Obesity Care After GLP-1 Discontinuation: Building a Maintenance Pathway Instead of a Cliff Edge
DOI:
https://doi.org/10.5281/zenodo.22261608Keywords:
GLP-1 receptor agonists, Discontinuation, Weight maintenance, Tapering, Service designAbstract
That weight is regained after incretin-based treatment stops is established. What services should do about it is not. Up to 65 per
cent of people starting these agents for obesity discontinue within a year, most often for reasons unrelated to whether the drug
worked, and roughly two thirds of the weight lost is regained within a year of stopping. Against that, no randomised trial has
evaluated any specific tapering, transition or maintenance regimen following withdrawal, so every proposed pathway is inference
from other settings. The available evidence is small and uncontrolled: in a digital clinic cohort, 353 people who wished to stop
after reaching target were tapered to zero over nine weeks with coaching, 240 completed the taper, and among 85 followed for a
further 26 weeks weight remained stable. Switching to older anti-obesity agents after a year of treatment has been reported to
maintain weight loss over two years. This review examines what a maintenance pathway could consist of and how thin its evidence
is.
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