A recent study has revealed that approximately half of patients using the weight loss drug semaglutide without diabetes discontinue treatment within a year. This finding, presented at the Annual Meeting of the European Association for the Study of Diabetes in Vienna, highlights a concerning trend in the long-term use of this medication.
Semaglutide, a member of the GLP-1 receptor agonists (GLP-1RAs) class, has shown significant effectiveness in promoting weight loss by reducing appetite and enhancing feelings of fullness. Originally developed for diabetes, it is marketed under the names Ozempic for diabetes and Wegovy for weight loss. Despite its potential benefits, the new research underscores high rates of early discontinuation among users, raising questions about the sustainability of weight loss treatment.
The study, conducted by researchers from Aarhus University, evaluated data from nationwide registries to assess the likelihood of discontinuation among adults aged 18 and older who began using semaglutide for weight loss between its launch date in Denmark on 1 December 2022 and 1 October 2023. Among the 77,310 first-time users, over half had stopped taking the drug after one year. Discontinuation rates were particularly steep, with 18% ceasing treatment within three months, 31% after six months, and 42% at nine months.
Professor Reimar W. Thomsen, the study’s lead author, emphasized the importance of sustained use for effective weight management. “For them to work effectively, they need to be taken long term,” he stated. He noted that stopping the medication results in the loss of beneficial effects on appetite control.
The research identified several factors influencing discontinuation rates. Age emerged as a significant factor, with younger users aged 18 to 29 being 48% more likely to discontinue treatment within the first year compared to users aged 45 to 59. Additionally, individuals living in low-income areas were 14% more likely to stop using semaglutide than those in higher-income regions, suggesting that the cost of the medication may be a significant barrier to ongoing treatment.
The study also indicated that previous experiences with gastrointestinal medications played a role in discontinuation. Users with a history of such medications were 9% more likely to stop taking semaglutide, possibly due to its common side effects, which include nausea, vomiting, and diarrhea. Furthermore, individuals with a history of psychiatric medication usage were 12% more likely to discontinue the drug, while those with cardiovascular disease or other chronic conditions had a 10% higher likelihood of stopping treatment early.
The research also found that men were 12% more likely to stop treatment within a year compared to women, which may indicate unsatisfactory weight loss outcomes, as women typically experience better results with GLP-1RAs. “I definitely think that some patients are happy with the weight loss they reached—maybe just a modest loss of some kilo—and then drop off,” Thomsen explained.
Thomsen stressed that pharmacotherapy alone cannot address the global obesity crisis. He believes that addressing the root causes of obesity is essential for improving health outcomes. “Understanding who may benefit most from interventions that encourage adherence is essential to improving treatment use and subsequent health outcomes and quality of life,” he added.
While the findings provide important insights into the reasons for early discontinuation, the researchers acknowledged limitations, such as the absence of precise body mass index (BMI) data in Danish health registries. They could not access individual-level income, insurance coverage, or out-of-pocket expenses, which may affect conclusions about the impact of socioeconomic factors on treatment adherence.
The researchers highlighted that GLP-1RAs are expensive and could potentially widen health disparities, particularly as obesity disproportionately affects marginalized communities. They also noted that milder side effects and other reasons for discontinuation may not be fully captured in registries, leading to potential underestimation of the data.
In conclusion, while semaglutide offers promising results for weight loss, the study reveals significant challenges related to long-term adherence. Understanding the factors contributing to discontinuation will be crucial in improving treatment strategies and ensuring better health outcomes for patients.
