Stopping weight loss medications leads to rapid weight loss and health decline.

Stopping weight loss medications leads to rapid weight loss and health decline.

Weight loss through medication: A new study

One today inThe BMJPublished study shows that discontinuing weight loss medications is often accompanied by weight gain and reversing the positive effects on cardiac and metabolic health markers such as high cholesterol and blood pressure.

The study found that the average rate of weight gain after stopping treatment was 0.4 kg per month. This means weight and risk factors for diabetes and heart disease are likely to return to pre-treatment levels in less than two years.

Additionally, weight gain was found to occur almost four times faster after discontinuing weight loss medications than after changes in diet and physical activity, regardless of the amount of weight lost during treatment.

The researchers say: “This evidence suggests that despite their success in initial weight loss, these medications may not be sufficient to ensure long-term weight control.”

Influence of medications on weight regulation

The development of highly effective weight control drugs, such as glucagon-like peptide-1 (GLP-1) -receptor agonists such as Semaglutide and tirzepatide, has revolutionized the treatment of obesity.

However, it is estimated that about half of people with obesity stop taking GLP-1 drugs within 12 months. Therefore, it is important to understand what happens to body weight and risk markers for diseases such as diabetes and heart disease after treatment is stopped.

Research methodology

A team of researchers at the University of Oxford searched registries and databases for studies that examined the effects of weight loss medications in adults compared to non-drug interventions (such as behavioral weight loss programs) or placebo.

Although the studies examined had different designs and differences in quality, researchers were able to assess the risk of bias using established tools.

Thirty-seven studies published through February 2025 and including 9,341 participants were included in the analysis. The average duration of weight loss treatment was 39 weeks, with an average follow-up of 32 weeks.

Results of the study

Participants treated with weight loss medications regained an average of 0.4 kg per month after stopping treatment. They were predicted to return to their pre-treatment weight within 1.7 years. All cardiometabolic risk markers are expected to return to pretreatment levels within 1.4 years of drug discontinuation.

Monthly weight gain was also faster after taking weight loss medications than after behavioral weight loss programs (by 0.3 kg), regardless of initial weight loss.

Limitations and conclusions

The authors acknowledge several limitations of the study. For example, only eight studies evaluated treatment with the newer GLP-1 drugs, and the maximum follow-up time in these studies was 12 months after drug discontinuation. Additionally, few studies were at low risk of bias.

Nevertheless, they emphasize that they used three analytical approaches and all produced similar results, which contributes to their findings.

Therefore, they conclude: "This evidence cautions against short-term use of medications for weight control, highlights the need for further research into cost-effective strategies for long-term weight control, and reinforces the importance of primary prevention."

In an accompanying editorial, a US researcher expresses skepticism about the idea that GLP-1 receptor agonists are a perfect anti-obesity drug. He writes, "People taking GLP-1 receptor agonists should be aware of the high discontinuation rate and the consequences of discontinuing the medication."

He adds: “Healthy diet and lifestyle practices should remain the foundation for the treatment and management of obesity, while medications such as GLP-1 receptor agonists should be used as a supplement.”

“Such practices not only help prevent excessive weight gain, but can also provide numerous health benefits beyond weight control,” he concludes.

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