GLP-1 medications have transformed the treatment of obesity, but new research suggests many patients do not remain on the drugs long term.
In a study published in JAMA Network Open, researchers found that fewer than one in four adults with overweight or obesity who started a glucagon-like peptide-1 receptor agonist (GLP-1RA) were still taking any drug in the class after one year.
GLP-1 medications, which include drugs such as semaglutide and liraglutide, work by mimicking a hormone involved in appetite regulation. They slow stomach emptying, increase feelings of fullness and help reduce food intake, which can lead to significant weight loss.
The study examined treatment patterns among adults without diabetes who were prescribed GLP-1 drugs for weight management.
Researchers found that persistence with the medications declined steadily over time. By 12 months after starting treatment, fewer than 25% of patients remained on a GLP-1 medication.
However, the researchers say that stopping treatment does not necessarily mean patients abandoned therapy entirely.
Switching between different GLP-1 drugs was common during the study period. According to the authors, these changes may reflect active adjustments in treatment as newer medications and formulations become available.
“In this large cohort of adults with overweight or obesity without diabetes, fewer than 1 in 4 patients remained on any glucagon-like peptide-1 receptor agonist after 12 months,” the researchers wrote.
“Switching between GLP-1RA agents was common and may reflect active therapy management rather than nonengagement, particularly as new formulations and weight management agents emerge.”
GLP-1 drugs have gained widespread attention in recent years because of their ability to help patients lose substantial amounts of weight while also improving blood sugar control and other metabolic markers.
But the medications can be expensive, and some patients experience side effects such as nausea or gastrointestinal discomfort, factors that may influence how long people remain on treatment.
Insurance coverage, medication supply issues and the rapid introduction of new drugs in the same class may also affect prescribing patterns and patient persistence.
The researchers say their findings highlight the importance of understanding how these medications are used in real-world settings outside clinical trials.
While clinical studies often track outcomes under controlled conditions, real-world prescribing patterns can reveal how patients and clinicians adjust treatment over time.
As GLP-1 medications become more widely used for obesity treatment, researchers say further study will be needed to understand why patients stop therapy and how treatment strategies evolve as new options enter the market.
The study was published in the peer-reviewed journal JAMA Network Open. Researchers analyzed treatment patterns among adults with overweight or obesity who were prescribed GLP-1 medications for weight management.