NEW STUDY ALERT: Are GLP-1 Meds For Life?

Original posted at obesity.news/ on Sep 26, 2025

Can We Finally Break Free From “GLP-1 for Life”?

One of the loudest knocks against GLP-1 medications is that you have to take them forever. The studies are brutal. Stop the drug and, almost without fail, the weight comes piling back on. Patients who fought for every inch of progress are forced to live with this haunting question: what happens if I can’t afford it, can’t tolerate it, or my insurance suddenly pulls the rug out? Let’s not remind ourselves of the PTSD around the shortages, and the stress about the future of compounds…

That’s been the heaviest stone in this new era of obesity care. A miracle that demands you never get off the aforementioned hamster wheel. Until now.

A New Kind of Answer

Fractyl Health just dropped data from their REMAIN-1 Midpoint Cohort, and it’s nothing short of amazing. They’re testing a procedure called Revita, an endoscopic resurfacing of the duodenum, the part of the gut that gets scarred by years of high-sugar, high-fat diets. The idea is to reset nutrient sensing and signaling at the organ level. Not a pill. Not another injection. A one-time, minimally invasive procedure designed to change the terrain where obesity begins. The gut.

Here’s the bottom line on Revita:

• Patients who had been on tirzepatide and then stopped were randomized to receive either Revita or a sham procedure.

• Three months later, Revita patients had lost another 2.5% of their body weight.

• Sham patients (someone in a clinical trial who receives a fake or placebo version of the procedure) regained about 10%.

  Instead of spiraling back, people kept moving forward, injection-free.

Why This Matters for Us

Every person who’s ever heard (or read in the comments), “you’ll regain it all if you stop,” knows the dread this addresses. Cost, coverage, side effects, scarcity, these are not hypotheticals. They are everyday landmines that we have been sidestepping for the last few years, and will be for years to come. Revita is offering something obesity medicine hasn’t been able to: a chance to preserve hard-won weight loss without chaining yourself to lifelong prescriptions.

Dr. Shelby Sullivan of Dartmouth called it “the first randomized, controlled evidence suggesting that a one-time endoscopic procedure may help maintain drug-free weight loss after GLP-1 discontinuation”.

That is a massive statement.

Bigger Than Weight

When I interviewed Fractyl’s CEO, Dr. Harith Rajagopalan, he said something that stuck with me: patients want durability. They don’t want to just chase weight loss. They want to sustain health. The Revita data hints at exactly that, a metabolic reset instead of the pharmaceutical roller-coaster ride that is GLP-1 accessibility.

These are early results. The pivotal cohort is still ongoing, with six-month readouts expected in early 2026. But this midpoint snapshot is the first true proof of concept that we don’t have to live inside the “GLP-1 for life” box. At least not if we don’t want to.

The Conversation We Need

So here’s the question I’ll leave you with: if Revita or a therapy like it delivers on this promise, what does that mean for the future of obesity care? Would patients finally feel free from the economic hostage situation of chronic meds? Would insurance step up or dig in deeper?

I’ll be embedding my previous interviews with Dr. Rajagopalan here so you can hear directly from him, in his own words.

For now, I can’t stop thinking about all of you, the hope that is buried inside this data. Maybe, just maybe, when folks lose access to the meds (for whatever reason), the story doesn’t have to end with “you’ll gain it all back.”

And here’s something exciting Dr. Harith Rajagopalan, CEO of Fractyl Health, will be joining me on the podcast next week to dig deeper into these results. If you’ve got questions you’d like me to ask him, drop them in the comments below. This is your chance to put patient voices right into the conversation.

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