Consultants say the findings spotlight a significant hole in weight problems care: Whereas GLP-1s may help individuals lose substantial quantities of weight, there are few confirmed methods to lock in these enhancements as soon as remedy ends.
“This reinforces what we’ve seen throughout different research and in real-world follow,” says Yuval Pinto, MD, an weight problems and household medication physician at Johns Hopkins Drugs in Baltimore, who was not concerned within the analysis. “When a medical intervention that helps weight reduction is eliminated, most individuals will regain weight.”
How Researchers Studied Weight Regain After GLP-1s
To raised perceive what sometimes occurs when somebody stops taking a weight reduction drug, researchers reviewed knowledge from 37 research that adopted greater than 9,300 adults after they stopped taking medicine for chubby or weight problems.
On common, members had been on remedy for about 9 months and had been adopted for roughly eight months after they stopped. The evaluation included older weight reduction medicine in addition to newer GLP-1 medicine, together with Wegovy (semaglutide) and Zepbound (tirzepatide).
Weight Regain Provides Up Month by Month
Throughout all medicines studied, individuals regained a mean of about 0.9 pound (lb) monthly after stopping remedy. At that tempo, many can be anticipated to return to their beginning weight inside 18 months.
For individuals taking newer GLP-1s, which usually assist individuals lose extra weight in a shorter time interval, regain was sooner, averaging about 1.8 lb monthly.
Earlier than beginning remedy, individuals ought to concentrate on this chance, says Sam West, PhD, a coauthor of the examine and a postdoctoral researcher on the College of Oxford in the UK.
“Folks want to know the danger of comparatively speedy weight regain if medicine stops — that must be a part of knowledgeable decision-making from the start,” he says.
Weight Regain Was Sooner After Stoppage of GLP-1s Than After Food regimen and Train Packages
When researchers in contrast weight regain after medicine to what occurred after the top of weight loss plan and train regimens, they discovered that weight returned about 0.7 lb monthly sooner after members stopped medicine than after they finish a weight loss plan and train plan — no matter how a lot weight individuals initially misplaced.
One doable clarification is that medicines cut back urge for food and calorie consumption with out requiring individuals to follow the day-to-day behaviors that help long-term upkeep.
And whereas individuals taking GLP-1s who had structured behavioral help (equivalent to instruction on wholesome consuming, portion management, and train) misplaced about 10 further kilos total, it didn’t have an effect on how briskly they regained the burden as soon as they stopped medicine.
Enhancements in Metabolic Well being Didn’t Final
Weight wasn’t the one factor affected after remedy stopped.
Though GLP-1 remedy led to enhancements in blood sugar, blood strain, and blood lipids (ldl cholesterol and triglycerides), these beneficial properties didn’t final as soon as medicine stopped.
Throughout research, these well being markers returned to unhealthy baseline ranges a mean of a yr and a half after remedy ended.
The outcomes underscore that these medicines are metabolic interventions, not simply weight reduction instruments, says Dr. Pinto.
“When weight comes again — and when the medicine’s metabolic results are eliminated — it’s anticipated that issues like blood sugar or blood strain will worsen once more, particularly if individuals don’t proceed life-style adjustments,” he says.
Why So Many Folks Cease GLP-1 Medication
The findings are particularly related as a result of many individuals don’t keep on GLP-1s long-term.
Affordability is a significant problem for many individuals, says Pinto. “Insurance coverage protection isn’t ceaselessly. Within the U.S., it lasts about a mean of 16 months — that makes planning for what comes subsequent extremely necessary,” he says.
May New GLP-1 Tablets Be the Reply?
One doable method to cease the burden from coming again is to transition to different medicines or cut back the dose slightly than cease remedy altogether.
In a current late-stage medical trial, individuals who switched from weekly injectable GLP-1 medicine equivalent to Wegovy or Zepbound to the experimental each day GLP-1 tablet orforglipron maintained almost all the burden loss they skilled over one yr.
“If price or insurance coverage protection is the rationale somebody stops injectable GLP-1s — and within the U.S., that’s usually the principle purpose — having a extra inexpensive oral possibility might make an actual distinction,” Pinto says.
There’s additionally proof that de-escalation of dosing — that’s, spacing out the doses to each different week or longer, or decreasing the dose — might assist individuals maintain the burden off as soon as they’re within the upkeep part.
What Sufferers Ought to Know Earlier than Stopping — or Beginning — a GLP-1
Extra analysis is required on methods to forestall weight regain after ceasing medicine, says Dr. West. Consultants agree that it’s best to speak together with your physician earlier than you determine to cease taking GLP-1s.
The takeaway from this evaluation shouldn’t be that folks ought to keep away from these medicine, says Pinto.
“It’s that weight reduction ought to occur underneath medical supervision, with frequent follow-ups and a plan for what occurs if remedy adjustments,” he says.
Ideally, that medical supervision can be from an weight problems medication specialist, an knowledgeable who goes by a particular medical fellowship to assist individuals shed weight and maintain it off, says Pinto.
