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Front Med 5:6161

Introduction Obesity, a chronic and relapsing condition, affects almost two billion adults worldwide1 and increases the risk of morbidity and premature mortality.23 Behavioural weight management programmes (BWMPs) that provide support to adopt a low energy diet and increased physical activity are the cornerstone of obesity management.4 However, new drugs, including the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide and GLP-1 receptor agonist and glucose-dependent insulinotropic polypeptide (GIP) dual agonist tirzepatide, are set to transform routine obesity treatment, with participants in clinical trials losing 15-20% of their baseline body weight.567 Regardless of the type of treatment, improvements in cardiometabolic markers and endpoints are broadly proportional to the magnitude of weight lost, and these new weight management medications (WMMs) have been shown to lead to notable short term improvements in liver fibrosis, renal outcomes, and sleep apnoea8 and in reduced incidence of cardiovascular disease.9 In a previous systematic review, we compared weight change after the withdrawal of BWMPs with weight change after either less intensive support or no support