Obesity surgeryJan 3, 2026

Repeated Weight Gain After Weight Loss from Lifestyle Changes, Weight-Loss Surgery, or Semaglutide in Adults with Obesity

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 27, 2026

Abstract

Essence

Long-term obesity treatment needs structured maintenance because recurrent weight gain differs by intervention type.

Evidence

This systematic review and network meta-analysis synthesized 29 randomized controlled trials of lifestyle interventions, semaglutide, and metabolic and bariatric surgery for long-term weight outcomes.

Caveat

Evidence for bariatric surgery from randomized trials was limited, and semaglutide durability depended on ongoing therapy with rebound after discontinuation.

Simplified

Obesity management is challenged by high rates of recurrent weight gain following initial loss. We systematically reviewed 29 randomized controlled trials comparing long-term outcomes of lifestyle interventions, semaglutide, and metabolic and bariatric surgery (MBS). Databases were searched to March 2025, and data were synthesized using pairwise and network meta-analysis. Lifestyle interventions ranked highest in preventing recurrent weight gain, while semaglutide may support sustained weight reduction during ongoing therapy but is followed by rebound after discontinuation. MBS demonstrated relatively sustained weight loss (> 10% maintained at 5-10 years), although RCT evidence was limited. These findings highlight the need for long-term, structured maintenance strategies and further high-quality trials with standardized outcomes.