[TaupeRanger]

Kind of a useless analysis if it doesn't compare the risk after stopping GLP-1s to the risk of NEVER taking GLP-1s in the first place.

We probably don't know the numbers yet, but one can easily envision a scenario like: risk of CE without GLP-1 weight loss: 20%. Risk after taking GLP-1s for 2 years: 10%. Risk after stopping GLP-1s: 12%. "Your heart attack chance goes up 20% after stopping GLP-1s!!!"

[r-johnv]

They actually do compare against a control group. This is the study that is being referenced.

https://bmjmedicine.bmj.com/content/5/1/e002150

The data on the results section shows almost parity between the control group and participants who discontinued for 2 years.

Note that while it is a well conducted study at the US VA with 300,000+ patients, it is not a randomized study so fully eliminating confounding variables and reverse causality is hard.

[gpt5]

Especially since every GLP-1 study shows almost complete regain to original weight after stopping.

It’s like stopping a blood pressure medicine and then being surprised that people have more heart attacks afterwards.

[watermelon0]

There is a recent one, which shows that the weight was generally stable after 1 year of discontinuation of GLP-1.

> In this cohort study of adults with overweight or obesity who initiated treatment with injectable semaglutide or tirzepatide and discontinued the index medication between 3 and 12 months after initiation, 19.6% restarted the index medication and 35.2% received an alternative treatment in the year after initial treatment discontinuation. The average weight change 1 year after index medication discontinuation was relatively small; however, there was considerable individual-level variability.

https://dom-pubs.pericles-prod.literatumonline.com/doi/10.11...

[gpt5]

Thanks for sharing. Note that the data quality from this study is quite low because 54.8% of the cohort eventually restarted their medication or transitioned to an alternative therapy (mostly a different weight loss medication).

I don't know why a study that focuses on discontinuation didn't split the groups that restarted or transitioned against the group that actually just stopped.

[cthalupa]

The discontinued and paused groups in the actual study had lower BMI than the continuing groups - so it seems like this is at least partially independent of any weight regain.

Which makes sense since we have strong evidence for the GLP-1s providing significant protective benefit even without weight loss.

[techjamie]

A tale older than the use of GLP-1. People do X to lose weight, they hit a target weight, declare victory and continue the habits that got them in trouble in the first place. You can go a little bit heavier on the meals and loosen the exercise if you desire, but you still have to keep yourself within maintenance threshold or the weight comes back.

GLP-1 masks the problem and people don't realize their actions aren't ideal once the mask is removed.

[smallnix]

It's not useless. It might be expected, but now it's more certain. This allows planning with it.

[esperent]

Scientifically it's valid, and good scientists and doctors would immediately pick up on the nuance.

The issue is shameless "science" reporting like this which packages up the results for non experts, without explaining the nuance because they know the sensational headlines will get more attention, and they know non-expert readers will get scared and share the article on places like HN or Facebook.

It's such an obvious play: find one doctor who'll make a loaded statement with the word "whiplash", write on this one study as if it's gospel truth, get everyone reading it as scared as possible. Throw in links to other emotional articles like "Can you die of a broken heart?" throughout the text to trigger secondary emotional reactions that will get confused with the main ones. Boom, social media sharing heaven, who cares if the science was valid or not?

And to be clear, the science underneath might be valid, probably even is, but it would need the expertise of someone who understands statistics and medicine to decide whether you should take action based on this or not.

[ajam1507]

The doctor using the word “whiplash” is one of the authors of the study.