Palmira Alvarez

New Lancet data on GLP-1 agonists 👇 A new paper in The Lancet eClinicalMedicine shows that when GLP-1 therapy is stopped, most people regain the lost weight and lose metabolic benefits. In practice, this means GLP-1s function as chronic, often lifelong therapy not a temporary fix. To be clear, GLP-1 agonists are improving the health of many people, especially patients with obesity, type 2 diabetes and high cardiometabolic risk. For these individuals, weight loss can be genuinely life-changing. The concern is not appropriate medical use but indiscriminate use. With millions already taking these drugs and numbers rising rapidly (specially with the new pill format), many users are not patients in the classical sense, but generally healthy or mildly overweight individuals. In this context, the risk–benefit balance changes. Once started, most users will need to stay on GLP-1s indefinitely or face significant rebound effects, often returning to baseline or worse. As an important caveat: GLP-1s improve metabolic control, but they do not rebuild metabolic capacity. Without resistance training, meaningful metabolic work (Zone 2 and above), and adequate protein intake, long-term use may promote lean mass loss, low energy flux and increased frailty risk with aging. In addition, we still lack long-term data on potential pancreatic, thyroid, and central neurotransmitter effects. GLP-1s are powerful tools, but not a standalone solution. Long-term success requires pairing pharmacology with training and metabolic resilience. IMHO: based on current clinical and research evidence, it is now urgent that clinicians clearly inform users that starting GLP-1 therapy likely means committing to long-term or lifelong use, with all the consequences that may entail. thelancet.com/journals/eclin…