Nearly half of U.S. adults admit they’d take one of the newer, injectable weight loss drugs, but concerns about potential weight regain after stopping significantly dampen their enthusiasm. This trend highlights the issue of discontinuation prevalent among users of these medications, raising alarms among healthcare providers.
The U.S. has one of the highest overweight and obesity rates globally, with alarming trends continuing to the present. A study published in the esteemed journal The Lancet found, across all 50 states and Washington, D.C., the prevalence of overweight and obesity exceeded 40% among adults, significantly impacting health and mortality rates.
Among the leading treatments is semaglutide, initially marketed as Ozempic for diabetes management, then rebranded as Wegovy for weight loss. The drug has gained popularity due to its efficacy at delivering quick weight loss results. According to various studies, semaglutide not only aids weight loss but also reduces the risk of cardiovascular events and chronic kidney disease related to diabetes.
Despite its benefits, many individuals are dropping out of the GLP-1 receptor agonist (RA) regimen. The independent health research organization KFF (formerly The Kaiser Family Foundation) conducted polling, reporting on Americans’ sentiments toward weight loss treatments. A survey from July 2023 found about 45% of U.S. adults expressed interest in taking safe and effective weight loss medications, yet this number shrank when they learned there was a risk of regaining weight after stopping the treatment—falling to just 14%.
Interestingly, concerns often outweighed other issues such as insurance coverage or the need for regular injections, indicating fluctuated attitudes toward these medications. Following up on these findings, KFF's May 2024 health tracking poll revealed enhanced awareness about GLP-1 drugs had grown from 19% to 32%, with approximately 12% of American adults stating they took such medications, including 6% who were actively using them. Among those taking GLP-1 RAS, 62% were addressing chronic conditions, like diabetes or heart disease, and 40% primarily aimed to lose weight.
Affordability emerged as another hurdle, as 54% of adults reported trouble managing the costs associated with these weight loss medications. This included 22% of respondents indicating the difficulty was acute. Even among insured individuals whose plans covered parts of the drug costs, 53% claimed they still struggled to afford the therapy.
A recent investigation published by the Evernorth Research Institute examined patient experiences with discontinuing GLP-1 RAS. The study analyzed data from over 195,000 individuals registered between January 2021 and December 2023, with findings indicating significant drop-off rates—26.2% at three months, 30.8% at six months, and 36.5% at the one-year mark.
Specific demographics also faced varying rates of discontinuation. Patients with only obesity struggling with adherence lifted their 12-month drop-off rate to 50.3%, substantially higher compared to 35.8% for those solely diagnosed with type 2 diabetes. Researchers identified heightened discontinuation likelihood among Black or Hispanic males and younger adults enrolled on Medicare or Medicaid.
Dr. Sadiya Khan, associate professor of cardiology and preventive medicine at Northwestern University Feinberg School of Medicine, raises the alarm about the concerning discontinuation trends. “The staggeringly high discontinuation rates of GLP-1 RA should raise alarms for clinicians, policy makers, and public health experts,” said Dr. Khan, who authored an opinion piece linked to the study's results published by JAMA in mid-November.
Dr. Khan emphasized the multifactorial nature of discontinuation. “First and foremost, the high cost of these therapies is likely a large barrier,” she stated, hypothesizing additional issues existed, as patients sometimes mistakenly viewed GLP-1 drugs as non-chronic therapies. Some individuals think they can simply stop once weight loss is achieved, or use them merely for cosmetic purposes, instead of managing underlying health concerns.
Dr. Khan and co-authors stressed the importance of discussing high discontinuation rates, especially considering the drugs' cardiovascular benefits, which can dramatically reduce disease events by 20-25% regardless of weight loss. “Newer, high-potency GLP-1 RAS have revolutionized the therapeutic outcomes for patients living with overweight, obesity, or diabetes,” she remarked.
Despite the medical advancements provided by these drugs, the U.S. obesity problem remains significant. Looking forward, the The Lancet study projects staggering figures—approximately 81.1% of adult males and 82.1% of adult females will be overweight or obese by 2050. Effectively addressing these health concerns requires continued advocacy for accessible, affordable treatment options and sustained conversations about the importance of managing disease beyond simply aiming for temporary weight loss.
