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Slowly Coming Off GLP-1 Drugs May Prevent Weight Gain


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New research suggests that slowly tapering off GLP-1 drugs like Ozempic and Wegovy may help prevent rebound weight gain. Yoshiyoshi Hirokawa/Getty Images
  • New research indicates that some patients may be able to go off GLP-1 anti-obesity medications like Wegovy and Ozempic without immediately regaining weight.
  • Using a combination of methods, including drug tapering and holistic health coaching, a small cohort of patients managed to maintain their weight six months after stopping the drug.
  • Obesity experts caution that more research is needed and that the vast majority of patients will experience weight regain if they go off their medication.

Can you safely stop taking Ozempic or other GLP-1 drugs like Wegovy and Zepbound without regaining the weight you lost?

Unfortunately, the answer is no for most people. However, doctors are continuing to pursue the possibility through a combination of lifestyle coaching and other strategies.

In a new study presented at the European Congress on Obesity, researchers found that patients receiving semaglutide (the generic active ingredient in Ozempic and Wegovy) were able to keep the weight off after slowly tapering down their dose to zero.

The study, which has yet to be published in a peer-reviewed scientific journal, involved individuals who underwent the tapering process while simultaneously participating in individualized “holistic health coaching” that included dietary guidance, behavioral therapy, a digital health platform (an app), and physical activity.

Additionally, patients tended to take less (about one-third) of the standard dose of semaglutide throughout the trial.

“We provide evidence supporting the ability to taper off semaglutide in the context of having assisted patients with changing their lifestyle behaviors and eating habits…weight maintenance is achievable if patients have access to ‘ongoing treatment’ in the form of either physical training, intermittent intensive low-energy diet periods, regular daily meal replacements, or, as in our case, a digital weight loss clinic with a team of cross-functional experts on hand to coach, support and guide individuals,” Henrik Gudbergsen, MD, PhD, the Senior Researcher and presenter of the study, told Healthline.

Gudbergsen serves as the Chief Medical Officer of Embla, an online health platform and app that sponsored the study.

Side effects of GLP-1 drugs, including nausea, vomiting, and diarrhea, are cited by some patients as to why they stop taking their medication.

While the study provides some promising data for individuals hoping to go off the medication without regaining the weight, other obesity experts cautioned that due to the chronic, pernicious nature of obesity, more long-term research is needed.

“We need studies that look at this five years down the line, 10 years down the line, right? Not six months,” said Dan Azagury, MD, section chief of Minimally Invasive and Bariatric Surgery and medical director for the Bariatric and Metabolic Interdisciplinary clinic at Stanford Health. Azagury wasn’t affiliated with the research.

Gudbergsen and his team investigated several strategies in their study. These included:

  • Drug tapering – slowly decreasing one’s dose of semaglutide over time, rather than all at once.
  • Personalized dosing – using the smallest effective dose of semaglutide for a patient to minimize side effects if they are achieving the desired weight loss.
  • Lifestyle coaching – utilizing a digital health platform and app alongside semaglutide to provide the patient a holistic health and nutrition program.

The study included 2,246 patients with an average BMI of 33, meeting the clinical threshold for obesity, enrolled in a weight management program through the Embla app in Denmark. The majority of patients were women (79%) with an average age of forty-nine.

Over the course of 76 weeks, patients lost, on average, nearly 15% of their body weight, which has become a benchmark of semaglutide and other GLP-1 drugs. However, through the use of personalized doses, participants tended to take less of the drug, leading the team to suggest that smaller doses may be just as effective as larger ones.

Only 353 participants took part in the “tapering” portion of the study.

When patients reached their target weight, they gradually (over the course of about 9 weeks) tapered their dose down to zero. Researchers continued to follow up with patients up to twenty-six weeks (about six months) from the end of the tapering period and found that they had not regained weight.

“It’s excellent that someone did this real-world study because we are always hungry for real-world data. We want to know what’s actually happening on the ground,” Beverly Tchang, MD, an endocrinologist, Spokesperson for the Obesity Society and Assistant Professor of clinical medicine at Weill Cornell Medicine, told Healthline.

Tchang wasn’t affiliated with the research.

However, Tchang reiterated to Healthline that the study shouldn’t be a greenlight for patients to stop their medication.

“We can’t look at the study and say, ‘everyone should now be okay stopping semaglutide because they have no weight issues for six months.’ This is a very small population of people where it is possible,” she said.

Other experts contacted by Healthline were far more critical about the study and its implications.

Caroline Apovian, MD, a Professor of Medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, said that tapering should not be part of the conversation for a lifesaving drug.

“Is tapering part of the discussion for an anti-hypertensive medication, for a statin? Why should we be talking about tapering for obesity?” she said.

“What do we do after the patients lose weight? The right answer is you stay on the medication,” said Apovian.

Apovian is concerned that semaglutide and other GLP-1 drugs, which are intended to treat obesity as a chronic condition, are instead being viewed as quick weight loss solutions that patients feel they can start and stop when they want. But that just isn’t how they are intended to be used.

“We tell patients: if you’re going to start on a GLP-1, you should be comfortable with the idea of staying on it forever. It doesn’t mean that you are going to stay on it forever, but you should be okay with the idea because there is a high chance that you might stay on it,” said Azagury.

Nonetheless, Azagury hopes that one day, there will be a clearer understanding of how patients can successfully stop taking GLP-1 medicaitons without regaining weight.

“Investigating healthy, productive ways to reduce or wean off the medication once a weight loss goal has been achieved is an area where I think we need to investigate. I’m sure that a few years from now we’ll realize that there’s a certain category of patients who have responded a certain way who might be good candidates to go off of this medication,” he said.

New research presented at the European Congress on Obesity indicates that some patients could go off of their anti-obesity medication without immediately regaining weight.

The study found that a combination of drug tapering and holistic health coaching led to a stable weight in a small cohort of patients at least six months out from stopping the drug.

Some obesity experts are critical of the findings, noting that obesity is a chronic condition that likely needs to be treated for the duration of an individual’s life.



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