vida: extract claims from 2025-lancet-eclinmed-glp1-weight-regain-meta-analysis

- Source: inbox/queue/2025-lancet-eclinmed-glp1-weight-regain-meta-analysis.md
- Domain: health
- Claims: 0, Entities: 0
- Enrichments: 3
- Extracted by: pipeline ingest (OpenRouter anthropic/claude-sonnet-4.5)

Pentagon-Agent: Vida <PIPELINE>

domains/health/glp-1-receptor-agonists-require-continuous-treatment-because-metabolic-benefits-reverse-within-28-52-weeks-of-discontinuation.md

@@ -10,7 +10,7 @@ agent: vida
 scope: causal
 sourcer: Tzang et al. (Lancet eClinicalMedicine)
 related_claims: ["[[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]", "[[SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent and no operational infrastructure connects screening to action]]"]
-related: ["glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks", "glp-1-receptor-agonists-require-continuous-treatment-because-metabolic-benefits-reverse-within-28-52-weeks-of-discontinuation", "semaglutide-outperforms-tirzepatide-cardiovascular-outcomes-despite-inferior-weight-loss-suggesting-glp1r-specific-cardiac-mechanism", "semaglutide-outperforms-tirzepatide-cardiovascular-outcomes-despite-inferior-weight-loss", "comprehensive-behavioral-wraparound-enables-durable-weight-maintenance-post-glp1-cessation", "glp1-receptor-agonists-provide-cardiovascular-benefits-through-weight-independent-mechanisms"]
+related: ["glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks", "glp-1-receptor-agonists-require-continuous-treatment-because-metabolic-benefits-reverse-within-28-52-weeks-of-discontinuation", "semaglutide-outperforms-tirzepatide-cardiovascular-outcomes-despite-inferior-weight-loss-suggesting-glp1r-specific-cardiac-mechanism", "semaglutide-outperforms-tirzepatide-cardiovascular-outcomes-despite-inferior-weight-loss", "comprehensive-behavioral-wraparound-enables-durable-weight-maintenance-post-glp1-cessation", "glp1-receptor-agonists-provide-cardiovascular-benefits-through-weight-independent-mechanisms", "glp1-response-variability-partially-genetically-determined-glp1r-gipr-variants-predict-weight-loss-and-side-effects"]
 reweave_edges: ["glp-1-receptor-agonists-produce-nutritional-deficiencies-in-12-14-percent-of-users-within-6-12-months-requiring-monitoring-infrastructure-current-prescribing-lacks|related|2026-04-09", "GLP-1 therapy requires continuous nutritional monitoring infrastructure but 92 percent of patients receive no dietitian support creating a care gap that widens as adoption scales|supports|2026-04-12", "Comprehensive behavioral wraparound may enable durable weight maintenance post-GLP-1 cessation, challenging the unconditional continuous-delivery requirement|challenges|2026-04-14"]
 supports: ["GLP-1 therapy requires continuous nutritional monitoring infrastructure but 92 percent of patients receive no dietitian support creating a care gap that widens as adoption scales"]
 challenges: ["Comprehensive behavioral wraparound may enable durable weight maintenance post-GLP-1 cessation, challenging the unconditional continuous-delivery requirement"]
@@ -46,3 +46,10 @@ The continuous treatment requirement extends beyond metabolic conditions to subs
 **Source:** WHO Global Guideline, December 2025
 
 WHO guideline specifies GLP-1 therapies for 'long-term obesity treatment (defined as ≥6 months continuous therapy)' and cites 'unclear maintenance and discontinuation protocols' as a reason for conditional rather than strong recommendation, confirming the chronic use requirement
+
+
+## Supporting Evidence
+
+**Source:** eClinicalMedicine/Lancet 2025 systematic review and meta-analysis (PMC12535773)
+
+Meta-analysis of discontinuation studies shows weight regain is proportional to original weight loss: liraglutide patients regained 2.20 kg, while semaglutide/tirzepatide patients regained 9.69 kg. Most patients regain two-thirds of prior weight loss within 6 months of stopping. Cardiometabolic benefits (blood pressure, lipids, CVD risk) reverse along with weight regain, confirming that GLP-1 suppression of appetite is pharmacological rather than behavioral modification. When drug is withdrawn, underlying neurobiological hunger signals return to baseline.

domains/health/glp1-long-term-persistence-ceiling-14-percent-year-two.md

@@ -37,3 +37,10 @@ Cell/Med 2025 connects low persistence rates to the sustainability concern: chro
 **Source:** PHTI Employer GLP-1 Coverage Market Trend Report, December 2025
 
 PHTI December 2025 report documents employer payer response to low GLP-1 persistence: movement toward bundled coverage requiring behavioral support programs as a condition of drug coverage. Employers are framing GLP-1 coverage without personal support as 'wasted wellness dollars' (Benefits Pro, March 2026). This represents the market mechanism translating adherence data into coverage architecture—payers are structurally responding to the persistence problem by mandating behavioral wraparound rather than covering drugs alone.
+
+
+## Extending Evidence
+
+**Source:** eClinicalMedicine/Lancet 2025 discontinuation meta-analysis
+
+The biological mechanism underlying low persistence creates a clinical revolving door: when patients discontinue (which 85% do by year two), they regain two-thirds of lost weight within 6 months. For semaglutide/tirzepatide users, mean regain is 9.69 kg. This means the 14% persistence ceiling isn't just an adherence problem—it's a structural barrier to population health impact, as discontinued patients return to near-baseline metabolic state within months.

inbox/archive/health/2025-lancet-eclinmed-glp1-weight-regain-meta-analysis.md

@@ -7,9 +7,12 @@ date: 2025-01-01
 domain: health
 secondary_domains: []
 format: peer-reviewed meta-analysis
-status: unprocessed
+status: processed
+processed_by: vida
+processed_date: 2026-04-27
 priority: high
 tags: [glp-1, weight-regain, discontinuation, metabolic-rebound, semaglutide, tirzepatide, chronic-disease, adherence]
+extraction_model: "anthropic/claude-sonnet-4.5"
 ---
 
 ## Content