Many patients stop taking weight control medication early

GLP-1 drugs such as Ozempic and Wegovy are growing in popularity due to their positive effects on weight management, but a recent report found that for many people, treatment does not last long enough to produce results.

The study, conducted by Blue Health Intelligence, found that more than 30% of people stopped taking prescribed GLP-1 medications – formerly known as glucagon-like peptide-1 receptor agonists – within four weeks of starting to take them.

While Wegovy has been approved by the US Food and Drug Administration to treat obesity, Ozempic is often prescribed outside of its approved indications. The drugs are intended to be taken for at least 12 weeks and are prescribed at a low dose that is increased over time. Patients can usually take them for years.

Taking GLP-1 for a month has minimal effect – it can take up to five or six months to reach the full dose, said Scott Isaacs, MD, president-elect of the American Association of Clinical Endocrinology. “Many people do not lose weight with the initial starting doses and need to titrate up to higher doses to achieve a weight loss effect,” he said Health.

In addition, quitting too early can also be harmful to your health, experts say.

Here’s what you need to know about the research and what to consider before stopping your treatment.

For the study, researchers used pharmacy and doctor billing data from nearly 170,000 people with Blue Cross Blue Shield health insurance who received prescriptions for GLP-1 between 2014 and 2023. The average age of the patients was 45 years.

They found that most people stopped treatment before 12 weeks.

People aged 18 to 34 were more likely to discontinue treatment, as were people with health inequities or those living in regions with poor health care. Gender did not appear to influence who discontinued treatment and who continued medication.

Factors that influenced continuation of GLP-1 treatment, researchers said, included whether the prescribing physician was an endocrinologist, obesity specialist, or otherwise specialized in the field of weight control and obesity. Individuals who visited their physician more frequently after receiving the GLP-1 prescription were also more likely to continue their treatment.

The researchers speculated that some people might stop taking the drug because of side effects. The drugs can cause nausea, vomiting and diarrhea, as well as other serious but less common side effects such as pancreatitis, gallbladder disease and kidney problems.

“Many prescriptions are being written due to extraordinary patient demand, but many of the prescribing physicians are not trained in the full range of wraparound care strategies needed to treat a patient with GLP-1,” said Rekha B. Kumar, MD, associate professor of medicine at Weill Cornell Medical College and chief medical officer at Found, Health.

Those strategies include knowing how to manage side effects rather than simply stopping medication, deescalating treatment when needed and providing behavioral support, she said.

In addition to side effects, other factors such as drug shortages, costs and limited availability could contribute to high dropout rates, Kumar noted.

“Long-term accessibility is a problem in part because of cost, which is why tactics are suggested that are not based on evidence, such as stopping medications and then going on strict diets,” she said.

Issacs said the danger of taking GLP-1 drugs temporarily is that people who take these drugs at least long enough to lose weight will quickly lose that weight again, meaning they’ll likely lose muscle as well. Although people tend to regain most of the weight they lost when they stop taking the drugs, they won’t necessarily build the muscle back.

“So, body composition changes with higher body fat percentage, which then translates into a slower metabolism,” he said. “Weight fluctuations – losing weight and then gaining it back – ultimately make losing weight more difficult because the metabolic rate is much lower.”

For this reason, GLP-1 has been approved by the FDA for long-term use in the treatment of obesity, Isaacs emphasized.

Isaacs said the key to maintaining GLP-1 medication is managing side effects.

“Gastrointestinal side effects are common when taking these medications,” he said. “The side effects usually resolve in four weeks or less, but may return for about four weeks with each dose increase.”

Because the medication slows down stomach emptying, it can cause a feeling of fullness, but also bloating. High-fat foods and eating too much can make this feeling worse, so Isaacs recommends avoiding food as soon as you feel full.

“Eating just one or two extra bites can cause severe side effects, nausea or even vomiting,” Isaacs said. “But keeping meals small can be very helpful with side effects.”

“In my experience, most patients tolerate the drug and continue taking it long-term if they follow these steps,” he continued.

In addition, Kumar emphasizes the importance of working with a qualified physician who can properly assess your overall health and develop strategies to help you maintain medication compliance long-term.

If you stop taking the medication, experts recommend a nutritional program and cognitive support to suppress possible cravings and increased hunger.

“Obesity is a chronic disease and it makes no sense to treat a chronic, lifelong condition with a temporary treatment,” Isaacs said.