Unboxing weight-loss meds: Keeping pounds off long-term after stopping medication

As weight-loss medication rises in popularity, so to have come increased warnings of the potential to re-gain weight after the pills or injections stop.

Dr. Jennifer McCauley with UNC Health Weight Management tells WRAL it’s not uncommon to see patients in her office who have regained most, if not all, their weight back.

“It is not universal, but it is probably more common than not,” she said. “All of people find their appetite comes back even stronger than they recall it originally.”

McCauley explained treatment of obesity needs to be a chronic treatment plan. This includes making sure patients are aware quickly re-gaining weight is almost guaranteed to occur if they don’t incorporate other healthy lifestyle changes.

“One of the parallels we make is treatment for high cholesterol or hypertension, if you stop either of those medications your blood pressure goes up and your cholesterol goes up. It is very similar to that,” said McCauley.

She continued, “I don’t want people left feeling of ‘Oh, I failed.’ No, it’s you’re no longer on a medication that had this effect and what can we do to help?”

The doctor shared that sometimes patients stop taking a weight-loss medication out of personal choice, but other times it is due to high out-of-pocket costs once insurance stops footing the bill.

“It definitely means there are significant disparities in people who can continue these disparities or not. We will actually try some of the other weight-loss medications that we’ve used prior to these GLP-1s to see if we can help at least decrease weight re-gain,” said McCauley.

The doctor explained she regularly incorporates behavioral work into her treatment plans. She also stated adding an additional weight management program, such as a smart phone app, may also benefit patients.

“Some people really like the idea of doing the homework behind Noom or the point counting of Weight Watchers. All of that to me is again, is something we can use additional,” McCauley said.

WRAL News reached out to both Noom and Weight Watchers to inquire about changes to programs since GLP-1 medications rose in popularity.

Noom CEO Geoff Cook shared the platform has seen significant use of its programs specifically tailored toward weight-loss drug users.

“We built the Noom GLP-1 program with muscle defense. We launched that in December and have continued to put multiple teams on it to refine it and improve it,” share Cook.

Cook stated one of the largest changes to the program compared to the flagship plaform was the addition of foods as green in the color-system along with greater emphasis on protein and less on calorie consumption.

Noom assigns foods colors based on their nutritional value. Users are recommended to eat a certain percentage of foods from the different color groups to achieve goals.

When WRAL asked Cook how users benefitted from the program while taking an appetite suppressant, he coined the platform’s previous slogan: It’s not a diet, it’s a mindset.

“The GLP-1 works in part by affecting the brain by reducing the food chatter that expresses there, thereby causing you to consume lesser calories. Noom works in a similar way on the brain essentially to change the relationship to food and teach the healthier habits that lead to sustained, long-term weight-loss,” Cook said.

He continued, “Folks on a GLP-1 will eventually plateau and many will eventually wish to taper off or simply stop using it all together. We continue to bring the mindset, cognitive behavioral therapy aspects of Noom into the program throughout your journey on the companion, just as we do if you were not in the companion.”

Most labels of popular weight-loss drugs state they are intended to be use in conjunction with diet and exercise. Cook said this is why Noom’s program now shares fitness plans with users to increase their regular exercise.

“We designed the Noom GLP-1 program with muscle defense to essentially be that diet and exercise companion,” he shared.

The muscle defense program aims to help users prevent the loss of lean muscle mass by incorporating more strength training. Loss of muscle mass is a common issue for those taking weight-loss medications.

“Conditions like sarcopenic obesity could result if you’re later off the GLP-1 as most folks are, and then they regain that weight as fat,” Cook said.

As weight-loss drugs continue to increase in popularity, Cook said Noom is already looking at new tools to provide users looking to achieve long-lasting healthy change.

He hinted to WRAL News that additional features for GLP-1 users could be released later this year.