A minimally invasive procedure called duodenal mucosal resurfacing may help patients maintain weight loss after discontinuing drugs like Ozempic and tirzepatide. Early results from the REMAIN-1 clinical trial show treated participants regained far less weight than those in a control group after six months off medication. The findings are set for presentation at Digestive Disease Week 2026.
Researchers presented early data from the REMAIN-1 trial, a blinded, randomized, sham-controlled study, at Digestive Disease Week 2026. In the trial's initial cohort of 45 participants, all of whom had lost at least 15% of their body weight—averaging 40 pounds—on tirzepatide before stopping the drug, 29 underwent duodenal mucosal resurfacing while 16 received a sham procedure. Six months later, the sham group regained about 40% more weight than the treatment group, with treated patients regaining only around 7 pounds and retaining more than 80% of their weight loss. The control group regained roughly twice as much, and the difference widened over time. Dr. Shelby Sullivan, lead author and director of the Endoscopic Bariatric and Metabolic Program at Dartmouth Health Weight Center, noted the benefit strengthened over time, resembling a dose-response effect from a drug. The procedure uses controlled heat to remove and renew the duodenal lining, aiming to reset metabolism in the upper small intestine where GLP-1-related hormones are produced. No serious complications occurred, and patients typically resumed normal activities within a day. Sullivan highlighted its potential for those stopping GLP-1 drugs due to cost or side effects, addressing the common issue where 70% regain much of their lost weight within 18 months. The full REMAIN-1 trial, with over 300 participants, is complete, with topline data expected in early Q4 2026.
