- A large real world study from Cleveland Clinic suggests average weight regain after stopping semaglutide or tirzepatide may be smaller in everyday practice than earlier trials implied.
- That does not mean stopping has no effect, because many patients restarted treatment or moved to another option.
- The main message is that obesity care often continues even after the first medication stops.
A new Cleveland Clinic study looked at what happened after nearly 8,000 patients stopped injectable semaglutide or tirzepatide in routine clinical practice.
The study included adults with overweight or obesity who had started one of these medicines for obesity or type 2 diabetes, then stopped within three to 12 months.
On average, people treated for obesity lost 8.4% of body weight before stopping, then regained 0.5% over the following year.
People treated for type 2 diabetes lost 4.4% before stopping, then lost a further 1.3% over the next year.
That sounds reassuring, but it needs context.
A substantial number of patients did not simply stop and walk away.
Around 19.6% restarted their original medication, while 35.2% received another obesity treatment within a year.
That included 27.4% who switched to another medicine, 13.7% who had lifestyle modification visits and 0.6% who moved on to metabolic or bariatric surgery.
There was also a lot of individual variation.
In the obesity group, 55% gained weight after stopping, while 45% either kept losing weight or stayed the same.
In the diabetes group, 44% gained weight and 56% stayed the same or kept losing.
So this is not really a story about people stopping treatment and being fine.
It is more a story about people adapting, restarting, switching therapies or continuing with other support.
That may explain why the average regain was smaller than in randomised trials.
- GLP-1 weight loss drugs linked to small rise in chronic cough
- Most weight lost on GLP-1 drugs returns within a year after stopping
- Weight loss surgery outperforms GLP-1 drugs in real-world use
The authors also note that cost, insurance limits and side effects are major reasons people stop in the first place, with cost and coverage being the main issue.
