Success of Weight-Loss Drugs May Depend on Exercise

Introduction: The Issue of Weight Regain

A long-term study has revealed that exercise may be key to preventing weight regain after stopping weight-loss drugs. Despite the effectiveness of drugs like Ozempic, many users quit within a year due to cost, side effects, or other reasons, leading to weight regain that is predominantly fat, not muscle.

Effectiveness and Real-World Challenges

The new weight-loss drugs that suppress appetite and reduce food cravings can be quite effective, helping many people lose at least 10 to 20% of their body weight. However, in the real world, studies show that as many as half of users quit these drugs within a year due to their expense, side effects, or other reasons.

Post-Drug Weight Regain

After quitting the drugs, the pounds almost invariably creep back, and worryingly, the weight people regain tends to be almost exclusively fat, with little muscle. This often leaves them metabolically less healthy than before they began the drugs.

Study Overview

An important new long-term study suggests a simple, accessible way to stave off unhealthy weight regain after stopping the drugs: exercise.

Combining Exercise with Weight-Loss Drugs

In the study, people who exercised while using a weight-loss drug kept off far more of their weight after quitting the medication than those who didn’t work out, and they maintained more muscle.

Study Details and Findings

Initial Phase: Rapid Weight Loss

The study began with 195 Danish adults with obesity, who were put on an extremely low-calorie diet to rapidly lose about 30 pounds. For the maintenance phase, some volunteers were assigned to start taking Saxenda (liraglutide), an early GLP-1 medication, to see if it would help them maintain and augment their dieting weight loss.

Introducing Exercise

A separate group started the same drug but also engaged in a supervised exercise program, including twice-weekly, half-hour group spinning classes and 15 minutes of high-intensity, full-body resistance training, along with two at-home jogs or similar workouts.

Control Group

A control group didn’t exercise and received a placebo instead of liraglutide. After a year, almost everyone who took the drug maintained or lost more weight, but those combining the drug and exercise lost the most weight, primarily fat instead of muscle.

Stopping the Medication

The researchers then stopped the medications and exercise sessions for everyone, leaving them to maintain or regain their weight loss on their own.

Long-Term Results

After a year, those who had taken the drug without exercise regained about 70% or more of their lost weight, mostly as fat. However, those who exercised while taking the drug maintained more of their weight loss and healthier body composition, with some weight regain being muscle.

Key Takeaways

Continued Exercise Benefits

The study found that participants who continued to exercise on their own, even without supervision, added fewer pounds after stopping the drug. Exercisers generally worked out several hours a week voluntarily, suggesting that about two hours a week of vigorous exercise, mixing aerobic and resistance exercise, may be a good goal for staving off weight regain after ceasing a weight-loss drug.

Sedentary Post-Drug Phase

Those who didn’t exercise while on the drug were almost completely sedentary afterward, averaging fewer than 30 minutes of exercise a week. More of these participants complained of fatigue during treatment and afterward, contributing to their inactivity.

Conclusion: The Importance of Exercise

Overall, the results strongly suggest the importance of adding exercise to a regimen that includes a GLP-1 medication. “The results are very encouraging,” said Robert Kushner, an endocrinologist and professor at Northwestern University Feinberg School of Medicine. Further studies are needed to determine if a less intense exercise routine has similar effects on weight maintenance when people stop a GLP-1 drug.