"What happens after stopping the 'miracle weight-loss drug'? Back to original 'fat' within two years."

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A recent prediction based on a wide-ranging review of research shows that patients who stop taking anti-obesity drugs will regain their original weight within two years and lose major benefits such as improved heart health, cholesterol levels, and blood pressure provided by the drugs.

On January 8, according to the Financial Times, this analysis published on Wednesday in the British Medical Journal (BMJ) covers data from over 9,000 participants. The results further confirm that for many users of drugs such as Ozempic, Wegovy, and Mounjaro, it is extremely difficult to maintain significant weight loss and related health benefits after stopping the medication. Data indicate that weight regain after stopping the drugs is not only common, but also rapid, with worsening health metrics occurring even before full weight regain.

The report notes that experts warn as millions of users may stop using these popular drugs in the coming years, health authorities in various countries urgently need to develop response plans. Susan Jebb, a public health nutrition scientist from the University of Oxford, pointed out that obesity is a chronic, relapsing disease, and to maintain the benefits of treatment, some form of ongoing intervention must be ensured.

In addition, another study published Thursday revealed the potential side effects of such medications in the absence of professional guidance. The study found that users who purchase the drugs themselves face risks of malnutrition and muscle loss, suggesting that in the pursuit of weight loss, some patients may be "replacing one health problem with another."

Weight regain is much faster than expected

According to reports, the above-mentioned study published in BMJ analyzed data from 37 studies on the effects after stopping medication. Researchers found that participants took the drugs for an average of 39 weeks, with an average follow-up of 32 weeks after stopping.

Scientists extrapolated the longer-term outcomes based on these data.

Model predictions show that although patients lost an average of 8.3 kilograms during treatment, they regained their original weight in less than 21 months after stopping the drugs. More worryingly, the beneficial effects on heart, cholesterol levels, and blood pressure are expected to disappear within 18 months after stopping the medication.

The study points out that compared to weight loss programs focused on behavioral changes, both the speed of weight loss and subsequent regain are much faster with drug treatment.

Susan Jebb, co-author of the study, emphasized: “Our specific analysis shows that weight regain after stopping the drugs is both widespread and rapid.”

The necessity of long-term intervention

Although scientists acknowledge limitations, including that nearly a third of the trials investigated had a high risk of bias and that there may be differences in obesity severity and complication rates between the drug group and behavior therapy group, experts not involved in the work say these conclusions align with emerging views on the advantages and limitations of these drugs.

Adam Collins, Associate Professor of Nutrition at the University of Surrey, noted that this study highlights the challenge of maintaining weight loss, especially given that “in the coming months and years, a large number of people may stop using these medications.”

Naveed Sattar, Professor of Cardiometabolic Medicine at the University of Glasgow, emphasized that for those with very high body mass index (BMI), weight loss drugs remain “essential.” He added:

“This paper cannot yet tell us if short-term use provides lasting benefits to organs, but there is reason to think that even maintaining a lighter weight for two or three years thanks to short-term medication may help slow damage to joints, heart, and kidneys.”

Muscle loss and nutritional risks

Besides weight regain, lack of professional guidance in medication use has also raised concerns about changes in patients’ body composition.

According to the report, a paper published Thursday in Obesity Reviews found that users of weight loss drugs may face problems of nutrient deficiency and muscle loss due to insufficient dietary guidance.

Researchers from University College London (UCL) and the University of Cambridge pointed out that evidence shows as much as 40% of the weight lost with these drugs may be lean mass, including muscle.

While the UK National Health Service (NHS) weight loss drug programs include plans to ensure a balanced diet and increased physical activity, the vast majority of users purchase drugs through private channels and often cannot access such support.

Marie Spreckley, the lead researcher from the University of Cambridge, stated:

“If nutritional care is not integrated with drug therapy, we face the risk of substituting one set of preventable nutrition deficiencies and largely avoidable muscle loss for another set of health problems.”

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