- An early clinical trial suggests a minimally invasive procedure called duodenal mucosal resurfacing may reduce weight regain after people stop drugs such as semaglutide or tirzepatide.
- Patients who had the real procedure regained less weight than those who had a sham treatment.
- The results are promising, but the procedure is still investigational and the evidence is not yet strong enough for routine use.
One of the biggest problems with GLP-1 weight loss drugs is what happens after people stop taking them.
Many regain a large share of the weight they lost.
A new study suggests an outpatient procedure targeting the upper small intestine may help reduce that rebound.
The treatment is called duodenal mucosal resurfacing.
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It works by using controlled heat to remove the top layer of the duodenal lining, allowing healthier tissue to grow back.
Researchers think that may help reset some of the metabolic signals involved in weight regulation.
In the REMAIN-1 trial, all participants had previously lost at least 15% of body weight on tirzepatide before stopping the drug.
The early six-month results compared 29 people who had the real procedure with 16 who had a sham version.
Those in the sham group regained more weight.
People who had more extensive resurfacing appeared to do particularly well, regaining less and keeping more than 80% of their earlier weight loss.
That is encouraging.
So is the safety profile reported so far, with no serious complications linked to the procedure and a quick recovery time.
But the limits need spelling out.
- GLP1 drugs commonly cause digestive side effects but may have wider benefits
- Most weight lost on GLP-1 drugs returns within a year after stopping
- What happens when patients stop taking GLP-1 drugs
This is still an investigational treatment.
The data are early, the sample is small and the longer-term picture is not yet known.
There is also a risk of getting carried away by the phrase “gut reset”, which sounds more settled than the evidence really is.
Still, the idea is important.
If some people cannot stay on GLP-1 drugs because of cost, side effects or preference, a treatment that helps preserve the benefit after stopping would fill a real gap.
