What happens after patients stop taking weight-loss drugs?

Interest in GLP-1 weight-loss drugs, such as Novo Nordisk's Wegovy and Eli Lilly's recently approved Zepbound, has surged in recent months, with some people hailing it as a "miracle" drug for obesity. However, as more patients take these drugs, there is a growing debate about whether they will need to be on them indefinitely to maintain their weight loss.

According to Axios, many patients stop taking these weight-loss drugs within a year, and a majority stop taking them within 24 months, either due to severe side effects or coverage limits. For many patients, their weight and other health benefits often rebound after they stop taking the drugs.

In a 2022 study, researchers found that people who stopped taking semaglutide regained two-thirds of the weight they originally lost after a year. Positive changes in cardiometabolic risk factors like blood pressure and blood lipids also reversed.

"There's a warning here: You take this drug and you lose a lot of weight. But you need to stay on it for the rest of your life," said Steven Heymsfield, a professor of metabolism and body composition at Louisiana State University. "Are you willing to do that? And if you get off of it, the chances are really good you're going to go right back to where you were."

So far, the best approach to taking these drugs isn't clear. While some health experts say weight-loss drugs should be treated like medications for other chronic conditions, others suggest more limited or tapered regimens.

"We wouldn't say, 'Well, great, your blood pressure is now down to normal, so stop the medication and we expect your blood pressure to stay down," said Susan Yanovski, co-director of NIH's Office of Obesity Research. "Right now, what I tell patients is that, if the medications work, they'll need to be on medication indefinitely."

To better understand the potential impact of these weight-loss drugs, Advisory Board has several useful resources, including the expert insights "5 catalysts that will impact the future of weight management drugs," and "What the headlines get wrong about weight management medications."

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the potential future of these drugs and how they could help — or hurt — health systems' finances.

How to maintain long-term weight loss

According to Kathleen Dungan, an endocrinologist in the division of endocrinology, diabetes, and metabolism at The Ohio State University Wexner Medical Center, since the optimal duration of use for weight-loss drugs is still unknown, it's important for patients also make lifestyle changes to maintain their weight loss over time.

Weight-loss drugs are "not a substitute for diet and exercise, but can be a very effective treatment," Dungan said.

Separately, Heymsfield noted that weight-loss issues typically don't go away after just a few years and can be a lifetime consideration, particularly for those living with obesity. Although weight-loss medications can be effective, they may just be one aspect of a long-term health plan for obesity.

"Keep focusing on those lifestyle changes. Try and learn as much as you can while you're on the drug," Heymsfield said. "Then when you go off the drug, maybe engage yourself in a more formal weight control program—whatever is successful to you."

There have also been efforts to change how healthcare approaches obesity. In a recent Radio Advisory episode, Rachel Woods and Advisory Board experts Darby Sullivan and Chloe Bakst discussed healthcare's current approach to obesity and whether it is helping or harming patients.

Similarly, this expert insight covers three missteps in our current approach to obesity and outlines five potential ways providers can address these issues. (Reed, Axios, 11/27; Bugos, Verywell Health, 4/13; Yamada, Good Morning America, 3/16; Schimelpfening, Healthline, 6/9)

Recent breakthroughs in obesity management medications have put a spotlight on the weight management field. Here's how industry leaders can use this turning point to address three key missteps in our current approach and advance health outcomes for higher weight patients.