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GLP-1 therapies are considered a medical breakthrough for those who are severely overweight. Not only do they reduce weight, but they also improve blood sugar, blood pressure and blood lipids. However, a new meta-analysis now shows that after discontinuation, there is often renewed and rapid weight gain and a deterioration in cardiovascular risk factors.
What does this mean in concrete terms – for those affected, specialists and health policy?
What happens when you stop GLP-1 medication?
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Many people are gaining weight again. A new meta-analysis in British Medical Journalwhich summarizes data from 37 existing studies with over 9,300 participants, shows: On average, weight increases by around 0.4 kilograms per month. This means that at this rate, in many cases the previous weight would be regained after about a year and a half. At the same time, the values of blood pressure, blood sugar and blood lipids worsen again – exactly the factors that had previously improved during the therapy.
Why does weight gain occur after weaning?
GLP-1 therapies have a strong impact on appetite regulation and metabolism. They reduce hunger and portion sizes and at the same time lower the basal metabolic rate.
If the therapy is stopped, the appetite-suppressing effect disappears while energy consumption remains low. The body therefore stores excess calories particularly efficiently. The new weight gain can be explained biologically – and is not a sign of a lack of discipline.
Why does this effect often occur faster than after classic diets?
Weight loss is usually rapid and significant with GLP-1 therapies. This is exactly what distinguishes them from classic weight loss programs, in which the weight falls more slowly. The body has more time to adapt metabolically. After discontinuing drug therapy, the adjustment phase is often missing – which is why weight and risk factors can increase more quickly.
Why do people still stop treatment?
According to clinical experience, side effects are rarely the main reason. Therapy is often stopped if it has too little effect – or because it is no longer being paid for. In Switzerland, reimbursement of costs for GLP-1 therapies is usually limited to three years.
If you want to continue treatment afterwards, you usually have to finance the medication yourself. For self-payers, the monthly prices, depending on the preparation, are significantly higher than normal therapy – we are talking about a price between 300 and 500 francs per month. This depends on the dosage, the specific medication and the pharmacy.
What does this mean for dealing with obesity overall?
The analysis emphasizes that obesity is not a short-term phenomenon, but a chronic disease – comparable to osteoarthritis or osteoporosis. International specialist societies and the WHO are increasingly emphasizing the need for long-term treatment strategies. At the same time, the question arises as to how medical benefits, long-term effects and costs can be fairly weighed against each other.
Experts advise not to view GLP-1 therapy in isolation. What is crucial is accompanying nutritional advice, exercise and medical follow-up – even after the possible end of therapy. Anyone who begins treatment should clarify early on how long it is planned for and what options there are afterwards.
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