Do You Have To Stay on Weight-Loss Drugs Forever? Maybe Not

It seems like the nation’s biggest trend is taking the new breed of weight-loss drugs to curb your appetite and drop lots of weight. The second-biggest trend might be going off the meds and putting most of the pounds back on.

There’s a whole lot going on in this arena, including who stops, why, how much weight returns — and how you can still benefit. Rig the system in your favor so you can eventually cease the prescriptions and remain thinner.

Weight-Loss Meds On-Off Ramp

We’ve all met people who went from plump to trim on the relatively new GLP-1 medications, exuberant about how their so-called food noise vanished and they suddenly had no interest in overeating.

Before beginning one of these regimes yourself, see if you’re a good candidate. You’re most likely to succeed if you need to lose a moderate amount of weight, not a huge amount. That would mean having a body mass index (BMI) of 35 or so, or a BMI of about 30 plus comorbidities such as diabetes, hypertension or sleep apnea.

The GLP-1s alone won’t be enough if your BMI is 50, although they’ll move you toward a healthy weight. That’s even more true if your BMI is 80 or 90, as you’ll need to lose a higher percentage of bodyweight. Still, the meds might be a good bridge to get you down to a size safe enough for receiving the anesthesia necessary for a surgical solution.

GLP-1s Might Be a Short-term Solution

Don’t look for any magic way to take weight off and keep it off. That doesn’t exist.

Chances are you’ll stop taking those drugs within two years. According to studies, you have a 50-50 chance of ending your prescription within a year, even higher within two years. That can be for several reasons:

• You dislike side effects like gastrointestinal discomfort
• You met your weight goal so prefer not to take meds anymore
• Insurance stops covering your prescription and you can’t afford it out-of-pocket
• You don’t have diabetes; patients with blood sugar conditions are more likely to continue than those without

There are still huge benefits to trying a GLP-1 prescription, and you’re most likely to have long-term success if you start with the lowest dose possible. See if your body tolerates the new substance well. Once your doctor checks lab results to see that you don’t have signs of pancreatitis, a possible side effect, you can always increase the amount you take. It’s best to lose all the weight you can first, then up your prescription when you plateau.

A low dose might be enough for you long-term. The European Congress on Obesity now suggests doctors prescribe custom small doses to patients, then ease them off the meds once they’ve lost enough weight and adopted lifestyle changes involving exercise and healthier eating habits.

Your Best Bets for Quitting and Staying Thinner

You’ll probably gain weight back once you stop getting your injections, but you’re likely to wind up with 5 percent less bodyweight overall. To some degree you can control what happens.

• Go slow. Work with your doctor to taper off your medication instead of quitting cold turkey. That might mean taking your dose less often, or decreasing the amount of each dose. Some research shows this method might minimize the return of your overwhelming urge to eat when not hungry. New studies are looking at intermittent med-taking, such as going on and off the GLP-1s at regular intervals.
• Choose your drug wisely. It’s possible that taking, then quitting, tirzepatide will set you up for better success than other GLP-1s. In one study, patients kept nearly 10 percent of their weight off the first year after stopping.
• Cement in good habits. Establish an exercise routine beforehand. Switch to a healthy diet of low-fat non-processed foods, allowing for an occasional planned splurge. Change your mindset and, for example, have a couple of spoonfuls of ice cream, not a whole scoop. You’re more likely to maintain your new size if you’ve already adopted such changes as a way of life.
• See 5 percent as a win. If you lost 15 percent of your bodyweight and 10 percent returns, you’ll still be lighter. Likewise, your prediabetes, diabetes and/or blood pressure might remain somewhat better. Various studies indicate that even keeping a small percent of your bodyweight off can help with diabetes, blood pressure, hyperglycemia and cholesterol.

Enter the GLP-1 arena with your eyes open and your game plan spelled out.