THE LACK of long-term support for patients taking GLP-1 weight-loss medications could undermine their benefits, according to a leading nutrition scientist, who has warned that healthcare systems are failing to address what happens when patients discontinue treatment.
Speaking at The Economist’s Future of Health Europe event on 3 November 2026, Dr Federica Amati, PhD, RNutr, Head Nutritionist at ZOE, UK, highlighted significant gaps in the care surrounding GLP-1 therapies, including insufficient attention to weight regain, muscle function, nutritional support, and long-term metabolic health.
During her presentation, Beyond Obesity: What GLP-1s Reveal About the Future of Metabolic Health, Amati argued that while the effectiveness of these medications is well established, healthcare systems have not developed adequate support for patients before, during, or after treatment.
GLP-1-based treatments, including semaglutide and tirzepatide, have demonstrated substantial benefits for weight loss and metabolic health. However, Amati warned that these improvements can diminish following treatment discontinuation, raising questions about how patients should be supported once medication is stopped.
Citing an analysis of 37 studies, she explained that patients regained weight at an average rate of approximately 0.4 kg per month following treatment cessation, with cardiometabolic markers projected to return towards baseline within approximately 1.4 years.
Nevertheless, Amati emphasised that weight regain varies considerably between individuals, challenging the assumption that all patients will regain their lost weight at the same rate.
She suggested that this variability makes individualised aftercare particularly important, yet healthcare services have largely failed to establish structured pathways for patients discontinuing GLP-1 treatment.
Amati described the absence of post-treatment support as one of the biggest gaps in current obesity care, calling for greater investment in maintenance strategies rather than focusing exclusively on initial weight loss.
Beyond weight regain, Amati questioned whether current research is adequately measuring the outcomes that matter most to patients.
Presenting findings from a pooled analysis of 20 randomised trials involving 15,782 participants, she highlighted that lean mass accounted for approximately 35.2% of weight lost with semaglutide and 25.4% with tirzepatide, compared with 17.5% following lifestyle interventions incorporating resistance training.
However, she cautioned that lean mass measurements do not necessarily reflect reductions in muscle strength or physical ability, as they can also include changes in body water and other tissues.
Importantly, the analysis found that none of the included trials measured physical function, highlighting a potential gap in the assessment of treatment outcomes.
Amati called for greater emphasis on measures such as grip strength, walking speed, and chair-stand performance, alongside adequate protein intake and resistance training during treatment.
The presentation also raised concerns about inequalities in access to GLP-1 medications across the UK.
Amati highlighted figures showing obesity prevalence of 37.4% in England’s most deprived communities, compared with 19.8% in the least deprived. Despite this disparity, private prescribing was lower among more disadvantaged populations.
She also pointed to the scale of the challenge facing the NHS, with approximately 220,000 treatment places planned over three years, compared with an estimated 3.4 million eligible patients.
According to Amati, this imbalance risks widening existing health inequalities, particularly if access to medication is not accompanied by nutritional, psychological, and long-term clinical support.
To address these challenges, Amati outlined several priorities for improving obesity treatment, including eating-disorder screening, nutritional and psychological support, routine assessment of physical function, and structured reviews of treatment response after three to six months.
She also stressed the importance of improving the wider food environment, arguing that medication alone cannot address the underlying conditions contributing to poor metabolic health.
Summarising her message to healthcare leaders, Amati stated: “The drugs work. The care model around them does not yet exist, and that is a commissioning decision rather than a scientific one.”
She added that healthcare systems must fund the maintenance phase of treatment and prioritise physical function rather than relying solely on weight as a measure of success.
The presentation concluded with a wider question for policymakers and clinicians: “Are we treating biology while leaving the environment intact?”
With GLP-1 therapies continuing to transform obesity management, Amati’s remarks highlight the need to move beyond demonstrating drug efficacy towards establishing sustainable, equitable models of long-term metabolic care.
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