Despite the effectiveness of the newer generation of anti-obesity drugs – called GLP-1 receptor agonists – few can tolerate them in the long term. A latest studypublished within the journal Obesity, reveals that of individuals prescribed weight-loss drugs, just 44% were still taking them after three months and only 19% after one yr.
Greater adherence to those drugs, reminiscent of Wegovy, which make you are feeling fuller faster and longer, is related to greater weight reduction. So why do people not stick with it?
Actually, it’s not that unusual. Not persisting with medication is a well-known phenomenon with other conditions, reminiscent of type 2 diabetes, chronic obstructive pulmonary disease and hypertension. Studies have shown that by the top of 1 yr, almost half of the people on blood pressure pills stop taking them.
The willingness to maintain taking medication could be influenced by the symptoms (or lack of) of the condition being treated; by points of the healthcare system (reminiscent of the flexibility to be seen by a physician or the cost of medication); in addition to by characteristics of the treatment itself (reminiscent of how incessantly it must be taken, or how tolerable the side-effects are).
Indeed, the frequency of GLP-1 dosing has been shown to be necessary for individuals with diabetes. Those who take GLP-1 drugs once per week usually tend to stick to it than those that have a every day injection.
The potential side-effects of GLP-1 medication have attracted attention. In clinical trials, the proportion withdrawing from GLP-1 treatment ranges from 15% to 25%. About half of people that stopped taking the drug did so in consequence of side-effects – mostly gastrointestinal problems.
Yet, on the entire, side-effects of GLP-1 drugs are likely to be mild or moderate. Some people experience bouts of nausea in the primary 4 weeks of using the drug, but this could grow to be worse if the dose is escalated. Diarrhoea, constipation, fatigue and sulphurous burping can also occur.
However, it’s value noting persistence with GLP-1 drugs appears much greater than with other weight reduction drugs.
Clinical trials have shown that maximal weight reduction with GLP-1 drugs just isn’t achieved until about one yr and it might be that some people want to see a more rapid response. However, about 6% weight reduction could be achieved inside 12 weekswhich can be an incentive to stick with treatment.
There is a well reported global shortage of GLP-1 drugs. This has occurred partly because of the very success of those drugs, and the shortage of availability may lead to patients being unable to stick with the drug.
What happens when people stop taking the drug?
While there may be some debate as to how sustainable GLP-1 drugs are for weight reduction, a more pertinent query is what happens when people stop this treatment.
These drugs could also be heralded as game changers relating to getting people to shed extra pounds, but several trials have shown clear weight regain when treatment is withdrawn. For example, participants who withdrew once-a-week treatment with Wegovy within the international Step-1 trialregained greater than half the load lost over the course of a yr.
A more recent study showed that those that stopped treatment with Mounjaro (one other GLP-1 drug) similarly regained around 60% of their lost weight.
The take home from these studies, and others like them, is that weight reduction could be maintained, provided you don’t stop the medication.
We have long known that, whatever the technique of dropping pounds, once the intervention is stopped, it is not uncommon for people to put weight back on.
Several biological and energetic changes occur in consequence of weight reduction which will make you healthier, but equally drive you to revive your lost weight – as discussed in a previous Conversation piece.
Yet the way in which these latest weight-loss drugs work may mean the likelihood of putting lost weight back on is even higher. The artificial GLP-1 you inject just isn’t the identical as your individual homegrown GLP-1, also often known as “endogenous GLP-1”.
Ordinarily, you release GLP-1 after a meal, however it doesn’t last long since it is rapidly broken down.
In contrast, injecting artificial GLP-1 gives you a much higher dose, that also lasts quite a bit longer. Equivalent to [ten times] normal lively GLP-1. Such levels are only ever seen naturally right after eating an enormous blowout meal, but with these drugs are present within the blood on a regular basis.
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Despite this being comparable to you overdosing on GLP-1, chances are you’ll grow to be no less sensitive to its effects, as seen in animal studiesat the least. All excellent news as it will not only make you are feeling full but sustain this fullness despite your body’s attempts to make you hungrier.
However, sustaining such high levels of “fake” GLP-1 could cause you to supply less of your individual endogenous GLP-1.
Cold turkey
All this is not any issue, presuming you proceed keeping GLP-1 levels artificially high. But like several addict will let you know, bad things can occur if you go “cold turkey”.
In this case, if you stop taking these drugs, lively GLP-1 levels will go off a cliff. No longer shackledhunger and appetite might return with a vengeance.
Combine this with all the opposite aspects conspiring to place the lost weight back on, and you may find yourself potentially becoming even fatter than they were to start with.
The realisation is that these “gamechanger” drugs at the moment are making weight reduction even easier, but as all the time our focus needs to be on the most important challenge of weight maintenance.