- Glucagon-like peptide-1 (GLP-1) receptor agonists are medications that can help with weight loss, but many people who use them eventually give up on them.
- A concern after stopping GLP-1 medications is weight regain.
- One study suggests that structured support, such as a wellness app, may help minimize weight regain that can occur shortly after stopping GLP-1 medications.
As noted in the current study, many people stop taking these medications and weight regain is common afterward.
The study found that participants who ate meals specially developed by a dietitian or used a wellness app gained less weight than participants in the control group.
For this study, participants were people who had recently stopped taking GLP-1 medications but experienced weight loss of more than 10% as a result of taking GLP-1 medications. The average weight loss recorded by participants was just over 18%.
The researchers divided the 39 participants into three groups. The first was a control group, which received usual care to maintain weight loss. The second received medically adapted meals, which the study describes as meals prepared specifically by a dietitian. Participants received ten of these meals each week. The third group used the Noom app for at least 15 minutes every day. This app helps manage things like overeating and “social and environmental eating cues.”
The study lasted 4 months. The main objective of the research was to examine the extent to which participants adhered to and their satisfaction with the two interventions. The researchers also focused on how well the groups maintained their weight loss and diet quality. Participants completed questionnaires at the beginning and end of the intervention period, and weight data were collected every 30 days and before the start of the intervention.
Overall, participants’ perceptions of adherence to intervention recommendations were similar between groups. Scores were similar for participants’ responses regarding effectiveness, convenience, and satisfaction. All groups also had similar scores regarding diet quality and participants’ perceptions of diet quality and health.
However, diet quality scores were slightly higher in the wellness application group than in the other two groups. The authors suggest this may show a trend in this group toward higher quality diets.
However, there was a difference in the amount of weight regained between the groups. Both the wellness app and medically tailored meal groups were associated with lower total weight gain.
The wellness app group only had an estimated weight regain of 3.60%, and the medically adapted meals group had a weight regain of 3.58%, compared to a weight regain of 10.75% in the control group. Rates of weight gain were also lower for the intervention groups. Each month, the control group recorded a weight gain of 2.94%, while the other groups recorded a weight gain of less than 1% each month.
“People who stopped taking a GLP-1 weight loss drug were better able to maintain their weight loss over the next 4 months if they received additional support, such as a home-delivered nutritious meal program or access to a digital wellness app.”
“The results suggest that what happens after people stop these medications is important. Rather than assuming that weight regain is inevitable, providing behavioral tools and tangible nutritional support can help people navigate this transition more successfully,” she said.
This study had a small number of participants, so it can only provide limited data and indicates the need for further research. The authors note that it was not “designed for definitive efficacy testing.” Thus, areas where they found insignificant effects may reflect limited statistical power. Due to the objectives of this study, the researchers also did not establish a baseline for intervention adherence.
The sample also has other limitations. Lack of diversity limited applications. For example, participants came from only two regions of Texas, more than 80% were women, and most were in stable financial situations.
The test also does not make it possible to establish a causal relationship between the factors studied. The intervention period lasted only four months, so it cannot guarantee long-term effectiveness. The trial was conducted entirely remotely, which could have influenced several factors and differed from what would have been the case with in-person visits. The use of technology could also have affected the study participants.
The exclusion and inclusion criteria may have affected the study sample and the researchers’ final selection of participants. Additionally, the researchers had limited data and results because they relied on participant reports.
The results may also have been limited by the questions the researchers chose to ask and other elements of the data collection. Using questionnaire data can only reveal so much, and the researchers suggest that objective measures could be a useful part of future research. Blinding was quite limited in this study and there may have been variations in the care received by the control group.
Participants who used the Noom app reported using it on average just under three days per week, which could also have affected the results. The authors note that using the app requires constant effort, while using medically tailored meals reduces the effort required. The researchers also suggest several factors that could have affected diet quality scores, such as the need for a longer time frame for self-assessment results to appear.
As noted in the study, post-discontinuation support of GLP-1 ARs is important. Hollis-Hansen noted the following:
“The results suggest that health care providers should plan for what happens next when patients may need or choose to stop taking GLP-1 medications. Clinicians and patients can work together to develop a transition plan that includes behavioral support, ongoing monitoring, and discussions about other treatment options if needed.”
“Rather than viewing stopping treatment as the end of treatment, it may be more helpful to view it as a new phase of weight management that often benefits from ongoing support,” Hansen added.
This study should also be considered within the broader framework of knowledge about GLP-1 RAs, as healthcare professionals do not recommend discontinuing them.
Mir Ali, MD, a bariatric surgeon, bariatric medicine specialist and medical director of the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, who was not involved in the study, noted:
“If patients stop these medications, other forms of structured support will likely be needed to help them maintain their weight loss. »
“This research demonstrates that providing alternative support to stopping GLP-1 medications improves the chances of weight maintenance. However, continuing GLP-1 treatment long-term remains the most effective strategy at present.”
—Mir Ali, MD
It is important that people work closely with healthcare professionals to lose weight and manage obesity, including the use of GLP-1 medications. People can get relevant medical advice when starting and stopping these medications.
Gn Health
