How sustainable is the GLP-1 receptor agonist drugs for weight loss?

Stoppage Rate of Semaglutide Use

According to data reported by Reimar Thomsen, MD, PhD, of Aarhus University Hospital in Denmark, about 52% (40,262 of 77310) adults without diabetes who took semaglutide for weight loss ceased to take the medication after 12 months, while about 18% of the adults stopping to take Wegovy injection within 3 months, 31% within 6 months, and 42% within 9 months.

Thomsen noted at the European Association for the Study of Diabetes (EASD) annual meeting that population-wide data confirming the cessation rate of the injectable GLP-1 receptor agonist, Wegovy, is still lacking, but this level of drop-off seen in Denmark is concerning because these GLP-1 receptor agonists are not meant to be a temporary quick-fix, but a long term treatment. He stated “All of the beneficial effects on appetite control are lost if the medication is stopped.”

Determining Factors of Semaglutide Stoppage

The analysis identified several factors associated with a higher likelihood of stopping the medication:

1.      Younger people ages to 18 to 29 and 30 to 44 were more likely to stop semaglutide than those ages to 45 to 59.

2.      Men were more likely to quit than women.

3.      People in areas with the least average disposable income were more likely to stop taking GLP-1 RA medication than those in the highest income area.

4.      People who had ever used another anti-obesity medication were more likely to stop than those who hadn’t.

5.      People who had ever used psychiatric medication or gastrointestinal medications were more likely to stop taking the medication – this may highlight side effects experienced by the users.

6.      People who had previously undergone bariatric surgery had a 15% lower likelihood of stopping semaglutide, but undergoing bariatric surgery after starting semaglutide was the strongest predictor of discontinuation.

7.      Other events such as newly developed biliary/pancreatic disease, thyroid disease, pregnancy, and cancer also increased the risk of stopping the medication, although these events were generally rare among users.

8.      People who had certain metabolic diseases or comorbidities such as prediabetes, hypertension, dyslipidemia, polycystic ovary syndrome, cardiovascular disease, or apnea were somewhat more likely to stop taking semaglutide.

9.      People who had an inadequate response to semaglutide were more likely to stop.

10. Individuals making 300,000 Danish Krones (about $48,000 in US dollars) per year were more likely to stop treatment than their higher-earning peers, as patients were taking psychiatric, GI, and other anti-obesity medications.

Thomsen indicated that ultimately, the cost of the drug appears to be the main driving force behind high rates of discontinuation. “As doctors, we really look forward to having these drugs [become] more affordable,” Thomsen added.

Additional Information about the observations:

1.      These findings reflect the first users of semaglutide approved for weight loss in Denmark from December of 2022 through October 2023. The cohort was restricted to adults without diabetes who started semaglutide specifically for weight loss. It did not include people who started semaglutide approved at lower doses for diabetes (Ozempic).

2.      The average age of people who started semaglutide for weight loss was 50 and 71% were women.

Concerns regarding the usage and the stoppage of GLP-1 receptor agonist.

Regarding the observation of the usage then the stoppage of GLP-1 receptor agonist such as semaglutide, Thomsen stated that “It may very well be the case for most people that for this to be effective, they need to basically take it the rest of their lives, like antihypertensives and [lipid-lowering agents] and so on.”

In terms of the health benefits while on GLP-1 receptor agonist, what happens when the users decide to stop?

According to the STEP 1 trial conducted by Wilding et al., participants who withdrew from receiving semaglutide treatment after 68 weeks regained about two-thirds of their prior weight loss, and the cardiometabolic benefits seen during semaglutide usage also reverted toward baseline level in similar fashion.

What’s next?

Dr. Reimar Thomsen believes the need for “some good counseling in these patients from the beginning,”  and people need to be prepared for what will happen once they decide to stop using GLP-1 drug. Thomsen also added that “it may very well be the case for most people that for this to be effective, they need to basically take it the rest of their lives, like antihypertensives and [lipid-lowering agents] and so on.” He believes physicians should talk about this with their patients. Dr. Niels Jessen from Aarhus University Hospital who observed the findings from Dr. Reimar’s study believes it is important to find ways to keep patients on GLP-1 drugs because “rapid discontinuation is something we do not encourage because we are afraid of this on/off use of the drugs may lead to unfavorable body composition.” People tend to lose more lean muscle mass while taking GLP-1 drug and then, when discontinuing, regained weight mostly come in the form of fat mass.

In addition to educating the potential GLP-1 drug users about the high rates of discontinuation observed in patients and the consequences, finding a way to keep patients on the drug seems to be necessary.

References

1.      Neale, Todd. "Half of Patients Stop Semaglutide for Weight Loss by 1 Year." TCTMD, 16 Sept. 2025, www.tctmd.com/news/half-patients-stop-semaglutide-weight-loss-1-year.

2.      Monaco, Kristen. "Substantial Number of People Ditch Wegovy Within a Year." MedPage Today, 16 Sept. 2025, www.medpagetoday.com/meetingcoverage/easd/117492.

3.      Wilding, J.P.H., R.L. Batterham, M. Davies, and Gaal et al. "Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension." Diabetes, Obesity and Metabolism, vol. 24, no. 8, 2022, pp. 1553–1564. Wiley, https://doi.org/10.1111/dom.14725.

Assessed and Endorsed by the MedReport Medical Review Board