BMJ：GLP-1类减肥药效果虽好，但反弹更快！停药后一年多后体重和心血管指标就恢复如初

Core Viewpoint - The emergence of GLP-1 receptor agonists, such as semaglutide and tirzepatide, has transformed obesity treatment, enabling rapid weight loss of 15%-20%. However, approximately 50% of obese patients discontinue these medications within a year, leading to significant weight regain and the need to understand post-medication weight changes [6][10]. Research Background: Current Status and Challenges in Obesity Treatment - Nearly 2 billion adults globally are affected by overweight or obesity, which significantly increases the risk of various complications and premature death. Behavioral weight management programs (BWMP) have traditionally been the cornerstone of obesity treatment, focusing on low-calorie diets and increased physical activity. The introduction of new weight loss medications is changing the treatment landscape [6][5]. Research Methodology: Rigorous Evidence Synthesis - The research team systematically reviewed seven databases and trial registries, including 37 studies with 9,341 participants. The average treatment duration was 39 weeks, with an average follow-up of 32 weeks post-medication. Various weight loss medications were analyzed, focusing on both weight changes and cardiovascular metabolic markers [8][7]. Key Findings: Dual Regain of Weight and Health Indicators - On average, participants lost 8.3 kg during medication use, but weight began to rebound post-discontinuation at a rate of 0.4 kg per month, leading to a full return to baseline weight in approximately 1.7 years. Newer medications like semaglutide and tirzepatide showed even faster rebound rates of 0.8 kg per month, returning to baseline in about 1.5 years. Cardiovascular metabolic benefits also diminished within 1.4 years after stopping medication [10][4]. Comparative Analysis: Differences Between Medication and Behavioral Interventions - While medication resulted in a greater average weight loss of 3.2 kg, the rebound rate was significantly faster compared to behavioral interventions, which had a rebound rate of only 0.1 kg per month, taking about 3.9 years to return to baseline weight. This indicates that behavioral interventions may equip participants with sustainable weight management skills, unlike medication, which primarily reduces hunger and increases satiety [12][14]. Insights and Recommendations: Rational Perspective on Weight Loss Medications - The research emphasizes that obesity is a chronic relapsing disease that may require long-term treatment for sustained health benefits. Evidence suggests that continuous use of semaglutide for four years can successfully maintain weight loss. Given the high discontinuation rates of weight loss medications, it is crucial to recognize that these drugs alone may not suffice for long-term weight control. Sustainable healthy lifestyle changes remain fundamental in obesity prevention and treatment [15][16].