Drugs alone not enough for long-term weight control: Study

Most patients will return to their original weight less than two years after stopping weight-loss medication, regaining an average of 0.4 kilograms a month, according to a new analysis.
 
The international research examined 37 studies of more than 9000 participants who took weight-loss medications for at least two months, including GLP-1 receptor agonists, among others.
 
It found that once patients had stopped using their medications, they not only regained weight, but their risk markers for diabetes and heart disease returned to their original levels in less than two years.
 
For GLP-1 medications, data was only available for a year after the drugs were stopped, with the overall projections based on follow-ups up to 52 weeks.
 
The study also found that the rate of weight regain after stopping the drugs is almost four times faster than after diet and physical activity changes alone, irrespective of the amount of weight lost during treatment.
 
‘Despite their success in achieving initial weight loss, these drugs alone may not be sufficient for long-term weight control,’ said the researchers.
 
‘This evidence cautions against short-term use of weight management medications, emphasises the need for further research into cost effective strategies for long-term weight control, and reinforces the importance of primary prevention.’
 
In response, Dr Trevor Steward, a senior research fellow in the School of Psychological Sciences at the University of Melbourne, said the analysis confirms what many doctors have experienced ‘in the real world’, that weight often returns after patients stop their medications.
 
‘This is important since many people discontinue because of their high cost, side effects, or the practical burden of ongoing injections,’ he said.
 
‘The key point is that medications should not be treated as a standalone cure.
 
‘We need better evidence on how these medications work and what to do after stopping, such as how to transition care and what kinds of lifestyle and psychological support help to maintain benefits.’
 
The new research comes at a time when access to, and interest in, weight-loss medications is rapidly expanding across the globe.
 
In America, one in eight people has used injectable GLP-1 drugs, while in Australia hundreds of thousands of people are using the medications under private prescription, paying up to $5000 a year.
 
However, the Federal Government appears poised to add GLP-1 drugs for weight loss to the Pharmaceutical Benefits Scheme, bolstered by a Pharmaceutical Benefits Advisory Committee recommendation to list semaglutide (sold as Wegovy) late last year.
 
Associate Professor Dominika Kwasnicka, a principal research fellow at the University of Melbourne, said that in this changing landscape, the new analysis has ‘important policy implications’ for Australia.
 
‘Access to these medications is expanding, often with substantial out-of-pocket costs and limited structured follow-up,’ she said.
 
‘Without long-term planning, there is a risk of short-term benefit followed by weight regain and loss of health gains once treatment ceases.
 
‘These results support the need to embed pharmacotherapy within comprehensive, long-term models of care that include behavioural support, continuity of care, and realistic discussions about duration of treatment, rather than viewing these medications as short-term solutions.’
 
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