High Discontinuation Rates of GLP-1RAs for Weight Loss: A Growing Concern

Recent research highlights the significant challenge of maintaining long-term adherence to weight-loss medications, specifically glucagon-like peptide-1 receptor agonists (GLP-1RAs) like semaglutide, which have demonstrated remarkable effectiveness in promoting weight reduction. A comprehensive population-based study presented at the European Association for the Study of Diabetes (EASD) meeting in Vienna revealed that approximately half of adults without diabetes who began using semaglutide to lose weight in Denmark ceased treatment within the first year.

The study analyzed data from over 77,000 first-time users between December 2022 and October 2023. Among these, about 72% were women with a median age of 50. Results showed that 18%, 31%, and 42% of users stopped treatment within three, six, and nine months, respectively. This high rate of discontinuation raises concerns because these medications, intended for long-term use, lose their effectiveness in controlling appetite and promoting weight maintenance once stopped.

Lead researcher Professor Reimar W. Thomsen emphasized that "This level of drop-off is concerning because these medications aren't meant to be a quick temporary fix. For them to work effectively, they need to be taken over the long term. Once people stop, the benefits are lost." The medications, originally developed for managing diabetes, work by reducing appetite and signaling fullness to the brain, thus aiding weight loss. However, their high cost—approximately 2,000 Euros per year for the lowest dose—poses a barrier, especially for individuals in lower-income groups, potentially contributing to their early discontinuation.

Additional factors influencing dropout include age, with younger adults (18–29) being 48% more likely to stop treatment early compared to those aged 45–59. Socioeconomic status also plays a role; individuals from low-income areas are 14% more likely to discontinue. Furthermore, individuals with a history of gastrointestinal or psychiatric medication use, or those with chronic conditions like cardiovascular disease, are more prone to discontinuing, likely due to higher susceptibility to adverse effects such as nausea, vomiting, and diarrhea.

Gender differences were observed, with men being 12% more likely to cease treatment within a year than women, possibly reflecting less satisfactory weight loss outcomes among men. These findings underline the importance of understanding adherence barriers to improve treatment efficacy and health outcomes.

The study acknowledges limitations, including the inability to assess individual BMI, income, insurance status, or precise weight loss outcomes, and potential underestimation of milder side effects. Nevertheless, the research underscores the urgent need for strategies to enhance adherence and address barriers such as cost and side effects to optimize the benefits of GLP-1RAs for weight management.

Source: https://medicalxpress.com/news/2025-09-people-popular-weight-loss-drug.html