Most patients stop taking GLP medications after two years, jeopardizing their weight loss

Four out of five people who take GLP-1 weight-loss drugs stop taking them within two years, even though the drugs need to be taken much longer to maintain their effects, according to a new report from Eagan-based Prime Therapeutics.

Wednesday’s report is disappointing because many people regain weight after stopping injectable drugs like Wegovy, putting themselves back at risk for costly chronic diseases, said Pat Gleason, assistant vice president for health outcomes at Prime, which manages pharmacy benefits for Blue Cross health plans nationwide.

“From a waste perspective, this is a concern for us,” he said.

The drugs’ rising popularity has increased costs for health plans and employers over the past two years, prompting some of them to stop covering them or cap how much they’ll cover. Even among health care providers, Hennepin Healthcare stopped covering GLP weight-loss drugs for its employees this year, and the Mayo Clinic capped lifetime GLP benefits in one plan at $20,000 per employee.

Cost issues and limitations alone don’t explain the 85% success rate after two years or the 47% rate after just six months, Gleason said. The study focused on 3,300 patients who started taking GLP weight-loss drugs in 2021 and whose Blue Cross plans didn’t make major changes to their drug formularies or coverage limits in the two years that followed, Gleason said.

The study excluded patients with diabetes because the drug offers additional benefits in this group. One version, Ozempic, is approved only for the treatment of diabetes but is often prescribed off-label for weight loss.

Prime did not ask patients why they quit, but Gleason said side effects and annoyance with the injections were likely reasons. The success rate was higher with the daily medications than with the once-weekly ones. Some also likely quit after meeting short-term weight-loss goals because they did not appreciate the risk of regaining the weight.

Shortages are also due to the immense popularity of the drugs, which are touted on social media platforms as short-term miracles when they are actually intended to be long-term treatments. They likely contributed to 26% of Prime trial participants switching to GLP drugs within two years.

Cost was a factor for Maja Smedberg. Last year, she protested her employer, Hennepin Healthcare,’s decision to stop covering the drug that had helped her lose more than 30 pounds. After losing coverage, she has now extended the injections from seven days to 10 days, but her supply will run out in two weeks. She’s learned a lot about portion control and hopes good eating and exercise habits will help her once she’s off the drug.

“I know the statistics on weight gain after weaning, but you never know if I’m an anomaly,” she said. “I worry about it, but I try not to be, because worrying just stresses me out and I can’t control how my body reacts.”

Novo Nordisk, the Danish maker of Wegovy and Ozempic, reported in 2022 that people regained an average of two-thirds of their weight after stopping the drugs. A global research group last year reported fewer heart problems in people with obesity who received GLP injections, but they had to take the drugs for three years to achieve those benefits, Gleason said.

Researchers are trying to find alternatives or exercise plans that will help people maintain their weight and manage their cravings and hunger after stopping the injections.

Epic Research found that 27 percent of patients regained all their weight after stopping GLPs. But that rate dropped to 19 percent when they switched to another weight-loss drug called phentermine. Although it’s only an eight percentage point difference, the risk reduction is enough for doctors to at least consider this follow-on therapy for patients, said Kersten Bartelt, lead author of the Epic report.

A Danish study found that a combination of GLP injections and structured exercise enabled many patients to maintain their weight for at least a year after stopping the medication.

Gleason said that’s encouraging, and Prime is promoting a KeepWell program to employers that can help their employees improve their diet and exercise while taking obesity medications. He compared the combination of GLPs with structured exercise and diet programs to the counseling programs that were first combined with nicotine therapy years ago.

“Quitting smoking is hard,” he said. “Losing weight is hard.”