November 28, 2023

A person injects medication into their abdomen.Share on Pinterest
New drugs called GLP-1 drugs can lead to weight loss, these drugs include Ozempic and Wegovy. Aaron Amat/Getty Images
  • A new report finds 2 out of 3 people on GLP-1 drugs like Ozempic stop within a year.
  • Experts point out the cost of these drugs may mean people feel unable to stay on them for more than year.
  • Additionally, some people may feel the drugs are also no longer working if they plateau at a new body weight.

GLP-1 drugs include new blockbuster drugs like Ozempic and Wegovy.

They have become incredibly popular in recent months a people realized these drugs, originally designed to help treat people with diabetes, can help with weight loss.

In clinical trials, Wegovy was shown to reduce body weight in people with BMIs of 27 or more by 15 % over 68 weeks.

But a new pharmacy analysis found few people taking GLP-1 drugs stay on these medications after a year.

In a report from Reuters, an analysis by Prime Therapeutics, a pharmacy benefits manager (PBM) found that only 32% of people taking GLP-1 drugs which include Ozempic and Wegovy were still taking the medication a year later.

For a drug that is allegedly so effective, why do so many people call it quits?

The answer, it turns out, could be a variety of reasons.

“There is never one answer. It is multiple things. Some of it may have to do with access and expense, and another may be expectation,” said Dr. Mitchell Roslin, a bariatric surgeon at Northwell Lenox Hill Hospital.

Glucagon-like peptide-1 receptor agonists or GLP-1 drugs work by mimicking the Glucagon-like peptide-1 hormone, which plays a key part in regulating appetite and blood sugar levels.

GLP-1 drugs like Ozempic and Wegovy have been approved to help treat diabetes. Wegovy has been approved to also help with weight loss.

These drugs work in part by decreasing appetite and slowing down stomach emptying so that people feel less hungry and eat less.

As Roslin mentioned, it’s not as simple as one answer. Several factors could be at play. First and foremost, Ozempic and Wegovy can be prohibitively expensive.

The annual cost of overall care for patients without insurance coverage can be around $1,000 a month, according to data from GoodRx.

According to Vox, drugs like Ozempic and Wegovy are often excluded from insurance coverage especially if they are used for weight loss .

But the financial burden is just one piece of it.

Roslin said it is natural that the body will start to plateau at a certain weight, and some people may think that these drugs are no longer working.

“No matter the [weight loss] treatment, you will reach a new weight. The stronger the treatment, the longer it takes to reach that new weight. After you reach that weight, people become convinced that the treatment no longer works,” Roslin said. “But that’s not true. Your body has just reached a new equilibrium. At that post, people have a high copay for the drug and they’re not losing weight, so they say it’s not working and they stop.”

Dr. Priya Jaisinghani, endocrinologist and obesity medicine specialist at NYU Langone Health adds that there are a lot of other factors to consider. “There have been a variety of shortages across different GLP-1s [glucagon-like peptide 1]. Was there discontinuation [for the patient] due to shortages and lack of consistent availably of certain dosages? Sometimes during shortages, medications were switched to alternatives.”

Another reason could be that patients didn’t fully stop treatment but switched to a different medication for weight loss.

Another potential reason for people stopping medication is side effects. These drugs can lead people to have a variety of side effects including nausea, vomiting, constipation or diarrhea. Severe symptoms can include pancreatitis, gallbladder disease and kidney issues.

No matter the reason for stopping the medication, everyone who stops the medication runs the risk of the weight returning.

“There are going to be people that lose weight and maintain it,” said Roslin. “The majority of the people who stop the drug will regain the weight back. Very few will truly eat differently for life.”

“Obesity is a chronic, complex disease. A multifaceted, chronic disease may need a multi-pronged, long-term, sustainable intervention,” added Jaisinghani. “You need comprehensive but sustainable approaches for weight management. Weight management is achieved through support and sustainable interventions.”

The most important factor for weight loss is consistency, whether that’s modifying your diet, increasing exercise, taking prescription medication, or surgery. The key to weight loss is keeping consistent and changing patterns. If Wegovy or Ozempic is the chosen avenue, then people, theoretically, should be taking that medication for life in order to maintain weight loss.

“Whatever you do for weight loss, you have to do it forever,” said Roslin. “Whatever you do you have to be consistent with your behavior. The only way to lose weight is to have a healthier lifestyle and whether it’s taking Wegovy, another medication, or bariatric surgery, these are all tools designed to make you feel full faster in order to make a healthier lifestyle more possible.”

Jaisinghani said one issue with maintaining long-term weight loss is that people may not have many resources to help maintain a significant drop in weight.

“People may have access to one arm of a multi-pronged approach, but not to others,” Jaisinghani said. “According to the CDC, many Americans lack healthy, affordable foods and places to be active. Fewer than 1 in 4 youth get enough aerobic activity and 40% of all US households do not live within one mile of healthier food retailers.”

A recent report found that just 32% of people on GLP-1 drugs like Ozempic and Wegovy remain on the drugs after a year. Experts say cost, access and plateauing weight may all contribute to people stopping these medications.

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