A new systematic review published in BMJ has found that patients who stop taking weight management medications often regain lost weight within two years, raising concerns about the effectiveness of short-term use for long-term obesity care.
The review analyzed data from more than 9,000 adults across 37 studies, focusing on what happens after patients discontinue drugs like semaglutide and tirzepatide. These medications are known to help patients lose between 15% and 20% of their body weight during treatment. However, the study projects that most people return to their original weight within about 1.7 years after stopping the medication. Cardiometabolic health markers such as blood pressure and blood sugar also tend to revert to pre-treatment levels within approximately 1.4 years.
"Review findings revealed that while modern drugs like semaglutide and tirzepatide drive significant weight loss, discontinuation leads to a rapid 'rebound' effect. On average, patients were projected to return to their starting weight within approximately 1.7 years, with cardiometabolic markers (blood pressure and blood sugar) projected to return to pre-intervention levels within about 1.4 years, with some markers reverting even sooner. However, the authors emphasise that individual trajectories varied substantially between participants."
The analysis showed that the rate of weight regain is faster after stopping medication compared to ending behavioral programs focused on diet and exercise. The average monthly weight regain was found to be 0.4 kg for all medications but doubled to 0.8 kg per month for newer drugs like semaglutide and tirzepatide.
"Crucially, the study found that weight rebounds significantly faster after stopping medication (pharmacological interventions) than it does after stopping behavioral diet and exercise programs in an indirect comparison between evidence bases."
Behavioral programs have long been considered essential in managing obesity but often produce modest results that are hard to maintain over time. The introduction of newer drugs has changed treatment approaches by providing more substantial short-term results.
The review used statistical models to project how quickly patients regained both body weight and key health indicators after stopping medication. Results suggest that unless there is a plan for ongoing management or transition strategies, benefits gained during drug therapy are unlikely to last.
"Consequently, the review emphasizes that without a long-term plan or a transition to alternative management strategies, the health benefits of short-term WMM use are fleeting and likely to be reversed upon discontinuation."
These findings come as real-world data indicate high dropout rates from these medications due in part to cost, supply issues, or side effects—about half of patients stop using them within one year.
The authors note this is the first comprehensive effort quantifying how quickly physiological rebound occurs after discontinuing various types of obesity medications.
The review concludes that sustained benefits from pharmacological treatments for obesity may require continuous use or effective long-term alternatives beyond temporary drug therapy.
