Real-world outcomes vs. clinical trials
Earlier randomised clinical trials painted a grim picture: patients who stopped GLP-1 drugs based on compounds like semaglutide (Ozempic) or tirzepatide (Mounjaro) regained more than half of their lost weight within a year. However, this new real-world study, published in Diabetes, Obesity and Metabolism, suggests that everyday clinical practice tells a different story. Here, patients have the flexibility to adjust their treatment plans, often with the support of healthcare providers.
“Our real-world data show that many patients who stop semaglutide or tirzepatide restart the medication or transition to another obesity treatment, which may explain why they regain less weight than patients in randomised trials,” explains Hamlet Gasoyan, the study’s lead researcher.
The numbers: weight loss, regain, and stability
The study tracked 7,938 adults with overweight or obesity in Ohio and Florida, all of whom had started and then stopped GLP-1 treatments within 3 to 12 months. The results were striking. Patients treated for obesity:
- Lost an average of 8,4% of their body weight before stopping.
- Regained only 0,5% of their weight after one year.
- 55% gained weight after discontinuation, while 45% either maintained or continued losing weight.
Patients treated for type 2 diabetes:
- Lost an average of 4,4% of their body weight before stopping.
- Lost an additional 1,3% over the following year.
- 44% gained weight, while 56% maintained or continued losing weight.
These findings show that weight management is not a one-size-fits-all journey. Many patients continue to make progress even after stopping their initial medication, often by adopting new strategies.
Why do patients stop, and what do they do next?
Cost and insurance coverage emerged as the primary reasons for discontinuation, followed by side effects. Yet, the study revealed that patients are proactive in seeking alternatives:
- 27% switched to another medication, such as older-generation obesity drugs or a different GLP-1 drug.
- 20% restarted their original medication.
- 14% pursued structured lifestyle interventions, working with dietitians or exercise specialists.
- Less than 1% opted for metabolic and bariatric surgery.
Notably, patients using GLP-1 drugs for type 2 diabetes were more likely to restart treatment, likely due to more consistent insurance coverage for diabetes prescriptions.
The role of ongoing support
The study highlights the critical role of individualised, long-term care in weight management. As Dr Gasoyan notes, “Many patients do not give up on their obesity treatment journey, even if they need to stop their initial medication.”
The researchers plan to further investigate the effectiveness of alternative treatments for those who discontinue GLP-1 drugs, aiming to provide patients and clinicians with data-driven insights for informed decisions. The key takeaways from the study are the following.
Real-world data differs from clinical trials: Patients often regain far less weight than expected after stopping GLP-1 drugs, thanks to alternative treatments and lifestyle support.
Insurance and cost matter: Financial barriers are a major reason for discontinuation, particularly for those using the drugs for obesity rather than diabetes.
Long-term support works: Structured care through medication, dietitians or exercise specialists plays a key role in sustaining weight loss.
This study confirms that weight management is a dynamic process, and setbacks can be mitigated with the right strategies and support. This is good news for anyone using or considering trying Ozempic or similar GLP-1 drugs.