A recent analysis reveals that individuals who are overweight or obese and discontinue their weight-loss medications tend to regain weight more rapidly compared to those who stop following a diet or exercise regimen. The surge in popularity of weight loss drugs containing semaglutide, found in Ozempic and Wegovy, has been notable. However, approximately half of individuals with obesity prescribed these medications, known as glucagon-like peptide agonists or GLP-1s, cease usage within a year due to factors like high costs and gastrointestinal side effects.
In a review published in the BMJ, researchers highlight the importance of understanding weight regain due to the health risks associated with conditions like diabetes and heart disease linked to excess weight. To address this issue, a team led by Sam West, a postdoctoral researcher at the University of Oxford, examined data from randomized trials and observational studies involving over 6,000 overweight or obese adults who were on GLP-1s or older weight-loss medications, in comparison to 3,000 individuals in behavioral weight management programs.
Participants who discontinued weight-loss medications regained an average of 0.4 kg per month post-treatment, resulting in an average weight regain of 4.8 kilograms or 10 pounds within the first year. Predictions suggest that risk factors for diabetes and heart disease, such as elevated cholesterol and blood pressure levels, would revert to pre-treatment levels within less than two years.
The rapid weight regain after stopping medication was a concerning discovery, according to West. Individuals who ceased weight-loss medications regained weight nearly four times faster than those who stopped exercising or adhering to their diets, including various structured programs like Weight Watchers. Even those who discontinued behavioral weight management programs experienced weight regain.
Dr. Sonja Reichert, an associate professor specializing in family medicine at Western University, emphasized that new weight loss medications are not a quick fix for obesity. Reichert stressed the long-term nature of these medications, likening their use to managing chronic diseases like high blood pressure.
The challenges associated with weight loss medications include the temporary effects they provide. Dana Small, a professor at McGill University, emphasized the importance of combining weight-loss medications with strategies for weight maintenance and efforts to improve the food environment to address weight regain.
Support during treatment, including guidance from dietitians, was found to enhance weight loss outcomes. The reasons behind the accelerated weight regain post-medication discontinuation remain unclear. It is suggested that individuals need to develop coping mechanisms to manage hunger once the hunger-curbing effects of the drugs wear off.
Looking ahead, Reichert expressed optimism about potential advancements in the field, such as improved access to medications, lower costs, and integrated behavioral programs from insurance providers. These developments, along with efforts to combat stigma and bias towards individuals with larger bodies, can contribute to supporting healthier lifestyle changes.
