medwireNews: People who lose weight while taking semaglutide 2.4 mg regain two-thirds of what they lost during the first year after stopping the medication, shows the STEP 1 extension study.
John Wilding (University of Liverpool, UK) and co-researchers say this is in line with studies of other weight loss medications, which also showed weight regain after withdrawal.
“Taken together, these findings and those of the present study confirm the chronicity of obesity and highlight the importance of maintaining long-term pharmacological treatment for weight management in people with obesity,” they write in Diabetes, Obesity and Metabolism.
Nevertheless, the 327 study participants in this analysis did retain some benefits of treatment.
During 68 weeks of treatment in the STEP 1 trial, people taking semaglutide had lost an average of 17.3% of their bodyweight, whereas those taking placebo lost just 2.0%. During the 52-week extension phase, after stopping randomized treatments, the average weight regain was 11.6 and 1.9 percentage points in the semaglutide and placebo groups, respectively.
However, at week 120, bodyweight was still at least 5% below baseline weight in 48.2% of the semaglutide group, compared with 22.6% of the placebo group.
The researchers found that people who lost the most weight while taking semaglutide tended to then regain the most after stopping it, although they still retained a larger reduction from baseline than participants who had lost less weight during the treatment period.
Wilding and co-authors describe the weight regain after semaglutide withdrawal as “relatively rapid” relative to that after withdrawal of other weight-loss medications, and also after withdrawal of semaglutide 2.4 mg following 20 weeks of treatment in STEP 4.
“This may well relate to participants who received semaglutide in STEP 1 having achieved greater weight loss prior to withdrawal than in other trials, and thus having greater potential for regain, driven by physiological and behavioural factors,” they suggest.
As well as retaining a degree of weight loss, the trial participants also retained some of the improvement in cardiovascular risk factors observed during the treatment period.
Systolic and diastolic blood pressure both returned to baseline values by 52 weeks after treatment withdrawal. But levels of C-reactive protein, high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and triglycerides were still significantly improved in the semaglutide group relative to placebo group.
“Overall, although a net beneficial effect on several cardiometabolic parameters was maintained 1 year after semaglutide withdrawal, greater benefits were seen during the treatment period, supporting the need for continued treatment,” conclude the researchers.
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