A groundbreaking study from the University of Oxford, published in the BMJ, reveals that individuals who cease weight loss injections typically reclaim all shed pounds within an average of 1.7 years. This comprehensive review analyzed 37 prior trials encompassing 9,341 participants, focusing on medications like GLP-1 receptor agonists—originally developed for type 2 diabetes management.

These drugs, including semaglutide (branded as Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound), mimic the glucagon-like peptide-1 (GLP-1) hormone. They promote insulin secretion, suppress appetite, decelerate gastric emptying, and stabilize blood glucose levels, leading to significant short-term weight reduction.

Key Findings from the Analysis

Participants underwent an average treatment duration of 39 weeks, with follow-up averaging 32 weeks. During therapy, they lost an average of 8.3 kg. Post-discontinuation, however, regain occurred at 0.4 kg per month across all medications.

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• Nearly half the cohort (including 1,776 on semaglutide or tirzepatide) experienced accelerated regain: approximately 0.8 kg (1.8 pounds) monthly.

• Within one year off medication, average regain reached 4.8 kg.

• Newer agents like semaglutide and tirzepatide prompted greater initial losses but returned users to baseline in about 1.5 years—slightly faster than the 1.7-year overall average.

• Weight regain outpaced that from behavioral interventions (e.g., diet and exercise programs) by roughly 0.3 kg (0.7 pounds) per month.

• Metabolic markers for diabetes and cardiovascular risk also reverted to pre-treatment levels within two years.

Lead author Sam West, a postdoctoral researcher at Oxford's Nuffield Department of Primary Care Health Sciences, emphasized: "These medicines are transforming obesity treatment and can achieve important weight loss. However, our research shows that people tend to regain weight rapidly after stopping—faster than we see with behavioural programmes."

Implications for Long-Term Management

West cautioned that this pattern reflects obesity's chronic, relapsing nature, not a flaw in the drugs. He advocated against short-term use without integrated strategies like sustained lifestyle changes and primary prevention efforts.

Senior researcher Dimitrios Koutoukidis noted: "Because people on semaglutide or tirzepatide lose more weight initially, they return to baseline at approximately the same time. Understanding who sustains losses remains a 'holy grail' in weight-loss research."

Prior research highlights ancillary benefits, such as GLP-1 agonists halving early mortality risk in heart patients. Yet, this study stresses the imperative for holistic, ongoing approaches.

Relevance in India

Novo Nordisk launched Ozempic (semaglutide) in India on December 12, targeting adults with type 2 diabetes via pre-filled pens (0.25 mg, 0.5 mg, 1 mg doses) for subcutaneous injection. Unlike in the US and Europe—where Wegovy approves it for weight loss—Indian marketing focuses solely on glycemic control.

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