Weight-loss medications such as semaglutide and tirzepatide are highly effective, but they should not be seen as short-term solutions, researchers from the University of Oxford have warned. As these drugs become more widely available through the NHS, general practitioners (GPs) will need to take a more active role in long-term obesity management, the researchers said.
A new study presented at the European Congress on Obesity shows that although patients using GLP-1 receptor agonists lost an average of 16 kilograms, most regained the weight within two years of stopping the medication. The findings highlight the need for careful planning on how to use these treatments effectively.
“Stopping the drugs leads to a return to baseline weight in less than two years,” the study concluded, noting that this rate of weight regain is faster than what is seen with behavioural weight management programmes.
The research adds a “cautionary note” to current guidance, which recommends using semaglutide for no longer than two years. NICE has yet to set a treatment duration for tirzepatide and is reviewing real-world evidence from NHS patients.
Professor Susan Jebb, lead author and professor of diet and population health at Oxford, said the results were not surprising. “We know people tend to regain weight after any method of weight loss,” she told Pulse.
She emphasised that GPs will have to become more involved in managing obesity as the NHS begins a phased rollout of weight-loss drugs in June. Initially, tirzepatide (Mounjaro) will be available to patients with a body mass index (BMI) of 40 or more and at least four comorbid conditions, such as high blood pressure or diabetes.
An estimated 1.5 million people in the UK are already using these medications, many through private online providers. NHS England has said that giving immediate access to all eligible patients would overwhelm primary care services. As a result, access will be limited at first.
Professor Jebb said a more structured system is needed: “We’ll need specialist weight management hubs with teams who understand the different treatment pathways and can help direct patients accordingly. That coordination can’t fall to individual GPs.”
She stressed that these medications are likely to be long-term treatments and warned that patients purchasing them privately should understand the commitment involved.
“The cost to the NHS will be significant, so we need to be careful about who receives these drugs,” she said. “It’s not just about giving effective treatment, but also ensuring it’s cost-effective.”
Jebb pointed to the NHS Path to Remission Programme — a low-calorie diet of soups and shakes — as an affordable and successful option, although not every patient is willing to follow it. In some cases, especially for people with severe obesity, bariatric surgery might prove more cost-effective in the long run.
“It’s important we don’t treat medication as the default for everyone,” she said, adding that the degree of weight regain after stopping the drugs is “astonishing,” though more data is needed.
She suggested a “pulsed” treatment model — where patients use the drugs intermittently — might be explored. “In research and clinical practice, we must figure out how to support patients long term,” she said.
Last week, a policy think tank proposed speeding up the rollout by using existing private providers and prioritising a “digital-first” approach to expand access to millions of working-age adults.
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