Stopping Ozempic? Low-Carb Might Help Keep the Weight Off

New injectable diabetes medicines, together with semaglutide (Ozempic) and tirzepatide (Mounjaro), are clearly the simplest weight reduction medication ever developed. These medication, often called GLP-1 receptor agonists, may additionally be essentially the most potent diabetes remedies for the reason that discovery of insulin, providing huge enhancements in blood sugar management and A1C.

However there’s a catch, and an enormous one: You most likely need to take them ceaselessly. Specialists agree that sufferers who wish to maintain their weight reduction and glucose enhancements have to preserve utilizing their GLP-1s indefinitely. Once you cease utilizing Ozempic, you may count on your urge for food to return, your weight to return again, and your blood sugar to return up.

A latest examine discovered that sufferers with out diabetes who used tirzepatide (Zepbound) regained about half of the burden they’d initially misplaced a 12 months after discontinuing the drug. That total weight reduction was nonetheless spectacular, however consultants appear resigned that almost all sufferers would finally regain all of it. Research coauthor Louis Aronne, MD, informed On a regular basis Well being, “In the event you cease the treatment, you regain the burden — there’s no query that may occur.”

Thousands and thousands of individuals have already encountered this drawback: Greater than two-thirds of GLP-1 customers cease utilizing their new treatment inside a 12 months. There are numerous the reason why individuals may stop utilizing these highly effective therapies, together with the excessive price (particularly when insurance coverage modifications or coupons expire), unintended effects, provide shortages, or easy discomfort with the concept of taking a weight reduction drug for years.

And there isn’t a lot good recommendation for individuals coming off of those potent medication. Many articles have been written on how one can preserve the burden off (and glucose underneath management) after discontinuing a drug like Ozempic, however there may be evidently no simple repair. Most recommendation — nutritious diet, portion management, train — is, whereas undoubtedly correct, precisely what so many individuals residing with sort 2 diabetes or weight problems have already heard 1,000,000 instances earlier than.

A Low-Carb Weight-reduction plan Helped Sufferers Maintain the Kilos Off

There’s a brand new examine in Diabetes Remedy suggesting {that a} very low-carb or keto weight loss plan may help individuals 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 prospects who had been deprescribed a GLP-1 treatment corresponding 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. (Lots 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 underneath 6.5 % 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 really useful by the American well being authorities. Virta customers are additionally instructed on the basics of a “well-formulated ketogenic weight loss 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 loss 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 people who 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 typical participant noticed their blood sugar rise 0.6 proportion factors, as much as 6.2 %, nonetheless under the official vary for diabetes.

The authors speculated that the low-carb weight loss plan might have been decreasing starvation and urge for food simply as successfully because the GLP-1 treatment. There’s a wealth of knowledge suggesting that low-carb and keto diets may help individuals with diabetes drop a few pounds. Some keto dieters even discover that they drop a few pounds virtually effortlessly as a result of they refill on wealthy low-carb meals earlier than consuming too many energy.

We must always definitely 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 typical 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.

However, the outcomes could also be encouraging for anybody with diabetes who’s planning to discontinue Ozempic, Trulicity, or Mounjaro and is anxious about dropping the well being advantages. A low-carb method might 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, lowered reliance on diabetes treatment, and different associated metabolic advantages corresponding to improved ldl cholesterol.