If type 2 diabetics switch to a ketogenic diet and stop taking weight-loss medications like Ozempic or Wegovy, they can prevent gaining back the weight they have lost. This small-scale study’s result casts doubt on the idea that these drugs are necessary for life in order to prevent unintended weight gain.
Ozempic and Wegovy are members of the GLP-1 agonist drug class, which decreases hunger and increases insulin release. They are frequently recommended to type 2 diabetics in order to help them control their blood sugar levels and reduce weight. Many doctors, however, have come to the conclusion that long-term medication use is necessary to prevent weight gain back.
It was the decision of Shaminie Athinarayanan and her colleagues at Virta Health, a US telemedicine startup that treats type 2 diabetes, to verify that theory. Their motivation for action stemmed from earlier studies that demonstrated how low-carb diets, such as the ketogenic diet, can assist type 2 diabetics control their weight and blood sugar levels.
Using data from 308 patients with type 2 diabetes living in the US who were receiving nutrition therapy at Virta Health, the researchers monitored blood sugar levels and weight. When they joined, they were all on GLP-1 agonists. The participants were instructed to adhere to the ketogenic diet, which calls for consuming roughly 1.5 grams of protein per kilogram of bodyweight and less than 30 grams of carbohydrates per day (or less than 50 grams if they were vegan). Regardless of the number of calories, they were advised to eat until they felt satisfied. Participants received virtual communication from health coaches and certified medical professionals as needed.
After three to nine months, half of the subjects stopped using GLP-1 agonists. Every participant kept up the ketogenic diet for a full year after that. Thus far, the investigators have not discovered any noteworthy variations in weight or blood sugar levels between the two cohorts. Individuals who ceased using GLP-1 agonists gained weight by roughly one kilogram on average. In contrast, individuals who kept using the drugs put on roughly 2 kg. Additionally, blood sugar levels below the cutoff point for diabetes diagnosis were present in the majority of participants in both groups.
“This study suggests that the continued use of GLP-1 agonists is not necessary for many people if [they] have the right intervention,” says Athinarayanan. “You can discontinue [these medications] safely and effectively and maintain weight and blood sugar outcomes.”
Priya Jaisinghani of NYU Langone Health in New York thinks that this might be useful for those who are unable to take the meds because of shortages or adverse effects. However, she advises people to consult their doctor before starting a low-carb diet because it can be risky, particularly for those who have underlying medical illnesses like kidney disease or eating disorders. She also notes that just a limited number of people participated in the study, which was funded by Virta Health. Jaisinghani concludes, “It is not the end-all, be-all.” However, it demonstrates the impact food may have.
