Weight Loss Drugs: Gains Frequently enough Reversed Within Two Years, Study Finds
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A new analysis published in The BMJ reveals that individuals who discontinue prescription weight loss medications typically regain weight and lose the associated health benefits, highlighting the need for long-term strategies beyond pharmaceutical intervention. the study found that improvements in cholesterol levels and blood pressure, tend to diminish after treatment ends.
The study, which reviewed data from over 9,300 participants across 37 clinical trials and observational studies, found that on average, individuals regained approximately 0.4 kilograms (0.88 pounds) per month after stopping medication. Based on this rate, researchers project that both body weight and key risk markers for diabetes and heart disease will return to pre-treatment levels in under two years.
Faster Regain Than With Lifestyle Changes
Notably, weight regain following medication cessation occurred at a significantly faster pace than after weight loss achieved through diet and physical activity. The analysis showed the rate of regain was nearly four times higher, irrespective of the initial weight loss achieved.
“This evidence suggests that despite their success in achieving initial weight loss, these drugs alone may not be sufficient for long term weight control,” researchers concluded.
GLP-1 Medications and Discontinuation Rates
The findings are particularly relevant given the increasing use of newer weight loss medications, including glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (Ozempic, Wegovy, and Rybelsus) and tirzepatide (Mounjaro and Zepbound). These medications have reshaped obesity treatment, enabling considerable weight loss for many patients. Though, approximately half of individuals with obesity discontinue GLP-1 drugs within the first year of use.
To understand the implications of this high discontinuation rate, researchers from the University of Oxford examined outcomes from studies comparing medication-based weight loss to non-drug approaches like behavioral weight management programs and placebo treatments. The studies included participants who received weight loss treatment for an average of 39 weeks, with follow-up lasting approximately 32 weeks.
Cardiometabolic Health Declines After Treatment
The pattern of regain extended beyond weight itself. Cardiometabolic risk markers – measures related to heart disease and metabolic health – where projected to return to baseline levels within roughly 1.4 years after medication was discontinued. This suggests that the protective effects of these drugs on cardiovascular health are not sustained without continued use.
The average difference in weight regain between drug-based and behavioral weight management programs was 0.3 kilograms per month, a pattern consistent across varying degrees of initial weight loss.
Study Limitations and Future Research
The authors acknowledge several limitations. only eight of the included studies focused on newer GLP-1 medications, and none tracked participants for longer than 12 months after stopping treatment. Moreover, a relatively small number of studies were assessed as having a low risk of bias.
Despite these limitations, the researchers emphasize the consistency of their findings across three different analytical approaches, bolstering confidence in their conclusions.
Experts Advocate for Holistic Approaches
Based on the study’s results, the authors urge caution against short-term use of weight management medications and emphasize the need for further research into cost-effective strategies for long-term weight control. They also reinforce the importance of primary prevention through lifestyle interventions.
A US researcher, commenting in a linked editorial, stated that “The study findings cast doubt on the notion that GLP-1 receptor agonists are a perfect cure for obesity.”
The researcher added that individuals taking GLP-1 receptor agonists should be aware of the high discontinuation rate and the potential consequences of stopping medication. “Healthy dietary and lifestyle practices should remain the foundation for obesity treatment and management, with medications such as GLP-1 receptor agonists used as adjuncts,” they concluded. “Such practices not only help prevent excess weight gain but can also lead to numerous health benefits that go beyond weight control.”
