What Happens To Your Weight After Quitting Glp-1 Anti-obesity Drugs?

A awesome meta-analysis finds that patients who discontinue anti-obesity medications quickly regain weight, yet, crucially, they still clasp immoderate of their original weight nonaccomplishment a twelvemonth later, spotlighting nan challenges and committedness of semipermanent obesity treatment.

Review: Trajectory of nan assemblage weight aft supplier discontinuation successful nan curen of anti-obesity medications. Image Credit: Caroline Ruda / Shutterstock

In a caller reappraisal article published successful nan diary BMC Medicine, researchers systematically reviewed and analyzed randomized controlled tests (RCTs) to measure nan effect of discontinuing anti-obesity medications (AOMs) connected semipermanent weight changes.

They concluded that important weight regain began 8 weeks aft stopping AOMs and continued done 20 weeks, peculiarly for individuals who had antecedently taken glucagon-like peptide-1 (GLP-1) receptor agonists aliases those who had knowledgeable greater weight nonaccomplishment during curen aliases ongoing manner interventions. However, successful respective subgroup analyses, immoderate differences—such arsenic betwixt those pinch greater versus lesser first weight loss—were not statistically important by week 12.

Concerns astir discontinuing AOMs

Obesity, affecting complete 2.2 cardinal adults globally successful 2020 and projected to emergence to 3.3 cardinal by 2035, is linked to important wellness risks, including immoderate cancers, cardiovascular disease, and type 2 diabetes.

Treatment typically involves manner changes, medications, and bariatric surgery. Among these, AOMs person shown occurrence successful promoting weight nonaccomplishment and improving related wellness outcomes.

However, concerns stay astir weight regain aft stopping AOMs. Studies person shown that discontinuation of narcotics for illustration semaglutide and orlistat often leads to important weight regain and worsening of metabolic measures, specified arsenic humor sweetener and humor pressure. Additionally, immoderate studies study that metabolic indicators specified arsenic plasma lipids and insulin concentrations whitethorn besides revert aft weight regain.

Yet, astir anterior investigation connected weight regain has focused connected surgical aliases behavioral interventions, leaving a spread successful knowing nan effects of stopping pharmacological treatments.

About nan review

This meta-analysis was designed to reside that spread by systematically evaluating nan semipermanent effects of AOMs aft curen cessation, peculiarly nan trajectory of weight changes successful nan weeks and months that follow.

The authors analyzed information from 11 randomized controlled tests involving 2,466 participants (1,573 successful nan curen group and 893 successful nan power group), each of which reported weight information some during and aft treatment.

The reappraisal covered a scope of medications, including six tests connected GLP-1 receptor agonists, 1 connected dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists, 1 connected orlistat, 2 connected phentermine-topiramate, and 1 connected naltrexone-bupropion.

Eight studies utilized placebo controls and 3 utilized progressive supplier controls. All studies were judged to person debased consequence of bias.

Weight regain patterns aft AOM discontinuation

Weight regain became noticeable astir 8 weeks aft stopping AOMs, expanding until astir week 20 earlier stabilizing. No important quality was observed astatine 4 weeks; however, from 8 weeks onward, those who had utilized AOMs regained importantly much weight than nan controls.

The magnitude of mean weight regain was 1.5 kg astatine 8 weeks, 1.76 kg astatine 12 weeks, 2.5 kg astatine 20 weeks, 2.3 kg astatine 26 weeks, and 2.47 kg astatine 52 weeks. Despite this regain, participants who had utilized AOMs still maintained a nett weight nonaccomplishment compared to their pre-treatment baseline astatine 52 weeks, indicating a lasting use moreover aft discontinuation of nan medication.

When grouped by first weight, some lower- and higher-weight subgroups showed important weight regain, pinch nary meaningful quality betwixt them. Body wide scale (BMI)-based subgroup study revealed important regain only successful those pinch a BMI beneath 35, which was unexpected.

BMI trajectory followed a akin shape to weight, pinch increases observed from week 10 onward. At 26 and 52 weeks, BMI gains were 0.70 and 0.82 kg/m², respectively.

Meta-regression study recovered that baseline BMI, wellness status, sex, and property did not importantly power nan grade of weight regain. Similarly, power type, curen duration, follow-up time, and weight nonaccomplishment complaint were not recovered to beryllium associated pinch differences successful post-treatment weight regain.

Other influencing factors

Significant weight regains occurred successful some placebo-controlled and actively controlled trials, pinch nary meaningful quality betwixt them. When comparing participants pinch obesity unsocial versus those pinch obesity and type 2 diabetes, some groups showed important regain, again pinch nary important difference.

Participants who had utilized GLP-1-based therapies knowledgeable important weight regain. In contrast, non-GLP-1-based supplier studies did not show statistically important weight regain. However, nan quality successful weight regain betwixt GLP-1 and non-GLP-1 groups was besides not statistically significant.

Interestingly, tests that continued manner interventions specified arsenic workout and fare aft stopping AOMs still showed important weight regain (1.83 kg). In contrast, studies without continued behavioral support did not show important regain, though this uncovering was based connected constricted information and should beryllium interpreted cautiously. The authors statement that these results opposition pinch erstwhile investigation supporting nan worth of ongoing manner intervention, and propose that constricted sample sizes, involution heterogeneity, aliases study designs whitethorn person contributed to this unexpected finding.

Participants who knowledgeable greater weight nonaccomplishment during curen were much apt to regain weight aft stopping medication. However, by 12 weeks post-treatment, nan quality successful regain betwixt those pinch larger versus smaller first losses was not statistically significant. Similarly, accelerated and slow weight nonaccomplishment subgroups some knowledgeable comparable levels of regain.

Adverse events were reported successful a subset of studies, but location was insufficient grounds to find immoderate relation betwixt adverse events during curen and consequent weight regain.

Conclusions

This meta-analysis recovered that stopping AOMs often leads to important weight regain, which originates astir 8 weeks and stabilizes by six months. This shape is akin to rebound effects seen aft bariatric room aliases behavioral weight loss.

Weight regain occurred crossed different subgroups, including those pinch varying wellness conditions, baseline weights, and BMIs, and was much pronounced successful individuals who mislaid much weight during treatment. However, galore subgroup differences were not statistically significant, and results should beryllium interpreted pinch be aware fixed nan constricted number of included studies for respective analyses.

GLP-1-based therapies showed a notable rebound, apt owed to nan nonaccomplishment of metabolic and appetite-suppressing effects aft curen cessation. Behavioral and biologic mechanisms, specified arsenic psychological factors and hormonal shifts, whitethorn contribute, but stay poorly understood. Lifestyle interventions did not forestall regain, contrasting pinch anterior evidence, though constricted information and variability betwixt studies whitethorn explicate this discrepancy.

Key limitations see a mini number of studies, variety successful design, and a deficiency of attraction connected post-treatment outcomes successful immoderate trials. The study was besides chiefly constricted to weight and BMI outcomes, and imaginable heterogeneity owed to different AOM classes and study durations whitethorn power nan results. More semipermanent studies are needed to amended understand weight regain and amended obesity curen strategies.