Weight Loss Medications: Great for Losing Weight, But Not for Keeping It Off?

This meta-analysis examined what happens after stopping weight loss medications, focusing on weight regain and health outcomes. While medications produced greater weight loss, they were also associated with faster regain and reversal of health markers once discontinued, compared with previous analyses of behavioral interventions. So, are these medications only effective if used long term?

Overview

• What did they test? The researchers performed a systematic review and meta-analysis of studies in overweight or obese adults examining weight loss medications used for more than eight weeks, with at least four weeks of follow-up after cessation. The primary outcome was weight regain after stopping medication, with cardiometabolic markers assessed as secondary outcomes.
• What did they find? Thirty-seven studies (63 intervention arms; 9341 participants) were included. The average treatment period was 39 weeks and 32 weeks of follow-up. Weight regain occurred at ~0.4 kg per month, with cardiometabolic markers projected to return to baseline within 1.4 years. Compared with behavioral interventions, regain was faster by ~0.3 kg per month, regardless of the amount of weight initially lost.
• What does it mean for you? While medications tend to produce greater weight loss than behavioral interventions, weight regain is more rapid once they are stopped. This means they are not a short-term fix, as clients are likely to regain weight and lose associated health benefits. Instead, they should be treated as long-term strategies, with clear expectations and a plan for what happens if or when medication is stopped.

What’s the Problem?

There has been a rise in the popularity and discussion of weight loss drugs in recent years. You’ve probably heard people talk about GLP-1s (glucagon-like peptide-1) on social media, or perhaps know friends or family who are taking these medications. Despite differences between individual drugs, most weight‑loss medications work by helping people feel less hungry, feel fuller, or both.

The effectiveness of these newer drugs has been well documented, which has driven rapid uptake for both weight loss and improvements in health markers. However, we also know that losing weight doesn’t guarantee it will be kept off. Whether coming off a diet, stopping a behavioral intervention, or discontinuing medication, maintaining weight loss is a challenge 1. In fact, we’ve previously covered the difficulty of maintaining weight loss after GLP-1 use in Issue 25 and Issue 24.

This study examined weight regain following the cessation of weight‑loss medications across a wide range of drugs, including these newer and more effective options. It also drew comparisons with previous analyses of weight regain following behavioral interventions. So, how do they stack up?

Purpose

The study aimed to assess and compare how quickly weight is regained after stopping weight management medications in adults with overweight or obesity.

Hypothesis

The authors did not state a specific hypothesis.