Review finds that people who stop taking GLP-1 drugs gain weight rapidly
When overweight and obese people stopped taking weight-loss medications, their weight came back faster than those who stopped dieting or exercising.Ram, a new review has been received.
Weight loss medications containing semaglutide, the active ingredient in Ozempic and Vegovy, have gained popularity. But about half of people with obesity take this class of drugs, called glucagon-like peptide agonists, or GLP-1s. Stop taking it within a yearStudies show that most people stop using it due to high cost and adversities gastrointestinal side effects,
Author of a review published in Wednesday’s issue BMJ issue That said, it’s important to understand weight regain given the risks of diabetes and heart disease from carrying excess weight.
To shed light on these questions, University of Oxford postdoctoral researcher Sam West and his co-authors reviewed randomized trials and observational studies on more than 6,000 adults who were overweight or obese and took GLP-1 or chronic weight-loss drugs compared with 3,000 others in behavioral weight management programs.
Participants treated with weight loss medications regained an average of 0.4 kg/month of weight after stopping treatment, gaining an average of 10 kg or 22 pounds in the first year.
Most were not followed up after that, but researchers used modeling to predict that risk markers for diabetes and heart disease, such as high cholesterol and high blood pressure levels, would return to pre-treatment levels in less than two years.
“What we found particularly surprising was how quickly the weight came back after people stopped taking the drug,” West said in an interview.
People who stopped taking weight-loss drugs regained their weight almost four times faster than those who stopped exercising or did not follow their diet. Diet plans ranged from those from groups like Weight Watchers to “soups and shakes.” People who stopped the behavioral programs also regained their weight.
Researchers say the popular notion of walking 10,000 steps a day is more marketing than science. So how many steps should you aim to take per day?
What does this mean for Canadians
The bottom line is that new weight loss drugs are not quick fixes for people with obesity, said Dr. Sonja Reichert, an associate professor of family medicine at Western University in London, Ontario, who treats and studies obesity and diabetes.
“Many of my patients are surprised when I tell them that these medications are long-term and this study really reinforces that message,” Reichert said.
“This makes sense because obesity is a chronic disease and like our other chronic diseases like high blood pressure, we would not imagine stopping high blood pressure medications once we reach the blood pressure target.”
Heather White knows firsthand the challenges of being overweight and its medical consequences. The 67-year-old woman from Toronto also has diabetes and was prescribed Ozempic in 2023 to reduce her weight and improve blood sugar control.
White experienced persistent nausea while taking the medication. “I can’t say it was all that bad,” she said. But the weight loss benefits of the drug were not enough for her, and she stopped taking it after six months.
For two years, White focused on his food choices without weight-loss drugs.
White said she is now more conscious of her food choices. She began injecting Monjaro, another weight-loss drug, which also contains semaglutide, about two months ago. “Touch wood, I have no problem with that.”
Boost coping skills when hunger strikes again
Part of the challenge is that GLP-1 drugs do not have lasting effects.
Once people stop taking weight-loss drugs, the drug’s appetite-control effects go away, but their “food environment,” such as ultra-processed foods, persists, and the weight returns, said Dana Small, a professor at McGill University who holds the Canada Research Chair in Metabolism and the Brain.
“I still think the GLP-1 drugs, as well as the new drugs in the pipeline, are incredibly helpful and should continue to be prescribed,” Small said. “However, we need to combine this with weight loss maintenance strategies and concerted efforts to change the food environment.”
West said one of his key findings from that review was that support during treatment, such as nutritional tips from a dietitian, helped people lose more weight.
It’s not clear why people gain weight faster after stopping weight-loss medications because it hasn’t been studied, West said.
“Our best guess is that when people follow a behavioral program, they are often given the skills to deal with their appetite while losing weight,” he said. But once people stop taking medications, they also have to learn ways to deal with hunger pangs.
“For individuals who want to taper off or are considering stopping medication, what does that support look like?” said Reichert, who has consulted with manufacturers of weight-loss drugs. “We don’t really know those answers.”
But Reichert said he’s excited about where the field is headed. better access potential medicinesSuch as a pill, low prices as well as behavioral programs from insurance companies along with efforts to reduce shame and prejudice by supporting people with larger bodies to make healthy lifestyle changes.
