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  • Kevin D. Hall

Physiology of the weight-loss plateau in response to diet restriction, GLP-1 receptor agonism, and bariatric surgery

We’ve all heard about the GLP-1 agonist weight loss drugs semaglutide (Ozempic) and tirzepatide (Mounjaro or Zepbound). A new study in Obesity found that the timing of the weight loss plateau was about the same for obesity surgery and the two GLP-1 agonists at 24 months.


With dietary restrictions, the plateau for weight loss occurred at 12 months. The explanation of the weight loss with either surgery or medications is thought to result from reduced appetite. Reduced appetite occurs because of changes in gut hormones. With calorie restriction, appetite increases after about a year. Both gastric bypass surgery and tirzepatide resulted in greater overall weight loss than semaglutide.


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