Why Many Individuals Discontinue GLP-1s for Weight Loss Prematurely: Insights from Recent Research

Demand for Wegovy and other GLP-1 drugs for obesity and diabetes treatment has surged. However, a recent report suggests that many individuals may not be adhering to their weight-loss regimen for a sufficient duration.

A study of health insurance claims published on Tuesday revealed that the majority of individuals using GLP-1 medications - approximately 58% - discontinued their treatment plan within less than 12 weeks. This timeframe falls short of the recommended benchmark set by professional organizations for assessing the effectiveness of weight-loss treatments in providing clinically significant results.

Rebekah Carl poses with her prescription of Wegovy in New Columbia, Pennsylvania, U.S., November 13, 2023. Photo taken on November 13, 2023. REUTERS/Hannah Beier

Rebekah Carl poses with her prescription of Wegovy in New Columbia, Pennsylvania, U.S., November 13, 2023. Photo taken on November 13, 2023. REUTERS/Hannah Beier

Hannah Beier/Reuters

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The results of Wegovy's longest clinical trial reveal important information about weight loss, side effects, and heart protection.

Users typically begin with a low dose of the medication and slowly increase it until they reach the desired dose. However, the analysis indicates that over 30% of individuals discontinued treatment within the first four weeks, before reaching the targeted dose.

The study analyzed data from 170,000 individuals covered by Blue Cross Blue Shield plans who were prescribed GLP-1 medications for weight management from 2014 to 2023.

Dr. Disha Narang, an endocrinologist and director of obesity medicine, emphasized the importance of viewing these medications as long-term treatment for a chronic condition. She warns against rushing the treatment process, as it may lead to patients discontinuing the medication prematurely.

Experts suggest that impatience with seeing results is a common reason why patients may discontinue their treatment. A recent poll by KFF found that only about two-thirds of adults who have tried injectable weight-loss drugs believe that they are effective. Interestingly, those who had stopped using the medications were much less positive about their benefits, with only about half of them thinking they were effective compared to nearly three-quarters of those currently using the treatments.

Additionally, side effects like nausea, diarrhea, vomiting, and constipation, particularly in the early stages, can also contribute to people discontinuing their treatment. In fact, data from the longest clinical trial of Wegovy revealed that 17% of participants stopped the trial due to side effects.

But experts say that many deterrents can be managed with appropriate counseling from a provider.

An Ozempic needle injection pen is seen in Poland on September 3, 2023.

An Ozempic needle injection pen is seen in Poland on September 3, 2023.

Jaap Arriens/NurPhoto/Getty Images

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Maintaining frequent touchpoints and interactions is crucial in managing side effects, expectations, and monitoring improvements in metabolic comorbidities, according to Dr. Jody Dushay, an endocrinologist at Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School.

It is important to recognize that each individual may respond differently to treatment and will weigh the costs and benefits to their health in a unique way.

"Not every person has a set rule to follow. Doctors and patients need to review all the information together and decide on the treatment," she explained.

The data from Blue Cross Blue Shield highlights how healthcare providers can support patients in staying committed to their GLP-1 treatment.

Patients who had fewer visits with their healthcare providers, especially those in underserved areas facing health disparities, were more prone to stopping GLP-1 treatment earlier. Dr. Razia Hashmi, VP of Clinical Affairs at Blue Cross Blue Shield Association, mentioned that each additional follow-up visit boosted a patient's likelihood of sticking with the treatment by 60%.

While most GLP-1 prescriptions were written by primary care doctors, patients who received them from endocrinologists or specialists in weight management were more successful in completing at least 12 weeks of continuous treatment.

"Wraparound support services can truly make a difference in someone's life. Whether it's managing lifestyle support, nutrition, diet, or dealing with side effects," Hashmi emphasized, "health equity is important. Factors like transportation, access to food, and socioeconomic status all play a role in overall health and well-being."

Catera Bentley

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Reports of unexpected pregnancies among women taking Ozempic, a weight loss drug, have raised concerns about the effectiveness of these medications. Cost can be a barrier for some people when it comes to accessing GLP-1 medications, as a month's supply can be as high as $1,000. However, the analysis focused on individuals with insurance plans that covered weight-loss medication prescriptions, so they were not paying out-of-pocket for their treatment.

Using GLP-1 treatments can be seen as an investment in various aspects.

Hashmi emphasized the importance of understanding the success factors for both employers and individual patients when making a decision. The goal is for the investment to ultimately pay off.

Another recent report provides further evidence that the benefits of GLP-1s continue over time with consistent use.

The initial findings from a study on real-world data revealed that individuals who consistently took GLP-1 medications experienced an average weight loss of approximately 1.4% after three months, which then increased to around 3% after a year of continuous treatment. This analysis, conducted by Dandelion Health, a healthcare analytics company, was based on the health records of close to 17,000 patients who were prescribed a GLP-1 between 2019 and 2023.

In a recent analysis comparing a group of individuals with similar clinical characteristics, including age, ethnicity, body mass index, diabetes prevalence, history of treatments, and related comorbidities, those taking GLP-1s were found to lose approximately twice as much weight.

GLP-1 agonists, a type of injected medication, are highly sought after due to their effectiveness in promoting weight loss. Clinical trials have shown that potent medications like Wegovy and Zepbound can help individuals shed at least 10% of their initial weight. However, a new report suggests that the real-world results may not be as impressive as the data from clinical trials.

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Experts caution that the response to GLP-1 treatment can vary from person to person. Some individuals may not respond well, while others may have an excessive response. There are also those who react as anticipated to the medication. Ongoing studies are being conducted to determine the reasons behind these differing responses.

According to data from Dandelion Health, the top 10% of individuals had positive responses to GLP-1s, aligning with findings from clinical trials. However, the bottom 10% experienced no weight change or even gained weight over time.

Experts suggest that GLP-1 medications offer additional benefits aside from weight loss, such as improving heart and liver health. These benefits may apply to individuals who do not lose as much weight as anticipated.

"It's crucial to remember that the scale should not be the sole factor in determining whether you should continue taking this medication," advised Dushay. "Even if progress is gradual, it could still be worth continuing treatment. There may be other positive effects of the medication besides weight loss, so it's important to have a thorough discussion with your doctor about your reasons for taking it."

Editor's P/S:

The article sheds light on the challenges associated with adhering to GLP-1 weight-loss treatments, highlighting the importance of patient support and managing expectations. It emphasizes that discontinuing treatment prematurely can hinder the achievement of clinically significant weight loss. The analysis of 170,000 individuals reveals that approximately 58% discontinue treatment within 12 weeks, falling short of the recommended benchmark. The article also explores the reasons behind discontinuation, including side effects, impatience, and lack of sufficient follow-ups with healthcare providers.

The report emphasizes the need for healthcare providers to provide comprehensive support and counseling to their patients. This includes managing side effects, setting realistic expectations, and monitoring improvements. The analysis suggests that individuals who have regular follow-ups with their providers are more likely to adhere to treatment. Additionally, the article stresses the importance of understanding individual responses to treatment, as not everyone experiences the same level of weight loss. It highlights the need for further research to determine the factors that contribute to varying responses and to optimize treatment strategies for all patients.