Endoscopic Procedure May Prevent Weight Regain After Glp-1 Discontinuation

An outpatient process whitethorn connection a measurement for nan estimated 70% of group who discontinue celebrated weight-loss narcotics to debar regaining nan pounds they shed, according to a study to beryllium presented astatine Digestive Disease Week® (DDW) 2026. Nearly 1 successful 5 adults pinch obesity person taken a glucagon-like peptide-1 (GLP-1), and galore acquisition weight rebound erstwhile they extremity nan drug, regaining their mislaid weight wrong 18 months connected average.

The study presents nan first blinded, randomized, sham-controlled grounds that nan process known arsenic duodenal mucosal resurfacing whitethorn connection a safe, effective and lasting measurement to support drug-free weight nonaccomplishment pursuing GLP-1 discontinuation.

As effective arsenic GLP-1 medications are, galore group extremity taking them because of cost, broadside effects aliases simply not wanting to return a supplier long-term. But, if they extremity these medications, weight regain occurs successful nan immense mostly of patients, and nan metabolic benefits are lost. Finding a curen that allows patients to extremity these medications without weight regain aliases nonaccomplishment of metabolic use is simply a immense unmet need. These findings bespeak that this minimally invasive process whitethorn supply lasting weight-loss maintenance."

Shelby Sullivan, MD, lead author, head of nan Endoscopic Bariatric and Metabolic Program astatine Dartmouth Health Weight Center and professor of medicine, Dartmouth Geisel School of Medicine

Duodenal mucosal resurfacing is an investigational endoscopic process that uses targeted power to ablate (burn) nan unhealthy soul mucosal lining of nan duodenum, nan precocious portion of nan mini intestine that sits conscionable beneath nan stomach. The REMAIN-1 proceedings is testing whether duodenal mucosal resurfacing, which stimulates nan maturation of new, patient tissue, tin consequence successful a sustained metabolic reset.

The findings are based connected nan first group of proceedings participants, who now person six months of follow-up data. Of nan 45 participants successful nan trial's midpoint cohort, 29 underwent resurfacing and 16 received a sham procedure. All participants underwent their process aft they mislaid astatine slightest 15% of full assemblage weight utilizing tirzepatide and past discontinued nan drug.

Patients mislaid astir 40 pounds connected GLP-1 therapy. Six months aft stopping nan drug, those who had nan sham process regained 40% much weight than nan curen group. Moreover, those who had much insubstantial resurfaced regained conscionable 7 pounds, maintaining complete 80% of their weight loss, while nan sham power group regained astir double that amount. The quality betwixt nan curen and power groups appears to beryllium widening from 1 to six months post-intervention, suggesting nan imaginable for durable weight attraction pinch nan procedure.

"What's peculiarly encouraging is that nan use appears to summation complete clip alternatively than fade, and that it behaves for illustration a supplier successful position of dose response," Dr. Sullivan said. "That gives america assurance that we're targeting nan correct biology."

No superior complications were reported from either nan instrumentality aliases nan procedure.

"Other than recovering from nan wide anesthesia, location isn't overmuch betterment clip involved," Dr. Sullivan said. "You tin beryllium backmost to your regular daily successful astir a day. Participants could not show if they had nan sham aliases existent process because location are not a batch of symptoms aft nan procedure."

The process focuses connected nan mini bowel, wherever nan hormones mimicked by GLP-1 narcotics are produced, Dr. Sullivan said. Over time, high-fat, high-sugar diets tin lead to thickening and different changes successful nan duodenal mucosal layer. These changes rewire really nan gut responds to food, affecting hormone accumulation and starring to insulin guidance and metabolic diseases. By rejuvenating nan mucosal layer, nan resurfacing process intends to reset individuals' metabolism to their caller post-GLP-1 weight, starring to sustained effects.

Duodenal mucosal resurfacing is an investigational outpatient procedural therapy. The much than 300-participant pivotal REMAIN-1 program, sponsored by Fractyl Health, is afloat enrolled and randomized, pinch topline six-month pivotal cohort information expected early successful nan 4th fourth of 2026 and a planned trading submission later successful nan year.