Weight Back After Stopping?

M

MounjaroMission

Well-known member
Has anyone seen this SURMOUNT-4 study? Basically, folks who were obese used tirzepatide and changed their lifestyles (cut 500 calories daily and exercised 150+ minutes weekly) for 36 weeks. Then, researchers divided them into two groups: one kept taking tirzepatide, the other got a placebo. Cruel, right? They continued for 52 weeks.

Even with lifestyle changes, 82.5% in the placebo group gained back at least 25% of the weight they lost within a year. Their health improvements like waist size, blood pressure, blood sugar, and cholesterol also went back to where they were before, based on how much weight they gained.

Worth checking out, especially the charts. The weight difference at 36 weeks is pretty wild.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2841273
 
Doesn't surprise me at all. Stop taking your statins, even if you're still eating well and exercising, and your cholesterol will climb again.

I bet those people on the placebo felt like they were losing it with the return of food noise!
 
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I can't imagine having no appetite for 36 weeks then getting a placebo. No way everyone kept up the lifestyle changes.
 
Totally! I'm sure the food noise came back with a vengeance. Wonder how that impacts trial results.
 
That's what I figured would happen, to be honest.

If the lifestyle changes could get us to a BMI of 25 (or whatever), no one would need the medication. The main change was cutting calories. That falls apart when you remove the drug that makes cutting calories easier.
 
I call BS on the "lifestyle interventions" part. Can someone explain how you gain weight on a 500-calorie deficit and 150+ minutes of cardio a week?
 
People lie or fail, but some genuinely gain weight on what they think is a 500-calorie deficit. The issue with calorie deficits is you only know after the fact. If you lose weight, it was a deficit. If not, it wasn't. 'Calories out' changes constantly.
 
I've tried every diet and always gain the weight back. So, no surprise here. I'm 75 weeks in and doing great. I'm staying on this stuff forever, thanks.
 
Thanks for sharing! Just to clarify, this article isn't about the actual SURMONT-4 trial, which was out last year. This is a new look at the Surmont-4 data, analyzing how heart health changed based on weight regain after stopping tirzepatide.

To me, this chart from Surmont-4 always pointed to weight coming back after stopping tirzepatide. No shock there.

For me, the big thing from this new study is that heart benefits stuck around for some people even after stopping. So, the weight gain wasn't the same for everyone. About 20% didn't gain back more than 25% of the weight.
 
That chart is great, shows what happens when you stop. Solid argument for staying on GLP-1s for maintenance. Even if you stop, there are still weight and long-term risk benefits. Before these meds, research talked about the good things from losing 5-10% of your weight, and those were still big benefits.
 
Important to note: people with diabetes were not part of this analysis. Seems harsh to put people through treatment and weight loss, then make them switch to a placebo. Drug companies are sending a clear message that obese people without diabetes need to stay on the meds or risk regaining weight and losing heart benefits. Sadly, I doubt insurance companies will pay for these meds forever if someone is no longer considered obese.
 
Yeah, it feels wrong to take people off meds, especially later in trials when we know the meds are safe and work. But we learn a lot from these trials, and people know about the placebo groups before joining. Still gotta suck. Imagine being on trizepatide for 9 months and then being taken off and expected to stay in the study for another year…
 
There are other options besides GLP-1s forever, like Contrave after stopping GLP-1s. One university found that non-diabetics kept the weight off by switching to metformin after stopping GLP-1s.

It's not in the drug companies' interest to help people find alternative drugs to stop GLP-1s, but universities are studying alternatives that work.

For those who can't afford or don't want GLP-1s forever, look at the non-pharma studies.
 
I'm guessing this is for people who finish a study, not those pulled out early.

Their choices to this free placebo study might be paying $$$$$/month, a huge monthly co-pay, or complete denial of insurance coverage and stopping.

Clinical trials don't offer anything post-graduation, do they...???
 
From a research view, I get the placebo arms. But, to me, that's for those getting the placebo from the start. Not putting people on a life-changing drug and then taking it away. But, everyone eventually gets taken off the meds. No free ride forever.

Is it better to have loved and lost than never to have loved at all? Now that I love tirzepatide, I don't want to lose it, so I want to keep on lovin' 😆
 
I think you're right. We've heard from people in clinical trials who said nothing was offered when the trials ended. People would do better with a plan if their insurance stopped paying for their GLP or if they couldn't tolerate it anymore.

If not a different med, then at least counseling or therapy.
 
I'm curious for those of you who have been on this longer term... How long are you in maintenance and what does that look like? I'm still losing, but trying to prepare myself!
 
That's a good question Bear_Fam. It seems like people have different experiences when trying to maintain. I've seen some people say they have to keep increasing the dose to get the same effect, while others do well on a very low dose.
 
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