Most people don’t like taking medications – especially longterm.
In fact, medication fatigue where individuals stop taking a new medication, like a statin or blood pressure pill, is commonplace.
But the number of individuals stopping GLP-1 medications is especially concerning as studies show that over 50% of GLP-1 users discontinue the medication by 1 year and over 70% discontinue use by 2 years.
But the story doesn’t end there, as reported in Diabetes, Obesity and Metabolism (2026).
In their study, one-fifth of patients reinitiated the same medication within 1 year of stopping treatment and another third received an alternative obesity treatment.
There are many reasons why an individual may discontinue medication, but the most common reasons for stopping and restarting a GLP-1 are:
- Cost
- Changes in reimbursement
- Medication side effects
As the field of obesity medicine continues to advance, here are some points to consider when prescribing or taking a GLP-1 medication:
1-Anticipate Persistence Problems
Prior to prescribing medication, healthcare professionals and patients need to discuss that obesity is viewed as a chronic condition that needs long-term management.
As a comparison, this is the same conversation that would take place when discussing the long-term management of patients with diabetes or hypertension.
GLP-1 medications address the appetite dysregulation that is seen among people with obesity by reducing hunger, increasing satiety, and lessening food noise.
However, medications do not cure obesity. They only work as long as one takes them.
Whereas persistence or staying on the medication, is often influenced by cost and reimbursement issues, another important factor is the patient’s ability to take the medication as prescribed along with the recommended lifestyle changes to optimize outcomes.
This is called adherence and needs to be the focus of all prescription counseling.
2-Offer Targeted, Patient-Centered Action Steps
It is important to review how and when the medication needs to be taken.
Medication adherence also depends on evaluating the patient’s health literacy (ability to understand and utilize information and apply necessary skills).
Equally important are the recommended dietary changes that can lessen the occurrence of gastrointestinal side effects (nausea, constipation, diarrhea and vomiting) – one of the most common reasons for drug discontinuation.
With less food noise and better appetite control, the new focus is on improving dietary and physical activity patterns to promote healthier body composition and improved overall health.
Discussion of socioeconomic factors that include insurance coverage, out of pocket costs and other financial barriers is necessary to ascertain if alternative treatment approaches or financial support needs to be considered.
3-Stay Connected and Accountable
Monitoring and follow up is vital when GLP-1’s are prescribed.
Using shared decision making and frequent touch points, the patient and healthcare professional determine:
- When to escalate or de-escalate dosing
- Address occurrence of side effects
- Maximize behavioral lifestyle patterns
- Assess health outcomes
Over time, additional support from a registered dietitian nutritionist, exercise specialist or health psychologist may be helpful as the patient’s goals and capabilities change.
RK
Robert Kushner, MD
