‘Doctors and patients should be aware.’
Research suggests that people who stop taking GLP-1 medications such as Ozempic, Wegovy and similar products are likely to regain the weight they lost within approximately 18 months. A study, which analysed existing research, also found that former users of the drugs put weight back on four times faster than those who had shed pounds through behavioural methods such as dieting and exercise.
Millions of people across the world use GLP-1 drugs to manage their weight. They function by reducing food cravings, slowing digestion and prolonging the feeling of fullness. However, a paper published in the British Medical Journal in January, which examined 37 previous studies involving 9,000 people, concluded that “cessation of weight management medications (WMMs) is followed by rapid weight regain and reversal of beneficial effects on cardiometabolic markers”.
It added: “Regain after [weight management medication] was faster than after [behavioural weight management programmes]. These findings suggest caution in short-term use of these drugs without a more comprehensive approach to weight management.”
GLP-1 drugs utilise active ingredients such as semaglutide, a medication originally developed to manage Type 2 diabetes that is now also prescribed to assist with weight management. Obesity is a chronic and recurring condition that affects nearly two billion adults across the globe and significantly raises the risk of illness and premature death. Researchers from the BMJ noted that weight loss “improves cardiovascular risk factors” and highlighted that a recent trial demonstrated “continuous use of semaglutide over four years reduced major cardiovascular disease events in individuals with existing cardiovascular disease”.
However, the researchers cautioned that the advantages of weight loss on diabetes and other cardiovascular risk factors were diminished by weight being regained once treatment had ceased. They went on to say: “We have shown that weight regain is faster (0.8 kg/month) and a return to baseline weight projected at 1.5 years after cessation of treatment, implying that the benefits on cardiovascular health will probably also attenuate more rapidly.”
They added that because “obesity is a chronic and relapsing condition, prolonged treatment with WMM may be required to sustain the health benefits” and concluded: “WMMs are associated with a reduction in weight and improvements in cardiometabolic health that are attenuated soon after treatment ends, with no evidence of benefit 1.7 years after the cessation of treatment. This evidence cautions against short-term use of WMMs, emphasises the need for further research into cost-effective strategies for long-term weight control, and reinforces the importance of primary prevention.”
The research encompassed studies using “any drug intervention that is currently or has previously been licensed for weight loss, or where there is reason to believe that the drug studied shares a class effect with a currently or previously licensed drug”. Among the various medications examined were semaglutide (used in Ozempic, Wegovy and others), tirzepatide (used in Mounjaro and others), liraglutide (used in Saxenda) and several others, reports the Mirror.
A separate study, published last month by researchers at the University of Cambridge, similarly found that “when individuals stopped taking the medication, they underwent rapid initial weight regain” and noted: “By 52 weeks, individuals had regained 60% of their original weight loss.”
Brajan Budini, a medical student at the School of Clinical Medicine and Trinity College, University of Cambridge, said: “Drugs such as Ozempic and Wegovy act like brakes on our appetite, making us feel full sooner, which means we eat less and therefore lose weight. When people stop taking them, they are essentially taking their foot off the brake, and this can lead to rapid weight regain.”
Researchers involved in the second study suggested that the reason some patients do not return to their original weight even a year after stopping the medications is that, by curbing appetite in the first instance, the drugs “may help individuals develop healthier eating habits, such as reduced portion sizes or more nutritionally-balanced meals, and these habits may persist even after treatment is discontinued”.
Steven Luo, also a medical student at the School of Clinical Medicine and Trinity College, said: “When stopping weight loss drugs, doctors and patients should be aware of the potential for weight regain and consider ways to mitigate this risk. It’s important that people are given advice on improving their diet and exercise, rather than relying solely on the drugs, as this may help them maintain good habits when they stop taking them.”
In response to the release of the BMJ report in January, pharmaceutical company Novo Nordisk, which makes Wegovy and Ozempic, told the BBC: “These findings highlight the chronic nature of obesity and suggest that ongoing treatment is necessary to maintain improvements in weight and overall health for patients, similar to the management of other chronic conditions such as diabetes or hypertension.”
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