WeightControl.com: What are the main findings?
Response: The significantly higher rate of discontinuation for patients without diabetes suggests cost and insurance coverage are barriers to continued use. For patients with diabetes and higher incomes, they were less likely to stop taking the medications. So, for patients with an income of $50-80,000 per year, they were 20% less likely than patients making less than $30,000 to stop the medication. When they make more than $80K per year, they were even less likely – 28% less likely – to stop the medications.” – Tricia Rodriguez, PhD, MPH, senior applied research scientist, Truveta Research and lead author on the paper
WeightControl.com: Are the findings expected to be similar for all/most drugs of this class?
Response: “This study focused on class-level effects, considering liraglutide, semaglutide, and tirzepatide, inclusive of indications for type 2 diabetes and obesity. Future studies are needed to understand differences in discontinuation and reinitiation patterns for individual drugs.” — Tricia Rodriguez, PhD, MPH, senior applied research scientist, Truveta Research and lead author on the paper
WeightControl.com: What should readers take away from your report?
Response: “This study sheds light on the challenges for real-world patients of staying on these medications and highlights the need to tackle barriers such as cost, insurance coverage, and equitable policies to ensure availability. Without these measures, we risk widening health disparities and denying countless individuals the chance to improve their health and quality of life.” — Ezekiel Emanuel, MD, PhD, vice provost for Global Initiatives, co-director, Healthcare Transformation Institute, University of Pennsylvania and senior author on the paper
“Improved understanding of the factors related to discontinuation and reinitiation of GLP-1RAs is essential for personalizing treatment to each patient’s unique health needs and circumstances. These insights allow us to identify barriers and align treatment plans with patients’ goals and lifestyles. Equally important is fostering a strong partnership between patients and their clinical teams, ensuring open communication and shared decision-making. This collaborative approach empowers patients to achieve the best possible outcomes and receive the care they truly deserve.” — Ty J. Gluckman, MD, MHA, FACC, FAHA, FASPC, Cardiologist, Providence Health, medical director at the Center for Cardiovascular Analytics, Research, and Data Science (CARDS), Providence Heart Institute, and an author on the paper
WeightControl.com: What recommendations do you have for future research as a result of this work?
Response: “Future research should examine long-term health outcomes associated with GLP-1 discontinuation, including metabolic and cardiovascular effects. Additionally, studies exploring interventions to improve medication adherence, such as insurance reform, financial assistance programs, and strategies to mitigate side effects, could help address barriers to continuous use.” — Ezekiel Emanuel, MD, PhD, vice provost for Global Initiatives, co-director, Healthcare Transformation Institute, University of Pennsylvania and senior author on the paper
WeightControl.com: Is there anything else you would like to add? Any disclosures?
Response: “This study shows the power of using real-world data to inform care more quickly. Real-world data gives us the opportunity to speed time to insight, because we can see what’s happening with patients across the country in large numbers today. Truveta makes it possible to use real-world data to study any drug, disease, or device, so as Truveta Research, we’re excited to continue to study these GLP-1 medications, as well as several other conditions and medications to inform important public health topics so we can all learn faster and make more informed decisions about care. By using payer-agnostic EHR data, we were able to include patients who paid for these medications out of pocket rather than through insurance. This is important because patients without insurance coverage for GLP-1 drugs face unique challenges in staying on these treatments, so their inclusion in research on adherence is essential.” — Tricia Rodriguez, PhD, MPH, senior applied research scientist, Truveta Research and lead author on the paper
“These insights emphasize the need for policy changes to improve insurance coverage for individuals without T2D, as well as strategies to manage side effects and enhance patient adherence. Personalized treatment plans that incorporate patient-specific weight loss goals and financial assistance programs may help improve long-term adherence.” — Ezekiel Emanuel, MD, PhD, vice provost for Global Initiatives, co-director, Healthcare Transformation Institute, University of Pennsylvania and senior author on the paper
No disclosures to report for Dr. Rodriguez or Dr. Gluckman.
Dr. Emanuel reports receiving personal fees from Advocate Aurora Health, Bowdoin College, Cain Brothers, Emory Health Care, Employer Direct Health Care Health Plan Alliance, Ontario Hospital, Sanford Health, the Suntory Foundation and University of California, San Francisco; receiving nonfinancial support from Amangiri, Arendalsuka Meeting, BCEPS International Symposium, Cell and Gene Therapy, Forerunner Conference, Future of Science, Galien Foundation, Hawaii Medical Services Association, Hlth Inc., Lazard, National University of Singapore, New York Historical Society, The Quadrangle, Tel Aviv University, University of Bergen and University of Virginia; serving on an advisory board for Alto Pharmacy, Cellares Corp., the Director General of WHO, FeelBetter Inc., HIEx Health Innovation Exchange, JSL Health, Peterson Center of Health Care, the Penn Parity Center, President Joe Biden’s Transition COVID-19 Committee and the WHO COVID-19 committee; advising for Clarify Health Solutions, Link Health Technologies, Notable Health and Nuna Health; serving as a member of the JAMA Editorial Board, WHO Expert Group on Ethics & Governance of Outbreaks/Emergencies and the WHO Guideline Development Group on the Use and Indications of GLP-1s for Adults Living With Obesity; and consulting for Aberdeen Inc. and Korr/Coach AI.
Citation:
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. doi:10.1001/jamanetworkopen.2024.57349
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Last Updated on February 3, 2025 by weightcontrol