New injectable diabetes medicines, together with semaglutide (Ozempic) and tirzepatide (Mounjaro), are clearly the simplest weight reduction medicine ever developed. These medicine, generally known as GLP-1 receptor agonists, may also be probably the most potent diabetes therapies because the discovery of insulin, providing huge enhancements in blood sugar management and A1C.
However there’s a catch, and an enormous one: You in all probability should take them perpetually. Consultants agree that sufferers who need to maintain their weight reduction and glucose enhancements have to hold utilizing their GLP-1s indefinitely. If you cease utilizing Ozempic, you possibly can anticipate your urge for food to return, your weight to come back again, and your blood sugar to return up.
A current research discovered that sufferers with out diabetes who used tirzepatide (Zepbound) regained about half of the burden they’d initially misplaced a 12 months after discontinuing the drug. That total weight reduction was nonetheless spectacular, however consultants appear resigned that the majority sufferers would finally regain all of it. Research coauthor Louis Aronne, MD, instructed On a regular basis Well being, “For those who cease the treatment, you regain the burden — there’s no query that can occur.”
Tens of millions of individuals have already encountered this downside: Greater than two-thirds of GLP-1 customers cease utilizing their new treatment inside a 12 months. There are various the explanation why individuals may stop utilizing these highly effective therapies, together with the excessive price (particularly when insurance coverage modifications or coupons expire), unintended effects, provide shortages, or easy discomfort with the thought of taking a weight reduction drug for years.
And there isn’t a lot good recommendation for individuals coming off of those potent medicine. Many articles have been written on how you can hold the burden off (and glucose beneath management) after discontinuing a drug like Ozempic, however there’s evidently no simple repair. Most recommendation — nutritious diet, portion management, train — is, whereas undoubtedly correct, precisely what so many individuals dwelling with sort 2 diabetes or weight problems have already heard 1,000,000 instances earlier than.
A Low-Carb Eating regimen Helped Sufferers Maintain the Kilos Off
There’s a brand new research in Diabetes Remedy suggesting {that a} very low-carb or keto weight loss program can assist individuals preserve weight reduction after discontinuing a GLP-1 treatment.
The research was carried out by Virta Well being, a number one on-line sort 2 diabetes administration platform. The enterprise recognized 154 clients who had been deprescribed a GLP-1 treatment corresponding to Ozempic or dulaglutide (Trulicity), and matched them with an equal variety of sufferers who continued to make use of a GLP-1 drug, and in contrast the outcomes. (Most of the former GLP-1 customers switched to metformin.)
Earlier than the research started, the GLP-1 medicines had helped each arms of the research obtain a mean A1C beneath 6.5 p.c and spectacular weight reduction (about 28 kilos).
All research individuals have been inspired to eat fewer than 30 grams of carbohydrates per day (vegans have been allowed 50 g) and to eat loads of protein (1.5 g per kilogram of physique weight), about twice as a lot as beneficial by the American well being authorities. Virta customers are additionally instructed on the basics of a “well-formulated ketogenic weight loss program,” filled with healthful low-carb choices like veggies, nuts, seeds, and berries.
One 12 months after discontinuing their weight reduction drug, Virta customers on their low-carb weight loss program:
- Maintained their weight reduction simply in addition to the individuals who continued to make use of their GLP-1. There was no statistically vital distinction in physique weight between those that went off the drug and those that continued to make use of it.
- Skilled a slight enhance in blood sugar ranges. Although A1Cs rose after deprescription, they largely remained in a wholesome vary. Twelve months after discontinuing a GLP-1, the common participant noticed their blood sugar rise 0.6 proportion factors, as much as 6.2 p.c, nonetheless under the official vary for diabetes.
The authors speculated that the low-carb weight loss program could have been decreasing starvation and urge for food simply as successfully because the GLP-1 treatment. There’s a wealth of data suggesting that low-carb and keto diets can assist individuals with diabetes drop some weight. Some keto dieters even discover that they drop some weight nearly effortlessly as a result of they replenish on wealthy low-carb meals earlier than consuming too many energy.
We must always actually take this consequence with a grain of salt. This was a retrospective evaluation slightly than a randomized managed trial, and it examined individuals who signed up for (and caught with) a low-carb diabetes program — not the common Ozempic consumer. Maybe extra importantly, the evaluation was carried out by staff of Virta Well being itself, introducing an apparent hazard of bias in research design and evaluation.
Nonetheless, the outcomes could also be encouraging for anybody with diabetes who’s planning to discontinue Ozempic, Trulicity, or Mounjaro and is anxious about shedding the well being advantages. A low-carb strategy might be an efficient off-ramp.
Virta Well being routinely releases real-world information on its customers. A five-year research of the outcomes of 200 Virta sufferers discovered that this system conferred weight reduction (a mean of 19 kilos), improved A1C, diminished reliance on diabetes treatment, and different associated metabolic advantages corresponding to improved ldl cholesterol.
