The use of diabetes and weight-loss medications like Ozempic or Wegovy - called GLP-1 drugs - has exploded in recent years, with 12% of U.S. adults having used one despite the high cost, according to a June 2024 poll.

What's less talked about is that 50-75% of people who start taking these drugs stop using them within a year.

Northwestern Medicine cardiologist Dr. Sadiya Khan wants to figure out why, what the harms may be of stopping therapy prematurely, and how to help patients continue their therapy.

This should 'raise alarms'

"The staggeringly high discontinuation rates of GLP-1 RA should raise alarms for clinicians, policy makers, and public health experts," said Khan, associate professor of medicine (cardiology) and preventive medicine (epidemiology) at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician.

"While research is needed to quantify and identify the drivers, we hypothesize that there are likely many issues," Khan said. "First and foremost, the high cost of these therapies is likely a large barrier. Also, unlike therapies that are used to treat blood pressure or cholesterol, the perception that these are not chronic disease therapies may also be contributing. For instance, some individuals think they will stop taking them once they've lost weight while others are only using themcosmetically and not for management of a chronic disease."

Call for more research

In a new JAMA Viewpoint opinion piece, Khan and others call for more research to understand the causes of this discontinuation and the development of clinical and policy interventions to support long-term use.

"Newer, high-potency GLP-1 RAs have revolutionized the therapeutic landscape for patients living with overweight, obesity or diabetes," she said. "In addition to the highly publicized weight benefits, these drugs, like semaglutide, have given the magnitude of benefit with a 20-25% reduction in cardiovascular disease events regardless of weight loss achieved."

The Viewpoint authors reference a survey published in 2023, which found that while 45% of U.S. adults were interested in the use of these drugs for weight management, this number declined to 14% when they were informed about gaining the weight back after discontinuing therapy.

Farewell frost!

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