Study Shows Exercise Can Help You Lose Weight After Taking Weight Loss Drugs

After that, the pound almost always creep up, and almost worryingly, the weight that people gain back tends to be almost exclusively fat and very little muscle. As a result, people are often in worse metabolic health than they were before they started using the drug.

But important, new, long-term study The proportion of people who used any of the weight-loss drugs and then stopped them suggests that there may be an easy and accessible way to prevent unhealthy weight gain after stopping the drugs: exercise.

In this study, people who exercised while using weight loss drugs lost significantly more weight and maintained more muscle after stopping the drugs than those who did not exercise.

Signe Sørensen-Trekov, professor of biomedical science at the University of Copenhagen in Denmark and senior author of the new study, said the results show that people who use drugs can continue to “stay healthy” even after they stop taking medication. “This strongly suggests that it is possible to maintain a healthy weight.” medicine. “But exercise is necessary.”

Weight loss, with catch

Most obesity experts agree that the ultimate goal of healthy, long-term weight loss is maintenance. For many people, it is possible to lose weight in the short term. It may seem almost impossible to maintain it.

A new class of GLP-1 diabetes or weight loss drugs with brand names such as Ozempic, Wegovy, Zepbound, and Mounjaro appears to be strengthening that dynamic. GLP-1 is an abbreviation for glucagon-like peptide 1 agonist. These drugs mimic the effects of a substance called GLP-1.

Most people lose a lot of weight quickly when taking these drugs. But if you stop, the pounds usually come back at about the same rate.

But is this rebound inevitable?

Tolekov and his colleagues devised a multi-year, multifaceted effort to find out.

The experiment began with 195 Danish adults who were obese but had no other major medical conditions. Under the supervision of scientists, they were fed an extremely low-calorie diet and rapidly lost about 30 pounds. Because this is a weight maintenance study, the scientists wanted to lose weight quickly and then move on to a maintenance phase.

At that stage, researchers assigned some volunteers to start taking an early GLP-1 treatment, Saxenda (commonly known as liraglutide), which helped them maintain weight loss from dieting and I checked to see if it would help with the increase. Saxenda is manufactured by Novo Nordisk, which also makes two similar drugs: the diabetes drug Ozempic and the weight loss drug Wigovy.

(The study was partially funded by the Novo Nordisk Foundation, a charity affiliated with the manufacturer of Saxenda. The drug company itself had no oversight of the study or its results, a company spokeswoman said. said the person.)

In addition to receiving the same medication, another group of volunteers also received a 30-minute group spinning class and 15 minutes of high-intensity full-body resistance training twice a week, as well as two at-home jogs and supervised sessions. He also started an exercise program. Similar training. The exercise was mostly strenuous, so strenuous that it was almost impossible to talk during the exercise.

The control group did not exercise and received a placebo instead of liraglutide. (Saxenda's prescribing information states that it should be used in conjunction with a low-calorie diet and increased physical activity, but that recommendation is often ignored.)

After a year, nearly everyone who took the drug maintained a lower weight or lost more weight than before.

But those who combined drugs and exercise suffered the most losses. They lost about 6 pounds more than those taking the drug alone, and much of that weight was made up of fat rather than muscle.

What happened when I stopped taking the drug?

researchers published those results Published in the New England Journal of Medicine in 2021. Then they began the most revelatory aspect of the study. They stopped everyone's medications and exercise sessions, allowing people to maintain or regain weight loss completely on their own.

After a year, the researchers invited all the volunteers to the lab. The 199 participants returned, and researchers looked at their weight, body composition, and current exercise habits.

For some, this year has been a discouraging one. People who previously took weight-loss drugs without exercise regained about 70 percent or more of the weight they had lost since the start of the study. Most of these regained pounds were in the form of fat rather than muscle, resulting in a relatively higher percentage of body fat than before starting the drug.

“They were gaining weight in an unhealthy way,” Trekov said.

However, those who exercised while taking the drug maintained significantly more weight loss during this phase. Many continued to weigh at least 10 percent less than they did at the start of the study, at least some of the weight they regained was muscle, and they had a healthier body composition than the other groups.

exercise only 2 hours a week

Trekov said it's easy to understand why the exercisers gained less weight after stopping drug use. Even without the supervision and nagging of scientists, “they were still on the move.” They typically continued to voluntarily work out several hours a week, according to surveys and activity trackers.

These findings suggest that “about two hours of vigorous exercise per week” may be a good goal to prevent weight gain after stopping weight loss drugs, she continued. It's probably best to combine aerobic and resistance exercise.

Meanwhile, people who took the drug without exercising are now almost completely sedentary, exercising less than 30 minutes a week on average.

“Many patients who did not exercise while on medication complained of fatigue during and after treatment,” Tolekov said, which may be contributing to the current lack of exercise. said.

Overall, the results make a strong case for the “importance of adding exercise to regimens that include GLP-1 drugs,” says Diabetes expert and senior research fellow at the Lunenfeld-Tannenbaum Institute in Toronto. said one Daniel Drucker, whose research contributed. Paving the way to GLP-1 drugs. He was not involved in the new research.

“The results are very encouraging,” agrees Robert Kushner, an endocrinologist and professor at Northwestern University Feinberg School of Medicine who specializes in weight loss. “However, further research will be needed to see if a less intense exercise routine has a similar effect on weight maintenance when GLP-1 drugs are discontinued.”

This study also has other limitations. It used liraglutide, which is not as powerful as newer obesity drugs. However, “we expect the direction of results to be similar with newer GLP-1 drugs,” Drucker said.

There were also relatively healthy Danes participating, who may not be the typical population looking to lose weight. And the exercise routines in this study weren't just intense, they were sometimes difficult. Also, his first year was closely monitored for free, a luxury many of us had.

Still, for now, the study shows that to prevent weight gain and maintain muscle mass during and after treatment with obesity drugs, Tolekov said, “It's really important to have an exercise program.”

Have fitness questions? Email [email protected] I may answer your question in a future column.

Sign up for the Well+Being newsletter for expert advice and easy tips to help you live well every day