Reacción a "A meta-analysis confirms weight regain after discontinuing anti-obesity drugs"

This is a timely and important paper that focuses not on weight loss but on the far greater issue of maintaining any lost weight.  Weight recidivism is a common issue seen across all weight loss interventions, and some weight regain in those coming off GLP-1 drugs would be arguably inevitable.  Yet, what this paper importantly suggests is that weight regain is amplified when you cease taking these drugs.  There are plausible explanations for why.  The first relates to how these drugs work.  Artificially providing GLP-1 levels several times higher than normal over a long period may cause you to produce less of your own natural GLP-1, and may also make you less sensitive to its effects.  No problem when taking the drugs, but as soon as you withdraw this GLP-1 “fix”, appetite is no longer kept in check, and overeating is far more likely.  Like any addict, going cold turkey is a real challenge.  This is further exacerbated if the individual in question has relied solely on GLP-1 to do the heavy lifting during weight loss, i.e. artificially suppressing their appetite without them establishing any dietary or behavioural changes that would help them in the long run.

These authors acknowledge that this review is limited by the length of time people have been followed up and by potential bias in these studies.  Nevertheless, the authors project, based on the observed studies, that all weight would be regained within 2 years.  Yet more worryingly, we know from other weight-loss studies that some people don’t just regain the lost weight but overshoot their original weight.  This is particularly concerning given that many people who pay privately for these drugs may not be that overweight to start with.

 So, the key message this paper supports is that weight-loss drugs (GLP-1 agonists) have arguably made weight loss very easy, but maintaining the weight loss is now a bigger challenge than ever.  Especially given the massive wave of people who will likely be coming off these drugs in the coming months and years.  This emphasises the even greater need for sound diet, behaviour, and lifestyle strategies at both the individual and public health levels.