Why People Stop Using Drugs Like Ozempic

In February 2021, a scientific paper came out that caused a sensation in the world of obesity research. It detailed the first results from studying weekly injections of the drug semaglutide—the generic name for Ozempic or Wegovy—to treat obesity. The paper showed that people taking the drug lost on average 15 percent of their body weight—a level of weight loss practically unheard-of for an anti-obesity medicine.

The paper, and the subsequent approval of Wegovy for weight management, kicked off an unprecedented clamor for this new generation of drugs. Demand for the injectables is so high that in May 2023, Wegovy manufacturer Novo Nordisk paused television advertising in order to buy itself time to produce more of the drug. Semaglutide is also used to treat type 2 diabetes, and in the UK patients have found it difficult to access the drug as Novo Nordisk struggled to keep up supply.

As demand for the drugs has risen, some have pointed out that for people to keep the weight off, they will likely have to stay on these drugs forever. That’s not surprising—the same is true for other weight loss interventions—but it raises a potentially vexing problem. The data we have suggests that a significant number of people stop taking these drugs after relatively short spans. We might have near-miraculous weight loss drugs, but what happens to the people who can’t stay on them?

These new drugs are part of a group called GLP-1 receptor agonists (GLP-1 RAs). They work by mimicking a hormone that regulates blood sugar levels and suppresses appetite by slowing down the rate at which food leaves the stomach. While using them to treat obesity is pretty novel, they’ve been approved for type 2 diabetes for a while. The first GLP-1 RA was approved by the US Food and Drug Administration in 2005. That means we have some decent real-world data about how long people stay on GLP-1 RAs and the reasons they quit them.

One study looked at GLP-1 RAs prescribed in the UK between 2009 and 2017. Out of the 589 patients who started taking a GLP-RA, 45 percent stopped taking the drug within 12 months, and 65 percent within 24 months. The same group of scientists also looked at people taking GLP-1 RAs in the US across a similar period of time. That study included a much larger group of diabetes patients but found that people quit taking the drugs at a similar rate as in the UK. Within 12 months, 47 percent of patients stopped taking their GLP-1 AR; after 24 months that figure was 70 percent. On average, people in that study spent around 13 months using the drug before they stopped taking it.

Other real-world findings paint a similar picture. About half of Spanish patients taking a GLP-1 RA had stopped taking the drug after two years—a higher dropout rate than for other diabetes drugs. In Denmark, around 45 percent of diabetes patients stopped taking GLP-1 RAs within five years of starting the therapy, although a quarter of them started again within the following year. In lots of these studies, the scientists note that people quit these drugs at much higher rates than they do during clinical trials.