The Opportunity Ahead

Unraveling the GLP-1 Patient Experience
Between Visits

glp-1 persistence and adherence hero banner glp-1 persistence and adherence hero banner

For many people living with obesity or overweight, GLP-1-based* treatments have created new possibilities, bringing weight management goals within closer reach.1

While treatment for this chronic condition begins in the clinic, much of the patient experience happens beyond it. Between visits, some patients continue moving forward with treatment, while others begin to struggle or drop off entirely.2

Understanding persistence and discontinuation may reveal new ways
to support patients in their weight management journey.

*GLP-1-based treatments include GLP-1 receptor agonists alone or in combination with other incretin mimetics.

The Importance of Persistence

Reaching and Sustaining Progress:
Obtaining the Benefits of GLP-1-based Treatment

A study including 48,950 US adults with overweight or obesity showed that2,†:

glp-1 treatment duration icon showing half discontinued glp-1 treatment at or before 8 months, glp-1 treatment duration icon showing persistent glp-1 treatment beyond 8 months glp-1 treatment duration icon showing half discontinued glp-1 treatment at or before 8 months, glp-1 treatment duration icon showing persistent glp-1 treatment beyond 8 months

While many patients initiate treatment with the goal of reaching a target weight, long-term benefits depend on the ability to sustain weight loss over time.3,4

For many patients, treatment burden and competing short-term priorities may make long-term persistence challenging, creating a gap between achieving initial results and sustaining them.1,4-6

What are the main factors influencing treatment persistence?

It's no surprise that more time on treatment means more progress3

Based on a meta-analysis of 47 randomized controlled trials of 23,244 patients with overweight or obesity with or without diabetes3,‡:

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Every additional month on treatment may represent an opportunity for patients to build on and sustain their progress.

When treatment stops, progress can become more difficult to sustain1,4,5

Results from an EHR claims data study showed that6,§:

58% of all patients regained weight within 12 months of GLP-1 discontinuation6

pie graph displaying the proportion of patients by degree of weight regain after discontinuing GLP-1 treatment. 42% maintained weight loss while 58% regained weight within 12 months. pie graph displaying the proportion of patients by degree of weight regain after discontinuing GLP-1 treatment. 42% maintained weight loss while 58% regained weight within 12 months.

Greater weight loss can raise the stakes of sustaining it6

graphic of weight scale, indicating patients with more than 20% initial weight loss regained an average of 17.2 lbs. (~9%) after discontinuing glp-1 treatment, graphic of weight scale, indicating patients with 5-10% initial weight loss regained an average of 11 lbs. (~5%) after discontinuing glp-1 treatment graphic of weight scale, indicating patients with more than 20% initial weight loss regained an average of 17.2 lbs. (~9%) after discontinuing glp-1 treatment, graphic of weight scale, indicating patients with 5-10% initial weight loss regained an average of 11 lbs. (~5%) after discontinuing glp-1 treatment

A systematic review and meta-analysis showed that following discontinuation of weight management medications1,**:

Patients were estimated to return to baseline weight within ~20 months1

line graph displaying estimated weight regain following the discontinuation of weight management medications, indicating return to baseline weight within 20 months. line graph displaying estimated weight regain following the discontinuation of weight management medications, indicating return to baseline weight within 20 months.

Results from that same study also highlighted that following discontinuation of weight management medications1,§:

Cardiometabolic benefits may be lost, with markers estimated to return to baseline within ~17 months1

Cardiometabolic Marker Monthly Change Following Discontinuation Time to Return to Baseline
Glucose HbA1c ↑ 2.2% ~17 months
Fasting glucose ↑ 0.06 mmol/L
(1.08 mg/dL)		 ~12 months
Lipids Total cholesterol ↑ 0.05 mmol/moL
(1.93 mg/dL)		 ~12 months
Triglycerides ↑ 0.03 mmol/L
(2.66 mg/dL)		 ~12 months
Blood pressure Systolic ↑ 0.5 mm Hg ~12 months
Diastolic ↑ 0.2 mm Hg ~17 months

Ongoing weight management is needed for sustaining weight loss and improvements in cardiometabolic markers.4

Obesity can carry an emotional and psychological burden7,8

Based on American Diabetes Association (ADA) Weight Stigma and Bias, Standards of Care in Overweight and Obesity7:

body image and self worth icon, emotional toll icon, compounding challenges icon body image and self worth icon, emotional toll icon, compounding challenges icon

Understanding who may need additional support

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Results from 2 real-world cohort studies evaluating GLP-1 treatment discontinuation and persistence among adults with obesity and/or type 2 diabetes revealed2,10,†,††:

  • Black or Hispanic patients
  • Men
  • Those facing higher out-of-pocket costs

may be more likely to discontinue GLP-1 treatment, highlighting how different factors can shape persistence.

Factors Influencing Long-Term Persistence

Adherence and Persistence Can Slip Away Over Time5

Long-term GLP-1 adherence is shaped by multiple, interconnected factors, and ongoing research continues to explore the interplay and evolution of these factors over time.5

graphic displaying the factors leading to GLP-1 discontinuation, including patient-related, HCP-related, treatment-related, and system-related burdens. graphic displaying the factors leading to GLP-1 discontinuation, including patient-related, HCP-related, treatment-related, and system-related burdens.

Engagement may evolve throughout the treatment journey as patients weigh benefit against burden

In a study conducted November to December 2022 where 351 US adults with obesity or overweight were asked to choose among 5 hypothetical weight management product profiles with varying modes of action, dosing and administration, key benefits, and adverse reactions13,‡‡:

patient icon, dosing schedule calendar icon, patient tolerability icon patient icon, dosing schedule calendar icon, patient tolerability icon

Higher weight loss can reinforce persistence

woman smiling from the positive effects of GLP-1 treatment woman smiling from the positive effects of GLP-1 treatment

A cohort study conducted from 2018 to 2023, including 48,950 adults who were overweight or obese and did not have diabetes when initiating GLP-1-based therapy showed2,†:

Higher weight loss was associated with lower risk of discontinuation

Each 1% reduction in weight from baseline was associated with a 3.3% (95% CI: 3.2%–3.5%) lower hazard of discontinuation for patients.

Side effects can erode motivation

woman suffering from GLP-1 side effects woman suffering from GLP-1 side effects

In a recent study of 6,939 patients who were prescribed GLP-1-based therapy for weight loss15,§§,

23%

cited side effects as a reason for discontinuation

More frequent HCP-patient touchpoints may be associated with improved outcomes, potentially through increased accountability.5

Building Persistence Together

Addressing Persistence Through Supportive Care

Every patient's journey is unique. Ongoing HCP engagement and individualized treatment approaches may help address the realities patients face between appointments and support persistence over time.

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Start with the individual

Expert recommendations emphasize tailoring treatment to16:

  • Patient preferences, goals, and behaviors
  • Socioeconomic and cultural contexts
  • of treatment response and tolerability
  • Expectations for long-term care

Across 12 studies of chronic diseases requiring ongoing treatment17,***,

A positive association between patient preference and adherence to therapy was identified, with reasons often including17:

reduced dosing frequency icon, route of administration needle and pill medication icon, lower prescription costs icon, favorable safety profile icon reduced dosing frequency icon, route of administration needle and pill medication icon, lower prescription costs icon, favorable safety profile icon

Comprehensive care can help support long-term outcomes18

how comprehensive care can support long-term outcomes icon how comprehensive care can support long-term outcomes icon

Nutritional guidance18

A patient-centric nutritional framework may help support maintenance of weight-loss benefits, with attention to nutrient adequacy within a reduced-calorie diet.

Behavioral support18

Behavioral therapy may help improve weight loss beyond initial reductions and support long-term management.

Social connection18

Positive social connections may support treatment outcomes and adherence, highlighting the importance of understanding each patient's broader environment.

Sleep improvement18

Sleep quality may be relevant to chronic weight management, as poor sleep has been associated with insulin resistance, increased hunger, and weight gain.

Stress reduction18

Chronic stress may contribute to obesity-related physiology through pathways that influence cortisol, insulin sensitivity, energy storage, and cravings.

Care considerations may evolve as patients progress through treatment

As patients lose weight or experience changes in cardiometabolic parameters, their needs may change. Ongoing monitoring can help HCPs identify when care plans, support needs, or treatments may need to be reassessed.

stethoscope icon, medication prescription icon, psychosocial self worth icon, relational hugging icon stethoscope icon, medication prescription icon, psychosocial self worth icon, relational hugging icon

Obesity can be a lifelong journey. Communication and education may help sustain progress

Because Persistence

persistence built between visits banner persistence built between visits banne

is built between the visits.

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BMI=body mass index; CI=confidence interval; EHR=electronic health record; GLP-1=glucagon-like peptide-1; HCP=healthcare professional; T2DM=type 2 diabetes mellitus.

† Based on 48,950 adults with overweight or obesity without type 2 diabetes who newly initiated GLP-1-based injectables between January 1, 2018 and December 31, 2023. Data were obtained from Truveta Data, which provides EHR data across 30 US healthcare systems. Primary discontinuation was defined as the first date a patient went 60 days or more without any GLP-1-based treatment on hand, using fill dates and number of days of medication supplied to account for excess (carryover) medication from previous fills. Fills of all GLP-1-based injectables were considered; GLP-1-based injectables dispensed on subsequent fills were not required to match the index GLP-1-based injectables brand. Reinitiation was defined as the first fill of any GLP-1 receptor agonist after primary discontinuation.2

‡ Systematic review, meta-analysis of 47 randomized controlled trials including 23,244 adults with overweight or obesity, with or without diabetes, evaluating the effects of GLP-1-based therapy on weight, BMI, and waist circumference. Literature searches were conducted in PubMed, Embase, and Cochrane CENTRAL through October 4, 2024.3

§ A retrospective cohort study of 18,228 US adults with or without T2DM and GLP-1 prescriptions for any indication from 2010 to 2024. 95.3% of the study population had a BMI ≥27 kg/m². Data were obtained from the Optum® Market Clarity™ database, which provides EHR and claims data.6

** Systematic review and meta-analysis of 37 studies of anti-obesity medications administered for at least 8 weeks and follow-up of at least 4 weeks after treatment cessation in adults with overweight or obesity. Studies were identified through search of trial registries and databases (Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science) from inception through February 2025 for randomized controlled trials, nonrandomized comparative trials, and observational studies. Estimates of cardiometabolic marker changes after treatment cessation are based on modeled projections of observed trends, with limited long-term follow-up. It was estimated that patients return to baseline weight within 1.7 years for any weight-management medication, 1.6 years for incretin mimetics, and 1.5 years for semaglutide and tirzepatide.1

†† Retrospective cohort study using Komodo HealthcareMap claims data (January 1, 2021–December 31, 2023) from 195,915 adults with obesity and/or type 2 diabetes who initiated a GLP-1. Discontinuation and adherence were assessed at 3, 6, and 12 months following treatment initiation.10

‡‡ In a cross-sectional online survey conducted November–December 2022, adults with obesity or overweight were asked to rank blinded anti-obesity medication product profiles that varied in mode and frequency of administration (daily oral, daily injectable, weekly injectable), weight loss at 1 year (3%–15%), as well as mode of action and adverse reactions (moderate or severe).13

§§ Retrospective real-world study using a subset of Truveta Data to evaluate reasons for GLP-1 receptor agonist discontinuation. The study included 78,781 patients with a GLP-1 receptor agonist prescription and a documented discontinuation reason between June 2021 through December 2024. Discontinuation reasons were extracted from clinical notes regarding 6,939 patients who stopped taking GLP-1-related therapy for weight loss or management.15

*** Narrative literature review assessing the impact of patient treatment preferences on medication adherence and persistence in chronic diseases. A PubMed search conducted through April 2021 identified 12 eligible studies examining the association between treatment preferences and adherence across multiple chronic disease states.17

††† Noninterventional, cross-sectional qualitative study conducted at 6 US clinical sites between January 2018 and June 2018. Face-to-face interviews were conducted with 36 adults with type 2 diabetes who were either current GLP-1 users (n=16) or had discontinued therapy (n=20) to evaluate their experiences, motivations, and challenges relevant to their persistence with GLP-1 therapy.22

‡‡‡ Retrospective cohort study conducted at two university-based specialty outpatient weight management clinics evaluating the association between the magnitude of weight loss and the effect on the need for antihypertensive medication use in adults with overweight or obesity and hypertension. Medical records from March 2008 through October 2011 of patients with a BMI >25 at baseline were analyzed.19

§§§ Retrospective cohort study of adults with overweight or obesity and type 2 diabetes conducted at two university-based outpatient weight management centers. The study assessed the magnitude of weight loss associated with dose reductions or discontinuation of anti-diabetic medications. Medical records were reviewed for patients enrolled between March 2008 and August 2010, and the final study cohort included 50 patients.23

Optum® and Market Clarity™ are trademarks of Optum, Inc.

References

  1. West S, Scragg J, Aveyard P, et al. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ. 2026;392:e083430.
  2. Rodriguez PJ, Zhang V, Gratzl S, et al. Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists among US adults with overweight or obesity. JAMA Netw Open. 2025;8(1):e2457349.
  3. Wong HJ, Sim B, Teo YH, et al. Efficacy of GLP-1 receptor agonists on weight loss, BMI, and waist circumference for patients with obesity or overweight: a systematic review, meta-analysis, and meta-regression of 47 randomized controlled trials. Diabetes Care. 2025;48(2):292-300.
  4. Kushner RF, Shapiro M. Obesity: assessment and treatment across the care continuum. Ann Med. 2025;57(1):2521433.
  5. Sharma AM, Birney S, Crotty M, et al. Determinants of adherence to obesity medication: a narrative review. Obes Rev. 2025;26(5):e13885.
  6. Weintraub M. Weight change after GLP-1 discontinuation in US patients with overweight/obesity or diabetes. Poster presented at: ObesityWeek 2025; November 4–7, 2025; Atlanta, GA.
  7. Bannuru RR, American Diabetes Association Professional Practice Committee. Weight stigma and bias: standards of care in overweight and obesity—2025. BMJ Open Diabetes Res Care. 2025;13(suppl 1):e004962.
  8. Segal Y, Gunturu S. Psychological Issues Associated With Obesity. StatPearls Publishing; 2024.
  9. Spreckley M, de Lange J, Seidell J, Halberstadt J. Primary care-led weight-management intervention: qualitative insights into patient experiences at one-year follow up. Int J Qual Stud Health Well-being. 2023;18(1):2256669.
  10. Do D, Lee T, Peasah SK, Good CB, Inneh A, Patel U. GLP-1 receptor agonist discontinuation among patients with obesity and/or type 2 diabetes. JAMA Netw Open. 2024;7(5):e2413172.
  11. Tacad DKM, Tovar AP, Richardson CE, et al. Satiety associated with calorie restriction and time-restricted feeding: peripheral hormones. Adv Nutr. 2022;13(3):792-820.
  12. Khani M, Afshari R, Ebrahimi Nasab A, et al. Addressing the challenge of obesity in primary care: a review of effective interventions and implementation strategies. Diabetes Metab Syndr. 2025;17(1):351.
  13. Le Roux CW, Koroleva A, Larson S, Foot E. Anti-obesity treatment preferences of healthcare providers and people living with obesity: a survey-based study. Clin Obes. 2025;15(1):e12704.
  14. Plenn E, Amin D, Henry J, Leavitt G, Walker J, Soleymani T. A qualitative analysis of patient experiences using semaglutide 2.4 mg for weight loss. Obes Sci Pract. 2025;11(4):e70085.
  15. Goodwin Cartwright BM, Rodriguez PJ, Do D, Stucky N. Real-world temporal and indication-specific variation in drivers of GLP-1 RA discontinuation. Abstract presented at: ISPOR 2025; May 13–16, 2025; Montreal, Canada.
  16. Kaplan LM, Apovian CM, Ard JD, et al. Assessing the State of Obesity Care Writing Group. Assessing the state of obesity care: quality, access, guidelines, and standards. Obes Sci Pract. 2024;10(4):e765.
  17. Losi S, Berra CCF, Fornengo R, Pitocco D, Biricolti G, Federici MO. The role of patient preferences in adherence to treatment in chronic disease: a narrative review. Drug Target Insights. 2021;15:13-20.
  18. Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional priorities to support GLP-1 therapy for obesity: a joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. Obesity (Silver Spring). 2025;33(8):1475-1503.
  19. Shantha GPS, Kumar AA, Kahan S, Cheah SY, Cheskin LJ. Intentional weight loss and dose reductions of antihypertensive medications: a retrospective cohort study. Cardiorenal Med. 2013;3(1):17-25.
  20. Mack I, Kullmann S, Le Morvan de Sequeira C, et al. Beyond weight loss: integrating GLP-1 RA therapies into psychological and behavioral care for obesity and binge eating disorder. Rev Endocr Metab Disord. Published online 2026.
  21. American Diabetes Association Professional Practice Committee for Obesity. Screening, diagnosis, evaluation, and staging of obesity in adults: Standards of Care in Overweight and Obesity—2026. BMJ Open Diabetes Res Care. 2026;(suppl 1):e006247.
  22. Polonsky W, Gamble C, Iyer N, Martin M, Hamersky C. Exploring why people with type 2 diabetes do or do not persist with glucagon-like peptide-1 receptor agonist therapy: a qualitative study. Diabetes Spectr. 2021;34(2):175-183.
  23. Kumar AA, Padmanar Subash Shantha G, Kahan S, Samson RJ, Boddu ND, Cheskin LJ. Intentional weight loss and dose reductions of anti-diabetic medications-a retrospective cohort study. PLoS One. 2012;7(2):e32395.