Weight regain after cessation of medication for weight management: systematic review and meta-analysis

To quantify and compare the rate of weight regain after cessation of weight management medications (WMMs) in adults with overweight or obesity.

Systematic review and meta-analysis. STUDY SELECTION: Trial registries and databases (Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries) were searched from inception until February 2025 for randomised controlled trials (RCTs), non-randomised trials, and observational studies that included WMM (≥8 weeks) with follow-up for ≥4 weeks after cessation of treatment in adults with overweight or obesity. Comparators were any non-drug weight loss intervention or placebo. DATA EXTRACTION AND SYNTHESIS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Two independent reviewers screened titles, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool for RCTs and the ROBINS-I tool for non-randomised trials. Data were analysed using mixed effect, meta-regression, and time-to-event models. Weight regain after cessation of WMM was compared with that reported after cessation of behavioural weight management programmes (BWMPs). MAIN OUTCOME MEASURES: The primary outcome was rate of weight regain from end of treatment, with associated changes in cardiometabolic markers as a secondary outcome.