Many Who Stop GLP-1 Medications Restart Within a Year, Study Finds

Key Takeaways: 

• Around 4 in 10 people with type 2 diabetes stopped their GLP-1 medication within the first year, rising to nearly 6 in 10 by the end of two years.
  
• Of those who stopped, more than half restarted within a year and nearly two-thirds within two years, suggesting use is often start-and-stop rather than permanent.
  
• Newer medications, a prescription from an endocrinologist, and fewer stomach-related side effects were all linked to a lower likelihood of stopping.
  
  
  

Use is more start-and-stop than assumed

People prescribed GLP-1 medications are more likely to start and stop treatment than many assume, according to a study being presented on Sunday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, Illinois.

“Our study asked two questions that haven’t been well answered until now: How many people with type 2 diabetes taking GLP-1 medications actually stop using them? And how many restart them?” said Sainikhil Sontha, M.S., a research associate at Boston University School of Public Health in Boston, Massachusetts.

How the study was carried out

The researchers ran a retrospective cohort study using Komodo Health US claims data covering January 2019 to June 2025. The group included adults aged 18 to 64 years with a BMI of 25 kg/m² or above and type 2 diabetes who had started liraglutide, semaglutide, or tirzepatide, and who had previously enrolled within the last year with more than six months of follow-up.

Discontinuation was defined as a gap of more than 60 days in filling a GLP-1 prescription. Obtaining a new fill after discontinuation was counted as reinitiation.

How many people stopped

“Using insurance records from more than 60,000 Americans with type 2 diabetes, we found that about 4 in 10 patients stopped their GLP-1 medication within the first year, and nearly 6 in 10 had stopped by the end of two years,” Sontha said.

But the team also found something more encouraging.

How many people restarted

“More than half of those who stopped restarted therapy within a year (41.5%), and nearly two-thirds did so within two years (58%),” Sontha said. “This suggests that for many patients, these medications aren’t being abandoned permanently; use is more start-and-stop than most people assumed.”

Who was more likely to stop

Using Cox proportional hazards models, the researchers also accounted for sociodemographic, clinical, and provider-level predictors.

Sontha and colleagues found that people on Medicaid or Medicare, people who are Black, and those experiencing nausea or other stomach-related side effects (37%) were more likely to discontinue a GLP-1 medication within a year.

What was linked to staying on treatment

People were 10% less likely to stop if their first GLP-1 medication was prescribed by an endocrinologist.

The type of medication also made a difference. People taking newer medications such as tirzepatide were 41% less likely to discontinue than those taking older drugs such as liraglutide, while people taking semaglutide were 28% less likely to discontinue anti-obesity medication use than those on older medications.

Why it matters

“This research matters because consistent use of these medications is what produces their protective effects,” Sontha said. “Stopping early may mean missed opportunities to prevent heart attacks, kidney disease progression and other complications.”

The researchers hope the findings give providers, insurers, and policymakers a clearer picture of which patients need more support to stay on GLP-1 medications.

CCH insights:

This study suggests most patients see GLP-1 medications as a temporary treatment to lose weight, rather than a long-term treatment for obesity and cardiometabolic health. It also suggests patients are not getting good advice regarding GLP-1 therapy. In the long-term, patients should be advised to reduce down to the minimum dose that enables them to maintain weight loss and also maintain gains in metabolic markers and improvements in cardiovascular risk factors, rather than stopping and restarting treatment.

Getting that judgement right – knowing when to hold a dose, when to step down rather than stop, how to keep a patient nourished when side effects bite, and how to prepare them for the long term – is exactly what our two-hour CPD course GLP-1RAs in Practice: Supporting Patients During Treatment is built around, for any clinician supporting patients across the full arc of therapy.

Source: Endocrine Society