adverse effects of stopping GLP medications, as evidence suggests risks are associated with Weight cycling

[Good-Heart6425]

Opinion | I No Longer Think GLP-1s Are the Answer

The drugs 'work' but may be working against us long-term

www.medpagetoday.com

 

[Laxfinity]

Opinion | I No Longer Think GLP-1s Are the Answer

The drugs 'work' but may be working against us long-term

www.medpagetoday.com

I hate to say it... I agree. After being on sema, and stacking others, I had to stop for 8 weeks as I had scheduled surgeries.. one that got pushed back two weeks. I had stopped a few other times but for only a week or two due to surgeries and colonoscopies.

I was at my absolute lowest since I started this peptide journey. The noise came back full force. I was ravenous. I ate like I had not in 4 years. The holidays and having junk in the house has not helped. Thankfully I have only gained about 7 lbs but... I absolutely hate this. I "thought" I had my shit in check. I eat healthy, walk a lot, do some strength training.. but I don't deprive myself when I want something sweet.. I just eat a "normal" portion. Now? Once I start eating junk I just want more...

I have restarted what I was taking but low and slow. I do not want to get sick because I am eating like an asshole. I still think they are the answer but I am convinced I will be pinning something until the day I die...

 

[Mr.Tired]

Thanks for sharing. It's good to hear other perspectives, but I don't find this guy particularly persuasive.

He cites is own personal anecdotal evidence and a study from several years ago that had been superceded by more recent and comprehensive research. This isnt to say that people don't come off of glps and gain back all their weight. That obviously happens, and I am sure it is unbelievably frustrating for those folks. But he asserts that as the norm, and it doesn't look like that is factually correct.

 

[tubby]

Was that doctor truly unaware of the muscle loss concerns prior to January of 2025 (date of the article)? And he also failed to understand that pharma viewed these drugs as a subscription plan rather than a cure? I'm not big on hurling insults around, but perhaps if he's been this hopelessly naive in the past, he should recognize his shortcomings and let others with better critical thinking skills author the contrarian articles of this sort. LOL

The article raises valid concerns. If one were paying full retail price ($1000+ per month in prior years), I can see where it might feel like extortion to have to keep paying that to maintain a stalled out weight loss and avoid regain, but I suspect many here aren't too worried about the financial aspect. The muscle-loss concerns are rather controversial as well with different studies showing different results in regards to body composition results and that likely varying across different formulations.

I think those who view GLP1's as first-line weight loss methods (while failing to address underlying food addiction issues or investigate their own relationship with food) may be disappointed, but like any other tool, these drugs have strong use cases for many people.

 

[byefatlicia]

My big takeaway from this article is that name brand prices aren't realistic for the long term for the average person.
Grey is the way. I may never stop and I'm okay with that.

 

[cygnus]

Stopping an exercise also comes with the risk of losing the positive benefits associated with exercise. Stopping a nutrition plan (drug aided or not) comes with the risk of worsening outcomes. Cutting back on sleep hygiene comes with risks associated with worsened sleep...

The GLPs and whatever drugs come next are incredible tools in the toolbox; sensationalist articles always seem to want to create a strawman fallacy of them being all-or-nothing in order to knock them down.

Until something better than reta comes along, I'll be pinning once a week. If the GGG III ends up being an oral reta analog that comes close and is easy to use in maintenance, cool. If something like some crazy GLP/GIP/Glucacon/Myostation/Activin/IGF mega awesome med comes along with minimal side effects, then yeah, I'm checking that out.

 

[Grogu]

All types of issues with the article, but I guess for me, I always thought that long-term use of a glp-1 was going to be required. In my mind, glp-1 medications treat an underlying metabolic disease and none of the glp-1s are cure for that disease. For me, I think if I stopped taking the medication, I would fully expect my symptoms (ravenous hunger, weight, joint pain, etc.) to return with a raging vengance. And even this go around with weight loss I've done nutrition counseling, cognitive behavioral therapy, and adjusted my behaviors, I honestly don't think that's going to "cure" bad physiology.

 

[cygnus]

All types of issues with the article, but I guess for me, I always thought that long-term use of a glp-1 was going to be required. In my mind, glp-1 medications treat an underlying metabolic disease and none of the glp-1s are cure for that disease. For me, I think if I stopped taking the medication, I would fully expect my symptoms (ravenous hunger, weight, joint pain, etc.) to return with a raging vengance. And even this go around with weight loss I've done nutrition counseling, cognitive behavioral therapy, and adjusted my behaviors, I honestly don't think that's going to "cure" bad physiology.

Blood pressure meds, cholesterol meds, blood sugar control meds are also long-term use. Reta offers the potential ability for many to just consolidate that into a singular med.

 

[CNCCurrency]

I read recently that cholesterol meds, ie statins reduce glp1 efficacy.

 

[cygnus]

What I was referring to is the tri-agonist GLPs showed drastic improvements across triglycerides, blood pressure, blood sugar and A1C, in addition to the actual weight loss. Those types of meds tend to be "for life" until something drastic changes...reta offers that drastic change.

The contraindications as I understood had to do more on the other direction, where GLP-1 agonism slows digestion and thus oral meds aren't absorbed on schedule.

 

[cookieguggleman]

As much as I am benefiting from these drugs, I could never do it without overeaters anonymous. I have been in that program for 16 years, and it changed my life. Even before the drugs, food noise was hugely diminished, and I had been at a stable weight for 14 years. Never perfect and it required constant spiritual work, but it changed my life. I started taking GLP because of menopause and an auto immune disorder that made my metabolism come to a screeching halt. I think most people who try to stop who had chronic issues with food addiction will definitely have trouble keeping the weight off.

 

[tubby]

I read recently that cholesterol meds, ie statins reduce glp1 efficacy.

Statins were found to significantly decrease naturally occurring GLP-1 levels (in addition to previously having been found to increase diabetes risk and increase plaque calcification). Not sure how that would affect GLP-1RA efficacy, unless you're saying they'd make it harder for someone to maintain a weight loss after going off GLP1 drugs.

 

[Laidbackleo87]

I'm no expert but I do think it's good to hear out constructive criticism when it's presented, in a world of echo chambers that are designed to keep us happily filled with whatever information the algorithm can get and keep our attention with it's good to read something even if we may not agree with it. There's no doubt critical thinking has taken a hit due to said echo chambers.

 

[tiddiesandnunchuck]

The article is only true because users don't make the lifestyle change required, ie: work out and consume enough protein. These two are non-negotiables, whether you take GLP's or not.

 

[Grogu]

As much as I am benefiting from these drugs, I could never do it without overeaters anonymous. I have been in that program for 16 years, and it changed my life. Even before the drugs, food noise was hugely diminished, and I had been at a stable weight for 14 years. Never perfect and it required constant spiritual work, but it changed my life. I started taking GLP because of menopause and an auto immune disorder that made my metabolism come to a screeching halt. I think most people who try to stop who had chronic issues with food addiction will definitely have trouble keeping the weight off.

Same for me. The drugs are truly amazing, but by this past summer after I had lost about 70 pounds, I was thinking that this is great, but why is this time going to be any different than all the other times I've lost a ton of weight just to regain it. Just by chance, my new pcp referred me to a nutritionist. I was like, okay, I'll give it a try. While working with the nutritionist we realized I had some messed up eating behaviors and I realized that I needed a psychotherapist. I found a therapist and she's been amazing and that has truly been life altering. I'll have to look into OA as a path forward.

 

[lessthanhalf]

Thanks for sharing. It's good to hear other perspectives, but I don't find this guy particularly persuasive.

He cites is own personal anecdotal evidence and a study from several years ago that had been superceded by more recent and comprehensive research. This isnt to say that people don't come off of glps and gain back all their weight. That obviously happens, and I am sure it is unbelievably frustrating for those folks. But he asserts that as the norm, and it doesn't look like that is factually correct.

This is just in relation to the image under this statement, not the comment itself.
When people stop glp medications, as is the case for all other weight loss interventions except surgery ( and even then regain after a few years is common ) , people will tend to gradually regain the weight lost. A tiny percentage will keep weight off long term <5%. Most will eventually return to a weight close to their starting weight. This has been found in hundreds to thousands of papers over decades.

I have come across this very poor piece of research before and made a comment on it on this forum. This information is bad because it looks like real research when it is not and is misleading to most people who see it. It shows that people are equally likely to lose more weight than regain weight after stopping semaglutide. This is simply wrong and totally at odds with every other published paper about glp medications.

The results they present may well be genuine but are very obviously suffering from poor data analysis, maybe the ones who lost weight switched to tirzepatide for example. The fact that they present information that is opposite to established understanding of this issue without any comment on this or attempt to explain their findings is indicative of research that would not be publishable in any peer reviewed journal. I did not have a huge amount of success finding out more about epic research other than finding the article it came from.

I believe the evidence is quite strong that people who wish to maintain the weight loss achieved with glp medications will need to stay on them long term to maintain that weight loss. I have no problem with anyone trying different approaches, and it is a bit less applicable to people who are only mildly overweight or have only been overweight for a short period of time .

I really could not disagree more with the doctor who wrote the article this post is about, almost every comment on the article itself disagreed with it . Being unhappy with a therapy that stops working after you stop taking it is fairly silly, the vast majority of medical treatments work this way, and essentially all that relate to hormonal or metabolic issues apart from a few rare problems that can be cured by surgery. The main reason apart from nausea that people stop these medications is their cost and unreliable and inconsistent and changing insurance coverage, which are political/economic problems not a fault with the drug.

 

[CNCCurrency]

Statins were found to significantly decrease naturally occurring GLP-1 levels (in addition to previously having been found to increase diabetes risk and increase plaque calcification). Not sure how that would affect GLP-1RA efficacy, unless you're saying they'd make it harder for someone to maintain a weight loss after going off GLP1 drugs.

I misread it, thanks

 

[Laxfinity]

I will also say that, as an early post menopausal woman, had I not done bloodwork and got my hormones in check I couldn't even start losing weight. We added Oz after I had already dropped a few pounds and stalled for a bit. Thyroid issues came up about a year ago and once I got those in check (lowest dosage of T3 and T4) I broke another stall. Everything needs to be working together... GLPs are not just a quick fix to everything. Just MY experience over the last 4 years.

 

[m100568]

I have always approached GLP-1s as a treatment, and not a cure. I intend to stay on some version of them for life. That might explain my completely irrational desire to hoard multiple years' worth. I'm never going off. I'm never going back. I just can't.

 

[ThatNextGril]

I have always approached GLP-1s as a treatment, and not a cure. I intend to stay on some version of them for life. That might explain my completely irrational desire to hoard multiple years' worth. I'm never going off. I'm never going back. I just can't.

I've come to this same conclusion. When I think of how freeing it's been to have no food noise for the 2.5 years I've been on glp (was sema, now tirz) I can't imagine going back. It actually scares me to think of having to live that life again. It's not the "eat better, exercise, sleep quality" part of it - I got that nailed - it's the actual, physical manifestation of food noise, that constant thought of eating all day long, that was like torture now that I look back. I almost cry for reals when I think of not having a glp to keep that at bay. I've got about 3 years of tirz stocked up, along with some reta if I go that route, but I seriously want to keep adding to the tirz pile as I'm so worried that years down the road I won't have access.