Weight will balloon back within two years of stopping ‘Hollywood drug’ weight loss medication, study reveals

People who stop taking weight loss wonder-drug medications bounce back to their original weight within about two years, significantly quicker than those who halt weight loss lifestyle changes, new research has revealed. The University of Oxford study, involving 9000 participants across 37 studies, found people regained about 0.4kg a month after they stopped taking the drugs, while their weight and risk factors for diabetes and heart disease returned to pre-medication levels in less than two years. Perth bariatric researcher Dr Sebely Pal told The West Australian the outcome was not surprising. She said most people on weight-loss medication, including injectable drugs such as Ozempic, who used it for a “quick fix”, failed to use them properly. “A lot of people who are dependent on these medications don’t do anything else related to their lifestyle to change their behaviour,” Dr Pal said. “Ultimately they’re overweight because of behaviours like overeating, not exercising, and not eating the right things, as well as issues with mental health and stress. These aren’t getting addressed by weight loss drugs.” Injectable drugs such as Ozempic, Saxenda, Wegovy and Mounjaro, known as GLP-1 receptor agonists, are among a relatively new and high-profile group of medicines now registered for use in Australia to help manage diabetes in adults and/or chronic weight in patients who are obese or overweight. From this week, Wegovy is being sold in the United States as a tablet, which will offer a cheaper, more accessible and user-friendly version of the drug and likely spike significantly further demand. The tablet is not registered for use in Australia. The UK research, published overnight in the peer-reviewed British Medical Journal, said about half of people with obesity who used the drugs stopped using them within 12 months. Participants included in the study spent an average 39 weeks on treatment. To understand what happens to patients’ bodies when they stop taking the drugs, the researchers searched for trials and observational studies that compared the effects of any licensed weight loss drug for adults with any non-drug weight loss intervention, such as behavioural programs, or a placebo. “This evidence suggests that despite their success in achieving initial weight loss, these drugs alone may not be sufficient for long term weight control,” say the researchers. In a linked editorial, a US researcher said: “The study findings cast doubt on the notion that (these drugs) are a perfect cure for obesity.” Dr Pal said many factors played into people regaining weight they lost taking medication, but it largely came down to not making behavioural changes. Rapid weight loss incurred by weight loss drugs was commonly linked with significant muscle mass loss, as well as drastic fat loss in the face, both of which could be detrimental in the long term, Dr Pal said. “When you gain weight back it’s often a lot of fat, especially if you’re not eating properly, and muscle mass might not come back from where it was originally,” she said. This was concerning in cases where medication had been used for quick short-term losses of five to 10 kilograms, because people were likely to end up far worse than where they started. “That’s what happens when you try to lose weight incorrectly with severe calorie restriction,” Dr Pal said, stressing the harm the could come from losing crucial muscle mass. “People who want to lose a small amount of weight shouldn’t have access to these drugs,” she argued. Those in “desperate need” of weight loss medication, such as people with chronic obesity and a high risk of heart disease and stroke, should combine it with significant lifestyle changes to maintain benefits long-term, she said. “Unfortunately everyone has access to these drugs, and people are not getting the right advice when they’re prescribed, because you can get them easily online,” she said. “They’re not getting the right advice about weight training or eating healthier foods, only about the short-term benefit.” UWA Medical School professor and Fiona Stanley Hospital consultant endocrinologist Bu Yeap described weight loss medications as “game changers” that were proving “really powerful agents” for a lot of people. “For the right people these drugs are really beneficial,” Professor Yeap said. He, who is conducting a study analysing whether combining weight loss medication with structured exercise delivered superior outcomes for cardiovascular health, compared to medication alone, said the “powerful medications” should only be used by people under the guidance of their doctor and in combination with good nutrition and exercise. The Therapeutic Goods Association recently issued a safety warning for the so-called GLP-1 class drugs, revealing they could lead to an increased risk of suicidal ideation.