Studie zeigt, dass 82 % eine Gewichtszunahme und eine Verbesserung der Herz-Kreislauf-Gesundheit nach dem Absetzen der GLP-1-Medikamente erlebten | Änderung des kardiometabolischen Parameters durch Gewichtszunahme nach Tirzepatid-Entzug bei Erwachsenen mit Fettleibigkeit

Highlights from the article:

>An analysis published this week in JAMA Internal Medicine found that most participants in a clinical trial who were assigned to stop taking tirzepatide (Zepbound from Eli Lilly) not only regained significant amounts of the weight they had lost on the drug, but they also saw their cardiovascular and metabolic improvements slip away. Their blood pressure went back up, as did their cholesterol, hemoglobin A1c (used to assess glucose control levels), and fasting insulin.
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>In an accompanying editorial, two medical experts at the University of Pittsburgh, Elizabeth Oczypok and Timothy Anderson, suggest that this new class of drugs should be rebranded from “weight loss” drugs to “weight management” drugs, which people may need to take indefinitely.
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>Some studies have found that about half of people who start taking a GLP-1 drug for weight loss stop taking it within a year—for various reasons—and many people think they can stop taking anti-obesity drugs once they’ve reached a desired weight, Oczypok and Anderson write. But that’s not in line with the data.
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>“It may be helpful to compare them to other chronic disease medications; patients do not stop their anti-hypertensive medications when their blood pressure is at goal,” they write.
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>…
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>But, overall, the study offers a gloomy outlook for patients hoping to avoid needing to take anti-obesity drugs for the foreseeable future.
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>Oczypok and Anderson highlight that the study involved an abrupt withdrawal from the drug. In contrast, many patients may be interested in slowly weaning off the drugs, stepping down dosage levels over time. So far, data on this strategy and the protocols to pull it off have little data behind them. It also might not be an option for patients who abruptly lose access or insurance coverage of the drugs. Other strategies for weaning off the drugs could involve ramping up physical activity or calorie restriction in anticipation of dropping the drugs, the experts note.
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>In addition to more data on potential GLP-1 off-ramps, the pair calls for more data on the effects of weight fluctuations from people going on and off the treatment. At least one study has found that the regained weight after intentional weight loss may end up being proportionally higher in fat mass, which could be harmful.

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Journal link:

[Cardiometabolic Parameter Change by Weight Regain on Tirzepatide Withdrawal in Adults With Obesity | A Post Hoc Analysis of the SURMOUNT-4 Trial](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2841273)

Abstract:

>**Importance** In the SURMOUNT-4 trial, most adults with obesity who had tirzepatide withdrawn following a 36-week treatment regained weight. The association between the degree of weight regain and cardiometabolic parameters after tirzepatide withdrawal is unknown.
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>**Objective** To assess changes in cardiometabolic parameters by degree of weight regain after withdrawal of tirzepatide.
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>**Design, Setting, and Participants** This post hoc analysis of the SURMOUNT-4 trial included tirzepatide-treated participants with 10% or greater weight reduction at week 36 initially randomized to placebo. Data were collected from March 2021 to May 2023, and data were analyzed from February 2024 to March 2025.
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>**Interventions** After 36 weeks of tirzepatide treatment (maximum tolerated dose of 10 mg or 15 mg), participants were randomized 1:1 to continue tirzepatide or to switch to placebo for 52 weeks (week 36 to 88).
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>**Main Outcomes and Measures** Changes from week 36 to week 88 in cardiometabolic parameters on tirzepatide withdrawal were assessed by the degree of weight regain at week 88 as a percentage of weight lost while receiving tirzepatide from week 0 to 36: less than 25%, 25% to less than 50%, 50% to less than 75%, and 75% or more.
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>**Results** Of 308 included participants, 219 (71.1%) were female, 89 (28.9%) were male, and the mean (SD) age was 47.1 (12.2) years. There were 54 participants in the less than 25% weight regain group, 77 in the 25% to less than 50% group, 103 in the 50% to less than 75% group, and 74 in the 75% or more group. Baseline demographic and clinical characteristics were similar across categories. During the initial 36 weeks of tirzepatide treatment, participants’ weight decreased and cardiometabolic parameters improved. After withdrawal of tirzepatide, from week 36 to week 88, the mean change in waist circumference increased by weight regain category (<25% weight regain, 0.8 cm; 95% CI, −1.0 to 2.6; 25% to <50%, 5.4 cm; 95% CI, 4.0-6.8; 50% to <75%, 10.1 cm; 95% CI, 8.9-11.3; ≥75%, 14.7 cm; 95% CI, 12.7-16.7; P < .001), as did systolic blood pressure (6.8 mm Hg [95% CI, 3.9-9.7], 7.3 mm Hg [95% CI, 4.8-9.8], 9.6 mm Hg [95% CI, 7.1-12.1], and 10.4 mm Hg [95% CI, 8.0-12.8], respectively; P = .002), non–high-density lipoprotein cholesterol (−0.4% [95% CI, −7.3 to 6.5], 1.6% [95% CI, −2.3 to 5.5], 8.4% [95% CI, 3.9-12.9], and 10.8% [95% CI, 5.3-16.3], respectively), hemoglobin A1c (0.14% [95% CI, 0.06-0.22], 0.15% [95% CI, 0.09-0.21], 0.27% [95% CI, 0.21-0.33], and 0.35% [95% CI, 0.29-0.41], respectively; P < .001), and fasting insulin (−4.0% [95% CI, −20.7 to 12.7], 15.4% [95% CI, 2.3-28.5], 46.2% [95% CI, 29.5-62.9], and 26.3% [95% CI, 9.6-43.0], respectively). Changes at week 88 in waist circumference, non–high-density lipoprotein cholesterol, and fasting insulin in those with less than 25% weight regain were not significantly different compared with week 36.
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>**Conclusions and Relevance** In this post hoc analysis of the SURMOUNT-4 trial, among participants with obesity who achieved weight reduction with 36-week tirzepatide treatment, withdrawing tirzepatide led to 25% or greater weight regain in most participants within 1 year and was associated with a greater reversal of their initial cardiometabolic parameter improvements compared with those who maintained weight reduction. These findings underscore the importance of continued obesity treatment.

I mean lets be frank none of these patients have made any meaningful life style changes. 

Its no different that a hypertensive patient, yea if they stop taking their medications with out any diet modification its no shock their BP will return to its elevated state. 

HTN,HLD,DM2, Obesity generally are a result of lifestyle issues and without lifestyle modifications combied with cessation of the managing medication will often put the pt back to square 1