Of the 308 who benefited from tirazepate, 254 (82 percent) lost at least 25 percent of the drug’s weight by 88 weeks. Generally, the more weight people gain back, the more their cardiovascular and metabolic health improves.
Data lag and potential off-ramps
On the other hand, there were 54 of 308 (17.5 percent) participants whose weight did not come back a significant amount (less than 25 percent.) This group saw some of their health indicators get worse when they stopped the drug, but not all — blood pressure increased slightly, but cholesterol did not increase significantly overall. About a dozen participants (4 percent of 308) continued to lose weight even after stopping the drug.
The researchers couldn’t figure out why these 54 participants performed so well; They reported that there were “no apparent differences” in demographic or clinical characteristics. It is clear that further study is needed on the topic.
But, overall, the study offers a disappointing outlook for patients hoping to avoid the need to take anti-obesity drugs in the near future.
Okzipok and Anderson highlight that the study involved abruptly stopping the drug. Conversely, many patients may be interested in weaning off medications gradually, reducing dosage levels over time. So far, there is little data on this strategy and the protocols behind implementing it. It may also not be an option for patients who suddenly lose access to medications or insurance coverage. Experts say other strategies for quitting drugs may include increasing physical activity or calorie restriction in anticipation of quitting drugs.
In addition to more data on potential GLP-1 off-ramp, the pair seeks more data on the effects of weight fluctuations in people taking and discontinuing treatment. At least one study has found that weight regained after intentional weight loss may contain disproportionately more fat mass, which can be harmful.
For now, Okzipok and Anderson say doctors should remain cautious in talking to patients about these drugs and what they might do in the future. “These results add to the evidence that physicians and patients should start [anti-obesity medications] “As long-term treatments, just as they do as medications for other chronic diseases.”
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