服用减肥针的人比节食者恢复体重速度快四倍。
People who come off slimming jabs regain weight four times faster than dieters

原始链接: https://www.bbc.com/news/articles/c050ljnrv2qo

《英国医学杂志》的新研究显示,停止使用像Mounjaro和Wegovy等减肥注射剂的人,体重恢复速度是停止传统饮食和运动的人的四倍,大约每月增加0.8公斤,可能在18个月内恢复到最初的体重。虽然这些注射剂可以带来显著的初始体重减轻(约占体重的20%),但对超过9000名患者的研究强调了快速反弹的显著风险。 研究人员认为,这些药物通过模拟一种天然的食欲调节激素,可能会减少身体自身对该激素的产生,从而导致停药后食欲增加。专家强调,除了药物治疗外,还需要改变生活方式——健康饮食和运动,并建议治疗可能需要终身进行以防止复发。 目前,英国国民医疗服务体系将这些注射剂限制用于那些存在与肥胖相关的健康风险的人群。随着使用人数的增加——160万英国成年人已经尝试过这些药物,了解其长期影响和肥胖症的慢性性质至关重要。

## 减肥针停用后体重反弹:Hacker News 讨论 一篇BBC文章报道了停止使用减肥针(GLP-1s)后体重反弹速度加快的情况,引发了 Hacker News 的讨论。 许多评论者强调了一个关键点:将减肥针使用者和节食者的反弹率进行比较是有缺陷的,因为存在**选择偏差**。 成功减肥的节食者本身就是少数,他们的反弹率不具有代表性。 然而,GLP-1s 能够让更大比例的人最初实现显著的体重减轻。 对话强调,这些减肥针最有效的使用方式是与生活方式改变一起进行——重新训练食欲并养成更健康的生活习惯。 它们不被视为“治愈方法”,而是食欲抑制剂,需要持续使用才能持续受益,类似于他汀类药物或胰岛素等药物。 财务可及性和终身承诺的可能性也被提出作为担忧。 一些用户分享了在停止使用 Ozempic 后成功保持体重减轻的积极经验,而另一些人则注意到停药后体重明显反弹,承认恢复了以前的饮食习惯。 讨论的结论是,这些药物是工具,而不是神奇的解决方案,需要现实的期望和持续的努力。
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原文

Michelle RobertsDigital health editor

Slimmers who come off weight-loss injections such as Mounjaro or Wegovy can regain their lost pounds four times faster than those who stop conventional dieting and exercising, new research suggests.

Data published in the British Medical Journal suggests overweight people shed large amounts when using jabs - about a fifth of their body weight - but once they quit they regain 0.8 kg every month, on average.

That means they return to their pre-treatment weight in a year and a half.

"People buying these need to be aware of the risk of fast weight regain when the treatment ends," warns investigator Dr Susan Jebb, from Oxford University.

She stressed that the findings come from medical trials rather than real life and more studies of the longer-term effects of new slimming jabs would be helpful.

The researchers looked at 37 studies with over 9,000 patients to compare the blockbuster weight-loss jabs with conventional dieting or other pills.

Only eight of the studies assessed treatment with the newer GLP-1 drugs, such as Wegovy and Mounjaro, and the maximum follow-up period in these studies was a year after medication stopped, so the figures are an estimate.

People who diet instead can expect to lose less weight than with the jabs, but afterwards weight creeps back on more slowly - perhaps around 0.1 kg a month - say the researchers, although it does vary.

Risk of relapse

The NHS recommends the jabs for people who are overweight with obesity-related health risks - not people who just want to get a bit slimmer.

And doctors should also prescribe lifestyle changes that include eating healthily and getting enough exercise to help people keep the weight off.

Many say the treatment should be considered life-long, given the risk of relapse.

People who have tried coming off the jabs describe it as "a switch that goes on and you're instantly starving".

One woman said: "It was like something opened up in my mind and said: 'Eat everything, go on, you deserve it because you haven't eaten anything for so long.'"

Dr Adam Collins, an expert in nutrition at the University of Surrey, says the way the jabs work in the brain and body might explain why weight regain is amplified once you stop taking them.

They mimic a natural hormone called GLP-1, which regulates hunger.

"Artificially providing GLP-1 levels several times higher than normal over a long period may cause you to produce less of your own natural GLP-1, and may also make you less sensitive to its effects.

"That's not a problem when taking the drugs, but as soon as you withdraw this GLP-1 'fix', appetite is no longer kept in check and overeating is far more likely."

Going cold turkey is a real challenge, he says.

"This is further exacerbated if the individual in question has relied solely on GLP-1 to do the heavy lifting... artificially suppressing their appetite without them establishing any dietary or behavioural changes that would help them in the long run."

According to latest best estimates by researchers from University College London, around 1.6 million UK adults have used these injections in the past year - mostly bought through private prescriptions rather than on the NHS.

An additional 3.3 million people say they would be interested in using "skinny jabs" over the next year, meaning one in 10 adults has either tried them or would like to, based on nationally representative surveys in the first quarter of 2025, funded by Cancer Research UK.

Use was twice as common among women compared to men, and more common among people in their 40s and 50s.

Chronic nature of obesity

Prof Naveed Sattar from Glasgow University said the jabs could provide added health benefits by working fast to get weight down.

"It's plausible that being lighter for even two to three years due to short-term use of the jabs could help slow damage to joints or the heart and kidneys. Larger and longer outcome trials will be needed to answer that question.

"Importantly, continued use of these medicines over three to four years enables people to maintain significantly lower weight than they would otherwise – a benefit not typically seen with lifestyle-induced weight loss, where many regain weight over time."

GPs and specialist weight-management services cannot automatically prescribe Mounjaro and Wegovy, even if patients have already been prescribed it privately.

The drugs can be offered to those in greatest clinical need who meet certain criteria, such as having weight-related health problems.

Currently, there is no specified time limit for Mounjaro prescriptions on the NHS, while Wegovy can only be prescribed for a maximum of two years.

A spokeswoman for Eli Lilly, a pharmaceutical company that makes Mounjaro, said use of weight-loss drugs needed to be accompanied by healthy eating, physical activity and medical follow-up.

"When treatment is stopped, weight can return, which reflects the biology of the condition rather than a lack of effort."

Pharmaceutical company Novo Nordisk, which makes Wegovy, said: "These findings highlight the chronic nature of obesity and suggest that ongoing treatment is necessary to maintain improvements in weight and overall health for patients, similar to the management of other chronic conditions such as diabetes or hypertension."

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