Discontinuing semaglutide after weight loss: strategy for weight maintenance and a possible new side effect.

Autor:	Carris NW; Department of Pharmacotherapeutics and Clinical Research, USF Health Taneja College of Pharmacy, University of South Florida; 12901 Bruce B. Downs Blvd MDC 30, Tampa FL, 33612, USA., Wallace S; Tampa General Medical Group, 2211 Lithia Center Ln, Valrico, FL 33594, USA., DuCoin CG; Department of Surgery, USF Health Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 410, Tampa, FL 33606, USA., Mhaskar R; Department of Internal Medicine, USF Health Morsani College of Medicine, University of South Florida, 560 Channelside Drive MDD 54, Tampa, FL 33602, USA., Stern M; Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida 13301 Bruce B. Downs Blvd., MHC 2510, Tampa, FL 33612, USA., Bunnell B; Department of Psychiatry and Behavioral Neurosciences, USF Health Morsani College of Medicine, University of South Florida 3515 E. Fletcher Ave, Tampa, FL 33613, USA.
Jazyk:	angličtina
Zdroj:	Canadian journal of physiology and pharmacology [Can J Physiol Pharmacol] 2024 Jun 01; Vol. 102 (6), pp. 391-395. Date of Electronic Publication: 2024 Apr 08.
DOI:	10.1139/cjpp-2023-0464
Abstrakt:	Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) facilitate weight loss. Weight regain off therapy is concerning. We reported the case of a 35-year-old male prescribed oral semaglutide with 22.7 kg weight loss over 120 days. Herein, we describe the clinical course when discontinuing GLP-1 RA therapy, one approach to maintaining weight loss after discontinuation, and a possible new side effect. At day 120, we continued oral semaglutide 7 mg daily, down from 14 mg, for weight maintenance with subsequent weight regain. We re-increased semaglutide to 14 mg/day with weight re-loss within 1 month and weight maintance for a year. We then discontinued semaglutide; weight loss was maintained for 6 months. The patient reported lactose intolerance ∼13 months before starting semaglutide. During semaglutide therapy, the patient reported worsened lactose intolerance and new gluten intolerance. Food allergy/celiac testing were negative. Intolerances did not improve with semaglutide discontinuation. Six months after semaglutide discontinuation, the patient was diagnosed with small intestinal bacterial overgrowth, possibly worsened by semaglutide. Factors potentially supporting weight maintenance were early drug treatment for new-onset obesity, non-geriatric age, strength training, and diet modification. The case highlights tailoring approaches to maintain weight loss without GLP-1 RAs. Trials are needed to optimize weight maintenance strategies. Competing Interests: Dr. Carris has received research funding (institution receives and manages funds) from Sanofi Winthrop Industries. Dr. DuCoin declares consulting for Johnson & Johnson, Medtronic, and Intuitive. The remaining authors have no conflicts of interest, or other interests, that might be perceived to influence the results and/or discussion reported in this paper.
Databáze:	MEDLINE
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