A new report from Eagan-based Prime Therapeutics finds that four in five people taking GLP-1 drugs for weight loss stop taking them within two years, even though the drugs need to be taken for longer to maintain their effectiveness.
Wednesday report “These findings are unfortunate because many people regain the weight when they stop using injectable drugs like Wegobee, putting them at risk again for costly chronic diseases,” said Pat Gleason, vice president of health outcomes at Prime, which manages pharmacy benefits for Blue Cross health plans nationwide.
“From a waste standpoint, it’s a concern for us,” he said.
The drug’s growing popularity has driven up costs for health insurers and employers over the past two years, leading some insurers to drop coverage or limit what they pay. Among health care providers, Hennepin Healthcare this year stopped covering employees for the GLP-1 drug solely for weight loss, and Mayo Clinic limited lifetime GLP-1 benefits to $20,000 per employee under any one plan.
Gleason said cost issues and restrictions alone cannot explain the 85% quit rate after two years or the 47% retention rate after just six months. The study focused on 3,364 patients who started taking GLP-1 drugs for weight loss in 2021, and whose Blue Cross plans made no significant changes to their drug formularies or coverage limits over the following two years, Gleason said.
The study excluded people with diabetes because the drug provides additional benefits to those with diabetes. One version, Ozempic, is federally approved only for diabetes management but is often prescribed off-label for weight loss.
Prime didn’t ask patients why they stopped taking the medication, but Gleason said side effects and the hassle of injections were likely to be to blame. Patients who took the medication daily were more likely to stop taking it than those who took it weekly. Some patients also may have stopped taking the medication after achieving their short-term weight-loss goal, not realizing the risk of regaining the weight.
The shortage has also been fuelled by the popularity of this drug, which is meant to be a long-term treatment but has been touted as a short-term miracle on social media platforms, likely contributing to the 26% of people in the Prime study who switched GLP-1 medications over the two-year period.
For Maya Smedberg, cost was an issue when she protested her employer, Hennepin Healthcare,’s decision last year to drop coverage for a drug that helped her lose more than 30 pounds. Without coverage, she extended her injections from seven to 10 days, but the drug wears off in two weeks. She said she’s learned a lot about portion control, and hopes good diet and exercise habits will help once she’s off the drug.
“I know the statistics about weight gain after stopping medication, but I don’t know if I’m the exception,” she says. “I’m worried, but I try not to worry because worrying just stresses me out and I can’t control how my body reacts.”
Denmark’s Novo Nordisk, which makes Vigovi and Ozempic, reported in 2022 that patients regained two-thirds of their body weight on average when they stopped taking the drugs. Fewer reports of heart disease Gleason said obese people who received GLP-1 injections did benefit, but they had to take the drug for three years to see the benefits.
Researchers are trying to find alternatives and exercise regimens that can help people maintain weight loss and manage cravings and hunger after they stop taking the injections.
Epic Research found While 27 percent of patients regained the weight after stopping the GLP-1 drugs, that rate dropped to 19 percent when they switched to a different weight-loss drug called phentermine. Though it’s only an 8 percentage point difference, the reduction in risk is enough that doctors should at least consider this follow-up therapy for their patients, said Kersten Bartelt, lead author of the Epic report.
a Danish study They found that combining GLP-1 injections with planned exercise helped many patients maintain their weight loss for at least a year after they stopped taking the medication.
Gleason said it’s an encouraging story and that Prime is promoting its KeepWell program to employers to help employees improve their diet and exercise while taking obesity medication. He likened the combination of GLP-1 medications with a structured exercise and diet program to the counseling programs that were first paired with nicotine therapy many years ago.
“Quitting smoking is hard,” he says. “Losing weight is hard.”
