ObesityWeek 2025 – De-escalation strategy cuts GLP-1 dosing frequency in half without loss of metabolic benefits

A study presented at Obesity Week 2025 evaluated a GLP-1 agonist therapy de-escalation strategy, reducing administration frequency from weekly to biweekly after weight stabilization and improvement of metabolic parameters. The proposal aims to minimize costs, reduce drug exposure, and expand access—common challenges in clinical practice with these therapies. 

In the study, 31 patients with a mean BMI of 31 kg/m² and a prior diagnosis of obesity were followed at a metabolic medicine clinic. After achieving a mean weight reduction of 12.3 ± 1.2 kg (-14%) with weekly semaglutide or tirzepatide (p<0.001), patients transitioned to biweekly dosing (q2weeks) at the same dose. After an average 32-week follow-up, an additional 1.3 ± 0.5 kg (-2%) weight loss was observed (p<0.05), along with maintenance of metabolic parameters such as glucose, triglycerides, HDL, and blood pressure. 

The prevalence of any metabolic syndrome component decreased from 79% to 35% after initiating weekly treatment and remained at 39% after switching to the biweekly regimen. Only 5 of 31 patients (16%) needed to return to weekly dosing due to weight regain. 

Although these findings suggest that reducing dosing frequency to 14-day intervals may be a safe and effective strategy to maintain GLP-1 therapy outcomes, this was a small, retrospective study that should be validated in larger, controlled clinical trials before broad adoption. 

Editorial note: This content was developed with the support of artificial intelligence technologies to optimize writing and structure. All material was carefully reviewed, validated, and supplemented by human experts before publication, ensuring scientific accuracy and adherence to editorial best practices. 

References:  

1. Biermann M, Wu A, et al. Half-frequency GLP1 De-escalation Maintains Weight and Metabolic Syndrome Improvements. Presented at: Obesity Week 2025, Abstract Oral-004.