Ending weight loss drug therapy linked to weight regain

Researchers report that ending the use of glucagon-like peptide-1 (GLP-1) receptor agonists for weight loss is associated with weight regain and a reversal of heart health markers.

The findings were published on Jan 7, 2026 in The BMJ.

“This evidence suggests that despite their success in achieving initial weight loss, these drugs alone may not be sufficient for long term weight control,” said the researchers.

As background, the authors noted that about half of people with obesity discontinue GLP-1 drugs within 12 months, making it imperative to know what happens thereafter to body weight and to risk markers for conditions like diabetes and heart disease.

The investigators identified trials and observational studies that compared the effects of any GLP-1 medication licensed for weight loss in adults with any non-drug weight loss intervention (behavioral weight management programs) or placebo.

They included in the analysis data from thirty-seven studies published up to February 2025 and enrolling a total of 9,341 subjects.

The average duration of weight loss treatment was 39 weeks, with an average follow-up of 32 weeks.

The primary endpoint was the rate of weight regained from the end of treatment. Associated changes in cardiometabolic markers were a secondary endpoint.

The subjects who had been treated with weight loss drugs regained an average of 0.4 kg/month after ending such treatment. Notably, they were projected by the investigators to return to their pre-treatment weight within 1.7 years.

The analysis also led the researchers to project that cardiometabolic risk markers would return to pre-treatment levels within 1.4 years after termination of drug treatment.

“Although weight loss resulted in improvements in HbA1c , fasting glucose, total cholesterol, triglycerides, systolic and diastolic blood pressure, all markers returned to baseline within 1.4 years of treatment cessation The rate of weight regain after the cessation of WMMs [drug therapy] was faster than after the cessation of BWMPs [behavioral therapy] , independent of the amount of weight lost during treatment,” the authors said.

They concluded, “This evidence cautions against short term use of weight management medications, emphasizes the need for further research into cost effective strategies for long term weight control, and reinforces the importance of primary prevention.”