Obesity is a chronic disease and it is not “cured” with medication. For example, a good comparison with obesity is high blood pressure. Patients need to take medication to achieve normal blood pressure and need to continue medication to maintain it.
With obesity, once weight goals are achieved, treatment can be tapered and discontinued, but many studies show that chronic therapy is needed.
The optimal method is to start implementing lifestyle changes alongside the medication, so even if the medication is stopped, the dietary habits, physical exercise, and behavioral components will prevent patients from reaching their pretreatment weights.
Will I gain the weight back if I stop taking them?
GLP-1 agonists work by suppressing appetite and making people feel full sooner so people do not feel as hungry. Once the drug is removed, those particular effects are removed as well.
In addition, our bodies have an adaptive response to weight loss which essentially leads to weight regain. These physiological responses
increase appetite stimulation and decrease calories burned from physical exercise. Appetite stimulating signals and energy storage signals increase after diet-induced weight loss, and signals that inhibit food intake
decrease.
Patients may not gain the entire weight back. One year after withdrawal of semaglutide and lifestyle intervention, patients regained two-thirds of their prior weight loss.
However, almost half of the participants in the semaglutide arm
still had clinically meaningful weight loss of 5% or more from
baseline, after stopping medication
What kind of side effects will I experience?
All medications have potential side effects and with GLP-1s, the most common ones are GI related (nausea, vomiting, diarrhea).
Side effects can be decreased by starting patients on the lowest dose of GLP-1 and increasing dosages gradually based on tolerability.
Dietary advice should be provided to prevent side effects (as noted above).
Side effects are also typically transient, mild to moderate in severity, and mainly occur during initiation and up-titration of treatment
General side effect management
GI related adverse effects may occur, these will be transient and of mild/moderate severity in the majority of cases
For example, these are examples of specific dietary recommendations that will help relieve symptoms:
