Stopping weight‑loss medications linked to rapid weight regain and returning heart risk, review finds

A BMJ review of clinical trials and observational studies found that people who stopped GLP‑1 and other prescription weight‑loss drugs regained about 4.8 kg (10 lb) in the first year and modelling suggested diabetes and heart‑disease risk markers could return to pre‑treatment levels within two years.

A review published in BMJ examined what happens after people stop prescription weight‑loss medications, including GLP‑1 drugs such as semaglutide. These drugs have become widely used, but about half of people with obesity stop GLP‑1s within a year, often because of cost or side effects. The authors reviewed randomized trials and observational studies to compare drug treatment with behavioural weight‑management programs. The review focused on weight regain and changes in risk markers for diabetes and heart disease after treatment ended. Key findings: - The review covered more than 6,000 adults treated with GLP‑1s or older weight‑loss drugs and about 3,000 people in behavioural programmes. - After stopping drug treatment, participants regained on average 0.4 kg per month, amounting to about 4.8 kg in the first year. - Researchers modelled that risk markers for diabetes and heart disease, such as cholesterol and blood pressure, would likely return to pre‑treatment levels in under two years. - People who stopped medications regained weight almost four times faster than those who stopped behavioural programmes, and most studies did not follow participants long beyond one year. Summary: The review indicates that stopping prescription weight‑loss drugs is commonly followed by rapid weight regain and a likely reversal of short‑term improvements in risk markers. Undetermined at this time.