed in studies was a gradual loss of therapeutic benefits, including:
- Recurrence of visceral abdominal fat
- Increased waist circumference
- Partial improvement of lipid profile
- Return of IGF-1 levels to baseline
- Gradual reduction in metabolic benefits
Although visceral fat often returns after therapy is discontinued, studies have generally not shown significant problems with blood sugar levels or serious endocrinological complications after discontinuing tesamorelin [1–4]. Hormone levels typically returned gradually to the ranges observed before treatment began.
General long-term safety data suggest that tesamorelin remains relatively well-tolerated with continued therapy. A meta-analysis by Badran AS et al. (2026) confirmed significant improvements in visceral fat, liver fat, and body composition, while also highlighting the importance of ongoing treatment to maintain these effects [6].
Generally speaking, current clinical evidence suggests that discontinuing tesamorelin often leads to a gradual regain of visceral fat and loss of some metabolic benefits, as the drug's effect is dependent on continuous activation of the GH–IGF-1 pathway. Available studies indicate that tesamorelin acts more as a long-term supportive therapy for metabolic control rather than a definitive solution for excess visceral fat accumulation.
Disclaimer
The content is for educational and informational purposes only and should not be interpreted as medical advice, diagnosis, or therapeutic recommendation. Tesamorelin is a prescription medication and should only be initiated or discontinued under the supervision of a qualified healthcare professional. Post-treatment reactions may vary based on an individual's metabolic status, comorbidities, and treatment history.
References
- Falutz J, Allas, S., Mamputu, J. C., et al. (2008). Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS, 22(14), 1719–1728. https://doi.org/10.1097/QAD.0b013e32830a5058
- Falutz J, Mamputu, J. C., Potvin, D., et al. (2010). Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: A pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. The Journal of Clinical Endocrinology & Metabolism, 95(9), 4291–4304. https://doi.org/10.1210/jc.2010-0490
- Stanley TL, Fourman, L. T., Feldpausch, M. N., et al. (2019). Effect of tesamorelin on nonalcoholic fatty liver disease in HIV-positive individuals: A randomized, double-blind, multicenter study. The Lancet HIV, 6(12), e821–e830. https://doi.org/10.1016/S2352-3018(19)30338-8
- Falutz J, Allas, S., Blot, K., et al. (2007). Metabolic effects of a growth hormone-releasing factor in patients with HIV. The New England Journal of Medicine, 357(23), 2359–2370. https://doi.org/10.1056/NEJMoa072375
- Mateo MG, Gutiérrez, M. D. M., & Domingo, P. (2011). Tesamorelin in the treatment of excess abdominal fat in HIV-1 infected patients with lipodystrophy. Expert Review of Endocrinology & Metabolism, 6(1), 21–30. https://doi.org/10.1586/eem.10.83
- Badran AS, Helal, A., Shata, K. S., & Ayesh, H. (2026). Body composition, hepatic fat, metabolic, and safety outcomes of tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Obesity Research & Clinical Practice, 20(1), 2–12. https://doi.org/10.1016/j.orcp.2026.01.002
- Fourman LT, Czerwonka, N., Feldpausch, M. N., Weiss, J., Mamputu, J. C., Falutz, J., Morin, J., Marsolais, C., Stanley, T. L., & Grinspoon, S. K. (2017). Visceral fat reduction with tesamorelin is associated with improvement in liver enzymes in HIV. AIDS, 31(16), 2253–2259.