WeightControl.com: Did the findings differ depending on which drug was used or how long the patient was on the medication?
Response: Yes. The degree of weight regain varied by medication and duration of follow-up. Participants who had taken semaglutide or tirzepatide experienced more substantial and clinically meaningful weight regain than those who had taken liraglutide, although this was proportional to the original weight lost. Moreover, weight regain increased with longer time off therapy and was observed even when lifestyle modifications continued.
Waist circumference and BMI followed similar patterns, though the proportional regain of waist circumference was often less than that of weight or BMI.
WeightControl.com: What should readers take away from your report?
Response: Discontinuation of GLP-1RA therapy typically results in weight regain, even when patients continue with unsupervised lifestyle interventions. These medications appear to act as ongoing tools for weight maintenance, suggesting they should be viewed as chronic therapies rather than short-term interventions. Clinicians and patients should consider this when evaluating long-term treatment plans for obesity and related metabolic conditions. Moreover, a growing body of literature, such as Kahn et al. (2025 10.1001/jama.2024.22284), estimates that the real-world discontinuation of GLP-1RAs is between 50% to 75% in one year. This is very concerning as we’ve shown that the weight lost will most likely be regained.
WeightControl.com: What recommendations do you have for future research as a result of this work?
Future studies should:
- Investigate long-term weight trajectories and body composition changes post-discontinuation to identify potential plateaus or delayed regains.
- Further assess changes in cardiovascular biomarkers in response to weight regain after stopping treatment.
- Examine the role of supervised exercise interventions and or/ lifestyle changes in mitigating post-GLP-1RA weight regain. Jensen et al. (2024 10.1016/j.eclinm.2024.102475) found that adding supervised exercise helped with weight maintenance after obesity pharmacotherapy; however, this may not be feasible for many.
- Evaluate oral GLP-1RA formulations to determine whether they can improve adherence and long-term maintenance.
WeightControl.com: Is there anything else you would like to add? Any disclosures?
Response:I have no disclosures to report. I’m grateful for the opportunity to collaborate with my students Sara & Hannah on this project.
Citation:
Discontinuing glucagon-like peptide-1 receptor agonists and body habitus: A systematic review and meta-analysis
Sara Berg, Hannah Stickle, Suzanne J. Rose, Eric C. Nemec
Obesity Reviews
First published: 04 April 2025
https://doi.org/10.1111/obr.13929
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Last Updated on April 13, 2025 by weightcontrol