Highly effective anti-obesity medications (AOMs), including semaglutide and tirzepatide, can produce mean weight loss of greater than 15% and have shown effectiveness in the prevention or control of obesity-related comorbidities and complications, such as type 2 diabetes, major cardiovascular events, obstructive sleep apnea, osteoarthritis, chronic kidney disease, heart failure with preserved ejection fraction, and metabolic dysfunction-associated steatohepatitis. Although evidence from industry-sponsored clinical trials shows average regain of two-thirds of initial weight loss after discontinuation of highly effective AOMs, the magnitude of weight regain in individuals is variable and the predictors of this variability are unknown. After initial treatment success, patients and providers may have concerns about indefinite use of these medications due to high drug costs, side-effects, and limited information on long-term safety and effectiveness, among others. The current evidence base for guiding treatment options after initial success is lacking. Options include continued use of the same highly effective AOM at the same dose and frequency, decreasing the dose or frequency of the same AOM, switching to a first-generation AOM or combination of medications, or discontinuing AOMs altogether. The optimum mode, intensity, timing of initiation, and duration of nutrition, physical activity, and behavioral interventions in supporting these strategies are also unclear.

This symposium explored clinical research strategies for generating evidence to guide individualized decisions for long-term maintenance of health gains after initial obesity treatment success with highly effective AOMs.

For questions related to the workshop topics and agenda, please contact Dr. Laurie Donze (NHLBI) at laurie.donze@nih.gov and Dr. Craig Hales (NIDDK) at craig.hales@nih.gov.

Agenda

See the agenda.

Recording

The meeting recording can be viewed here: https://videocast.nih.gov/watch=57065.