Weight regain seems to occur within 2 years of stopping obesity drugs

People who stop taking weight loss medications tend to regain the weight they lost in less than two years, according to a study of more than 9,000 people. Some argue that this highlights that obesity is a chronic disease that requires long-term treatment.

“These drugs are very effective, but obesity is a chronic, relapsing disease,” Susan Jebb of the University of Oxford told a news briefing. “One would expect these treatments to be continued for life, just like blood pressure medications. »

Weight loss drugs have undoubtedly helped in the fight against obesity. This is particularly the case with newer GLP-1 drugs – which mimic a gut hormone called glucagon-like peptide-1 – such as semaglutide, sold under the names Ozempic and Wegovy, and tirzepatide, sold under the names Mounjaro and Zepbound. These medications also have other effects on our health, such as lowering blood pressure and cholesterol levels.

But many people are abandoning GLP-1 drugs because of side effects such as nausea or because of supply shortages following increasing demand. “About half of people stop taking these medications within a year,” Jebb said.

Additionally, while many countries, including the United States and some countries in Europe, allow long-term use of GLP-1 drugs, England’s National Health Service, for example, limits the use of semaglutide for weight loss to two years, based on estimates of its cost-effectiveness.

Previous studies show that people tend to regain weight when they stop taking semaglutide. However, it was less clear whether this applied more broadly to stopping weight loss interventions and how quickly any weight gain occurred.

To find out, Jebb and his colleagues analyzed 37 trials that looked at the weight of more than 9,000 people in total. The individuals were either overweight or obese and taking some form of weight-loss medication, including GLP-1 drugs, for an average of 10 months. Participants were then followed over a follow-up period of approximately eight months.

Combining the effects of all the weight-loss drugs, researchers found that participants lost an average of 8.3 pounds and also saw improvements in metabolic measures, such as blood pressure, cholesterol levels and blood sugar.

The team then fed the weight measurements from the follow-up periods into a statistical model and estimated that, on average, participants would have regained all the weight lost within 1.7 years of stopping taking the different medications.

Focusing on six trials of semaglutide and tirzepatide, the researchers found that these drugs caused greater weight loss than other drugs – at 14.7 kilograms on average – but that participants taking these drugs were expected to regain all of their lost weight within a year and a half. More research is needed to determine why weight gain appears to be faster with these drugs than with others, Jebb said.

The team also calculated that the rate of weight regain after stopping weight-loss drugs is about four times faster than that observed after stopping a structured behavioral weight-loss program, in which they are encouraged to eat healthily and exercise more, and are then told to incorporate this into their lives.

However, the difference between these interventions may simply be that people who enroll in such a behavioral program may be more motivated to lose weight than those who undertake to do so using medication.

Another reason for the difference in the speed of weight regain could be that people who take such medications lose weight primarily because the medications suppress their appetite. Stopping them quickly increases people’s hunger and cravings they haven’t had to deal with in a while, potentially leading to faster weight gain, says Taraneh Soleymani of Pennsylvania State University.

Yet another analysis by the team found that providing behavioral support during study follow-up periods did not prevent weight gain. More studies are needed to understand how best to support those stopping weight-loss medications, Soleymani says.

What Jebb’s study shows, she says, is the importance of treating obesity as a long-term disease. “We know that weight loss medications are effective and that weight regain is common when you stop taking them,” says Soleymani. “These results confirm the fact that obesity is a chronic disease and that we must keep patients on treatment long-term. »