Sometimes a little goes a long way. That just might be true when it comes to taking GLP-1 treatments like semaglutide (Ozempic and Wegovy) for weight loss, recent research finds.
Doctors at Scripps Health studied the outcomes of people who switched to a reduced dosing schedule of their GLP-1 therapy. They found that people generally maintained their weight loss and other improved health markers, even if they dosed as little as once every two months. Though still preliminary, the results suggest it could be easier and more affordable to stay on GLP-1s long-term than is currently assumed.
“These findings support structured de-escalation as a promising strategy to reduce treatment burden without sacrificing efficacy,” the authors wrote in their paper, published last week in the journal Obesity.
An effective tapering
GLP-1s have changed obesity treatment for the better, allowing people to reliably lose much more weight than they would with diet and exercise alone. But these medications, like any, have their drawbacks, such as a high rate of gastrointestinal side effects. They’re also far from cheap, though the average price of GLP-1 therapy has dropped over time.
Unfortunately, due to the chronic nature of obesity, people who stop taking GLP-1s tend to regain much of their lost weight back. So it’s likely for the best that most people stay on these drugs for a long time, possibly their whole lives. And that makes the costs of this treatment all the more impactful. Someone might be okay with having added stomach issues and hefty prescription bills for a year, for instance, but understandably balk at doing so for decades.
The Scripps researchers wanted to explore whether reduced dosing could provide the same benefits in people who had seemingly reached their maximum weight loss. They tracked what happened to patients who were offered the chance to taper their medication after getting to a weight plateau.
In total, they studied 30 people who stayed on a reduced dose, 21 of whom were on tirzepatide (Mounjaro and Zepbound) and nine on semaglutide. Twenty-three people switched to dosing around every two weeks (at least 10 days), while 7 switched to longer-spaced doses, including one who opted to wait every five to six doses. The average length of follow-up was 36 weeks.
Practically everyone stayed around the same BMI post-tapering, the researchers found. Only five had a slight regain, with the largest increase amounting to eight pounds. Many actually saw a slight drop in BMI, including the person who dosed every six weeks. Most patients also experienced a maintenance of their improved blood pressure, cholesterol, and blood sugar control.
Should people wean off their GLP-1s?
These findings, as the researchers admit, are based on a very small sample size. So it will absolutely take larger studies to know whether reduced dosing can be a viable approach for the average GLP-1 user. Ideally, such studies would randomize and compare people who taper off their meds to those who stay on the same dose or other kinds of control groups.
It’s also likely this strategy won’t work for at least some people. In this very study, for instance, four patients who started to taper off soon switched back to their original schedule after they began to regain weight.
If tapering continues to show promise, though, it could help people cut down their GLP-1-related costs and side effects while also making the prospect of lifelong treatment less daunting, the researchers say.
“Larger randomized controlled trials are needed to confirm these findings and may help address concerns about indefinite therapy, lower health care costs, ease supply constraints, and broaden access to GLP1 medications to improve public health,” they wrote.
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