Considering that more than 73% of US adults have obesity or are overweight, it is not surprising that at some point, roughly 1 out of every 5 adults have taken a GLP-1 medication. However, in a large US cohort study of 125,474 patients initiating GLP-1 medications, 53.6% of patients discontinued within one year, rising to 72.2% who discontinued the medication by two years. Ongoing use of GLP-1 medications may be limited by tolerability, efficacy, access, and cost.
More than 70% of patients in clinical trials of GLP-1 medications reported adverse events, which may include nausea, vomiting, diarrhea, constipation, abdominal pain, and bloating. Less common but potentially serious side effects include gallbladder problems, pancreatitis, dehydration, delayed gastric emptying, worsening diabetic retinopathy, diabetic macular edema, and observational cases with unclear etiology of non-arteritic anterior ischemic optic neuropathy causing vision loss. Of increasing concern is rapid weight loss leading to significant loss of muscle mass and facial fat, with further concerns including the development of malnutrition.
For some patients, the GLP-1 medication was discontinued due to achieving an ideal body weight goal and the desire to no longer stay on a long-term, costly medication. Unfortunately, a 2026 systematic review/meta-regression of 48 studies found that, on average, people regained approximately 60% of their previous weight loss by one year after stopping a GLP-1 drug. The model estimated that patients could eventually regain about 75% of the weight originally lost.
Regardless of why they discontinue the GLP-1 medication, patients have other options to help them achieve their weight-loss goals or maintain their ideal body weight. Understanding how GLP-1 medications work helps when considering alternative treatment options for weight loss.
How GLP-1 medications work
GLP-1 RA stands for glucagon-like peptide-1 receptor agonist. These are medications that mimic the action of a naturally occurring hormone in the body called GLP-1, which is involved in blood-sugar regulation, appetite, and digestion. The GLP-1 medications decrease appetite, slow stomach emptying, enhance satiety, increase insulin release when blood glucose is elevated, and improve blood-glucose control. Together, these effects can lead to significant weight loss.Interestingly, complementary medicine offers options that can mimic the similar mechanisms of action of GLP-1 medications to help promote weight loss. Evidence-based medicine shows that these treatment modalities include Acupuncture, Nutritional Counseling with specific dietary modifications, and Naturopathy.
Acupuncture
Acupuncture has been studied and proposed as a complementary and integrative approach to weight loss, with many clinical trials and evidence-based analyses showing its efficacy. Proposed mechanisms of action include effects on appetite and satiety signaling through hormonal regulation and communication, autonomic nervous system activity, stress and emotional eating, sleep, glucose metabolism, and possible impacts on inflammatory pathways. The following abstract is a 2025 umbrella review encompassing 22 systematic reviews and 60 meta-analyses, which concluded that, “Based on high-quality evidence, clinicians can recommend acupuncture to patients with obesity, particularly as adjunctive therapy to lifestyle interventions. For patients unable to tolerate pharmacological treatments, acupuncture represents a reasonable alternative.”
https://pubmed.ncbi.nlm.nih.gov/41071083/
Nutritional Counseling
Since every patient is unique with differing metabolic rates, medical history, nutritional needs, and food allergies, intolerances, and preferences, Nutritional Counseling is essential for weight loss management plans. For example, adequate intake of protein and fiber throughout the day can support weight management through several complementary mechanisms by enabling a lower-calorie diet that enhances satiety and provides adequate nutrition. Protein supports weight management by promoting fullness, reducing hunger between meals, preserving muscle, and increasing thermogenesis since digesting protein expends more energy than digesting carbohydrates or fats. Fiber promotes weight management by adding volume in the stomach to enhance the sensation of fullness, slows eating and digestion, helps to regulate blood glucose, supports the gut microbiome that may influence appetite and metabolic regulation, and improves bowel regularity. The following abstract is a 2025 systematic review/meta-analysis of randomized trials in which the results indicated a significant effect of the reduction of body weight, body mass index (BMI), and percent body fat after having a fiber-rich diet.
https://www.sciencedirect.com/science/article/abs/pii/S0985056225000500
Naturopathy
Naturopathic medicine supports weight loss by helping the body to heal and rebalance naturally through nutrition, lifestyle changes, stress management, gut health, and targeted supplements. Naturopathic approaches to weight loss include a variety of complementary options that necessitate a healthcare provider to individualize and integrate management of supplements, diet, and lifestyle modifications to avoid side effects with concurrent prescription medications and to optimize weight loss outcomes. A few examples of evidence-based supplements that might be used for certain patients include berberine and resveratrol.
Berberine: The following abstract is a 2025 systematic review/meta-analysis of 23 randomized trials which found that berberine produced an average additional weight loss of about 0.9 kg (2 pound) versus control, along with small reductions in BMI and waist circumference.
https://pubmed.ncbi.nlm.nih.gov/41310257/
Of further interest is berberine’s clinical evidence for effects on blood glucose and insulin resistance. A 2024 meta-analysis containing 50 randomized trials and 4,150 participants found that berberine alone modestly reduced fasting glucose, post-meal glucose, LDL cholesterol (low-density lipoprotein considered the “bad” cholesterol related to coronary heart disease), total cholesterol, and triglycerides. When added to diabetes medications, the effects on HbA1c (lab test measuring 3-month average glucose levels) and glucose were larger. https://pmc.ncbi.nlm.nih.gov/articles/PMC11617981/
Resveratrol: Although studies have shown mixed results, there may be benefit for select patients to implement resveratrol in their weight management plan under the supervision of a healthcare provider, considering the following 2025 umbrella review of 18 interventional meta-analyses concluded “that resveratrol supplementation reduces body mass index (BMI), body weight, waist circumference, and body fat particularly on doses greater than 400 mg/day and interventions lasting more than 12 weeks, with small effect sizes. Based on our findings, resveratrol supplementation could be considered as a complementary therapy in the management of obesity."
https://pubmed.ncbi.nlm.nih.gov/41317227/
Therefore, patients who have discontinued GLP-1 medications have multiple evidence-based integrative modalities and complementary treatment options at their fingertips to promote their weight loss management with the guidance and support of knowledgeable healthcare professionals.
References:
- Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960-1962 through 2017-2018. National Center for Health Statistics. 2020. Accessed August 24, 2021. https://www.cdc.gov/nchs/data/hestat/obesity-adult-17-18/obesity-adult.htm
- Rodriguez PJ, Zhang V, Gratzl S, et al. Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity. JAMA Netw Open. 2025;8(1):e2457349. doi:10.1001/jamanetworkopen.2024.57349
- Khan SS, Ndumele CE, Kazi DS. Discontinuation of glucagon-like peptide-1 receptor agonists. JAMA. Published online November 13, 2024. doi:10.1001/jama.2024.22284
- Budini, Brajan et al. “Trajectory of weight regain after cessation of GLP-1 receptor agonists: a systematic review and nonlinear meta-regression.” EClinicalMedicine vol. 93 103796. 4 Mar. 2026, doi:10.1016/j.eclinm.2026.103796
- Zhang, Rong-Qiang et al. “Acupuncture for the treatment of obesity in adults: a systematic review and meta-analysis.” Postgraduate medical journal vol. 93,1106 (2017): 743-751. doi:10.1136/postgradmedj-2017-134969
- Dhananjay Sharma, Luxita Sharma, Debasrita Banerjee, Kajal Dhama, Effect of dietary fiber on obese/overweight persons and its mechanism of action: A systematic and meta-analysis on randomized controlled trials, Nutrition Clinique et Métabolisme, Volume 39, Issue 3, 2025, Pages 164-179, ISSN 0985-0562, https://doi.org/10.1016/
- Elahi Vahed, Iman et al. “The effect of berberine on obesity indices: a systematic review and meta-analysis.” International Journal of obesity (2005) vol. 50,1 (2026): 53-73. doi:10.1038/s41366-025-01943-x
- Wang, Jiacheng et al. “Effects of administering berberine alone or in combination on type 2 diabetes mellitus: a systematic review and meta-analysis.” Frontiers in Pharmacology vol. 15 1455534. 21 Nov. 2024, doi:10.3389/fphar.2024.1455534
- Abu-Zaid, Ahmed et al. “The effect of resveratrol supplementation on obesity indices: a critical umbrella review of interventional meta-analyses.” Eating and Weight Disorders: EWD vol. 30,1 92. 29 Nov. 2025, doi:10.1007/s40519-025-01800-w
