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The remaining majority either restart treatment or experience significant regain, leading many clinicians to recommend long-term continuation as the most realistic approach for durable results

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The post-discontinuation phase remains the least investigated, although extension studies consistently show that weight regain occurs rapidly, with patients regaining up to two-thirds of the lost weight within one year after withdrawal ( As the field evolves, questions remain about whether the future of obesity and diabetes management will prioritize pharmacotherapy, lifestyle, or a hybrid approach, especially given the challenges of long-term adherence and the broader health impacts of lifestyle change ( This narrative review synthesizes current evidence on GLP-1RAs, including both conventional single-agent therapies and dual GIP/GLP-1 receptor agonists, versus exercise, their combined effects, and the implications for future clinical and public health priorities

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