Consultants say the findings spotlight a significant hole in weight problems care. GLP-1 may help with vital weight reduction, however there are few confirmed methods to lock in that enchancment after remedy ends.
“This confirms what we have seen in different research and in real-world follow,” says Yuval Pinto, M.D., a bariatric and household drugs doctor at Johns Hopkins College of Medication in Baltimore. He was not concerned on this research. “When medical interventions that help weight reduction are discontinued, Most individuals achieve weight again”
How researchers studied weight restoration after taking GLP-1
To raised perceive what sometimes occurs when individuals cease taking weight-loss medication, researchers reviewed knowledge from 37 research that adopted greater than 9,300 adults who stopped taking medicines to deal with obese or weight problems.
On common, individuals acquired remedy for about 9 months and had been adopted for about 8 months after discontinuing remedy. The evaluation included older weight reduction medication in addition to newer GLP-1 medication reminiscent of Wegovy (semaglutide) and Zepbound (tirzepatide).
Weight achieve will increase month by month
Throughout all drug remedies studied, individuals regained a median of about 0.9 kilos (kilos) per thirty days after stopping remedy. At this charge, most individuals can anticipate to be again to their beginning weight inside 18 months.
Usually, individuals taking the brand new GLP-1, which helps them lose extra weight in a shorter time period, recovered quicker, shedding about 1.8 kilos per thirty days on common.
Dr Sam West, a co-author of the research and a postdoctoral researcher on the College of Oxford, UK, says individuals ought to concentrate on this risk earlier than beginning remedy.
“Individuals want to grasp the chance of gaining weight again comparatively shortly in the event that they cease taking the remedy. That ought to be a part of their knowledgeable decision-making from the start,” he says.
Weight regain was quicker after discontinuing GLP-1 than after weight-reduction plan and train packages
When researchers in contrast weight regain after remedy with what occurred after weight-reduction plan and train remedy ended, they discovered: Weight got here again about 0.7 kilos per thirty days quicker No matter how a lot weight individuals initially misplaced, they had been higher off after stopping the remedy than after they completed their weight-reduction plan or train plan.
One potential clarification is that the drug reduces urge for food and caloric consumption with out requiring individuals to have interaction in day by day behaviors that help long-term upkeep.
And whereas these taking GLP-1 who acquired structured behavioral help (reminiscent of wholesome consuming, portion management, and train instruction) misplaced about 10 additional kilos general, it didn’t have an effect on how shortly they regained weight after stopping the remedy.
Enhancements in metabolic well being had been short-lived
It wasn’t simply weight that was affected after stopping remedy.
GLP-1 remedy led to enhancements in blood sugar, blood stress, and blood lipids (ldl cholesterol and triglycerides), however the enhancements weren’t sustained as soon as the remedy was discontinued.
All through the research, these well being markers returned to unhealthy baseline ranges a median of 1.5 years after remedy ended.
The outcomes emphasize that these medication are metabolic interventions, not simply weight-loss instruments, Dr. Pinto says.
“As you achieve weight again and the metabolic results of the drug put on off, you may anticipate issues like blood sugar and blood stress to worsen once more, particularly in case you do not proceed with the life-style adjustments,” he says.
Why accomplish that many individuals cease taking GLP-1 medication?
This discovering is particularly vital as a result of many individuals don’t take GLP-1 for lengthy durations of time.
Affordability is an enormous subject for many individuals, Pinto says. “Insurance coverage protection does not final endlessly. Within the U.S., the common protection interval is about 16 months, so it is actually vital to plan for what’s subsequent,” he says.
Might the brand new GLP-1 capsule be the reply?
One potential solution to cease weight achieve is to maneuver to a different drug or scale back the dose, relatively than stopping remedy fully.
In a current late-stage scientific trial, individuals who switched from weekly injectable GLP-1 medication reminiscent of Wegovy or Zepbound to experimental day by day GLP-1 tablets or forglipron maintained practically all the weight reduction they skilled over a one-year interval.
“If price or insurance coverage protection is a purpose for discontinuing a GLP-1 injection, which is commonly the first purpose in the US, having a extra inexpensive oral choice may make an enormous distinction,” Pinto says.
There may be additionally proof that tapering the dose steadily (i.e., taking doses each different week or extra or lowering the dose) could assist individuals drop some weight after coming into the upkeep section.
What sufferers ought to know earlier than stopping or beginning GLP-1
Dr. West says extra analysis is required on methods to forestall weight achieve after drug discontinuation. Consultants agree that you must seek the advice of your physician earlier than stopping taking GLP-1.
The takeaway from this evaluation just isn’t that folks ought to keep away from these medication, Pinto stated.
“Weight reduction ought to be carried out underneath medical supervision and requires frequent follow-up and a plan for what is going to occur if remedy is modified,” he says.
Ideally, that medical oversight could be by an weight problems drugs specialist, a specialist in a particular medical fellowship who helps individuals drop some weight and maintain it off, Pinto says.
