AOMs associated with weight recurrence post-treatment

Patients prescribed drugs to help them lose weight may experience a recurrence in weight gain after stopping their anti-obesity medication (AOM) prescription, according to a meta-analysis by researchers from Peking University People’s Hospital, Beijing, China.

The study, which analysed data for patients receiving weight loss drugs across 11 randomised trials, suggests that while the amount of weight recurrence varies depending on the specific drug, there is a broad trend in associated weight recurrence after the course of medication concluded.

Drs Xiaoling Cai and Linong Ji, and colleagues, conducted a meta-analysis of 11 studies from around the world investigating weight change in patients after they stopped taking AOMs. Overall, the authors analysed data from 1,574 participants in treatment groups and 893 in control groups. Weight change was measured by changes in body weight and BMI after stopping medication.

Of the 11 studies included in the meta-analysis, six focused on GLP-1 receptor agonists (RAs); one focused on GLP-1 and GLP dual Ras; one study focused on orlistat; two studies on phentermine-topiramate; and one study on naltrexone-bupropion.

The authors controlled for different contributing factors, including medication type, the presence of diabetes, and the presence or absence of lifestyle changes like diet or exercise. Their analysis found that AOMs were associated with significant weight loss while being used, followed by weight recurrence starting eight weeks after AOM discontinuation, with weight recurrence then continuing for an average of 20 weeks before plateauing. Weight recurrence varied with follow-up, with study participants experiencing significant periods of weight recurrence at eight, 12 and 20 weeks after AOM discontinuation.

At eight weeks after drug discontinuation, AOMs were associated with significant weight recurrence compared with the control group (WMD = 1.50 kg, 95% CI 1.32–1.68, p<0.0001, I2 = 0.0%). The weight regain trend remained at 12 and 20 weeks (WMD = 1.76 kg, 95% CI 1.29–2.24, p<0.0001, I2 = 72.0%; WMD = 2.50 kg, 95% CI 2.27–2.73, P < 0.0001, I2 = 0.0%). Among the different subgroups of AOMs, significant weight recurrrence after 12 weeks of drug discontinuation was observed only in studies with GLP-1 RA related drugs. In addition, studies in which weight loss was greater during treatment than in the control group and studies in which lifestyle interventions were continued observed significant weight gain after drug discontinuation.

The amount of weight regained depended on several factors, including the type of medication taken by participants and the consistency of their lifestyle change. For example, participants who completed a 36-week treatment with tirzepatide, a commercially available GLP-1 RA, regained almost half the weight previously lost after switching to a placebo.

The authors note the meta-analysis did not include studies of lifestyle interventions and bariatric surgery, reducing the degree to which different weight loss approaches could be compared within the context of the study.

“Significant weight regain occurred eight weeks after discontinuation of AOMs and was sustained through 20 weeks. Different weight regain was observed in subjects with different characteristics,” the authors concluded. “Studies with longer follow-up duration are required to further investigate the potential factors associated with weight change after discontinuation of treatment.”

The findings were reported in the paper, ‘Trajectory of the body weight after drug discontinuation in the treatment of anti-obesity medications’, published in BMC Medicine. To access this paper, please click here