A new forecast based on a comprehensive research review indicates that patients who stop taking anti-obesity medications will regain their original weight within two years, simultaneously losing the primary health benefits provided by the drugs, such as improvements in heart health, cholesterol levels, and blood pressure.
The analysis, published on Wednesday in The BMJ (British Medical Journal) and encompassing data from over 9,000 participants, further confirms the extreme difficulty for many users of drugs like Ozempic, Wegovy, and Mounjaro to maintain significant weight loss and associated health dividends after discontinuing treatment. Data reveals that post-treatment weight rebound is not only common but also rapid, with the deterioration of health markers potentially occurring even before full weight restoration.
Experts warn that as millions of users may stop using these popular drugs in the coming years, health authorities urgently need to develop contingency plans. Susan Jebb, an Oxford University public health nutrition scientist, emphasized that obesity is a chronic, relapsing disease, and maintaining treatment benefits requires some form of ongoing intervention.
Furthermore, another study published on Thursday highlighted potential side effects when such drugs are used without professional guidance. It found that users self-procuring medications face risks of malnutrition and muscle loss, suggesting that in the pursuit of weight loss, some patients might be substituting one set of health problems for another.
According to the report, the BMJ study analyzed data from 37 investigations into the effects of treatment cessation. Researchers found that the average treatment duration for participants was 39 weeks, with follow-up data provided for an average of 32 weeks after stopping.
Scientists used this data to project outcomes over a longer timeframe.
Model predictions show that although patients lost an average of 8.3 kg during treatment, they would regain their original weight in less than 21 months after stopping. More worryingly, the drugs' beneficial effects on the heart, cholesterol levels, and blood pressure are projected to disappear within 18 months of discontinuation.
The study noted that compared to weight loss programs focusing on behavioral changes, the speed of weight loss achieved with drug therapy—and the subsequent rate of rebound—is significantly faster.
Susan Jebb, a co-author of the study, stressed, "In this specific analysis, we show that weight regain after stopping treatment is common and rapid."
Although scientists acknowledge limitations in their work—including nearly a third of the trials investigated having a high risk of bias, and potential differences in the severity of obesity and complication rates between drug therapy and behavioral therapy groups—experts not involved in the research stated that these conclusions align with the emerging consensus on the advantages and limitations of such drugs.
Adam Collins, an Associate Professor of Nutrition at the University of Surrey, pointed out that this study underscores the challenge of sustaining weight loss, particularly considering that "a large number of people are likely to stop these drugs in the coming months and years."
Naveed Sattar, a Professor of Cardiometabolic Medicine at the University of Glasgow, emphasized that for individuals with a 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 for organs, but there is reason to think that even maintaining a lower body weight for two or three years due to short-term drug use could help slow damage to joints, the heart, and kidneys."
Beyond weight regain, the use of medication without professional guidance raises concerns about changes in patients' body composition.
Another paper published on Thursday in Obesity Reviews suggested that weight-loss drug users might face nutritional deficiencies and muscle loss if they fail to receive adequate dietary guidance.
Researchers from University College London (UCL) and the University of Cambridge indicated that evidence suggests up to 40% of the weight lost using these drugs could be lean mass, which includes muscle.
Although obesity drug treatment within the UK's National Health Service (NHS) includes plans to ensure a balanced diet and increased physical activity, the vast majority of users procure the drugs privately and often lack access to such support.
Marie Spreckley, a Cambridge University scientist who led the research, stated, "If nutritional care is not incorporated alongside pharmacological treatment, we risk substituting one set of health problems for another through preventable nutrient deficiencies and largely avoidable losses of muscle mass."
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