Hello, I’m Dr. William Berger, owner and founder of Northeast Medical Practice. We are a primary care, weight management, and aesthetic medicine practice located on Long Island in New York.
Good afternoon, and I’m Irina Berger, co-founder of Northeast Medical Practice and also the administrative director. Dr. Berger, today I’d like to talk about weight management medication. A lot of times patients ask, “As soon as I start this medication, does it mean I’m going to stay on it forever, or if I change my lifestyle, will I be able to come off the medication?”
Yes, that’s a common and important question. Obesity is considered a chronic disease. Since 2013, the American Medical Association has recognized it as such. Whether we use lifestyle changes alone or in combination with medication, it’s important to view this as a long-term endeavor. Like with blood pressure, even if medication gets someone’s condition under control, lifestyle changes are required to maintain that success and potentially reduce the need for medication.
There are some new studies that are encouraging in this area. Specifically, when it comes to weight loss medications like Semaglutide (Ozempic for diabetes and Wegovy for weight loss) and Tirzepatide (Mounjaro for diabetes and Zepbound for weight loss), research is starting to show how patients might be able to reduce their reliance on these medications.
One study involving Semaglutide showed that tapering the medication, rather than stopping it abruptly, can have benefits. Patients were tapered off over nine weeks after about 64 weeks on the maximum dose, and when they were checked 26 weeks later, about half of the patients continued to lose weight, while the other half regained some weight.
It’s important to note that all of the patients in the study were also involved in an intensive lifestyle modification program, which included nutrition counseling, exercise, and mental health support. This could explain why the weight regain was minimal for many patients.
Another study, the SURMOUNT 4 trial with Zepbound, had a group of patients lose 20% of their body weight over six months while on the medication. Half of the patients then switched to a placebo without knowing, and they only maintained about 10% weight loss, while those who continued the medication lost 25%.
Although these studies show promise, they reinforce that weight loss is a long-term process. Patients need to adopt lasting lifestyle changes, especially if they want to taper off or reduce the dose of their medications after reaching their goal weight.
Patients often say that when they stop weight loss medication, their appetite returns. That’s usually true due to changes in hormones. Leptin, which controls appetite, can become less effective after weight gain, and ghrelin, the hunger hormone, increases with weight loss, creating a strong urge to eat. This makes it challenging for many patients to maintain their weight loss without ongoing support.
Dr Berger: I hope you found this informative. Please reach out to us at Northeast Medical Practice, 516-604-3418, or visit our website at northeastmedicalpractice.com. We look forward to seeing you in the office. Bear in mind, all the things we share in our videos and blog posts are for educational purposes only. We have not yet established a doctor-patient relationship, but we look forward to hearing from you soon. Thank you.
