For example, in SUSTAIN-1, semaglutide 1.0mg achieved 4.5 kg weight loss (4.7%) while placebo achieved 1.0 kg (1.1%), a 3.6% treatment difference at 30 weeks.11 In LEAD-2, liraglutide 1.8mg achieved 2.8 kg weight loss (3.3%) versus 1.5 kg loss (2.0%) in control (metformin monotherapy), a 1.3% treatment difference at 26 weeks.12 In AWARD-3, dulaglutide 1.5mg achieved 2.3 kg weight loss (2.4%) at 26 weeks, an amount that was not statistically different from metformin.13 A substantial larger proportion of participants who had exercised compared with non-exercise were able to sustain a weight loss of at least 10%, and greater, of initial body weight one year after treatment termination. Collectively, these results indicate that the addition of supervised exercise during obesity pharmacotherapy improves maintenance of healthy body weight and body composition after treatment termination. More participants who had previously received combination treatment maintained a weight loss of at least 10% of initial body weight one year after treatment termination compared with participants who had received liraglutide alone or placebo. Our cohort included 2,405 patients (meanSD age 48, 53% female), with a BMISD of 37 kg/m2and a mean baseline weight of 238 lbs. Weight loss achieved with standard doses of GLP-1 agonists (GLP-1a) among real-world patients with type 2 diabetes has not been determined. Remember, weight loss is a journey filled with ups and downs. Points on the right indicate the typical values of the pure effect of 52-week weight reduction for each drug, with error bars denoting 95 % CIs of the estimates. Distribution of typical pure effect values for weight reduction at week 52 for each drug Based on the final model parameters, we simulated the time-course distribution of weight reduction for each GLP-1RA drug. Therefore, we investigated whether weight loss and improved body composition are sustained better at 1 year after termination of active treatment with GLP-1 receptor agonist, supervised exercise program, or both combined for 1 year. In addition, it has not been investigated whether incorporating exercise together with GLP-1 receptor agonist treatment can improve the sustainability of healthy weight loss maintenance after treatment is terminated. These results indicate that incorporating supervised exercise together with obesity pharmacotherapy helps preserve the improved body weight and body composition after termination of obesity pharmacotherapy. No studies have investigated whether improved body weight and body composition are maintained differently after the termination of a treatment regimen with exercise, pharmacotherapy, or both combined. With these tips in mind, here’s a sample meal plan for weight loss while on GLP-1 medications. GLP-1 medications have been around for a while for managing diabetes and some other conditions, and now they’re being used to help people lose weight. After years of ineffective or dangerous options, it seems as though we now have weight loss medications with real potential. These types of medications can help reduce hunger and cravings to help with weight loss, but you still need to do your part to stay healthy and hit your goals. Glucagon-like peptide-1 receptor agonists — or GLP-1s for short — are a class of medications that, while initially developed for type 2 diabetes, can be very effective at treating overweight and obesity too. This aligns with Mayo Clinic research showing that while "tirzepatide and semaglutide are the most effective for weight loss," different medications work better for different people. "If they're on the maximum dose for a couple of months and they really haven't seen a significant weight loss, like 5% or more of their total body weight, then it's really time to think about getting some labs," Dr. Meghan advises. For others who are not as sensitive to the medication, weight loss may not start until they reach higher doses. Belle connects patients with licensed providers who determine treatment plans based on individual health needs. If you’re starting GLP-1 or GLP-1/GIP medication for weight loss, you’re probably wondering As Dr. Meghan shows, success comes from understanding and working with your body's individual response to these powerful medications. Understanding how your medications interact leads to an important timeline most people don't know about. If foundational habits weren’t built, weight often creeps back. When the medication stops, so does the appetite suppression. Here’s how I help patients transition off while maintaining their results. Flow Wellness provides IV & oral ketamine treatments in a safe, controlled, and supportive environment. All treatments are medically supervised for safety and results. 4. Typical efficacy comparison You can also get access to an expert Care Team, including a Registered Dietitian and Fitness Coach, who will provide ongoing support for your weight-loss journey. With WeightWatchers, you’ll get a variety of resources that support lasting, comprehensive weight management. If you’re eligible and join, you’ll be able to make a virtual appointment with a provider to develop a medical weight-loss plan. One study he cites in the book showed that 40% of the weight loss in patients on once-a-week injections of semaglutide came from lean body mass. Family physicians may feel angst when patients request these medications, considering that weight and body mass index (BMI) are flawed health metrics, and the current societal desire for thinness has murky origins. Although the magnitude of weight loss reported in our observational study is not as impressive as what is described in the weight-loss specific GLP-1 agonist trials (e.g. 9.6% for semaglutide 2.4mg in STEP 2), our results are similar in magnitude to the results seen among participants of diabetes trials testing GLP-1 agonist at standard dosages for HbA1c reduction. But the drug form of GLP-1, known as GLP-1 agonists, can last up to 14 hours in your body. While GLP-1 naturally occurs in the body, it only lasts about two to three minutes upon release. We asked top weight-loss experts whether these new meds are worth the hype. Table 1. For example, in SUSTAIN-1, semaglutide 1.0mg achieved 4.5 kg weight loss (4.7%) while placebo achieved 1.0 kg (1.1%), a 3.6% treatment difference at 30 weeks.11 In LEAD-2, liraglutide 1.8mg achieved 2.8 kg weight loss (3.3%) versus 1.5 kg loss (2.0%) in control (metformin monotherapy), a 1.3% treatment difference at 26 weeks.12 In AWARD-3, dulaglutide 1.5mg achieved 2.3 kg weight loss (2.4%) at 26 weeks, an amount that was not statistically different from metformin.13When heterogeneity was obvious (I2 ≥ 50 %), a random-effects model was used to summarize the RRs; otherwise, a fixed-effect model was applied.However, compliance and adherence dropped significantly at the 24‐month mark, with only 4.7% of the patients following up with either an obesity provider or a primary care physician.However, this content should not be used as a substitute for individualized medical care, diagnosis, or treatment.Another limitation of this study is that it did not capture lifestyle modifications, including the patients' nutritional intake, exercise, sleep quality, emotional state, or stress level experienced in the weight maintenance phase, which could have also confounded the results.Therefore, we investigated whether weight loss and improved body composition are sustained better at 1 year after termination of active treatment with GLP-1 receptor agonist, supervised exercise program, or both combined for 1 year.This includes getting enough exercise, eating a diet rich in protein and fiber and making behavioral changes that promote better eating habits. By targeting the areas of the brain that regulate appetite and slowing digestion, GLP-1 medications can lead to significant weight loss. If you access your weight-loss medication through WeightWatchers, your healthcare provider will help you to find the appropriate maintenance dose or changes in the care plan when the time is right. It is also common to see faster weight loss in the initial few weeks, followed by a few weeks of slower weight loss. You've seen the headlines about dramatic weight loss results with GLP-1 medications. What was found is that these medications also helped with weight loss as they assisted in controlling appetite and reducing food intake. If you’re on a GLP-1 weight-loss program, it’s important to formulate a weekly exercise routine that includes strength training to protect your health and your physical independence. In targeting the brain’s pathways, they’re able to lead to long-term, meaningful weight loss without sustained side effects for people with obesity who are willing to stay with the drug. “It is important to follow a healthy diet and be as physically active as possible, since these are foundational treatments for weight loss and improved health,” says Kushner. Whether or not you commit to a lifetime of taking a GLP-1 medication for weight loss, taking care of yourself goes far beyond a pill or injection. Like the other GLP-1 weight-loss medications, Zepbound has a counterpart form of tirzepatide that’s FDA approved for type 2 diabetes — Mounjaro. A linear mixed model was used to estimate percent weight change, with follow-up time as a discrete fixed effect (i.e., 8-week intervals from baseline to 72 weeks). Descriptive statistics summarize baseline characteristics and percent weight change and at least 5% weight loss in each 8-week follow-up interval between the index dispense date for a GLP-1 agonist and 72 weeks after the index dispense date. Baseline demographic and clinical variables were measured during the 52 weeks prior to the first GLP1-a dispense date and extracted from the electronic health record portion of the dataset. We conducted a retrospective cohort study of non-pregnant adults first dispensed a GLP-1a between 2011 and 2018 using electronic health record data from patients receiving care at a large health system. Hitting a weight loss stall while on GLP-1 medications can be super frustrating, but it’s totally normal. The primary outcome of the post-treatment assessment was change in body weight from after the initial weight loss (at randomisation, week 0) to one year after treatment termination (week 104) in the intention-to-treat population."I’m happier, I’m more energetic, and there's no question I'm healthier.""So keeping the GI tract healthy is essential."For example, fiber supplements can help control appetite, while omega-3 fatty acids support metabolic health.More participants who had previously received supervised exercise maintained a weight loss of at least 10% compared with placebo (OR 3.7 1.2; 11.1).The study protocol25 and primary trial report (including reported harms)7 have been published.Reducing weight by 5 % or more significantly improves obesity-related health complications .You've seen the headlines about dramatic weight loss results with GLP-1 medications. GLP-1 isn’t something that your body is unfamiliar with, in fact, it’s something that your body is probably making right now! So, what happens once you’ve reached the target weight set by you and your provider? Reach the right audience at the right time. Specifically, obesity has been shown to involve high rates of plasma fatty acid mobilization and uptake, which play a central role in development of insulin resistance . As demonstrated in Table 4, the average BMI decreased significantly at 12 months compared to the initial visit, remained about the same at 18 months, and again remained about the same at an average of 576 ± 20.2 days (after initial visit) at the patient's follow‐up visit, indicating that the severity of obesity had decreased. Furthermore, it can alter the gut microbiome and can induce expression and secretion of growth‐differentiating factor 15, which reduces food intake, body mass, fasting insulin, and glucose intolerance 11, 12. This follow‐up appointment was, on average, 166 days (5.5 months) after the most recent visit in the bundle program when the patients were on GLP‐1 RAs. Although some weight regain was observed by 24 months, the difference in weight reduction between 18 months and 24 months was not statistically significant. Prescribing a GLP-1 agonist may be appropriate for these patients. We can also redirect the conversation toward health-promoting behaviors. Adverse effects can include nausea, vomiting, diarrhea, and bloating due to gastroparesis (tolerability). Your metabolism naturally slows down when you lose weight—but you can keep it strong by staying active. However, with significant weight loss, particularly a combination of healthy dietary modifications, GLP‐1 RA therapy, and an increase in physical activity, there is a reduction in fatty acid mobilization and uptake, which is a key process in reducing insulin resistance. Studies have shown that obesity directly mediates systemic inflammation, which contributes to insulin resistance and makes sustained weight loss difficult to achieve . These data indicate significant weight loss during the initial 12 months of GLP‐1 RA therapy, with continued weight loss after transitioning to AOM therapy. Notably, there was a reduction in BMI from 36.5 to 27.2 over the study period, and weight loss of 20.6% was maintained over 24 months. Furthermore, this subgroup of patients who transitioned from GLP‐1 RA therapy to generic AOMs experienced significant weight loss (Table 5), with an average reduction from 219.5 lb to 163.5 lb over approximately 593 days. Your Post-GLP-1 Action Plan: In this real-world study using data from over 2,400 patients with overweight or obesity and type 2 diabetes, most patients who started a GLP-1 agonist lost weight through 72 weeks and one third lost a clinically meaningful amount (at least 5% of body weight). Using data from a large integrated healthcare system, we sought to describe the percent change in body weight from baseline among patients with overweight or obesity and type 2 diabetes 72 weeks after starting a GLP-1 agonist. Similarly, in the STEP‐4 trial (effect of continued weekly subcutaneous semaglutide vs. placebo on weight loss maintenance in adults with overweight or obesity), individuals who stopped semaglutide treatment and started placebo regained 6.9% body weight, on average, after 48 weeks . To understand body weight changes at 72 weeks after index dispense date, we used descriptive statistics to compare participants with and without weight data in the 72-week time window. Markedly elevated body weight is a well described risk factor for major adverse cardiovascular events and all-cause mortality among patients with type 2 diabetes.1–3 Achieving and maintaining weight loss in this group of patients may result in improved glycemic control and help patients reduce the dosage or number of glucose lowering medications.4,5 In some cases, more substantial weight loss (i.e. ≥10% to 15%) may result in disease remission.6,7 Incorporating genetic information into obesity management can significantly enhance treatment plans and improve long‐term outcomes for patients transitioning from GLP‐1 RA to AOM therapy. As a result, a patient who is now in the overweight category is more likely to respond to these older‐generation AOMs, as there is less inflammation and insulin resistance, even though (on average) these generic medications are weaker in efficacy compared to GLP‐1 RAs. Phentermine/topiramate, metformin, bupropion, and naltrexone can also improve insulin sensitivity by facilitating calorie restriction by decreasing hunger, thereby promoting weight loss over time. In contrast, with liraglutide combined with exercise, after one year of habitual living after treatment termination, participants were 5.1 kg weight reduced compared with after termination of liraglutide alone. The primary outcome of the study was the change in body weight (kg) from randomisation to one year after termination of the weight maintenance intervention (week 0–104). All participants who had undergone randomisation were invited to participate in the post-treatment study, which was composed of a set of outcome assessments one year after the planned completion of the 52-week weight maintenance intervention. To induce a similar, fast, and effective weight loss, all participants initially underwent a controlled low-calorie diet of 800 kcal/day for eight weeks, where all food was replaced with four meal replacement products per day (Cambridge Weight Plan). Since these older‐generation AOMs also target appetite, insulin resistance, cravings, and satiety, they are suitable and cost‐effective alternatives for the treatment of obesity and overweight at the appropriate doses. These generic medications can offset the weight regain expected with GLP‐1 RA discontinuation. This demonstrates that alternative and inexpensive medications can be used for weight maintenance if GLP‐1 RA therapy cannot be continued. This suggests that these patients were able to maintain weight loss on generic second‐generation AOMs. Weight loss maintenance outcomes of successful medical weight loss bundle patients (defined as BMI 2 at 12 mo) Phentermine/topiramate, metformin, bupropion, and naltrexone can also improve insulin sensitivity by facilitating calorie restriction by decreasing hunger, thereby promoting weight loss over time.Like the other GLP-1 weight-loss medications, Zepbound has a counterpart form of tirzepatide that’s FDA approved for type 2 diabetes — Mounjaro.For one, you can’t use them to jump-start your weight loss, and then attempt to maintain your weight on your own without making necessary lifestyle changes.Similar to the GLP-1 response that slows digestion, protein takes longer to break down, contributing to lasting satiety.I would often visualize an attractive healthier version of myself and this helped to motivate me on the days I felt like giving up.So, what happens once you’ve reached the target weight set by you and your provider?In this review, we explore the current medical therapies for obesity, including all major categories, individual mechanisms of action, pharmacokinetics and pharmacodynamics, adverse effects, risks, and absolute contraindications.We calculate your BMI based on your height and weight.Even healthy foods can contribute to weight gain if consumed in large quantities. You may lose weight, but it is often difficult to sustain meaningful weight loss, and you find yourself on a rollercoaster of weight going up and down and back up again. They should always be combined with a healthy lifestyle which will include a healthy diet and a regular exercise routine. Glucagon-like peptide-1 receptor agonists (GLP-1s or GLP-1RAs) are used in the management of obesity and type 2 diabetes. Better blood sugar and insulin balance can make weight loss easier. Some of these medications have been cleared by the U.S. We ensure that patients stay on track with their prescriptions by identifying potential drop-off points in real-time. Effortless online ordering that keeps your patients happy and healthy. Recent Posts SST, SBKJ, and SM contributed to the design of the post-treatment study.Starting at low doses may help circumvent these, says Kushner, who also notes that these side effects can usually be alleviated if people eat low-fat foods, smaller portion sizes, and a balanced meal plan.Regular monitoring of your weight and dietary habits can help you stay on track.These medications are expensive (price), and injections are more complex than oral medications (simplicity).GLP-1 medications don't change the fundamentals of healthy eating, Kessler writes, and it's important to be mindful about your food choices on the drugs.These data can assist clinicians in selecting appropriate medications based on specific adverse reaction profiles of patients.Descriptive statistics summarize baseline characteristics and percent weight change and at least 5% weight loss in each 8-week follow-up interval between the index dispense date for a GLP-1 agonist and 72 weeks after the index dispense date. Despite the sustained weight and fat reduction after termination of combined exercise and liraglutide compared with after termination of liraglutide alone, some weight gain after treatment was not entirely prevented. Although the exercise program in our study was not specifically focused on maintaining habits after the intervention, a sustained effect on healthy weight was present one year after the intervention was completed. Therefore, our results show that supervised exercise, as a weight maintenance strategy, improves body weight and composition, which can be sustained after termination of the supervised exercise. The analyses of exercise versus non-exercise groups showed that the improvements in body weight and body composition obtained with a one-year exercise intervention were maintained one year after the completion of the intervention. These results are noteworthy as many patients lose insurance coverage for GLP‐1 RAs and are concerned about weight regain off the medications. Additionally, from the last visit at our obesity center (around 14 months) and the most recent follow‐up appointment at another provider's office within the health system (when the patients were not on GLP‐1 RAs), there was still a mean 1.46 lb decrease in weight noted using older‐generation generic AOMs. At 12 months, patients had lost an average of 18.3% ± 5.3% body weight from baseline, obtaining an average BMI of 27.9 ± 0.8 kg/m2, which was a statistically significant difference (p 2). This time period was chosen because it coincided with activation of 12 months of obesity pharmacotherapy benefits (including GLP‐1 RA therapy) for patients enrolled in the MWLB at our institution, and weight measurements beyond 12 months would likely be assessable for these patients. The bundle lasts 18 months, has zero out‐of‐pocket costs for patients, and includes Food and Drug Administration (FDA)‐approved and off‐label antiobesity medications (AOMs), including several GLP‐1 RA medications. However, studies have shown some weight loss but not as much as Wegovy, so it’s not approved for the treatment of obesity. We can promote healthy behaviors and acknowledge the dissonance of living in a diet-entrenched society with the understanding that weight loss may not be the answer. Even without a medical need for weight loss, we can work with patients toward an informed approach that respects their bodily autonomy and recognizes their societal discord and experiences living in larger bodies. Coming off GLP-1 medications doesn’t mean you’re doomed to regain weight. In conclusion, the results of this study underscore the importance of personalized, adaptable treatment strategies in obesity management. This study provides valuable insights into the potential of older‐generation AOMs as a cost‐effective strategy for maintaining weight loss achieved through GLP‐1 RA‐based pharmacotherapy. Lastly, among patients transitioning from GLP‐1 RAs to generic AOMs, those who underwent bariatric surgery (gastric sleeve or Roux‐en‐Y gastric bypass) introduce additional metabolic complexities that could confound treatment effects. Although some patients did have medical visits around the 2‐year period, these visits occurred either before or after the defined 24‐month time frame in the study and were therefore excluded from the results. Specifically, only five individuals shown in Table 4 and two in Table 5 had weight data available at the 24‐month mark after starting treatment, resulting in a small cohort that makes it challenging to generalize findings. The FDA has approved GLP-1 receptor agonists such as Liraglutide, Semaglutide, and the GLP-1/GIP dual agonist Tirzepatide for the treatment of obesity , , . For those unable to control their weight through lifestyle changes or additional comorbidities, pharmacological treatment is often essential 9,10. According to the WHO, approximately 1.9 billion adults are overweight, with over 650 million with obesity . Recent statistics indicate that overweight/obesity continues to increase globally, with the overweight population reaching 2 billion, or 30 % of the world's population . Obesity is a major global epidemic, defined by the World Health Organization (WHO) as “an excessive accumulation of body fat that may impair health” 1,2. Create a file for external citation management software Regular physical activity is a cornerstone of long-term weight maintenance.As long as you are on the medication, you may experience temporary side effects.Together, we’ll create a weight loss plan that supports your long-term health.Obesity is a growing public health issue that increases the risk of developing heart disease, type 2 diabetes, and osteoarthritis.As a GLP-1/GIP/GCG tri-agonist, Retatrutide's interaction among the three receptors significantly enhanced its weight reduction effect.After signing up, let us know if you’re living with type 1 or type 2 diabetes and we'll take your needs into account.These four reasons are the key to GLP-1 receptor agonists’ weight loss effects and can lead to steady, long-term weight loss but they are not meant to be used alone.During your consultation, we will help determine the best option for your health and weight loss goals. All patients in the study were part of a “medical weight loss bundle” (MWLB), an 18‐month program (12 months of treatment plus 6 months to transition care) designed by our institution . Furthermore, the literature has demonstrated that those who start using GLP‐1 RAs can see weight regain when they discontinue the medications; this occurs because these medications reduce body weight set point through hormonal changes that promote satiety and diminish appetite. It’s recommended that patients stay on GLP-1 medications for at least 12 weeks — but seeing meaningful results may take even longer. GLP-1 medications have emerged as a game-changer for patients looking to manage their type 2 diabetes and weight. For many patients, this makes the prospect of taking their GLP-1 medications indefinitely much easier to manage. The GLP-1 medications were the mechanism for your body to better regulate blood sugar and slow gastric emptying. For many patients, significant weight loss is achieved — but what happens once you’ve reached your goal weight? Let’s dive into the science behind GLP-1s and what it means for taking the medications long-term or after you’ve reached your goal weight. Use this printable pdf to reach your health and weight loss goals this year! Weight regain during the one-year post-treatment phase was 6 kg larger after GLP-1 receptor agonist treatment compared with after supervised exercise. We conducted a post-treatment study in extension of a randomised, controlled trial in Copenhagen. Moreover, regular follow‐up visits are crucial to assess weight maintenance and treatment efficacy. Clinicians should account for these surgical effects when evaluating treatment outcomes. GLP-1 medications don't change the fundamentals of healthy eating, Kessler writes, and it's important to be mindful about your food choices on the drugs. These data can assist clinicians in selecting appropriate medications based on specific adverse reaction profiles of patients. The safety of weight reduction medications has long been a concern, with numerous drugs being withdrawn from the market owing to safety issues 28,29. Achieving and maintaining weight loss is challenging for many individuals. Weight loss can reduce the risk of developing these health problems but, despite this, levels of obesity remain high. Obesity is a growing public health issue that increases the risk of developing heart disease, type 2 diabetes, and osteoarthritis. Despite the benefits of weight reduction, there are many challenges in losing weight and maintaining long-term weight loss. All interventions except diet restriction substantially weakened the appetite feedback control circuit, resulting in an extended period of weight loss prior to the plateau. Learn what happens when you stop GLP-1, how to manage weight loss after GLPs, and effective, long-term options for losing and keeping weight off. While many people lose weight when taking these drugs, a large number regain it after stopping. First, our findings may have limited generalizability since they were derived from patients who predominately identify as white and are receiving care at a single large regional healthcare system. BMI, body mass index; GLP-1, glucagon-like peptide 1; HbA1c, hemoglobin A1c; HDL, high-density lipoprotein; LDL, low-density lipoprotein. Statistical Analysis More participants who had previously received combination treatment had a weight loss of at least 10% of initial body weight one year after treatment termination (week −8 to 104) compared with participants who had received placebo (odds ratio OR 7.2; 95% CI, 2.4; 21.3) and liraglutide (OR 4.2; 95% CI, 1.6; 10.8) (Fig. 3D and Table S7). More participants who had previously received combination treatment maintained a weight loss of at least 10% of initial body weight one year after treatment termination (week −8 to 104) compared with participants who had previously received placebo (odds ratio OR 7.2 2.4; 21.3) and liraglutide (OR 4.2 1.6; 10.8). The medications — drugs like Ozempic, Wegovy and Mounjaro that were originally created to treat type 2 diabetes — have been shown to produce superior weight loss effects with little risk, according to a 2023 study. For example, one cohort study used United Kingdom claims data to examine body weight changes among 589 patients with T2D initiating a GLP-1 agonist.22 In that sample, 33% achieved weight loss ≥5% at 12 months. The results suggested that for certain drugs, such as Tirzepatide, BI , Semaglutide, and Mazdutide, a 26-week course only achieved 46.4 % to 69.4 % of their maximum effect. This indicates that when evaluating the efficacy of different GLP-1RA drugs, varying treatment durations should be employed to fully reflect the therapeutic potential of each drug. For instance, Orforglipron demonstrated the fastest onset (6.4 weeks); conversely, Tirzepatide had the slowest onset (19.5 weeks), taking 46 weeks to reach its efficacy plateau. Given the sociopolitical origins of our weight-focused culture, how should we address our patients' desires to achieve a certain weight, even if there is no strict medical need to do so? The cultural fear of weight gain and larger body size has insidious origins. One of the biggest dangers after stopping GLP-1 medications? The exercise intervention started with a six-week introduction phase, where exercise volume was gradually increased. Participants who lost at least 5% of initial weight loss were then randomised. An initial weight loss before randomisation was chosen because the primary aim was to investigate maintenance of weight loss. All randomised participants were invited for post-treatment outcome assessments one year after treatment was stopped. Other insurance plans limit the use of GLP‐1 RAs to only a short period of time (e.g., 12 months) and/or require individuals to lose a certain percentage of body weight (e.g., 5%) to permit the renewal of coverage . In addition, these medications have demonstrated improvement in weight‐related comorbidities, such as type 2 diabetes, fatty liver, hyperlipidemia, hypertension, sleep apnea, cardiovascular disease, and joint pain. Return to the dietary and exercise habits that supported your initial weight loss and consider seeking additional support from a healthcare provider or a registered dietitian. Food and Drug Administration for weight management — and many patients who have struggled with obesity have experienced monumental weight loss. Your food choices affect your results and how you feel while you’re on GLP-1 medications, and a smart meal plan can help you lose more weight and minimize side effects. "So keeping the GI tract healthy is essential." Remember, the drugs slow down the emptying of the stomach into the small intestine, and that can lead to things getting backed up further down the line, Kessler says. "If you are increasing the protein, you're decreasing the rapidly absorbable carbohydrates, you're decreasing fat, excess calories, and sugar," says Kessler. In the book, Kessler acknowledges that you can't really separate those unpleasant feelings from the effective mechanism of the drugs themselves. GLP-1 drugs are powerful appetite suppressants, Kessler says. The great thing about these drugs, says Kessler, is that they allow you to relearn how to eat. A body composition scan can offer a more precise measurement. By helping you focus on healthy habits — exercising regularly, drinking plenty of water, and getting enough protein and fiber — it helps you mitigate side effects while maximizing health benefits as you lose weight on medication. Research in the New England Journal of Medicine shows that people living with obesity and without diabetes lost an average of 21% of their total body weight in just over a year with Zepbound. Similar to semaglutide, there is another form of liraglutide, Victoza, that is FDA approved for managing type 2 diabetes, but not weight loss; it’s also rarely used off-label. However, “semaglutide is over two times more effective than liraglutide in causing weight loss,” says Kushner. Metformin has been shown to helpful in weight loss by improving insulin resistance and promoting appetite suppression through increased secretion of GLP‐1 and peptide YY and increased hypothalamic leptin sensitivity 9, 10. The most common medications prescribed were metformin, topiramate, bupropion, and phentermine. Overall, these findings support the use of GLP‐1 RAs followed by AOM therapy as a viable strategy for significant and sustained weight loss. Learn why leading life science companies partner with Nimble to generate revenue across millions of high-intent patients. Eating better and feeling healthier can be as simple as adding vegetables, enjoying flavors, drinking more water, and shifting portion sizes. Skip the drive and chat with a telehealth provider to find out. This contrasts with physical activity interventions, where increased physical activity in principle can be continued in a real world-setting after intervention termination and, thus, treatments effects can be maintained.Physical activity and excess body weight and adiposity for adults.It is linked to adverse metabolic changes and chronic diseases such as type 2 diabetes, coronary artery disease, neurological disorders, and certain cancers 3,4.We sought to describe the percent change in body weight 72 weeks after starting a GLP-1a.The following lifestyle habits gleaned from NWCR participants and nutrition experts may help you keep the pounds you’ve lost from creeping back.He says GLP-1 drugs are remarkably effective in countering this pattern.If you feel that the pecans trigger side effects from your GLP-1 medications, you can skip them or have a smaller portion. Among this cohort, those who transitioned to generic AOMs (such as metformin, topiramate, phentermine, and bupropion) after the MWLB pharmacy coverage ended at 12 months were able to maintain their weight loss up to 24 months. Table 5 shows this subgroup of patients who completed GLP‐1 RA therapy in the MWLB and then transitioned to second‐generation AOM therapy for weight maintenance. This suggests that the 18‐ to 24‐month weight maintenance phase may be a critical time to educate primary care providers on the importance of continued and more frequent medical visits to prevent weight regain until stability is achieved. However, compliance and adherence dropped significantly at the 24‐month mark, with only 4.7% of the patients following up with either an obesity provider or a primary care physician. Of note, this includes all patients who received 12 months of AOM therapy, regardless of treatment completion or type (novel GLP‐1 RA therapy and/or older generic options). If the influence of covariates was involved, adjustments were made through the inverse operation of the covariate formula to mitigate the effects of uneven distribution across different studies owing to covariate effects. First, individual estimates of model parameters for each drug group and their standard errors were obtained using data output by the NONMEM software. The potential covariates examined included age, male ratio, baseline weight, and baseline BMI. The error margin for data extraction from the graphs was kept below 2 %; if it exceeded this threshold, the data were re-extracted. Participants who had previously received liraglutide alone regained 9.6 kg in the one-year period after treatment was terminated (week 52–104), resulting in a net weight regain from randomisation (week 0–104) of 8.7 kg (Fig. 3A and B and Table S3). Four participants had initiated treatment with liraglutide in the post-treatment phase (one in the placebo group, one in the liraglutide group, and two in the exercise group). The mean time from treatment completion to post-treatment outcomes assessments was 55 ± 7 weeks. Participants were initially recruited for the weight loss and weight loss maintenance phases of the study (week −8 to 52). Finding the right medication often requires patience and close work with your healthcare provider. While thyroid issues, when treated, usually don't pose major problems, even well-controlled diabetes might affect your response to the medication. "I like to think about weight loss kind of like the stock market where you're looking at the overall trend," Dr. Meghan explains. I wanted to live a healthy and active life. When I reached my heaviest weight at 298 pounds I became frightened at the thought of being immobilized. The birth of my son and wanting to be around for him was definitely a major factor in my desire to lose weight. Fewer participants from the placebo group participated in the post-treatment study. Thus, people randomised to exercise may have had acquired exercise behaviours during the intervention and, therefore, were able to sustain higher physical activity levels after medication was stopped to minimise the otherwise insistent weight regain. Panel B shows the self-reported daily sitting time in the week leading up to post-treatment assessments (week 104). Taking injectable Semaglutide (1.0 mg) as an example, the efficacy at 26 weeks, and 52 weeks was 5.77 kg, and 7.57 kg, respectively, representing 49.3 %, and 64.7 % of its maximum effect (Fig. 5). The results indicated that Liraglutide exhibited the fastest onset, reaching an efficacy plateau (80 % of the Emax value) by week 17, whereas Tirzepatide showed the slowest onset, requiring 46 weeks to reach the efficacy plateau. We simulated the dose-response weight reduction effects at their lowest, median, and highest doses. “We also focus on complex dynamic movements like squats and dead lifts more than machines, as they teach coordination in using different body parts simultaneously.” As a result, your strength training should begin with a lower intensity than the average person, and your progression to heavier weights should be more gradual. Before you rush to the gym and start pumping iron, be aware that while on a GLP-1, you may experience a reduced appetite and nausea, especially during the dose-adjustment phase at the start of your treatment. “Even when you’re relatively young, you feel so much older because you lose muscle mass so rapidly on these drugs,” Wenger said. Strong muscles are key to maintaining sturdy bones and preventing falls, and they are important for long-term metabolic health. Total body-fat and lean mass (dual-energy x-ray absorptiometry, Hologic Discovery), HbA1c, lipid levels, and self-reported quality of life were measured at weeks −8, 0, 52, and 104. Body weight, hip and waist circumferences, fasting glucose levels, blood pressure, and resting heart rate were measured in the fasted state before the low-calorie diet (week −8), at randomisation (week 0), at weeks 4, 13, 26, 39, 52 after randomisation, and one year after intervention completion (approximately 104 weeks after randomisation). The use of supplements, concomitant medication, and treatments for obesity (e.g., pharmacotherapy) were recorded. During the one-year post-treatment phase, none of the interventions were continued, and participants had neither restrictions nor encouragement in terms of weight management strategies. At week 52, the supervised exercise program was terminated and participants returned the sports watches and heart rate monitors. First, some GLP-1RA drugs are still under development, and the related clinical trial data are limited, which may affect the robustness of the pharmacodynamic models. This study found that the dropout rates for injectable Semaglutide, Liraglutide, Mazdutide, Retatrutide and Tirzepatide were significantly lower than those for the placebo, suggesting that these drugs have a favorable risk-benefit ratio. Thus, dropout rates can reflect the safety and efficacy of medications to some extent. Therefore, when assessing the efficacy of GLP-1RA drugs, the heterogeneity in participants'ages must be considered. It can be challenging not to gain weight after stopping Ozempic, Wegogy, Mounjaro, Zepbound and other GLP-1s, but several alternatives can be more effective in the long term. Check out our patient success stories to see the difference our treatments can make in your life. At the Center for Weight Loss Surgery, we understand that obesity is a chronic disease, and there is no one-size-fits-all solution. Regular check-ins with health care professionals can support these efforts. Discussing options with a health care provider can help find better alternatives that align with the patient’s health goals, such as controlling appetite or improving metabolic health. In obesity pharmacological research, glucagon-like peptide-1 (GLP-1) promotes insulin secretion, inhibits glucagon release, slows gastric emptying, reduces appetite, and decreases food intake 11,12. Key strategies for managing obesity include improving diet and increasing physical activity . It is linked to adverse metabolic changes and chronic diseases such as type 2 diabetes, coronary artery disease, neurological disorders, and certain cancers 3,4. However, “semaglutide is over two times more effective than liraglutide in causing weight loss,” says Kushner.Those living with diabetes who are taking GLP-1 medication can still benefit from our programme.Cravings are also normal to experience, so if the medication does not eliminate cravings entirely for you, that’s okay.Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medication condition or medication.All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.At the Center for Weight Loss Surgery, we provide surgical and nonsurgical weight loss treatments to help you look and feel your best.For patients who underwent a bariatric procedure during the 72-week follow-up period, we censored all body weight and BMI measurements that occurred following the bariatric procedure. “They will often not eat for extended periods of time. “Because people on GLP-1s have reduced appetites and sometimes nausea, that can lead to underfueling,” Wenger said. The timing of your protein intake, along with the necessary carbohydrates, is also important. Supervised exercise together with obesity pharmacotherapy holds more potential for preventing body weight and fat mass regain after treatment termination compared with obesity pharmacotherapy without supervised exercise. One year after treatment termination, participants who had previously received combined supervised exercise and GLP-1 receptor agonist treatment had maintained weight loss and body-fat reduction, in contrast to weight regain for participants who had previously received GLP-1 receptor agonist alone. In this study, we investigated whether weight loss and improved body composition were preserved better at 1 year after termination of active treatment with glucagon-like peptide-1 (GLP-1) receptor agonist, supervised exercise program, or both combined for 1 year. How much is uncertain, but studies have indicated that anywhere between 15% to 60% of the weight people lose is lean muscle mass — meaning that if you shed 50 pounds, you will potentially be losing 7.5 to 30 pounds of your lean muscle. If you’re taking one or considering it, though, it’s important to remember that using the drugs to suppress appetite doesn’t just contribute to fat loss. Before beginning any new exercise program, consult your doctor. Once you’ve reached the weight goal decided upon by your provider, that doesn’t necessarily mean your journey on GLP-1s is over. Your dosage, ramping schedule, and so many other details should be decided between you and your provider to maximize results and avoid side effects as much as possible. This hormone plays a rather large role in how your body functions and in the regulation of blood sugar. For someone weighing 150 pounds (68 kilograms), that equals 68 to 81.6 grams of protein daily. Specifically, Shah said people on GLP-1s need about 1 to 1.2 grams per kilogram of weight. Experts emphasize the importance of taking in enough protein every day, which is key to building muscle. Ideally, a professional will develop an individualized exercise plan for you. The results indicate significant variability in the efficacy of these drugs in reducing body weight. The results indicated that at 52 weeks, the weight reduction effects of mono-agonists, dual-agonists, and triple-agonists were 7.03 kg, 11.07 kg, and 24.15 kg, respectively. Taking injectable Semaglutide (1.0 mg) as an example, the weight reduction effects at 52 weeks for subjects aged 45, 55, and 60 were 9.88 kg, 7.27 kg, and 6.24 kg, respectively, with the latter being 3.64 kg lower than the former (Fig. 6). This study simulated the weight reduction effects of the drugs across three age groups (45, 55, and 60 years). For example, with injectable Semaglutide, at doses of 0.05 mg, 1.0 mg, and 2.4 mg, the weight reduction effects at 52 weeks were1.21 kg, 7.6 kg, and 9.05 kg, respectively (Fig. 4). “Wegovy is inducing an average 15% reduction in baseline body weight, roughly twice as much as other earlier types of FDA-approved weight-loss medications,” says Wadden Altogether, this leads to weight loss — an average of 15% to 21% body weight, per studies on semaglutide and tirzepatide (two popular GLP-1s) published in the The New England Journal of Medicine. GLP-1s like semaglutide might not have been intended as weight-loss medications, but they are on track to be game changers for treating obesity. Because patients often seek validation from physicians to lose weight, we can acknowledge their goal while emphasizing a more holistic approach to health, encouraging patients to engage in exercise they enjoy and eat nourishing foods that make them feel good and not deprived. Your weight loss stalled and it’s been a solid two, maybe three weeks of zero movement. Thus, apart from modifying the specificity of drugs to receptors, enhancing their affinity can significantly improve the weight reduction outcomes of GLP-1RA drugs. This study systematically quantitatively assessed the efficacy and safety characteristics of 12 marketed and experimental GLP-1RA drugs. Impact of age on the weight reduction effects of Liraglutide (A) and Semaglutide (B) Covariate analysis identified age as a significant factor affecting the weight reduction efficacy of GLP-1RA drugs. Finally, parameters from the distribution of pharmacodynamic parameters in each subgroup were randomly selected, and drug effects at different time points were calculated. Additionally, we conducted subgroup analyses based on receptor specificity to explore the differences in weight reduction effects among mono-agonists, dual-agonists, and tri-agonists. This study established time-course, dose-response, and covariate models for each drug.