A major study presented at the Endocrine Society's annual meeting reveals a pattern doctors and patients need to understand: most people on blockbuster weight-loss and diabetes drugs like Ozempic and Mounjaro stop taking them. But the surprise is what happens next.
Researchers analyzed insurance claims for over 60,000 Americans with type 2 diabetes who started GLP-1 medications between 2019 and 2025. Within one year, roughly 4 in 10 patients had stopped their medication. By year two, that climbed to nearly 6 in 10. But here's the critical finding: more than half of those who quit restarted within a year, and nearly two-thirds resumed by the two-year mark.
"These medications aren't being abandoned permanently," said Sainikhil Sontha, a research associate at Boston University School of Public Health who led the analysis. "Use is more start-and-stop than most people assumed."
The research identified specific groups at higher risk of stopping treatment early. Patients on Medicaid or Medicare, Black patients, and those experiencing nausea or gastrointestinal side effects were significantly more likely to discontinue within the first year. Roughly 37 percent of patients reported side effects as a reason for stopping.
One finding offered a clear path for better outcomes: patients whose initial GLP-1 prescription came from an endocrinologist were 10 percent less likely to stop taking the medication.
The type of drug also mattered. Newer medications like tirzepatide were 41 percent less likely to be discontinued compared to older options like liraglutide. Semaglutide users were 28 percent less likely to quit than those on first-generation drugs.
The clinical stakes are substantial. These medications offer documented protection against heart attacks, kidney disease progression, and other diabetes-related complications. Stopping early means forfeiting those benefits at a critical window.
"Consistent use is what produces the protective effects," Sontha said. "Stopping early means missed opportunities."
The findings suggest healthcare providers, insurers, and policymakers now have a clearer picture of which patients need extra support to stick with GLP-1 therapy. Better screening for side effects, proactive follow-up calls, and potentially earlier involvement of specialists could help close the persistence gap.
Author Jessica Williams: "The real story here isn't that people quit these drugs, it's that the industry has been ignoring the on-and-off pattern all along, and now we finally have numbers to prove it matters."
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