Glucagon-like peptide (GLP-1) receptor agonists such as semaglutide and tirzepatide have revolutionised obesity treatment, delivering rapid weight loss.
But a new Oxford University study published in The BMJ suggests the benefits may be short-lived. Researchers found that people tend to regain weight quickly after discontinuing weight-loss medications, and that improvements in heart and metabolic health, including high cholesterol and high blood pressure, largely disappear within two years.
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The researchers analysed 37 studies involving 9,341 adults who discontinued one of 18 weight-loss medications—both older drugs and the newer GLP-1 therapies—after an average of 39 weeks of treatment. Participants were followed for an average of 32 weeks after stopping the medication.
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On average, individuals regained about 0.4 kg a month after stopping treatment, a pace that would return them to their pre-treatment weight in 1.7 years. Weight regain was even faster with newer GLP-1 medications, averaging 0.8 kg per month—suggesting a return to baseline in about 18 months.
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Cardiometabolic markers that improved during treatment—including HbA1c, fasting glucose, blood pressure, cholesterol and triglycerides—were also estimated to revert to pre-treatment levels within approximately 1.4 years after discontinuation.
Notably, the rate of weight regain after stopping these drugs was nearly four times faster than that seen after ending behavioural weight-loss programmes such as diet and exercise.
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