This content originally appeared on On a regular basis Health. Republished with permission.
By Becky Upham
After losing greater than 20 percent of their body weight in eight months, individuals who stopped taking the weight reduction drug Zepbound (tirzepatide) regained about half the burden inside a yr, based on a brand new study published today in JAMA.
Individuals who continued to take the medication lost an extra 5 percent of their original body weight, for a complete average weight reduction of 25 percent over the 88-week study.
Tirzepatide was first approved by the U.S. Food and Drug Administration (FDA) in May 2022 under the name Mounjaro, to enhance blood sugar control in adults with type 2 diabetes — however it also showed impressive weight reduction results.
In November, the FDA approved tirzepatide under the brand new name Zepbound, for weight reduction in individuals with a body mass index (BMI) of 30 or higher, and for those with a BMI of 27 or greater who also had health conditions comparable to high cholesterol or hypertension.
Tirzepatide May Be a Lifelong Drug
In case you stop the medication, you regain the burden — there’s no doubt that can occur, says coauthor Louis Aronne, MD, a professor of metabolic research and director of the Center for Weight Management and Metabolic Clinical Research at Weill Cornell Medicine in Latest York City. “But that shouldn’t be surprising. Obesity is a chronic disease that needs chronic treatment for the profit to be completely maintained,” he says.
The findings here highlight that to take care of weight reduction, people should proceed on tirzepatide long-term, says Fatima Cody Stanford, MD, MPH, an associate professor of medication at Harvard Medical School and obesity medicine specialist at Massachusetts General Hospital, each in Boston. Dr. Stanford, who can be a medical reviewer for On a regular basis Health, was not involved within the study.
“As noted with other GLP-1 agents, weight gain happens when patients are taken off the agent. These agents act on pathways of the brain that regulate weight and food intake, and when these patients aren’t any longer receiving treatment, they not have these brain pathways to manage weight, they usually regain it,” she says.
People Who Stopped Taking Zepbound Were Still 22 Kilos Lighter on Average After 1 Yr
The aim of this study was to search out out if the impressive initial weight reduction after the primary eight months would proceed beyond the period of lively treatment. A complete of 670 eligible participants were randomly assigned to either proceed taking Zepbound for an extra yr (52 weeks) or to modify to a placebo.
Throughout the trial, all participants received lifestyle counseling from a certified healthcare skilled to assist them stick with a healthy 500 calories per day deficit food plan and no less than 150 minutes of physical activity per week.
Those that continued to take Zepbound lost an extra 5.5 percent of their weight (on top of the 20.9 percent they already lost), while those that went on placebo regained about half the burden they lost over the course of the yr — meaning they were still down nearly 10 percent compared with their original weight.
In other words, at the top of 88 weeks, those that continued taking tirzepetide had lost on average 60 kilos, and people who went on the placebo maintained a 22-pound weight reduction.
That quantity of weight reduction continues to be excellent, says Aronne. “I believe many individuals think that everybody will immediately regain weight; that was not the case. Of the patients who switched to placebo, 16.6 percent were able to take care of 80 percent or more of the burden they’d lost,” he says.
The results of intensive behavioral therapy on the upkeep of weight reduction weren’t evaluated, which could make a difference in stopping weight regain after coming off the drug, the authors acknowledged.
Treating Obesity Can Also Improve Hypertension, Heart Disease, and Diabetes
Obesity is a number one driver of many diseases, including hypertension, heart disease, diabetes, and fatty liver disease, says Aronne. “In case you were to treat any of those conditions, you wouldn’t be treating any of the others, but with obesity treatment, you’ll be able to address all of them, and get improvement in quality of life measures, especially physical functioning,” he says.
Participants taking Zepbound had significant improvements in BMI, cholesterol and triglyceride levels, blood sugar, and blood pressure. Some, but not all, of those advances were lost within the placebo group.
“The metabolic advantages tended to revert back towards baseline, but some, like insulin, triglycerides, and enhancements in quality of life, were still significantly higher. None were worse than when the trial began,” says Aronne.
Again, that is to be expected, since weight reduction produced all these advantages — and when there’s not as much weight reduction, there’s not as much profit, he says.
Once People Stop Taking GLP-1s, They Will Progressively Regain Lost Weight
If the trial had continued to follow the people on placebo after a yr, each Dr. Aronne and Stanford agree that those individuals would eventually regain most, if not all of the burden they lost.
“Would it not take one other yr? We’re unsure. In the event that they restarted the medication, would they return to where the group who was treated went and with the identical profit? We don’t know that either, but based on our clinical experience with medication, that’s what I might expect,” says Aronne.
Weight Cycling Can Harm Health and Contribute to Obesity
“Weight cycling causes harm to your health and it contributes to obesity,” says Stanford.
Continually losing and gaining weight — called weight cycling or yo-yo weight-reduction plan — results in adversarial health outcomes, based on the Endocrine Society. Research has also linked weight cycling with risk of early death.
More Research Is Needed to Explore Long-Term Risks of Medications
These findings suggest that individuals might have to remain on Zepbound long-term to take care of weight reduction and the associated health advantages, says Aronne.
Further studies might be needed to evaluate the long-term risks and advantages related to these drugs, especially considering the potential for his or her lifelong use, the authors wrote.
This study is a very important step in continuing to construct the case for the continued insurance coverage of GLP-1 medications, so that individuals can maintain weight reduction advantages, says Suki Singh, MD, a family medicine and obesity medicine physician and system medical director for weight management and obesity medicine at Henry Ford Health in Detroit.
But however, more research is required to know if taking these drugs indefinitely is protected, she points out. “It’s still unknown if there are long-term complications or unintended effects related to these medications, or what their impact goes to be on the gut, or [if] there’s an increased risk of C-cell tumors,” she says.
In rats, tirzepatide caused thyroid C-cell tumors however it isn’t yet known if the drug poses any risk for the rise of C-cell tumors in humans.
“Until we’ve got more data available, it’s hard to say if these medications are the long-term answer to treating obesity,” says Dr. Singh.