Weight Regain Common After Stopping Weight Management Medications: Meta-Analysis Finds

The systematic review and meta-analysis study was published in the BMJ in January 2026.

Obesity is a chronic, relapsing condition increasingly managed with potent new medications; however, real-world data suggest that nearly half of all patients discontinue these treatments within the first year. The analysis was conducted to quantify the specific rate of weight regain after ceasing WMM and to compare these trajectories against traditional behavioral weight management program (BWMP) outcomes.

The systematic review included 37 studies encompassing 63 intervention arms and a total of 9,341 adults with overweight or obesity. The medications studied ranged from older agents such as orlistat to newer incretin-based therapies, including glucagon-like peptide-1 receptor agonists and dual GLP-1/glucose-dependent insulinotropic polypeptide agonists.

The study included randomized controlled trials (RCTs) and observational cohorts with at least eight weeks of treatment and four weeks of follow-up, based on a comprehensive database search through February 2025. Researchers used mixed-effect and time-to-event models to quantify the rate of weight regain and the reversal of benefits in secondary endpoints, such as glycated hemoglobin (HbA1c), blood pressure, and lipid profiles.

Key Clinical Findings

• Following the cessation of any WMM, patients regain weight at an average monthly rate of 0.4 kg, leading to a projected return to their baseline weight within 1.7 years.
• The rebound notably got more aggressive with newer incretin mimetics, where weight increases by 0.8 kg monthly, resulting in a return to baseline in just 1.5 years.
• Weight regain becomes significantly faster after medication withdrawal compared to lifestyle-only programs, occurring at a rate 0.3 kg per month quicker than BWMP cessation, independent of the initial weight lost.
• Cardiometabolic benefits are transient; initial improvements in HbA1c (0.9 mmol/mol reduction) and systolic blood pressure (5.8 mm Hg reduction) are projected to vanish within 1.4 years post-treatment.

The findings conclude that discontinuing weight management medications leads to an average monthly weight regain, a projected return to baseline weight, and the reversal of cardiometabolic benefits. It also advises caution against short-term pharmacological treatment, emphasizing the need for cost-effective long-term weight maintenance research and the prioritization of primary prevention.

Clinically, the results reinforce the concept of obesity as a chronic condition requiring ongoing management. Sustained treatment adherence and integrated care pathways may be necessary to prevent the rapid loss of benefits observed after pharmacological withdrawal.

Reference

West S, Scragg J, Aveyard P, Oke JL, Willis L, Haffner SJP, Knight H, Wang D, Morrow S, Heath L, Jebb SA, Koutoukidis DA. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ. 2026;392:e085304