New injectable diabetes medicines, together with semaglutide (Ozempic) and tirzepatide (Mounjaro), are clearly the simplest weight reduction medicine ever developed. These medicine, referred to as GLP-1 receptor agonists, may additionally be essentially 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 a giant one: You most likely should take them endlessly. Specialists agree that sufferers who need to maintain their weight reduction and glucose enhancements must hold utilizing their GLP-1s indefinitely. While you cease utilizing Ozempic, you possibly can anticipate your urge for food to return, your weight to return again, and your blood sugar to return up.
A current examine discovered that sufferers with out diabetes who used tirzepatide (Zepbound) regained about half of the load they’d initially misplaced a 12 months after discontinuing the drug. That general weight reduction was nonetheless spectacular, however specialists appear resigned that the majority sufferers would ultimately regain all of it. Research coauthor Louis Aronne, MD, instructed On a regular basis Well being, “Should you cease the treatment, you regain the load — there’s no query that may occur.”
Hundreds of thousands 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 numerous explanation why folks would possibly stop utilizing these highly effective therapies, together with the excessive value (particularly when insurance coverage modifications or coupons expire), uncomfortable side 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 folks coming off of those potent medicine. Many articles have been written on how one can hold the load off (and glucose beneath management) after discontinuing a drug like Ozempic, however there’s evidently no straightforward 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 one million occasions earlier than.
A Low-Carb Food plan Helped Sufferers Preserve the Kilos Off
There’s a brand new examine in Diabetes Remedy suggesting {that a} very low-carb or keto weight-reduction plan may also help folks preserve weight reduction after discontinuing a GLP-1 treatment.
The examine 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 comparable 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 examine started, the GLP-1 medicines had helped each arms of the examine obtain a mean A1C beneath 6.5 p.c and spectacular weight reduction (about 28 kilos).
All examine members had been inspired to eat fewer than 30 grams of carbohydrates per day (vegans had been allowed 50 g) and to eat loads of protein (1.5 g per kilogram of physique weight), about twice as a lot as advisable by the American well being authorities. Virta customers are additionally instructed on the basics of a “well-formulated ketogenic weight-reduction plan,” 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-reduction plan:
Maintained their weight reduction simply in addition to the members who continued to make use of their GLP-1. There was no statistically important 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-reduction plan might 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 may also help folks with diabetes shed extra pounds. Some keto dieters even discover that they shed extra pounds 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 person. Maybe extra importantly, the evaluation was carried out by staff of Virta Well being itself, introducing an apparent hazard of bias in examine 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 worried about dropping the well being advantages. A low-carb method could possibly be an efficient off-ramp.
Virta Well being routinely releases real-world knowledge on its customers. A five-year examine 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 comparable to improved ldl cholesterol.
Sources
Put up Views: 36