Weight Regain: What to Expect After Discontinuing Obesity Medications in Two Years

A recent study involving over 9,000 participants revealed that individuals who discontinue weight loss medications often regain the weight lost within two years. This finding underscores the notion that obesity should be viewed as a chronic disease necessitating ongoing treatment.

“These medications are very effective; however, obesity is a chronic, relapsing condition,” explained Susan Jebb, who addressed the press at the University of Oxford. “Similar to hypertension medications, these treatments are likely needed for life.”

It’s evident that weight loss medications can significantly aid individuals in combating obesity, particularly newer GLP-1 medications mimicking gut hormones such as glucagon-like peptide 1—examples include semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound). These drugs not only facilitate weight loss but also positively impact health metrics like blood pressure and cholesterol levels.

Nevertheless, many patients have ceased using GLP-1 medications due to side effects, including nausea, or a lack of availability triggered by heightened demand. “Approximately half of users discontinue these drugs within a year,” remarks Jebb.

While nations like the United States and parts of Europe permit long-term use of GLP-1 medications for weight control, frameworks like the UK’s National Health Service are restricting semaglutide usage for weight management based on cost-effectiveness evaluations over two years.

Previous studies indicate that individuals often regain weight post-semaglutide discontinuation. Yet, it remains unclear if this pattern extends to other weight loss interventions and the swift occurrence of weight gain upon cessation.

To investigate this, Jebb and colleagues reviewed 37 trials, combining data from over 9,000 participants, all classified as overweight or obese and using some form of weight loss medication (including GLP-1) for about 10 months, followed by a monitoring period of roughly 8 months.

From their analysis, the researchers noted that participants lost an average of 8.3 kilograms and experienced improvements in metabolic parameters like blood pressure, cholesterol, and blood glucose levels.

When examining weight patterns during the follow-up phase, the model suggested participants regained the average weight lost within 1.7 years after stopping their medications.

In trials specifically addressing semaglutide and tirzepatide, participants lost an average of 14.7 kilograms, yet it was anticipated they would regain all lost weight within a year and a half. Jebb points out that further insights are required to understand the accelerated weight gain associated with these drugs compared to others.

Additionally, the team discovered that the weight regain rate after ceasing weight loss drugs was about four times steeper than that observed following the termination of a structured behavioral weight loss program, which typically emphasizes healthy eating and increased physical activity.

However, this disparity may be attributed to the greater motivation for weight loss among individuals participating in behavioral programs compared to those relying on medications.

Another factor contributing to this swift weight regain may be the appetite suppression induced by these drugs. Users often report significant increases in hunger and cravings upon discontinuation, possibly leading to rapid weight resurgence, as noted by Taraneh Soleimani from Pennsylvania State University.

Yet, a separate analysis suggested that offering behavioral support during the follow-up phase did not effectively curb weight gain. Soleimani emphasizes that more research is essential to determine optimal strategies for supporting individuals transitioning off weight loss medications.

What Jebb’s research illustrates, according to her, is the critical need to consider obesity as a long-lasting condition. “Weight loss drugs demonstrate effectiveness, and weight regain is prevalent upon cessation,” states Professor Soleimani. “These results confirm obesity as a chronic condition that requires prolonged treatment.”