More than half of semaglutide users quit within a year, study finds, threatening long-term benefits

More than half of people who started semaglutide-based GLP-1 drugs for weight loss stopped taking them within a year, according to a Danish study that raises concerns about the durability of benefits from these medications.

Researchers analyzed prescription and health records for 77,310 first-time users of semaglutide who did not have diabetes and found that nearly one in five had quit by the third month and 42% had discontinued by month nine. Overall discontinuation exceeded 50% within the first year of treatment.

"This level of drop off is concerning because these medications aren’t meant to be a temporary quick fix," said Reimar W. Thomsen, a professor in the Department of Clinical Epidemiology at Aarhus University and the study’s lead author. He noted that semaglutide and similar GLP-1 drugs suppress appetite and increase feelings of fullness, but that "all of the beneficial effects on appetite control are lost if the medication is stopped."

Past studies have shown that many patients who discontinue GLP-1 therapy regain much or all of the weight they lost. One prior analysis found a majority returned to their baseline weight within two years of stopping the drugs, a pattern that researchers said can erase much of the health advantage aimed for by prescribing the medications.

The Danish team identified groups more likely to stop treatment early. People aged 18 to 29 were 48% more likely to discontinue within a year than those 45 to 59. Living in a lower-income neighborhood raised the odds of stopping by 14% compared with residents of wealthier areas. Men were 12% more likely to quit within a year than women.

Researchers also found higher discontinuation among people with certain medical histories. Prior use of gastrointestinal medications was associated with a 9% greater likelihood of stopping early, and prior psychiatric medication use with a 12% greater likelihood. Patients with cardiovascular disease or other chronic conditions were roughly 10% more likely to discontinue. The authors suggested that those with prior gastrointestinal drug use may be more susceptible to common GLP-1 side effects, such as nausea, vomiting and diarrhea.

Cost emerged as a major barrier to sustained use. In the United States, the average retail price for drugs such as Ozempic and Wegovy can run about $1,000 to $1,200 a month without insurance, according to GoodRx. Prescription rates for GLP-1 drugs have more than tripled since 2020, and surveys indicate nearly 12% of Americans have tried semaglutide-containing medications for weight loss.

Experts said the pattern of early discontinuation is particularly worrisome because people with obesity-related comorbidities — who may stand to gain the most from weight-loss treatment — were among those more likely to stop. Obesity is common in the United States: nearly 40% of adults are classified as obese and about 20 million are considered severely obese, according to the Centers for Disease Control and Prevention.

The study’s authors said understanding the reasons patients stop GLP-1 therapy could inform strategies to improve adherence, such as addressing cost and access barriers, managing side effects more effectively, and tailoring support for younger patients. They argued that addressing these obstacles is essential to realizing the potential health benefits of long-term treatment.

The findings add to a growing body of evidence that while GLP-1 drugs can produce substantial short-term weight loss, their benefits are closely tied to continued use. Without measures to improve persistence, clinicians and policymakers said the public-health impact of the drugs may be limited by high rates of early discontinuation and the subsequent return of weight and associated health risks.