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The Biggest Mistake People on Weight Loss Drugs Make, According to Doctors

  • Nearly 60% of people on weight loss drugs stop them early, according to a new report.

  • There are a few reasons why people stop using these medications.

  • Doctors say weight regain is likely when someone stops using the drugs.

Weight loss drugs have exploded in popularity over the last year–with people scrambling to get their hands on them—which in turn caused widespread shortages.

But despite the huge demand for these medications, a new report analyzing health insurance claims from about 170,000 people finds that the majority of people on these drugs don’t stay on them for long. The report, which was conducted by the Blue Cross Blue Shield Association, found that nearly 60% of people on GLP-1 agonists—which is a class of medications that Ozempic and Wegovy are a part of—stop taking them within 12 weeks.

The data also shows that more than 30% of these patients stop taking the drugs before four weeks.

Meet the experts: Michael Russo, M.D., board certified bariatric surgeon at MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA; Steven Batash, M.D., gastroenterologist and leading physician at Batash Endoscopic Weight Loss; Dina Peralta-Reich, M.D., director of New York Weight Wellness Medicine

More than two in five adults in the U.S. have obesity, which GLP-1 agonists are typically designed to treat. But why are so many people stopping these medications early and what is the concern with that? Weight loss experts explain.

Why do people stop these medications early?

As with all medications, everyone can have a different experience while taking weight loss drugs. Here’s what doctors say are the biggest reasons they’ve had patients stop using GLP-1 agonists early.

They’ve already seen results.

Semaglutide and other GLP-1 agonists can go to work fast, helping users to drop weight quickly. In fact, Ozempic—which is technically a blood sugar management drug for people with type 2 diabetes—can lead to an average weight loss of 6% to 11% of a person’s body weight within months. But some people lose more weight even faster.

“Users of these weight loss medications typically stop taking them because they see results,” says Steven Batash, M.D., gastroenterologist and leading physician at Batash Endoscopic Weight Loss. Meaning, people may hit their goal weight and decide to stop taking the medications as a result.

They’re having side effects

Side effects can vary slightly depending on the medication you take, but the Ozempic website lists these as the most common side effects:

  • Nausea

  • Vomiting

  • Diarrhea

  • Stomach pain

  • Constipation

There is also a risk of serious side effects like inflammation of the pancreas, changes in vision, kidney failure, gallbladder issues, and serious allergic reactions. Some patients also claim that these medications can lead to a serious condition known as gastroparesis, aka stomach paralysis.

“Some people are more sensitive to side effects than others,” says Dina Peralta-Reich, M.D., director of New York Weight Wellness Medicine. But Dr. Peralta-Reich says that patients can minimize the risk of side effects by getting information from their doctors in advance about how to prevent these symptoms. She says nausea, headaches, and constipation are the most common side effects that cause people to stop taking these drugs. “Most of them are caused by dehydration,” she says.

They’re too expensive.

The Blue Cross Blue Shield Association points out that the average monthly list price for semaglutide is over $1,000, which is out of reach for most Americans. Given that the drug is meant to be used continuously, people may need to pay $12,000 a year or more to be on Ozempic or Wegovy, depending on their insurance coverage.

“Cost is definitely an issue, especially when people don’t have weight loss coverage for the medication and they’re paying out of pocket,” Dr. Peralta-Reich says. She points out that there are coupons available “but not everybody qualifies for the coupons and the medication may still be $600 a month,” she says.

Michael Russo, M.D., board certified bariatric surgeon at MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, says that cost is the most common reason he hears from patients who stop their weight loss drugs early. “Just because something is covered by the insurance doesn’t mean it’s not a prohibitive cost,” he says.

As a result, some people will discover they just can’t continue to take GLP-1 agonists. “Pricing definitely interferes with the ability to continue treatment,” Dr. Peralta-Reich says.

The medications can be hard to find.

The Food and Drug Administration (FDA) does not currently list Wegovy and Ozempic on its official list of drug shortages, but semaglutide is in shortage, according to the list. “There are a lot of shortages of these medications,” Dr. Russo says. Because of this, people who want to take the drugs may have trouble getting their hands on them—and continuing to take them.

What happens if you stop taking weight loss medications early?

The Blue Cross Blue Shield Association report says that patients on GLP-1 agonists should finish at least 12 weeks of these medications “to be able to achieve clinically meaningful
weight loss that will positively impact their health,” but doctors say it’s often best to take them for longer periods of time.

Many people who stop weight loss medications early “don’t consider what may happen next,” Dr. Batash says. There are no significant withdrawal symptoms or major rebound effects, but weight gain is likely, he says. That’s especially true if you didn’t change your dietary or exercise habits while you were on the medication, Dr. Peralta-Reich says. “If you do this correctly and you use the time you’re on the medication to modify lifestyle habits, you will eventually be able to maintain the weight on your own,” she says.

But “some people may experience a return of increased appetite over time, resulting in weight gain,” Dr. Batash says. “These medications have proven to be a potent tool in treating obesity, provided they continue taking the medication,” he adds.

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