An outpatient endoscopic procedure used to treat type 2 diabetes can help prevent people from regaining weight after they discontinue taking GLP-1 drugs, interim results from a clinical trial suggest.
Patients in the trial had each lost at least 15% of their body weight (approximately 40 pounds, or 18 kilograms) using Eli Lilly's tirzepatide before they stopped taking the drug, sold as Zepbound for obesity and Mounjaro for diabetes.
Trial participants either underwent a procedure used to improve blood sugar control in type 2 diabetes called duodenal mucosal resurfacing, or a sham procedure.
Results from the first 45 people in the more than 300-patient trial found that those who had the sham procedure had regained 40% more weight than the treatment group at six months.
Patients who had the most tissue resurfaced maintained over 80% of their weight loss, regaining about 7 pounds (3.2 kg) on average - roughly half the weight regained by the control group, the researchers said.
Over time, high-fat, high-sugar diets can lead to changes in the lining of the duodenum - the upper part of the small intestine – ultimately rewiring how the gut responds to food. This affects hormone production, leading to insulin resistance and metabolic diseases, the researchers explained.
“As effective as GLP-1 medications are, many people stop taking them because of cost, side effects or simply not wanting to take a drug long-term,” study leader Dr. Shelby Sullivan of the Dartmouth Geisel School of Medicine said in a statement.
“Finding a treatment that allows patients to stop these medications without weight regain or loss of metabolic benefit is a huge unmet need,” she added.
Duodenal mucosal resurfacing uses heat to destroy the interior surface of the duodenum, allowing for regeneration of healthier tissue and "resetting" of individuals’ metabolism to their new post-GLP-1 weight.
The procedure is approved for patients with type 2 diabetes in Europe but is still considered experimental in the United States.
“These findings indicate that this minimally invasive procedure may provide lasting weight-loss maintenance,” Sullivan said.
The researchers plan to report their findings at the upcoming Digestive Disease Week meeting in Chicago.
Trial sponsor Fractyl Health has said it expects to release six-month data on the entire study population and apply for regulatory approval by the end of 2026.
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