Following discontinuation of tesamorelin therapy, many individuals will 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 cessation of therapy [1–7]. What is described as the post-tesamorelin discontinuation effects demonstrates that the benefits associated with therapy are strongly linked to its continuation.
Tesamorelin works by stimulating the pituitary gland to release the body's natural growth hormone, which subsequently increases IGF-1 production and helps to reduce visceral fat, improve lipid profiles, and support metabolic functions [1–3]. Following the cessation of treatment, GH and IGF-1 activity gradually returns to baseline levels, reducing the metabolic effects that aid in controlling 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 reported 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, whereas discontinuing treatment led to a gradual reversal of some of these benefits [2]. These findings suggest that tesamorelin does not permanently alter fat distribution. Instead, it impacts metabolic pathways only when therapy is active.
Research into liver fat also suggests 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 during 12 months of tesamorelin therapy in individuals with HIV-associated non-alcoholic fatty liver disease (NAFLD) [3]. Fibrosis refers to the scarring of the liver. Although long-term effects after stopping treatment are less studied, the mechanism of action of tesamorelin suggests that some benefits may disappear once GH–IGF-1 stimulation ceases.
The re-accumulation of fat after discontinuation of 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 adipose tissue signalling, and reduced endogenous GH secretion can continue to favour abdominal fat deposition even after the temporary improvement achieved during treatment [1–5].
Importantly, discontinuing tesamorelin does not appear to cause classical 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
- Increase in waist circumference
- Partial loss of improvement in lipid profile
- IGF-1 levels returning closer to baseline
- Gradual reduction of metabolic benefits
Although visceral fat often returns after therapy completion, studies have typically not shown significant issues with blood sugar levels or major endocrine complications after discontinuing tesamorelin [1–4]. Hormone levels usually gradually returned to the ranges observed before treatment initiation.
General data regarding long-term safety suggest that tesamorelin remains relatively well-tolerated with continued therapy. A meta-analysis conducted by Badran AS et al. (2026) confirmed a significant improvement 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 withdrawal of tesamorelin often leads to a gradual regain of visceral fat and loss of some metabolic benefits, as the drug's effect depends on continuous activation of the GH–IGF-1 pathway. Available studies indicate that tesamorelin functions more as a long-term supportive therapy for metabolic control rather than a permanent solution to excessive 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 can vary based on an individual's metabolic state, 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(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 analogue, in human immunodeficiency virus-infected patients with excess abdominal fat: A pooled analysis of two multicentre, 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 non-alcoholic fatty liver disease in HIV-positive individuals: A randomised, double-blind, multicentre 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 randomised 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.