Discontinuing glucagon-like peptide-1 receptor agonists and body habitus: A systematic review and meta-analysis
Open accessAbstract
Summary Research on Glucagon‐like peptide 1 receptor agonist (GLP‐1RA) has mainly focused on the efficacy of weight loss and not the long‐term efficacy of weight loss maintenance. This systematic review and meta‐analysis aims to evaluate the sustainability of weight loss of patients taking GLP‐1RAs following the discontinuation of the drug. EBSCOhost was used to simultaneously search Academic Search Premier, CINHAL Ultimate, Cochrane Central Register of Controlled Trials, MEDLINE with full text, Cochrane Database of Systematic Reviews, and separate PubMed search was systematically investigated using a predetermined search strategy from inception to February 1st, 2024. The authors extracted data regarding body weight change from baseline on treatment and off treatment, change in waist circumference from baseline on and off treatment, and change in BMI from baseline on and off treatment. Meta‐analysis was conducted using RevMan (version 5.4) to calculate pooled mean differences using a Der Simonian‐Laird Random Effects model. ResultsThe initial search yielded 497 relevant articles and, after screening, retained 8 randomized controlled trials comprised of 2372 participants, all with a BMI ≥ 27 kg/m 2 . After discontinuing GLP‐1RA therapy, weight regain was proportional to the original weight loss. Participants who took liraglutide regained 2.20 kg (95% CI 1.69 to 2.70, P < 0.00001), and participants taking semaglutide/tirzepatide regained 9.69 kg (95% CI 5.78 to 13.60, P < 0.00001). This systematic review and meta‐analysis show that significant weight is regained after discontinuing GLP‐1RA treatment, which should be discussed when stopping therapy. Practitioner Points Question: Does discontinuation of Glucagon‐like peptide 1 receptor agonist (GLP‐1RA) treatment lead to significant weight gain? Findings: In this systematic review and meta‐analysis, discontinuing GLP‐1RA treatment led to a pooled overall mean weight regain of 2.20 kg in participants taking liraglutide and 9.69 kg in those patients prescribed semaglutide/tirzepatide. The proportion of weight regained was proportional to the amount originally lost. Meaning: Discontinuation of GLP‐1RA treatment leads to weight regain, regardless of lifestyle interventions, and should therefore be considered a chronic therapy to prevent weight regain and associated undesirable outcomes related to obesity.
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Written from the paper’s full text.
TL;DR
This systematic review and meta-analysis of eight randomized trials found that stopping GLP-1 receptor agonists leads to significant regain of weight, waist circumference, and BMI, with larger regain after semaglutide/tirzepatide than liraglutide. The authors conclude these agents should be considered chronic therapy to maintain body habitus benefits.
Key findings
- Across 8 RCTs (2372 participants, BMI ≥27 kg/m²), discontinuation produced pooled weight regain of 2.20 kg for liraglutide (95% CI 1.69–2.70; P<0.00001; 5 studies, 1572 participants; I²=0%) and 9.69 kg for semaglutide/tirzepatide (95% CI 5.78–13.60; P<0.00001; 3 studies, 800 participants; I²=97%).
- Waist circumference increased by 1.37 cm after liraglutide cessation (4 studies, 1473 participants; I²=0%) and 5.78 cm after semaglutide/tirzepatide cessation (2 studies, 603 participants; I²=97%).
- BMI rose by 0.73 kg/m² after liraglutide cessation (3 studies, 438 participants; I²=10%) and 3.59 kg/m² after semaglutide/tirzepatide cessation (3 studies, 800 participants; I²=97%).
- The amount regained tracked the amount initially lost: liraglutide short-term regained 25.3–29.6% of lost weight and long-term 60.0–163.0%; semaglutide/tirzepatide regained 52.6–63.5%. Semaglutide/tirzepatide regain was clinically significant (6.4–13.1% body weight), while liraglutide regain was not (1.9–2.7% short-term; 1.8–4.6% long-term).
Methods
- Systematic review/meta-analysis; searched EBSCOhost databases (Academic Search Premier, CINAHL Ultimate, Cochrane CENTRAL, MEDLINE, Cochrane Database of Systematic Reviews) and PubMed from inception to February 1, 2024, plus gray literature and reference lists; two reviewers screened/extracted via Covidence. Inclusion: English RCTs of patients previously on GLP-1RA; exclusions: animal studies, post-bariatric surgery, DPP-4 inhibitors, outcomes without weight.
- Included 8 RCTs (2372 participants; BMI ≥27 kg/m²): six randomized double-blind controlled trials (1769 in cessation group) and two randomized double-blind withdrawal studies (603 in cessation group). Drugs: liraglutide 3.0 mg (5 studies), semaglutide 2.4 mg (2), tirzepatide 10/15 mg (1); treatment duration 20–160 weeks; follow-up 12, 20–22, 26, 48, or 52 weeks. Lifestyle modification was used in all studies; one stopped lifestyle changes at discontinuation, others continued.
- Analysis used RevMan 5.4 with DerSimonian-Laird random-effects model to pool mean differences (95% CI); heterogeneity assessed with I²; risk of bias via Cochrane RoB 2.0 (all studies low risk); subgroups by drug and short- vs long-term follow-up.
Limitations
- Stated: pooled semaglutide/tirzepatide analyses had considerable heterogeneity (I²=97%); stepwise removal showed Rubino et al. had largest influence, and removing it reduced I² to 0% for weight and BMI. Authors attribute possible difference to follow-up length (52 vs 48 weeks) and unequal representation of semaglutide/tirzepatide versus liraglutide.
- Stated: only two semaglutide/tirzepatide studies reported waist circumference, so time-off-treatment effects could not be meta-analyzed; DerSimonian-Laird method cannot reliably estimate heterogeneity with few studies; adherence to lifestyle interventions was not consistently reported, which likely affects regain.
- Evident from text: some outcomes rested on few studies (2–3), one included trial had only 15 participants, and the review included both pediatric and adult populations with different comorbidities, which may limit generalizability. The search was also restricted to English and 2015 onward.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
13 of 29 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Early follow-up studies observed that patients regain weight after discontinuing GLP-1 treatment.
“as early follow-up studies on GLP-1 treatment have observed that patients regain weight upon discontinuation.12”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [12] 12. Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardi- ometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. doi:10. 1111/dom.14725 source
- Premisecitation
In the STEP 8 trial, semaglutide 2.4 mg had a statistically significant greater effect on reduction in body weight from baseline compared with liraglutide 3.0 mg.
“with the seminal STEP 8 clinical trial reporting semaglutide at the maximal dose of 2.4 mg had a statistically significant greater effect on reduction in body weight from baseline when compared to the maximal dose of liraglutide (3.0 mg) 3”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [3] 3. Rubino DM, Greenway FL, Khalid U, et al. Effect of weekly subcuta- neous Semaglutide vs daily Liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 randomized clini- cal trial. Jama. 2022;327(2):138-150. doi:10.1001/jama.2021.23619 source
- Premisecitation
Among GLP-1 receptor agonists, semaglutide and liraglutide have the most significant effect on weight loss.
“Of the GLP-1RAs, semaglutide and liraglutide have the most significant effect on weight loss, 2”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [2] 2. Trujillo JM, Nuffer W, Smith BA. GLP-1 receptor agonists: an updated review of head-to-head clinical studies. Ther Adv Endocrinol Metab. 2021;12:2042018821997320. doi:10.1177/2042018821997320 source
- Premisecitation
The Der Simonian and Laird meta-analysis method cannot reliably estimate heterogeneity when only a few studies are analyzed.
“Finally, the Der Simonian and Laird meta-analysis methodology cannot reliably estimate heterogeneity when analyzing only a few studies.43”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [43] source
- Findingcitation
Two included studies observed worsening of cardiovascular biomarkers after discontinuing GLP-1RA therapy.
“two studies did observe worsening of cardiovascular biomarkers after discontinuing GLP-1RA therapy.5,12”
Quote in the paperNot a substantial claim2 of 2 sources checked- cites [5] 5. Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous Semaglutide vs placebo on weight loss mainte- nance in adults with overweight or obesity: the STEP 4 randomized clinical trial. Jama. 2021;325(14):1414-1425. doi:10.1001/jama.2021. 3224 source
The available passages contain only author and publication information (pp. A63–A64), not study results. Searches for cardiovascular biomarkers after GLP-1RA discontinuation and for blood pressure, lipids, and semaglutide withdrawal found no substantive passage, so our copy cannot verify this attribution. (LLM, conf=0.72)
Experimental — accuracy not yet measured - cites [12] 12. Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardi- ometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. doi:10. 1111/dom.14725 source
- Findingown data
The proportion of waist circumference regained was not similar to the proportion of weight and BMI regained.
“Overall, the proportion of waist circumference regained from the cessation of treatment to the end of the study was not similar to the proportion of weight and BMI regained.”
Quote in the paperSubstantial claim - Findingown data
Pooled data for liraglutide discontinuation were homogeneous (I2 = 0%).
“Pooled data for liraglutide discontinuation were homogonous (I 2 = 0%)”
Quote in the paperNot a substantial claim - Findingown data
Pooled overall increase in waist circumference between weeks 48 and 52 after semaglutide/tirzepatide discontinuation was 5.78 cm.
“The pooled overall increase for waist circumference between weeks 48 and 52 of semaglutide/tirzepatide discontinuation, was significant at 5.78 cm”
Quote in the paperSubstantial claim - Findingown data
Pooled overall mean increase in BMI after liraglutide discontinuation was 0.73 kg/m2.
“The pooled overall mean increase of BMI after liraglutide discontinuation was highly significant at 0.73 (kg/m 2 ).”
Quote in the paperSubstantial claim - Findingcitation
Mean weight regain after discontinuing semaglutide/tirzepatide was assessed in 3 studies including 800 participants.
“Mean weight regain was assessed after discontinuing semaglutide/ tirzepatide in 3 studies that included 800 participants”
Quote in the paperSubstantial claim - Findingown data
Pooled overall mean weight regain after semaglutide/tirzepatide discontinuation was 9.69 kg.
“The pooled overall mean weight regain after semaglutide/tirzepatide discontinuation was a significant finding at 9.69 kg.”
Quote in the paperSubstantial claim - Findingcitation
The percentage of BMI regained was almost equal to corresponding weight regain in all but one study.
“The percentage of BMI regained that was lost on GLP-1RA treatment was almost equal to corresponding weight regain in all but one study.23”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] 23. Johnston BC, Kanters S, Bandayrel K, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta- analysis. Jama. 2014;312(9):923-933. doi:10.1001/jama.2014.10397 source
- Findingnone given
In the short term after liraglutide discontinuation, participants regained between 25.3% and 29.6% of the weight lost on GLP-1 treatment.
“In the short-term, after liraglutide discontinuation, participants regained between 25.3% and 29.6% of the weight that they lost on GLP-1 treatment”
Quote in the paperSubstantial claim - Findingown data
Pooled data on semaglutide/tirzepatide discontinuation had considerable heterogeneity (I2 = 97%).
“Pooled data on semaglutide/tirzepatide discontinuation had considerable heterogeneity (I 2 = 97%)”
Quote in the paperNot a substantial claim - Findingcitation
Mean weight regain after liraglutide discontinuation was 2.20 kg based on 5 studies including 1572 participants.
“Mean weight regain after discontinuation of liraglutide was 2.20 kg based on data from 5 studies, inclusive of 1572 participants.”
Quote in the paperSubstantial claim - Findingnone given
32.7% of waist circumference was regained in the semaglutide study.
“32.7% of waist circumference was regained in the semaglutide study.”
Quote in the paperSubstantial claim - Findingnone given
After semaglutide/tirzepatide discontinuation, participants regained between 52.6% and 63.5% of weight lost on treatment.
“Similarly, after semaglutide/tirzepatide discontinuation, participants regained between 52.6% and 63.5% of weight lost on treatment.”
Quote in the paperSubstantial claim - Findingown data
The percentage of weight and BMI regained from originally lost increased predictably between short-term and long-term liraglutide subgroups.
“The percentage of weight and BMI that is regained from what was originally lost predictably increased between the short-term and longterm subgroups of liraglutide.”
Quote in the paperSubstantial claim - Findingown data
Pooled data on liraglutide BMI were homogeneous (I2 = 10%).
“The pooled data on liraglutide discontinuation was homogonous (I 2 = 10%)”
Quote in the paperNot a substantial claim - Findingown data
Before semaglutide/tirzepatide discontinuation, mean weight loss ranged from 11.1 to 21.1 kg.
“Before discontinuation, mean weight loss ranged from 11.1 to 21.1 kg.”
Quote in the paperNot a substantial claim - Findingown data
This dissimilarity was particularly true for liraglutide and semaglutide.
“This was particularly true for GLP-1RA's liraglutide and semaglutide.”
Quote in the paperSubstantial claim - Findingown data
In the long term after liraglutide discontinuation, participants regained between 60.0% and 163.0% of the weight lost.
“and in the long-term, between 60.0% and 163.0% of the weight was regained.”
Quote in the paperSubstantial claim - Findingown data
Eight randomized controlled trials were retained for the review and meta-analysis.
“Based on our criteria, 8 randomized controlled trials were retained for this literature review and meta-analysis”
Quote in the paperSubstantial claim - Findingown data
Pooled data for semaglutide/tirzepatide waist circumference had considerable heterogeneity (I2 = 97%).
“though pooled data for semaglutide/tirzepatide had considerable heterogeneity (I 2 = 97%)”
Quote in the paperNot a substantial claim - Findingown data
Pooled overall mean increase in BMI after semaglutide/tirzepatide discontinuation was 3.59 kg/m2.
“The pooled overall mean increase of BMI after semaglutide/tirzepatide discontinuation was highly significant at 3.59 (kg/m 2 ).”
Quote in the paperSubstantial claim - Findingown data
Before liraglutide discontinuation, mean weight loss ranged from 2.7 to 9.34 kg.
“Before discontinuation, mean weight loss ranged from 2.7 to 9.34 kg.”
Quote in the paperNot a substantial claim - Findingown data
Mean change in BMI after liraglutide discontinuation was measured in 3 studies including 438 participants who originally lost between 1 and 2.5 kg/m2.
“The mean change in BMI after liraglutide discontinuation was measured in 3 studies and included 438 participants who originally lost between 1 and 2.5 kg/m 2”
Quote in the paperSubstantial claim - Findingown data
These waist circumference regain percentages are smaller than the percentages of weight and BMI regain.
“These percentages are smaller when compared to the percentages of regain of weight and BMI.”
Quote in the paperSubstantial claim - Findingcitation
Two included articles were randomized, double-blind withdrawal studies with 603 participants in the drug cessation group.
“Two articles were randomized, double-blind withdrawal studies with 603 participants in the drug cessation group.”
Quote in the paperNot a substantial claim - Findingown data
Discontinuing GLP-1RA treatment leads to significant weight regain.
“This systematic review and meta-analysis show that significant weight is regained after discontinuing GLP-1RA treatment”
Quote in the paperSubstantial claim- Rests on an assumption: The withdrawal or placebo groups in the included randomized trials are a valid proxy for real-world discontinuation of GLP-1 receptor agonists.
- Rests on an assumption: The populations in the included trials are representative of patients who discontinue GLP-1 receptor agonists in clinical practice.
- Findingown data
In this systematic review and meta-analysis, stopping GLP-1 receptor agonist therapy resulted in overall increases in body habitus measures-mean weight, waist circumference, and BMI-irrespective of lifestyle interventions.
“This systematic review and meta-analysis detail the result of body habitus outcomes post GLP-1RA treatment cessation, demonstrating that discontinuation of GLP-1RA treatment leads to increased body size outcomes, regardless of lifestyle interventions.”
- Also stated in: § 5 | CONCLUSION · plain
“This systematic review and meta-analysis show that body habitus outcomes (mean weight, waist circumference, and BMI) increased overall after cessation of GLP-1RA treatment regardless of lifestyle intervention, which continued in six of the eight included studies.”
- Also stated in: § 4.1 | Summary of key findings · plain
“These data show that the body habitus benefits of GLP-1RA therapy are lost without continued treatment”
Quote in the paperSubstantial claim - Also stated in: § 5 | CONCLUSION · plain
- Findingnone given
Semaglutide/tirzepatide showed a clinically significant percentage of body weight regain throughout all studies, ranging from 6.4% to 13.1%.
“Semaglutide/tirzepatide showed a clinically significant percentage of body weight regain throughout all studies, ranging from 6.4% to 13.1%.”
Quote in the paperSubstantial claim - Findingown data
Participants taking liraglutide regained 2.20 kg (95% CI 1.69 to 2.70, P < 0.00001).
“Participants who took liraglutide regained 2.20 kg (95% CI 1.69 to 2.70, P < 0.00001)”
Quote in the paperSubstantial claim - Findingnone given
In the long-term subgroup, the percentage of body weight lost on treatment was not considered clinically significant according to the FDA definition.
“Interestingly, in the long-term subgroup, the percentage of body weight lost on treatment was not considered clinically significant according to the FDA's definition.”
Quote in the paperSubstantial claim - Findingreasoning
People who stop taking a GLP-1 receptor agonist regain some or all of the weight they had lost during treatment.
“After discontinuation, participants will regain some, if not all, of the weight they were able to lose while on GLP-1RA treatment.”
Quote in the paperSubstantial claim - Findingreasoning
Longer time off GLP-1 receptor agonist treatment is associated with greater increases in body habitus measures.
“As more time passes off the drug regimen, the larger the body habitus outcomes increase”
Quote in the paperSubstantial claim - Findingown data
Weight regain after GLP-1RA discontinuation is proportional to the original weight loss.
“After discontinuing GLP-1RA therapy, weight regain was proportional to the original weight loss.”
Quote in the paperSubstantial claim - Findingown data
Participants taking semaglutide/tirzepatide regained 9.69 kg (95% CI 5.78 to 13.60, P < 0.00001).
“participants taking semaglutide/tirzepatide regained 9.69 kg (95% CI 5.78 to 13.60, P < 0.00001)”
Quote in the paperSubstantial claim - Interpretationreasoning
As time passes after GLP-1RA cessation, mean weight and BMI regain increase, regardless of the GLP-1RA used.
“As time passes after the cessation of GLP-1RA treatment, the mean weight and BMI regain also increase, regardless of the GLP-1RA used.”
Quote in the paperSubstantial claim - Interpretationcitation
Without GLP-1RA, dietary suggestions became challenging to adhere to.
“and in these data, without the use of GLP-1RA, these dietary suggestions became challenging to adhere to.27”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [27] 27. Tan B, Pan XH, Chew HSJ, et al. Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta- analysis. Int J Obes (Lond). 2023;47(8):677-685. doi:10.1038/s41366- 023-01321-5 source
- Premisecitation
Research on GLP-1 receptor agonists has primarily addressed weight-loss efficacy, not long-term maintenance of weight loss.
“Studies that have explored weight loss during GLP-1RA treatment have noted a clear need for research focused on the long-term efficacy of weight loss maintenance, 11”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] 11. Arastu N, Cummins O, Uribe W, Nemec EC. Efficacy of subcutaneous semaglutide compared to placebo for weight loss in obese, non- diabetic adults: a systematic review & meta-analysis. Int J Clin Phar- macol. 2022;44(4):852-859. doi:10.1007/s11096-022-01428-1 source
- Premisenone given
No systematic reviews or meta-analyses had evaluated weight-loss maintenance after GLP-1RA discontinuation to guide practice.
“Upon careful review of the literature, there are no systematic reviews or meta-analyses evaluating weight loss maintenance following the discontinuation of GLP-1RAs to guide current practice.”
Quote in the paperSubstantial claim - Interpretationreasoning
Participants still regained a significant portion of the weight lost despite lifestyle modifications.
“Yet, they still regained a significant portion of the weight lost.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants in the included studies adhered to the lifestyle interventions during off-treatment periods sufficiently to test whether weight regain occurs despite lifestyle changes.
- Study design and conductown data
Risk of bias was assessed as low for all included studies.
“The risk of bias of included articles was evaluated using the Cochrane Risk of Bias tool for randomized controlled trials (RoB 2.0) 26 and assessed as low for all studies”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [26] 26. Research C for DE and. Developing Products for Weight Manage- ment Revision 1. April 28, 2020. Accessed February 8, 2024. https:// www.fda.gov/regulatory-information/search-fda-guidance- documents/developing-products-weight-management-revision-1
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisereasoning
Limited definitive data exist to quantify how much weight a patient will regain after discontinuing GLP-1RA.
“However, there are limited definitive data available to quantify on how much weight a patient will potentially regain following discontinuation of GLP-1RA.”
Quote in the paperSubstantial claim - Study design and conductnone given
Adherence data were not consistently reported in the included studies.
“Finally, while the included studies implemented structured lifestyle interventions, adherence data were not consistently reported.”
Quote in the paperSubstantial claim - Interpretationcitation
Physical activity may be important for reducing weight regain after stopping GLP-1 receptor agonist treatment.
“These findings support the intuitive conclusion that physical activity may be crucial in mitigat-”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] 33. Novo Nordisk hits out as Dutch agency advises against insurance cover for Wegovy. The Independent July 17, 2024. Accessed October 2, 2024. https://www.independent.co.uk/news/health/wegovy- weight-loss-holland-insurance-b2581279.html
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Study design and conductown data
Because only two studies of semaglutide and tirzepatide reported waist circumference, the meta-analysis could not assess outcomes related to duration off treatment.
“Only two studies of semaglutide and tirzepatide included waist circumference; therefore, outcomes related to the amount of time offtreatment could not be assessed in the meta-analysis.”
Quote in the paperSubstantial claim - Study design and conductnone given
The review was limited by unequal representation of semaglutide and tirzepatide compared with liraglutide.
“In addition, the unequal representation of semaglutide and tirzepatide compared to liraglutide was also a limitation.”
Quote in the paperNot a substantial claim - Premisecitation
Weight loss is maintained when GLP-1 receptor agonist therapy is continued, according to long-term efficacy studies.
“In contrast, it is seen in long-term efficacy studies that weight loss is maintained if GLP-1RA therapy is continued.21,34”
- Also stated in: § 4.1 | Summary of key findings · plain
“continued treatment has also been shown to maintain the benefits.21,34”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [21] 21. Tirzepatide Once Weekly for the Treatment of ObesityjNEJM. Accessed February 8, 2024. 10.1056/NEJMoa2206038 source
- cites [34] 34. New Weight Loss Drugs Expensive For Insurers to Cover, But May Help Address Costs of ObesityjMorningstar DBRS. Accessed October 2, 2024. https://dbrs.morningstar.com/research/430889/new- weight-loss-drugs-expensive-for-insurers-to-cover-but-may-help- address-costs-of-obesity
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Also stated in: § 4.1 | Summary of key findings · plain
- Premisecitation
A cited study found that supervised exercise during GLP-1 receptor agonist treatment led to better weight-loss maintenance one year after discontinuation than GLP-1 receptor agonist treatment without exercise.
“A recent study found that participants who engaged in supervised exercise during GLP-1RA treatment maintained weight loss more effectively one year after discontinuation than those who received GLP-1RA without an exercise intervention.33”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [33] 33. Novo Nordisk hits out as Dutch agency advises against insurance cover for Wegovy. The Independent July 17, 2024. Accessed October 2, 2024. https://www.independent.co.uk/news/health/wegovy- weight-loss-holland-insurance-b2581279.html
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
Discontinuation of GLP-1RA treatment leads to weight regain regardless of lifestyle interventions.
“Discontinuation of GLP-1RA treatment leads to weight regain, regardless of lifestyle interventions”
Quote in the paperSubstantial claim- Rests on an assumption: Participants in the included studies adhered to the lifestyle interventions during off-treatment periods sufficiently to test whether weight regain occurs despite lifestyle changes.
- Rests on an assumption: The withdrawal or placebo groups in the included randomized trials are a valid proxy for real-world discontinuation of GLP-1 receptor agonists.
- Rests on an assumption: The populations in the included trials are representative of patients who discontinue GLP-1 receptor agonists in clinical practice.
- Classified as probably not a substantial claim. 12
- May combine two claims. 24
- The quote only partly states this claim. 1
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPharmacokinetic/pharmacodynamic modeling using data from three randomized controlled trials predicted weight loss on GLP-1RA treatment and weight regain after discontinuation.
“Recently, pharmacokinetic/pharmacodynamic modeling, including data from three randomized controlled trials, predicted how much weight one would lose on GLP-1RA treatment and how much a patient would regain after discontinuation.13”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [13] 13. Papathanasiou T, Strathe A, Agersø H, Lund TM, Overgaard RV. Impact of dose-escalation schemes and drug discontinuation on weight loss outcomes with liraglutide 3.0 mg: a model-based approach. Diabetes Obes Metab. 2020;22(6):969-977. doi:10.1111/ dom.13985 source
May combine two claims.
PremisecitationNo satisfactory universal method exists for meta-analysis with very few studies, and the random-effects model used here is among the best given the sample size.
“However, no satisfactory universal method is currently available to perform meta-analyses in the case of very few studies, and other studies have suggested that given the sample size of these data, the random effects model as employed is among the best methodology.43,44”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [43] source
The Discussion states that no satisfactory universal method exists for meta-analysis with very few studies. The Conclusions recommend random-effects meta-analysis when heterogeneity is expected and pooling remains meaningful, but say method choice is case-by-case; the paper does not establish that the citing study’s model is among the best simply given its sample size. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [44] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationGIPs have a similar mechanism to GLP-1 receptor agonists and, when combined, create a synergistic effect resulting in increased weight loss similar to that observed with semaglutide.
“GIPs have a similar method of action as GLP-1RAs and, when combined, create a synergistic effect resulting in increased weight loss similar in effect to those observed with semaglutide.4,5”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [4] 4. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. doi: 10.1056/NEJMoa2206038 source
- cites [5] 5. Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous Semaglutide vs placebo on weight loss mainte- nance in adults with overweight or obesity: the STEP 4 randomized clinical trial. Jama. 2021;325(14):1414-1425. doi:10.1001/jama.2021. 3224 source
The available passages are author and publication metadata (pp. A63–A64), not study findings. Searches for GIP, combined GLP-1/GIP action, synergy, and comparative weight loss returned no substantive passage, so our copy cannot verify the attributed claim. (LLM, conf=0.76)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationRoughly 50% of persons with type 2 diabetes and 68% of those in weight-loss care who start a GLP-1RA discontinue treatment after 1 year.
“Roughly, 50% of persons with type 2 diabetes and 68% of those engaging in weight loss care who start a GLP-1RA are reported to discontinue treatment after 1 year.6,7”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [6] 6. Leach J. Real-World Analysis of Glucagon-Like Peptide-1 Agonist (GLP-1a) Obesity Treatment One Year Cost-Effectiveness and Ther- apy Adherence. Prime Therapeutics Published online 2023. Accessed October 6, 2024. https://www.shpnc.org/media/3334/download? attachment
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [7] 7. Weiss T, Carr RD, Pal S, et al. Real-world adherence and discontinua- tion of glucagon-like Peptide-1 receptor agonists therapy in type 2 diabetes mellitus patients in the United States. Patient Prefer Adher- ence. 2020;14:2337-2345. doi:10.2147/PPA.S277676 source
The Results > Discontinuation section reports that 47.7% of patients with type 2 diabetes discontinued GLP-1RA therapy by 12 months, supporting the roughly 50% figure. This paper does not report a one-year discontinuation rate for people in weight-loss care, so it does not support the 68% figure. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationExcess visceral adipose tissue can threaten cardiovascular health and is linked to worsening cardiovascular biomarkers.
“Excess visceral adipose tissue can pose a threat to cardiovascular health and is linked to worsening cardiovascular biomarkers.28,29”
Quote in the paperNot a substantial claim2 of 2 sources checked- cites [28] 28. Konwar M, Bose D, Jaiswal SK, Maurya M, kumar, Ravi R. Efficacy and safety of Liraglutide 3.0 mg in patients with overweight and obese with or without diabetes: a systematic review and meta-analy- sis. Int J Clin Pract. 2022;2022:1201977. doi:10.1155/2022/1201977 source
The Background states that obesity increases the risk of cardiovascular disease, supporting the general cardiovascular-health concern. It does not specifically link excess visceral adipose tissue to worsening cardiovascular biomarkers; the Results instead report changes in body weight and waist circumference. (LLM, conf=0.83)
Experimental — accuracy not yet measured - cites [29] 29. Jensen SBK, Blond MB, Sandsdal RM, et al. Healthy weight loss main- tenance with exercise, GLP-1 receptor agonist, or both combined fol- lowed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial. eClinicalMedicine. 2024;69: 102475. doi:10.1016/j.eclinm.2024.102475 source
The Methods and Results (pages unavailable) report waist circumference, total fat mass, and metabolic measures, but do not identify visceral adipose tissue or link excess visceral fat to worsening cardiovascular biomarkers. Searches for “visceral,” “abdominal obesity,” and cardiovascular risk terms found no passage establishing the claimed relationship. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Classified as probably not a substantial claim. May combine two claims.
InterpretationcitationBecause waist circumference regain is not proportional to weight and BMI regain for semaglutide and liraglutide, adipose tissue may be redistributed to visceral rather than subcutaneous depots, making waist circumference gain less apparent.
“Since waist circumference is not proportional to weight and BMI regain for semaglutide and liraglutide, this could mean that although weight is regained, the adipose tissue may be dispersed in other forms, for instance as visceral, not subcutaneous, causing the appearance of waist circumference gain to be less apparent.28”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [28] 28. Konwar M, Bose D, Jaiswal SK, Maurya M, kumar, Ravi R. Efficacy and safety of Liraglutide 3.0 mg in patients with overweight and obese with or without diabetes: a systematic review and meta-analy- sis. Int J Clin Pract. 2022;2022:1201977. doi:10.1155/2022/1201977 source
The Methods (§2.5) and Results (§3.4; page unavailable) report changes in weight, BMI, and waist circumference during liraglutide treatment, not how those measures change during weight regain. Searches for regain, semaglutide, and visceral versus subcutaneous fat found no passage assessing the claimed disproportion or proposed fat redistribution. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAll included studies used lifestyle changes such as a low-calorie diet and increased physical activity in treatment and placebo groups.
“All studies used lifestyle changes such as a low-calorie diet and increased physical activity with the treatment and placebo groups.”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown dataPooled data on semaglutide/tirzepatide BMI had considerable heterogeneity (97%).
“The pooled data on semaglutide/tirzepatide discontinuation had considerable heterogeneity (97%)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingnone givenTirzepatide participants regained 47.7% of waist circumference originally lost, proportional to weight and BMI regain.
“Tirzepatide did not have the same effect and participants regained 47.7% of the waist circumference that was originally lost which was proportional to the weight and BMI regain.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMean change in BMI after semaglutide/tirzepatide discontinuation was measured in 3 studies including 800 participants who originally lost between 4 and 7.9 kg/m2.
“The mean change in BMI after semaglutide/tirzepatide treatment discontinuation was measured in 3 studies and included 800 participants who originally lost between 4 and 7.9 kg/m 2”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationDuring off-treatment periods, one study stopped all lifestyle modifications, while all other studies continued lifestyle modifications.
“During the off-treatment periods, one study stopped all lifestyle modifications in addition to the interventions.12,23 All other studies continued lifestyle modifications during the offtreatment periods.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataMean change in waist circumference after liraglutide discontinuation was measured in 4 studies including 1473 participants who originally lost between 5.6 and 9.4 cm.
“The mean change in waist circumference from baseline after liraglutide discontinuation was measured in 4 studies and included 1473 participants who originally lost between 5.6 and 9.4 cm”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationMean change in waist circumference after semaglutide/tirzepatide discontinuation was measured in 2 studies including 603 participants who originally lost between 10.1 and 17.4 cm.
“The mean change in waist circumference from baseline after semaglutide/tirzepatide discontinuation was measured in 2 studies and included 603 participants who originally lost between 10.1 and 17.4 cm”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataPooled overall waist circumference regain after liraglutide discontinuation was 1.37 cm and homogeneous (I2 = 0%).
“After Liraglutide discontinuation, the pooled overall waist circumference regain was significant at 1.37 cm and homogonous (I 2 = 0%)”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationAfter liraglutide discontinuation, between 16.1% and 18.4% of waist circumference was regained in the short term, and 19.6% in the long term.
“After liraglutide discontinuation, between 16.1% and 18.4% of waist circumference was regained in the short term, and 19.6% was regained in the long term.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataThe database search yielded 497 results, with 16 full-text articles and 1 conference abstract screened.
“The database search yielded 497 results, with 16 full-text articles and 1 conference abstract screened for eligibility.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingnone givenAll studies except Kelly et al used WHO exercise and diet guidelines and provided dietician or nutritionist advice; participants were encouraged to do 150 minutes of high-intensity exercise per week, and except for Wilding et al, to continue after stopping GLP-1RA therapy.
“All studies except Kelly et al (who had personalized nutrition counseling) employed the World Health Organization exercise and diet guidelines for lifestyle interventions and provided advice from a dietician or nutritionist; additionally, participants were encouraged to engage in 150 minutes of high-intensity exercise per week, and except for Wilding et al, to continue these after stopping”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSix included studies were randomized, double-blind, controlled trials with 1769 participants in the drug cessation group.
“Six were randomized, doubleblind, controlled trials with 1769 participants in the drug cessation group.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe initial search yielded 497 relevant articles and retained 8 randomized controlled trials with 2372 participants, all with BMI ≥27 kg/m2.
“The initial search yielded 497 relevant articles and, after screening, retained 8 randomized controlled trials comprised of 2372 participants, all with a BMI ≥ 27 kg/m 2 .”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataStepwise removal of studies showed that Rubino et al. had the largest influence; removing it reduced I2 to 0% for both the weight regain and BMI pooled analyses.
“A stepwise removal of studies was performed to identify causes of heterogeneity.Rubino et al 5 had the largest influence, and when removed, the I 2 was 0% for both the weight regain and BMI pooled analyses.”
Quote in the paperSubstantial claimMay combine two claims.
FindingreasoningThe percentage of weight regained in liraglutide studies was not clinically significant, ranging from 1.9% to 2.7% short-term and 1.8% to 4.6% long-term.
“The percentage of weight regained in the Liraglutide studies was not clinically significant, ranging from 1.9% to 2.7% short-term and 1.8 to 4.6% long-term.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataStopping semaglutide or tirzepatide produces clinically meaningful weight regain, and the amount regained is proportional to the weight lost initially.
“Semaglutide or tirzepatide discontinuation causes a clinically meaningful weight regain, which was proportional to the original weight loss.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationCalorie deficit is the primary driver of weight loss, followed by macronutrient composition.
“Meta-analysis shows calorie deficit is the primary weight loss driver, followed by macronutrient composition”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [27] 27. Tan B, Pan XH, Chew HSJ, et al. Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta- analysis. Int J Obes (Lond). 2023;47(8):677-685. doi:10.1038/s41366- 023-01321-5 source
May combine two claims.
InterpretationreasoningWeight loss was not sustainable with long-term discontinuation of GLP-1RA therapy, even though lifestyle modifications continued in six of eight studies.
“The weight regain shown, in addition to lifestyle modifications being continued in six 5,[19][20][21]23,24 of the eight studies, shows that weight loss was not sustainable with long-term discontinuation of GLP-1RA therapy.”
Quote in the paperSubstantial claim- Rests on an assumption: Participants in the included studies adhered to the lifestyle interventions during off-treatment periods sufficiently to test whether weight regain occurs despite lifestyle changes.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe review protocol was prospectively registered with INPLASY.
“The review protocol was prospectively registered with INPLASY (DOI number: 10.37766/inplasy2024.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenRisk of bias was evaluated using the Cochrane Risk of Bias tool for randomized controlled trials (RoB 2.0).
“Risk of bias was evaluated using the Cochrane Risk of Bias tool for randomized controlled trials (RoB 2.0).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataTwo independent reviewers screened titles and abstracts for eligibility and extracted full-text data.
“Two independent reviewers (SB and HL) screened titles and abstracts for eligibility based on the following inclusion criteria”
- Also stated in: § 5 | CONCLUSION · plain
“Full-text articles that met inclusion and exclusion criteria were extracted for systematic review through the Covidence platform by two independent reviewers (SB and HL).”
Quote in the paperNot a substantial claim- Also stated in: § 5 | CONCLUSION · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationTirzepatide is a dual GLP-1 receptor agonist and glucose-dependent insulinotropic polypeptide co-agonist.
“Tirzepatide is a dual GLP-1RA and glucosedependent insulinotropic polypeptide (GIP) co-agonist, otherwise known as GIP/GLP-1RA.4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] 4. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. doi: 10.1056/NEJMoa2206038 source
May combine two claims.
PremisecitationData from other meta-analyses suggest semaglutide yields mean weight reduction of 11.62 kg, tirzepatide 12.47 kg, and liraglutide 5.04 kg.
“Data from other meta-analyses suggest that semaglutide yields a mean weight reduction of 11.62 kg, tirzepatide 12.47 kg, and liraglutide 5.04 kg for liraglutide.11,31,32”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [11] 11. Arastu N, Cummins O, Uribe W, Nemec EC. Efficacy of subcutaneous semaglutide compared to placebo for weight loss in obese, non- diabetic adults: a systematic review & meta-analysis. Int J Clin Phar- macol. 2022;44(4):852-859. doi:10.1007/s11096-022-01428-1 source
- cites [31] 31. Hinton E, Williams E, Raphael J, et al. 50 State Medicaid Budget Sur- vey Fiscal Years 2023-2024 -Pharmacy -10244. KFF November 14, 2023. Accessed February 4, 2024. https://www.kff.org/report- section/50-state-medicaid-budget-survey-fy-2023-2024-pharmacy/
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [32] 32. Medicare to Cover Weight-Loss Drug Wegovy for Certain Patients. March 21, 2024. Accessed March 23, 2024. https://www. medpagetoday.com/publichealthpolicy/medicare/109305
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Study design and conductnone givenThe review had a large sample size and included studies with low risk of bias.
“This review had a robust sample size, including studies with a low risk of bias”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
InterpretationreasoningMinimal weight loss may have affected the clinical significance of long-term weight regain.
“It is possible that minimal weight loss affected the clinical significance of long-term weight regain”
Quote in the paperSubstantial claim
The paper relies on this without support.
Participants in the included studies adhered to the lifestyle interventions during off-treatment periods sufficiently to test whether weight regain occurs despite lifestyle changes.
“Thus, if participants continued lifestyle modifications as they were encouraged to do, they theoretically should have been able to keep the weight off.”
The paper relies on this without support.
The withdrawal or placebo groups in the included randomized trials are a valid proxy for real-world discontinuation of GLP-1 receptor agonists.
“These studies randomized participants to continue treatment with GLP-1RA or a placebo injection with subsequent patient follow-up.”
The paper relies on this without support.
The populations in the included trials are representative of patients who discontinue GLP-1 receptor agonists in clinical practice.
“While all articles had participants who were obese or overweight, each article focused on a specific comorbidity, which included either type 2 diabetes, 20 pre-diabetes, 21 obesity, 5,12,19,22,23 or obesity with non-alcoholic fatty liver disease.24”
The paper relies on this without support.
How well patients follow prescribed lifestyle changes probably affects how much weight they regain after stopping GLP-1 receptor agonists.
“This is a significant limitation, as adherence to prescribed lifestyle changes likely influences weight regain after GLP-1RA discontinuation.”
The paper relies on this without support.
A six-week difference in follow-up length is not expected to be clinically important.
“We did not expect 6 weeks to make a clinically significant difference.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The abrupt resurgence of intrusive food-related cognitions upon a missed dose or discontinuation can be profoundly distressing, frequently precipitating rapid weight regain and a sense of treatment failure.
“Consequently, the abrupt resurgence of intrusive food-related cognitions upon a missed dose or discontinuation can be profoundly distressing, frequently precipitating rapid weight regain and a sense of treatment failure [61,62].”
From Adherence and Persistence with GLP-1-Based Therapies: International Real-World Evidence and the Role of Nutritional and Lifestyle Support—A Narrative Review (2026) · cites this paper as [61]
Section 3.4 reports significant weight regain after GLP-1RA discontinuation, and section 4.1 says regain increases with time off treatment (page numbers unavailable). The paper does not establish that a missed dose causes an abrupt return of intrusive food-related thoughts, or that such thoughts precipitate weight regain, distress, or a sense of treatment failure. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPrevious meta-analyses have consistently demonstrated weight regain following discontinuation of GLP-1 receptor agonists or other anti-obesity medications.
“Previous meta-analyses have consistently demonstrated the phenomenon of weight regain following the discontinuation of GLP-1 receptor agonists or other anti-obesity medications.”
From Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis (2025) · cites this paper as [33]
One study showed approximately 50-60% of lost weight was regained within one year after cessation of GLP-1 receptor agonist therapy.
“One study systematically quantified the rebound of body habitus after cessation of GLP-1 receptor agonist therapy, showing that approximately 50–60% of the lost weight was regained within one year.33”
From Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis (2025) · cites this paper as [33]
Hormonal changes, including a rise in soluble leptin receptor and sustained free leptin levels, reverse more gradually, followed by behavioral effects.
“In contrast, hormonal changes, including a rise in soluble leptin receptor and sustained free leptin levels, reverse more gradually, which is further followed by behavioral effects.33”
From Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis (2025) · cites this paper as [33]
Weight regain is a common phenomenon after discontinuation of GLP-1 RAs.
“Weight regain is a common phenomenon after discontinuation of GLP-1 RAs, suggesting that the therapeutic benefits largely depend on treatment and subsequent management.”
From GLP-1 Receptor Agonists for Obesity Management in Older Adults: A Scoping Review on the Risk of Sarcopenia and Sarcopenic Obesity (2026) · cites this paper as [101]
Weight regain after GLP-1 RA discontinuation can range from 2.2 kg to 9.7 kg, proportional to initial loss and varying by type of anti-obesity medication (AOM).
“Indeed, a recent meta-analysis reported that, while proportional to initial loss and varying by type of AOM, weight regain can range from 2.2 kg to 9.7 kg [101].”
From GLP-1 Receptor Agonists for Obesity Management in Older Adults: A Scoping Review on the Risk of Sarcopenia and Sarcopenic Obesity (2026) · cites this paper as [101]
Cessation of GLP-1 treatment is associated with marked weight regain.
“cessation of GLP-1 treatment is associated with marked weight regain, as highlighted in a recent meta-analysis of eight randomised controlled trials”
From Weighing the risk of GLP-1 treatment in older adults: Should we be concerned about sarcopenic obesity? (2025) · cites this paper as [4]
In a meta-analysis of eight randomised controlled trials, participants taking semaglutide/tirzepatide regained 9.69 kg (95% CI 5.78, 13.60) over 48-52 weeks after discontinuation.
“participants taking semaglutide/tirzepatide regained 9.69 kg (95% CI 5.78, 13.60) over 48–52 weeks [4]”
From Weighing the risk of GLP-1 treatment in older adults: Should we be concerned about sarcopenic obesity? (2025) · cites this paper as [4]
Two prior reviews reported weight regain after GLP-1RA cessation but neither modelled the trajectory of weight over time.
“Two reviews9,10 reported weight regain after GLP-1RA cessation but neither modelled the trajectory of weight over time.”
From Trajectory of weight regain after cessation of GLP-1 receptor agonists: a systematic review and nonlinear meta-regression (2026) · cites this paper as [9]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
The same study is listed as both stopping and continuing lifestyle changes
MinorStudy 23 is cited among the studies that stopped lifestyle modifications during follow-up and among those that continued them.
“During the off-treatment periods, one study stopped all lifestyle modifications in addition to the interventions.12,23”
“All other studies continued lifestyle modifications during the offtreatment periods.5,[19][20][21]23,24”
Figure 3b is labeled with the wrong body-size measure
MinorThe results identify Figure 3b as the liraglutide BMI analysis, while its caption describes a waist-circumference analysis in centimetres.
“The pooled overall mean increase of BMI after liraglutide discontinuation was highly significant at 0.73 (kg/m 2 ).The pooled data on liraglutide discontinuation was homogonous (I 2 = 10%) (Figure 3b).”
“b.Mean difference of change in waist circumference (cm) from baseline of liraglutide treatment versus discontinuation.”
The publication-date range excludes an included study
MinorThe stated publication range ends in December 2023, but the study-characteristics table identifies an included study as published in 2024.
“The eight studies utilized in this review were published between July 2015 and December 2023.”
“Aronne, 2024.19 Randomized Controlled Withdrawal Study”
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Comprehensive Lifestyle Intervention as Primary Therapy for Obesity: A Case Study
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- Authors
- Berg, S., Stickle, H., Rose, S. J., & Nemec, E. C.
- Affiliations
- Sacred Heart University (US)
- Stamford Hospital (US)
- Corresponding author
- Nemec, Eric C.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2025-04-04
- Volume
- 26
- Issue
- 8
- Pages
- e13929-e13929
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W4409189297
- Semantic Scholar
- 6f4739138b424b528cafdae0a49c7b35d605ff93
- Cited by
- 111
- References
- 35
- Citations by year
- 2026: 81 · 2025: 30
- FWCI
- 14.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- GLP-1 receptor agonists, weight regain, weight loss maintenance, drug discontinuation, liraglutide, semaglutide, tirzepatide, obesity, body mass index, waist circumference, body build, weight loss sustainability, antipsychotic-induced weight gain, antipsychotic-induced akathisia, antipsychotic-induced tardive dyskinesia
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Humans, Hypoglycemic Agents, Obesity, Weight Loss, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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