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New Delhi: The rapid rise of new injectable weight-loss medicines has reshaped how obesity is treated worldwide. However, taking this shortcut may come at a cost - evidence suggests that the benefits of weight loss drugs can be reaped for as long as one is on the treatment - once discontinued, weight can pile up four times faster than the conventional methods of dieting and workouts.
According to a large review published on January 8 this year in the BMJ, people who discontinue anti-obesity medicines or GLP-1 receptor agonists tend to gain weight at a much faster pace compared to those who lose the extra kilos through diet and exercise alone.
GLP-1 drugs, including widely prescribed medicines like semaglutide and tirzepatide, suppress appetite and slow digestion. Clinical trials have shown they can help patients lose between 15% and 20% of their body weight — a level of reduction rarely achieved with lifestyle changes alone. “At first glance, this looks like a major success story,” said Prof Susan Jebb, a public health nutrition expert at the University of Oxford and a co-author of the study.
However, the review highlights a key challenge: many people do not stay on these medications long term. Data suggest that roughly half of users stop treatment within a year, often due to side effects such as nausea or the high cost, which can exceed US$1,000 a month in some countries.
The researchers analysed 37 studies that tracked patients after stopping various weight-loss drugs. On average, participants regained about 0.4 kg per month. In six trials focused specifically on semaglutide and tirzepatide, patients lost close to 15 kg while on treatment but regained around 10 kg within a year of stopping. Based on available follow-up data, researchers estimated that most would return to their original weight within 18 months.
Improvements in cardiovascular markers, including blood pressure and cholesterol, also faded over time, typically reverting to baseline levels within about 14 months after treatment ended. By comparison, people who lost weight through diet and exercise alone regained weight much more slowly. Although they lost fewer kilos overall, it took an average of four years for their weight to return — making post-drug weight regain roughly four times faster.
Experts stress that this does not diminish the value of GLP-1 medicines. Instead, it reframes how they should be viewed. “Obesity is a chronic, relapsing condition,” Prof Jebb noted, adding that long-term or even lifelong treatment may be necessary, similar to medication for hypertension.
The findings also raise important questions for health systems assessing cost and access. According to Prof Garron Dodd of the University of Melbourne, who was not involved in the research, these drugs should be seen as a foundation rather than a standalone solution. Sustainable weight management, he said, will likely depend on combining medication with long-term strategies that address behaviour, metabolism, and brain signalling — not just appetite alone.
