Keeping weight off after semaglutide may need a second drug

On Friday, September 25, 2026, two developments touched people who use or are considering GLP-1 drugs for weight loss. One involves how medications are made and dispensed. The other involves what happens after the weight loss itself, once treatment ends. Together they point to the same reality: staying on a GLP-1 drug, or moving off one, involves choices that go beyond the prescription itself.

The Minnesota change addresses a narrow, practical question. Under state law, a pharmacy that adds an ingredient to a drug can be treated as compounding it, which brings stricter rules. SF 3783 proposed that adding a flavoring agent alone would not count as compounding. That bill did not move on its own, but the same language was enacted in a larger health bill, Laws 2026, chapter 127, which the governor signed on May 26, 2026. Minnesota law, since May 2026, no longer treats adding a flavoring agent to a drug as compounding. The change applies to all drugs and does not mention GLP-1s.

The ALV-100 trial speaks to a different kind of problem, one that appears after treatment seems to have worked. Many people who lose weight on semaglutide regain some or all of it once they stop the drug, and researchers are now recruiting participants for a Phase 2 study to test whether ALV-100 can help maintain that loss instead. The trial is open specifically to people who already lost at least 10 percent of their weight on GLP-1 type drugs such as semaglutide, rather than to new users starting treatment. If the drug proves effective, it could offer a way to preserve results without staying on semaglutide indefinitely, though that remains to be tested rather than assumed.

If you get a flavored medicine from a Minnesota pharmacy, the May 2026 change means adding the flavor no longer counts as compounding; it does not change which GLP-1 drugs you can get. If you lost weight on semaglutide and are concerned about regaining it, you may want to look into whether the ALV-100 trial is enrolling near you and whether you meet its criteria. Neither development changes anything about your current treatment plan today, and any decision about switching drugs or joining a trial should be made with your prescriber. The Minnesota change is already law, and the ALV-100 trial is still early in testing, so that is the one to keep an eye on.

By Amanda Bonello