The majority of clinicians agree that GLP-1 weight loss medications are a long-term and potentially life-long solution to weight management. In other words, you’ll need to keep taking a maintenance dose for a long time, maybe forever (that is if you don’t want to regain any of that weight). Unfortunately, estimates put the discontinuation rate of these medications as high as 50 percent in the first year. And now, we’re seeing how GLP-1 withdrawal can impact health.
The Prevalence of GLP-1 Withdrawal
“A lot of people are going on these drugs and then going off, and there’s not going to be a benefit from doing that,” Ethan Lazarus, an obesity medicine physician based in Colorado told Axios.
A recent study published in JAMA Network tracked patients who stopped taking their GLP-1 medications. They found these patients were more likely to experience adverse side effects and have higher costs associated with their medications. Patients were more likely to withdraw if they were Black, Hispanic, or living in an area of high social need. “Discontinuation could have policy and medication coverage implications,” the study explains, “especially if the weight reduction is not sustained after medications are discontinued.”
And there’s ample evidence to suggest that weight loss will not be sustained after discontinuation.
Will the Weight Come Back?
A 2022 study in PubMed found that patients who stopped taking their GLP-1 gained back most of the weight.
“One year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg and lifestyle intervention, participants regained two-thirds of their prior weight loss, with similar changes in cardiometabolic variables,” explains the study. “Findings confirm the chronicity of obesity and suggest ongoing treatment is required to maintain improvements in weight and health.”
Kevin Hall, a senior investigator at the National Institutes of Health, confirms that GLP-1s are likely a life-long prescription. “Usually what I will communicate to the patients is that these drugs are indicated by the [Food and Drug Administration] so that you could be on it for the rest of your life,” he says. “But on the other hand, [I say that] if the patient were to stop the drug, really the worst thing that is going to happen is they’re going to regain the weight that they lost.”
But with regained weight comes regained weight-related health issues.
This confirms to physicians that obesity’s chronic nature won’t be beaten in just one shot. Instead, GLP-1s need to be part of a clinician-monitored long-term health plan.
