Introduction — Are GLP-1 Drugs Forever?

Have you heard experts say that GLP-1 medications like Ozempic, Wegovy, or Zepbound are forever drugs — because once you stop, you regain all the weight?

I’m not fully convinced that’s true.

I’ve found three promising approaches being developed that may help people stop medication without immediate weight regain.

Each approach is completely different:

• One focuses on the stomach
• One on the brain
• One on structured lifestyle intervention

I’m Dr. Gary Pepper. I’ve practiced endocrinology for over 30 years. This podcast is unsponsored, and I receive no financial compensation from the treatments discussed. This content is educational only and not a substitute for medical care from your physician.

Chapter 1 — Resetting the Gut (DMR)

The first approach is called Duodenal Mucosal Resurfacing (DMR).

The theory is that while you’re on GLP-1 medication, the part of the stomach that normally produces appetite-regulating hormones becomes dormant. After long enough, it may struggle to restart when medication stops.

DMR removes the top layer of the stomach lining using a heated endoscope. This forces regeneration of fresh cells that produce appetite-controlling hormones.

In a short three-month study, patients who underwent the procedure did not regain weight after stopping medication — some continued to lose.

This sounds dramatic, but the technique is already FDA-approved for other stomach conditions. It is not yet approved for weight management, but it shows where research is heading.

Chapter 2 — Retraining the Brain (rTMS)

The second approach targets the brain instead of the gut.

It’s called Transcranial Magnetic Stimulation (rTMS) — already used for depression treatment.

Magnetic coils stimulate appetite control centers in the brain. After just five weeks of treatment, participants lost as much weight over a year as those taking semaglutide for a full year.

This is early research, but it suggests appetite control may eventually be trained neurologically rather than chemically.

Chapter 3 — Exercise as Hormone Rehabilitation

The third approach is the most practical and immediately available: structured exercise.

Researchers at the University of Copenhagen studied people stopping GLP-1 medication after a year of use.

Those who followed a structured program of resistance and cardio training regained almost no weight — averaging about five pounds over a year.

Those returning to sedentary habits regained most of their weight.

Exercise appeared to restore the body’s natural GLP-1-like hormone production.

This is not about willpower.

It’s biological rehabilitation.

Closing — A Changing Landscape

These three approaches show that weight regain after GLP-1 is not inevitable.

The science is evolving quickly.

I’ll continue tracking new developments and sharing updates here.

Thanks for listenin

Gary Pepper, M.D., an associate professor at a prominent medical school and endocrinologist with 40 years of experience, brings clarity to numerous topics within the field of metabolic health. His view points are unhindered by corporate interests, unlike many other current "thought leaders" in medicine. Dr. Pepper, a dedicated educator, established his homebase website www.metabolism.com in 1996 and has blogged on important topics since then. Not one to be left behind by technology he began podcasting in 2020 with the onset of the pandemic and continues publishing vlogs on YouTube at his channel metabolism123. So whatever your choice in media, you will be gaining fresh insights by tuning in to his opinionated shows or reading his blogs on critical health topics.