Maintaining Weight Loss with a Gradual Semaglutide Taper.

Maintaining Weight Italy’s Venice Retrospective, real-world data indicates that patients who also follow a computerized weight loss program can maintain their target weight up to six months after starting personalized doses and slowly reducing semaglutide (Segovia or Osmic, Novo Nordisk).

It was discovered that for weight loss, lower dosages were equally as helpful as greater amounts. Henrik Gudbergsen, MD, the study’s principal investigator and chief medical officer of Embla, a digital weight loss clinic in Copenhagen, Denmark, noted that gradually cutting back on medication while emphasizing lifestyle modifications through the use of a digital program seems to help avoid weight regain.

Maintaining Weight Loss with a Gradual Semaglutide Taper.

Maintaining Weight A third (36.1%) of the recommended cumulative semaglutide dose was used by patients in the weight reduction program, and they dropped a median of 14.8% (95% CI, 14.3%-15.2%) of their body weight.

by week sixty-four. The minor and temporary side effects included nausea, vomiting, and stomachaches.

People who participate in our program lose about 15% of their starting weight, but they only use a third of the medicine, which is the same level of weight reduction as observed in the phase 3 trials of semaglutide. According to Gudbergsen, the lifestyle changes are effective, as reported by Medscape Medical News.

Maintaining Weight For the first 26 weeks, patients who weaned off semaglutide to zero—data are available for 85 participants—maintained a constant body weight.
Two posters showcasing the results will be displayed at the European Congress on Obesity (ECO) 2024 on May 13 and 14.

“Our results show that weight loss is achievable regardless of initial body mass index (BMI) and the amount of semaglutide used,” Gudbergsen stated. “Using lower doses of semaglutide is cheaper for patients, results in fewer side effects, and helps ensure that stocks of the drug, which are still limited, go further.”

Maintaining Weight Loss with a Gradual Semaglutide Taper.

Maintaining Weight Gudbergsen commented, “The combination of support in making lifestyle changes and slow tapering seems to allow patients to avoid regaining weight after coming off semaglutide,” in reference to the sustained modest weight reduction following cessation. That, in my opinion, is evidence that they have not only stopped using semaglutide to help them lose weight, but have also learned more about food, exercise, lifestyle, and emotional eating patterns. In actuality, they are in charge.”

Gudbergsen added that

Maintaining Weight The program’s reduced maximum dose encouraged participants to make supportive lifestyle adjustments that “should help with losing weight and with keeping it off.”

Losing Weight Without Negative Effects
Gudbergsen and his Embla colleagues sought to see whether semaglutide could be customized to cause weight reduction with negligible adverse effects and whether the medicine could be gradually reduced to zero dosage without causing weight gain when the desired weight was reached.

The study included 2246 people who were overweight and had at least one weight-related comorbidity (BMI between 27 and 29.9) or who were obese (BMI > 30). Every participant was a resident of Denmark, with a median age of 49 (ranging from 41 to 55) and a median body mass index of 33.2. They  were signed up for the Embla app, a digital weight loss program.


Maintaining Weight Embla is a weight loss program that combines medication and lifestyle modifications supervised by physicians, nurses, health coaches, and psychologists with peer support from Embla communities.

Maintaining Weight To ensure the lowest effective dose that accommodated any adverse effects, participants received a customized version of the conventional semaglutide dosing regimen, starting at 0.25 mg once weekly and increasing incrementally every 4 weeks to a maximum of 2 mg for Osmic and 2.4 mg for Segovia. If weight reduction did not progress, doses were raised; however, if at least 0.5% of body weight was lost each week, the dose did not change. The tapering strategy called for gradually reducing the drugs over a median of nine weeks.

Maintaining Weight Weight Loss Sustaining Following Semaglutide Cessation — Limited Data
A total of 1,392, 359, and 185 people were still in the program after 26, 64, and 76 weeks, respectively (the median follow-up period for the 2246 program participants was 32 weeks).

All participants with a reported weight at week 64 lost more than 5% of their body weight, and 85.3% of them lost more than 10% of their baseline body weight. The average maximum dose of semaglutide was 0.77 mg. Neither the cumulative dose of semaglutide nor the initial BMI significantly affected the amount of weight lost.

The median tapering period for the 353 individuals who reduced their semaglutide dosage was 9 weeks (95% CI, 8%–10%), following which the

Maintaining Weight The body weight changed by −2.1% on average (95% CI: −3.5% to −0.8%). Within 72 weeks of starting the program, nearly 40% started tapering.

Maintaining Weight A total of 240 people (out of 353) totally ceased using the medication; available data from 85 of these individuals indicated an average loss of body weight at 26 weeks of −1.5% (95% CI, −6.4% to 3.3%). 19.5 weeks was the median follow-up period following cessation.

Maintaining Weight Loss with a Gradual Semaglutide Taper.

Maintaining Weight “Because they’ve engaged in some of the lifestyle changes, when they eventually taper off, they keep the weight off without semaglutide,” Gudbergsen stated. “I think there’s a strong linkage between the initial phase of using this medication with lifestyle changes and actually being capable of keeping the kilos off once they’ve stopped.”

Of the 46 individuals who

When semaglutide was resumed, body weight had grown by 1.3% (95% CI, −0.1% to 2.7%) since discontinuing, and the likelihood of restarting was 21.5% (95% CI, 14.8-27.6%) 26 weeks after the last dose.

Maintaining Weight Essen Selmer Buhl, MD, PhD, a general practitioner physician at the Institute for Health and Society, University of Oslo, Oslo, Norway, was asked to comment on the work. He said, “We know from other studies that after a major weight loss — regardless of the regimen used — the weight adjusted metabolic rate is reduced by approximately 25%, and the patient’s ability to feel satiety is vastly impaired while the feeling of hunger is vastly upregulated.” He also added, “Studies also suggest this situation persists for years in those very few who are able to maintain their weight for a long time, ” following a significant weight loss.”

Maintaining Weight Loss with a Gradual Semaglutide Taper.

Maintaining Weight It’s because of dealing with a lower basal metabolic rate along with increased hunger that prolonged weight reduction proves to be challenging. “I don’t think that cutting back on semaglutide will significantly alter the situation. Based on my clinical expertise, I think most of the patients in Embla’s study would eventually start gaining weight after being left on their own.”

“We’ve tried lowering or even weaning off semaglutide, but all of our patients start gaining weight eventually, usually between three and eighteen months. It turns out that our patients require multiple therapy cycles in order to maintain their body weight. Many patients would rather have long-term semaglutide therapy to ensure weight maintenance and lower their chance of yo-yo weightlifting.”

Maintaining Weight Loss with a Gradual Semaglutide Taper.

Maintaining Weight “Nevertheless, not least due to the costs for semaglutide, lower-dose semaglutide, for instance, 1.0 mg per week in addition to diet and exercise, seems to be a sweet spot for maintaining the weight lost,” noted Selmer Buhl.

Maintaining Weight Gudbergsen holds equity in Embla and works there. Selmer Buhl worked for Novo Nordisk (Head of Medical Affairs, NN Scandinavia, area Denmark) and McKinsey & Company (2010–2011; servicing customers in the pharmaceutical industry that I cannot disclose) before leaving. The American Beverage Association has provided cash for studies to Dr. Halford.

Article Source Medscape

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