European Journal Pharmaceutical and Medical Research
Weight rebound after GLP-1 discontinuation in india: A high-risk cardiometabolic transition
By Dr. Depti Bellani1*, Dr. Anish Desai1, Dr. Sunaina Anand1, Dr. Shivani Mishra1, Dr. Srishti Priya Maldahiar1.
Abstract
Background
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/GIP agonists have transformed obesity and diabetes care, but rapid weight regain and partial reversal of cardiometabolic gains follow discontinuation. In India, rebound occurs on a high-risk substrate of central adiposity, thin-fat and sarcopenic-obesity phenotypes and dense metabolic obesity at lower BMI, so even modest off-drug weight or waist increases may accelerate glycaemic and vascular deterioration.
Methods
This narrative review integrates randomised trials and real-world cohorts of GLP-1/GLP-1–GIP tapering or withdrawal, metabolic/bariatric surgery data, and Indian epidemiological, body-composition and pharmacogenomic studies. We searched major databases to March 2026 for studies on incretin discontinuation, weight rebound, Indian obesity phenotypes, sarcopenic and abdominal obesity and incretin-pathway variants (TCF7L2, ADIPOQ, ARRB1), and reviewed National Family Health Survey-5 (NFHS-5) and Indian Council of Medical Research–India Diabetes Study (ICMR–INDIAB) datasets.