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Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity.

ObservationalHigh evidence

This record provides bibliographic details and links to the original research. An editorial study breakdown is not available.

What the researchers found

Among 125,474 US adults, 65% without diabetes discontinued GLP-1 RAs within one year vs. 47% with diabetes. Weight loss predicted staying on treatment; GI side effects and lower income predicted stopping.

Why it matters

This is the largest study of GLP-1 RA adherence patterns. It reveals that most patients stop these drugs within a year, especially those using them for weight loss without diabetes, highlighting a major treatment gap.

The numbers in context

125,474 adults (65.4% women, mean age 54.4). 1-year discontinuation: 64.8% without T2D, 46.5% with T2D. Each 1% weight loss reduced discontinuation hazard by 3.1-3.3%. GI adverse events: HR 1.19-1.38 for discontinuation. Income >$80K: HR 0.72 for discontinuation (T2D only). 1-year reinitiation: 36.3% without T2D, 47.3% with T2D.

How the study worked

Retrospective cohort using electronic health records from multiple US health systems. 2018-2023. Kaplan-Meier for discontinuation/reinitiation. Time-varying Cox regression for predictors. Up to 4-year follow-up.

Who was studied

US adults with overweight or obesity newly starting GLP-1 RAs (liraglutide, semaglutide, or tirzepatide)

What this study cannot tell us

EHR-based, may miss prescriptions filled outside system. Cannot distinguish intentional discontinuation from access barriers. Observational design. US-specific. Newer agents (tirzepatide) had shorter follow-up.

Read the original research

Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity.

JAMA network open, 8(1), e2457349

Citation

Rodriguez, Patricia J; Zhang, Vincent; Gratzl, Samuel; Do, Duy; Goodwin Cartwright, Brianna; Baker, Charlotte; Gluckman, Ty J; Stucky, Nicholas; Emanuel, Ezekiel J. (2025). Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity.. JAMA network open, 8(1), e2457349. https://doi.org/10.1001/jamanetworkopen.2024.57349