A Gut-Level Pivot from Diabetes to a GLP-1 Off-Ramp

GLP-1 medicines have transformed obesity treatment, but what happens when patients stop taking them? For Fractyl Health, the challenge of preventing weight regain has become the focus of its development strategy. The company is advancing Revita, an experimental outpatient procedure designed to regenerate the lining of the duodenum and potentially change how the body regulates weight and blood sugar. Harith Rajagopalan, co-founder and CEO of Fractyl Health, discusses the company’s shift from focusing on type 2 diabetes to maintaining weight loss after patients stop taking GLP-1 medicines, the biology behind its approach, and what it takes to turn the promise of a metabolic reset into a treatment option.