The popularity of GLP-1 weight-loss medications continues to rise, leading to a national decrease in obesity rates. Despite this success, a safe and evidence-based method for discontinuing these drugs remains elusive.
A recent analysis published in JAMA Internal Medicine indicates that most participants in a trial who stopped taking tirzepatide (marketed as Zepbound by Eli Lilly) regained a significant portion of the weight lost while on the drug. Their cardiovascular and metabolic health improvements also deteriorated, with increases in blood pressure, cholesterol levels, hemoglobin A1c, and fasting insulin levels.
In an accompanying editorial, Elizabeth Oczypok and Timothy Anderson from the University of Pittsburgh suggest rebranding this new class of drugs from 'weight loss' to 'weight management' drugs, which might need to be used indefinitely.
Many studies show that about half of those starting a GLP-1 drug for weight loss discontinue it within a year due to various reasons. The common misconception is that anti-obesity drugs can be stopped once the desired weight is achieved, but Oczypok and Anderson argue that the data doesn't support this. They recommend viewing these drugs similarly to chronic disease medications, where patients continue their anti-hypertensive treatments even if their blood pressure reaches targeted levels.
The trial, led by Eli Lilly scientists, followed 670 participants with obesity or overweight issues (excluding diabetes) treated with tirzepatide for 36 weeks. Participants were then divided into groups, either continuing with the drug for another 52 weeks (totaling 88 weeks) or switching to a placebo, all while maintaining a reduced-calorie diet and exercise. Of the 335 participants switched to placebo, their weight and cardiovascular health metrics were closely monitored, particularly for the 308 who initially lost at least 10% of their body weight on the drug.