Most people stop taking their weight loss drugs too soon—here’s why that can be a problem

More than 30% of people prescribed GLP-1 drugs for weight loss like Saxenda (liraglutide) and Wegovy (semaglutide) stop within just four weeks of starting treatment. More than half of people stop within 12 weeks.

That’s according to a 2024 study published by Blue Health Intelligence, the data research arm of the health insurer Blue Cross Blue Shield (BCBS). The researchers reviewed the national pharmacy and medical claims data for 169,250 members with commercial insurance coverage for GLP-1s for weight loss who were using these medications between January 2014 and December 2023. The study looked at claims for Saxenda (liraglutide), which was first approved for weight loss in January 2014 (hence the study’s start date) and Wegovy (semaglutide). Zepbound (tirzepatide), as a newer GLP-1 medication FDA-approved for weight loss, was not included in the study as it just came out last year.

Weight loss medications like Wegovy and Saxenda are designed to be taken on a long-term basis, certainly longer than 12 weeks and possibly for years. In the case of Wegovy, it can take four to five months alone to ramp up to the full maintenance dosage of the drug. Stopping too soon can prevent you from seeing results. 

So, why are so many people stopping these medications after just a matter of weeks, as the study suggests? Keep reading to find out what might be contributing to their decision to stop treatment and why stopping may not be a good idea, according to  Beverly Tchang, MD, endocrinologist and  Ro advisor, as well as research. 

According to the study, more than half of people prescribed GLP-1 medications for weight loss stop taking them within the first 12 weeks, which may prevent them from achieving clinically meaningful weight loss. Only 42% of the people in the study continued GLP-1 treatment for 12 weeks or longer and met the definition of clinical success. People who were more likely to stop GLP-1 treatment early included people who:

• Were younger, between 18 to 34 years old

• Received their prescription from their primary care provider (PCP) as opposed to  someone specializing in weight management and obesity, like an endocrinologist or obesity specialist

• Saw their provider less frequently after receiving their prescription

• Lived in underserved health regions or had more barriers to care

People who were more likely to continue treatment until at least the 12-week mark included those who were 35 years old or older, received their prescription from a health provider specializing in weight management (like an endocrinologist or obesity medicine specialist), and saw their health provider more frequently after receiving their initial prescription.

Gender didn’t seem to be a factor in who stopped or continued GLP-1 treatment. Nor did which drug they took (Wegovy or Saxenda).

It’s worth noting there are some limitations to the study. For one, it’s based on claims data of people with commercial insurance coverage for GLP-1s, which may not reflect the typical situation for the average person taking GLP-1s. It’s also not yet published in a peer-reviewed journal. And as a study funded by a major insurer, it may be biased in its findings, Dr. Tchang warns. “The study by BCBS should be viewed with extreme caution and consideration for the author's agenda. It reports rates of GLP1 discontinuation but little detail is given as to why.”

“There are several reasons people might stop taking their GLP-1: shortages, withdrawal of insurance coverage, transition to an alternative anti-obesity medication, or side effects,” Dr. Tchang says. “Some of these reasons may be patient-related while others are systemic barriers.” 

According to the study, some of the factors that affected whether people stopped taking GLP-1 included:

• Age: Around 80% of the study participants were female, with an average age of 45. People ages 35 and older were 41-48% more likely to continue treatment for 12+ weeks than those ages 34 and younger.

• Limited access to healthcare: Those with the most barriers to care—including cost, transportation, and language barriers—were least likely to continue treatment.

• Cost of  GLP-1s: In the study, those who paid less than $60 per month for their medication were significantly more likely to stay on it than those paying more. While this study looked at claims of people with insurance coverage for GLP-1s, not all insurers cover weight loss medications, and the retail price of Wegovy and Saxenda can be upwards of $1,000. Moreover, many insurance plans require prior authorization before covering Saxenda or Wegovy, which can further delay treatment and increase the likelihood that someone stops treatment entirely, according to a 2023 survey of physicians by the American Medical Association.

• Side effects: Study researchers hypothesized side effects may also have led people to stop taking their GLP-1s too soon, as other studies have found. Nausea, vomiting, and diarrhea are common when starting treatment on GLP-1s.  In clinical trials, nearly 10% of people taking Saxenda and around 7% of people taking Wegovy stopped treatment early due to these side effects and others. 

The person’s healthcare team and how frequently they saw their care provider after receiving their prescription also influenced whether they stopped taking their GLP-1s early, according to the study findings. Those who saw their healthcare providers more often after being prescribed a GLP-1 were more likely to stay on the medication. Each time a person saw their provider, their chances of continuing treatment for at least 12 weeks increased by about 60%. 

If the prescribing provider was an endocrinologist or obesity medicine specialist, people were 22% more likely to continue treatment for 12 weeks or longer than those who received their prescription from a PCP.  However, in the study, fewer than 5% of people received their prescription from an obesity medicine specialist or endocrinologist. 

Did Covid affect the study results? 

Given the time period observed in the study, it’s possible that other factors may have influenced a participant’s decision to stop GLP-1 treatment. 

For example, the study period (2014–2023) overlapped with the COVID-19 pandemic. During the height of the pandemic, when people were in lockdown, any sort of medical treatment that was considered non-urgent was put on hold—including treatment for obesity. This made people with obesity more vulnerable to gaining weight, especially given what life during lockdown was like. People were less likely (or told not) to exercise, more likely to be sedentary, and more likely to turn to the food in their homes to cope with the negative emotions, worries, and fears brought up by the pandemic and living in social isolation. 

Since the pandemic, American views on obesity have changed. People are more aware of the risks of living with obesity, and the benefits of treatment, since living through COVID-19, and are now more likely to look into treatment, including with GLP-1s. According to one study, 28 million people explored obesity treatment for the first time after the pandemic. 

GLP-1 drug shortages are another confounding factor that may have affected the BCBS study results. Given the high demand for these medications, they tend to experience shortages from time to time. According to the World Health Organization, during the last few years of the study period (2021-2023), GLP-1 drug shortages were at their peak. Semaglutide, the active ingredient in Wegovy, first started experiencing shortages in late summer 2022, while liraglutide, the active ingredient in Saxenda, went into shortage the following year. 

“[This question] implies that there is a point where you should be stopping GLP-1,” Dr. Tchang says. “GLP-1s for obesity treatment should be considered long-term medications. Studies like STEP 4 show weight regain when people stop semaglutide 2.4 mg.” 

Indeed, in the STEP 4 trial, people ramped up to the highest 2.4 mg dosage of Wegovy for 20 weeks and lost an average of 10.6% of their body weight. Then, over the next year, they either kept taking Wegovy or were given a placebo. At the end of the study, those who kept taking Wegovy lost 8% of their body weight while those who took the placebo gained 7%. 

In another study of Wegovy, participants lost over 17% of their body weight over 68 weeks before stopping treatment. By week 120, they regained over 11% of their body weight back, resulting in a net loss of 5.6% over the entire study period. 

While the BCBS study points to several factors that may lead someone to stop GLP-1 treatment early, the decision is a personal one, and we can’t say for sure why any one person would decide to stop treatment. Some people might decide to stop once they see some weight loss, but these medications are meant to be a long-term treatment for a chronic condition: obesity. 

If you’ve recently started taking a GLP-1, there are several steps you can take to help you stick with it. Your first step is to ask for help, Dr. Tchang says. “If patients are no longer able to continue their medication, they should reach out to a professional for guidance, depending on the issue.”

Many of the possible issues, explains Dr. Tchang, could be easily fixed with support. “If they are unable to find the medication in their pharmacy, perhaps their pharmacist could recommend alternative locations that would have it in stock. If it's an issue with insurance coverage, they can reach out to their employer's HR department.” Another helpful solution is signing up for Ro’s Supply Tracker to track when your medication is in stock. 

Here are a few more tips to stick with your GLP-1 treatment.

• Find a way to make side effects manageable. Side effects are usually most intense and frequent when starting GLP-1 treatment and escalating your dose. Knowing that there’s an end in sight can help you get through it. Nausea is one of the most common side effects of GLP-1 drugs—affecting nearly 40% of people starting Wegovy or Saxenda. If you experience nausea, try switching up what you eat. Swap out fatty foods for mild, low-fat options like crackers or toast. Foods with a lot of water in them, such as soup or gelatin, can also help. Avoid lying down after you eat, and get some fresh air outside. 

• See if you are eligible for any savings programs. Many GLP-1 drug makers, including Eli Lilly and Novo Nordisk, offer savings programs that can significantly bring down the cost you pay at the pharmacy. You can also look up specific pharmacy coupons online on sites like GoodRx or Optum Perks.

• Ask your healthcare provider about other weight loss medications. For example, some studies have found that people tend to have an easier time sticking to their treatment on weekly GLP-1 drugs, like Wegovy, vs. daily injections, like Saxenda.

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Current version

September 17, 2024

Written by

Amelia Willson

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.