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10% weight loss with anti-obesity drugs and lifestyle changes

Updated: Jun 15, 2022

A new study finds overweight and people with obesity maintained an average weight loss of 10.6% over three to five years with a programme of lifestyle changes in combination with anti-obesity medications. Weight loss of more than 10% provides significant health benefits, according to researchers who are presenting their findings, ‘Long-term Weight Loss Maintenance with Obesity Pharmacotherapy: a 5-Year Retrospective Study’, at ENDO 2022, the Endocrine Society's annual meeting in Atlanta, GA.

"Data on the effectiveness of anti-obesity medications for long-term weight loss maintenance in the real world has been limited to 1 to 2 years," said lead researcher, Dr Michael A Weintraub, Weill Cornell Medicine in New York, NY. "Our study is unique because we analysed weight loss maintenance over three to five years in more than 400 adults with overweight and obesity who were taking weight-loss medications."

The study reviewed data from 428 patients at an academic weight management centre. All patients received counselling focused on a low-glycaemic diet and exercise by the obesity medicine specialist during their office visits. Patients were also offered additional counselling with a registered dietitian. Medical therapy included FDA-approved and off-label weight-loss medications. The most common medications observed at the final visit alone or in combination were metformin (76.2% of patients), phentermine (31.1%), topiramate (30.8%), bupropion (29.9%), and semaglutide (24.5%).

The mean age was 50.9 years, 73% were female, and median initial BMI was 34.3 kg/m2. Weight categories were as follows: 19% overweight, 35% class 1, 25% class 2, and 20% class 3 obesity. In addition, 16% had diabetes and 36% had prediabetes.

The patients were followed for a median of 4.7 years. They lost and maintained an average weight loss of 10.6%, which was maintained with medical therapy and lifestyle interventions over 3 to 5 years.

"A 10% weight loss is clinically significant because it is associated with improvements in cardiovascular risk factors like diabetes, hypertension, high cholesterol and obstructive sleep apnoea as well as improvements in mobility and overall quality of life," he said., "Anti-obesity medications are an underutilised treatment option for obesity and can prevent obesity-related diseases including diabetes and cardiovascular disease. This research supports the utility of anti-obesity medications in achieving long-term weight loss maintenance."

The median nadir BMI was 25.6 with a median maximum weight loss of 14.7%. The median time to achieving nadir weight was 1.9 years. Average weight change from the initial to final visit was -10.6% (-10.9 kg), with a final visit median BMI of 27.4. The proportion of patients who achieved >5%, >10%, >15%, and >20% total weight loss was 70.8%, 48.1%, 30.1%, and 16.8%, respectively. During the 4.4 years the patients were followed, weight regain following the nadir weight was 6.3%. At the last observation, 40.2% of all patients had maintained their maximum weight loss.


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