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Dr Anne Peters discusses the need for lifestyle changes in combination with antiobesity medications for weight loss. https://www.medscape.com/viewarticle/maintaining-weight-loss-glp-1s-needs-lifestyle-changes-2024a1000ld0?src=soc_yt -- TRANSCRIPT -- Nearly every patient I start on incretin therapy for weight loss asks me the same question, which is, will I have to stay on this forever? The answer is probably yes, but I think it’s much more nuanced than that because A) forever is a long time and B) I think there are various ways to approach this. I want people to start just saying, let’s see how this works, because not everyone’s going to lose the same amount of weight or respond in the same way. I say let’s try it, but don’t stop it suddenly. If we decide at some point you don’t need quite the same dose, we can reduce the dose and maybe even reduce the frequency of giving it, but you don’t want to stop cold turkey because you may well regain the weight, and that’s obviously not our desired outcome. There have been multiple clinical trials in which people started on an incretin hormone, either a glucagon-like peptide 1 (GLP-1) receptor agonist or a dual hormone, and they’ve actually shown that stopping it and then continuing patients on a placebo vs active drug results in continued weight gain over time vs either weight maintenance or weight loss when they remain on the incretin hormone. Clearly, on average, people will regain the weight, but that isn’t always true. One of the things I think is really important is that, from the get-go on starting on these hormones, people start working with a lifestyle plan, whether it’s working with a coach or an online program. However they approach this, it’s important to start changing habits and increasing exercise. I can’t say how important this is enough, because people need to increase their physical activity to enhance the benefits of these agents and also to help retain lean body mass. I don’t want people losing a large amount of lean body mass as they go through the process of weight loss. I set the stage for the fact that I expect people to adhere to a lifestyle program, and maybe losing weight with the medications is going to help them do even better because they’re going to see positive outcomes. When they get to the point of weight maintenance, I think we need to reinforce lifestyle. I either go down on the dose given weekly or I start having patients take the dose every other week, for instance, as opposed to every week, and then sometimes every month. Depending on the patient, I get them potentially to a lower dose, and then they’re able to maintain the weight as long as they improved their lifestyle along with the changes in the medication. Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/maintaining-weight-loss-glp-1s-needs-lifestyle-changes-2024a1000ld0?src=soc_yt

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