A RECENT study has revealed that a significant proportion of adults prescribed glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight management discontinue treatment within a year, with discontinuation rates notably higher among those without Type 2 diabetes.
The cohort study, which analysed data from 125,474 adults with overweight or obesity, found that 46.5% of patients with Type 2 diabetes and 64.8% of those without the condition discontinued GLP-1 RAs within one year of starting treatment. Furthermore, among those who discontinued, 47.3% of patients with Type 2 diabetes reinitiated the medication within a year, compared to just 36.3% of those without the condition.
Researchers examined factors influencing both discontinuation and reinitiation rates. They found that greater weight loss and higher income levels were significantly associated with lower discontinuation rates. For instance, a 1% reduction in body weight from baseline was linked to a 3.1% lower likelihood of discontinuation for patients with Type 2 diabetes and a 3.3% lower likelihood for those without. Conversely, gastrointestinal side effects, particularly moderate or severe adverse events, were associated with an increased risk of discontinuation.
Weight regain was identified as a key factor influencing reinitiation. Patients who regained 1% of their body weight after discontinuation were significantly more likely to restart GLP-1 RA therapy, with hazard increases of 2.3% for those with Type 2 diabetes and 2.8% for those without.
The study underscores concerns about treatment adherence and its implications for long-term weight management. While GLP-1 RAs have been shown to be effective for weight loss and glycaemic control, the high discontinuation rates—especially among individuals without Type 2 diabetes—raise questions about barriers to sustained use. Researchers pointed to factors such as cost, accessibility, and medication side effects as potential contributors to these trends.
The findings highlight disparities in access to and adherence to effective obesity treatments, with researchers cautioning that such inequities could further widen health disparities related to weight management. As the use of GLP-1 RAs continues to grow, ensuring long-term adherence and addressing barriers to sustained treatment remain critical challenges in obesity care.
Victoria Antoniou, EMJ
Reference
Rodriguez PJ et al. Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists among US adults with overweight or obesity. JAMA Netw Open. 2025;8(1):e2457349.
