Can You Reduce GLP-1 Doses and Keep Weight Off?
Scripps study examines lower dosing for lasting result
Scripps study examines lower dosing for lasting result
While glucagon-like peptide-1 (GLP-1) receptor agonists have been used to treat Type 2 diabetes for more than 20 years, their recent emergence as weight-loss wonder drugs marked a new frontier in medicine. But their effectiveness has left some patients wondering what to do once they’ve reached their goal.
Stopping the medication could mean regaining some, if not all, of the weight — and the almost immediate return of “food noise.” But staying on these pricey drugs indefinitely can prove prohibitive.
Can fewer GLP-1 injections maintain weight loss?
Mitch Biermann, MD, PhD, an internal medicine physician at Scripps Clinic Carmel Valley, conducted a small study of whether GLP-1 patients who had reached their goal weight could maintain that weight by taking their regularly prescribed injection every other week instead of weekly.
“When people reach the point where they have normalized their weight and reversed their metabolic problems, they often ask, ‘What do I do now?’ In the beginning, nobody had an answer for patients expressing an interest in trying to get off the medicine,” says Dr. Biermann.
“Drug companies have done discontinuation trials where they stop the medicine and see what happens, and in those, most people regained most of their weight and reversed the metabolic improvements that they made.”
Scripps study shows promise for reducing dosing
After hearing anecdotes from patients who had experimented with their dosage, Dr. Biermann theorized that reducing injections to every other week would allow patients to keep most of the weight off.
In the trial, 30 of 34 patients were able to maintain their weight loss without further diet or lifestyle changes. Some even lost a few more pounds without losing muscle. Dr. Biermann’s results were published in the Journal of Obesity.
Oral GLP-1 medications: new option on horizon
Dr. Biermann is eager to see if the findings hold true as pharmaceutical giants introduce oral GLP-1 medications.
Though data suggests more modest weight loss, the once-daily pills could give people additional options to get their weight and metabolic issues under control — and maintain that lower weight.
Dr. Biermann stresses that while GLP-1 drugs are effective, diet and exercise — which affect how much of the GLP-1 hormone your body naturally produces — are essential to maintaining weight loss and staying healthy long-term.
“Exercise is the most important thing to prevent regaining weight. It’s paradoxical, because exercise doesn’t cause people to lose a lot of weight upfront, but it is our number one tool to prevent regaining it,” he says. “When you exercise, your GLP-1 levels rise, which usually causes people to eat less as well.”
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.