ISLAMABAD, May 24 (Online): Researchers report that more than half of people on weight loss drugs Wegovy and Saxenda stop taking them at 12 weeks or earlier.
They said that 30% of people on the drugs stop using them within the first four weeks before the target dose is reached.
Weight loss experts say that in order to achieve the maximum benefit, people on weight loss drugs should expect to take them long term.
Less than half of people on weight loss medications such as Wegovy and Saxenda reportedly continue to take the medications for 12 weeks or more.
Research by Blue Shield, which has has yet to be published in a peer reviewed journal, states that 30% of people stopped treatment within four weeks before they had reached their target dose.
In all, more than half of those studied quit the medications before 12 weeks.
“When looking at patients using GLP-1 drugs for weight management, our findings show that most individuals did not stay on their prescribed treatment for a minimum of 12 weeks, suggesting that they were unlikely to achieve clinically meaningful weight loss,” the report states.
Those aged between 18 and 34 years were less likely to stay on the weight loss medications and those who had the highest barriers to care were the least likely to stay on the medications, the report authors noted.
How weight loss medications work
Wegovy (semaglutide) and Saxenda (liraglutide) are GLP-1 antagonists. These drugs work by mimicking a type of hormone that naturally occurs in the body called glucagon like peptide (GLP-1).
This hormone helps regulate blood sugar, reduces hunger, and can increase the feeling of being full by causing a delay in the emptying of the stomach.
But to achieve the maximum benefit from the drugs, people must remain on them for an extended period.
“The medications don’t reach effective dose until they have been on it for 5 months, so we don’t expect to see effective weight loss at 12 weeks. Additionally, medications for weight loss should be expected to be used chronically to help with maintenance of weight loss and actual reduction in cardiometabolic diseases associated with weight loss,” Dr. Diana Thiara, the medical director of the UCSF Weight Management Clinic in San Francisco who was not involved in the report, told Medical News Today.
People prescribed drugs like Wegovy build up their dosage over a period of time before reaching their target dose. However, the Blue Shield research suggests that 3 in 10 people stop taking these medications before their target dose is reached.
“The goal is for patients to stay on this for a significant amount of time. Most likely… beyond 12 weeks. For example, for semaglutide the idea is that every month you go up a dose. So it takes about, give or take, six months to get to the highest therapeutic dose. Not everybody gets to it, but it is a long term medication and to get the highest benefit you stay on it for multiple months,” Dr. Dan Azagury, the section chief of Minimally Invasive and Bariatric Surgery at Stanford University in California, told Medical News Today.
“The longer you stay on it, the better until you reach your plateau, which is the point where your body is going to adapt to your weight loss and say, ‘OK, I’m done with this weight loss. I’ve lowered my metabolism enough that no matter what you do at this point, I’m not going to lose any more weight on this drug’. And that happens at a different point for every patient. But usually it does not happen until months down the line,” said Azagury, who was not involved in the report.
Reasons people quit weight loss medications
In a statement to Medical News Today, Novo Nordisk, the company that manufactures the drugs Wegovy and Saxenda, said there are numerous reasons a person may not remain on weight loss drugs.
“There is a lack of discussion around the barriers that can impact a patient’s ability to adhere to treatment, including disease bias or stigma, supply constraints, and access to medicines. The American Medical Association has also raised serious concerns about aggressive utilization management techniques and published a physician surveyTrusted Source in 2022 showing that 94% of physicians report care delays due to prior authorization, 64% reported that prior authorization has led to ineffective treatment, and many reported prior authorization challenges have led to additional office visits, urgent care, or emergency room trips,” company officials wrote.
They noted that for people to achieve the greatest benefit from their drugs, they need to be on them long term.
“Obesity is a chronic, progressive, and misunderstood disease that requires long-term medical management, much like high blood pressure or high cholesterol, for which most patients remain on therapy long-term in order to continue to experience the benefits of their medications,” the company officials said.
Nearly half of people interested in trying a weight loss drug
In the United States, 73%Trusted Source of adults aged 20 and older are overweight or have obesity. In addition, 42%Trusted Source of adults have obesity and 9%Trusted Source have severe obesity.
In children and adolescents, roughly 1 in 6Trusted Source are overweight, 1 in 5 have obesity, and 1 in 16 have severe obesity.
A 2023 poll found that 45% of people said they would be interested in taking a prescription weight loss drug if it was safe and effective.
The National Institutes of HealthTrusted Source notes that weight loss medications are intended for people who have health issues that are related to being overweight or having obesity. Adults with a body mass index of 30 or greater, or 27 or greater with health issues such as type 2 diabetes and high blood pressure, may be candidates for the drugs.
“These can be good for individuals who have tried every other avenue and have been unsuccessful and who, for medical reasons, need this medication. I think it’s not good for individuals who just ‘want’ to lose weight for reasons related more to outward appearances but might otherwise be healthy and therefore do not have a true medical need,” Dana Ellis Hunnes, PhD, a senior dietitian supervisor at RR-UCLA Medical Center in Los Angeles who was not involved in the report, told Medical News Today.
Cost, healthcare access, issues obtaining medications, and side effects are just some of the many potential reasons people on weight loss medications may discontinue use.
The Blue Shield researchers reported that people who were prescribed weight loss medications by an obesity medicine specialist or endocrinologist were more likely to continue taking the medications for a longer period of time.
Weight loss medications are a long term commitment
Both Azagury and Thiara said that people who are prescribed weight loss medications should expect to stay on the medications long term to achieve the greatest benefit.
“Obesity is a chronic disease that will require long term treatment. We should expect people with obesity who are treated with anti-obesity medication to likely need some form of medication support for the majority of their lives,” Thiara said.
In some cases, coming off the drugs may cause a person to regain weight that was lost.
“What I tell patients is, if you are considering starting this drug, which I think is a very good drug, or this family of drugs, you should be OK with the idea of staying on this drug forever. Now, it doesn’t mean that you will. It just means that some people will not be able to get off of it without significant weight gain,” Azagury added.
In Conversation: What do we know about the weight loss plateau on Wegovy?
Semaglutide drugs, used to treat type 2 diabetes, also help with weight management. One such drug, sold under the brand name Wegovy, is approved as a treatment for overweight and obesity. But why do some people hit a weight loss plateau on Wegovy? We explore this topic with our expert guest In Conversation.
Illustration by Diego Sabogal for Medical News Today.
Semaglutide, or GLP-1 receptor agonist drugs, are typically prescribed to people with type 2 diabetes to help them with blood sugar management by prompting their bodies to produce more insulinTrusted Source.
These drugs can also help with weight loss by suppressing a person’s appetite. At the moment, however, only one semaglutide drug is approved as a weight management aid in people with overweight and obesity in the United StatesTrusted Source and the United Kingdom. That drug is Wegovy.
Still, a significant number of people who use semaglutide report hitting a weight loss plateau that they find difficult to overcome.
How does semaglutide help with weight management, why do some people on Wegovy hit a weight loss plateau, and what are some issues to keep in mind when it comes to using semaglutide for weight loss?
In this instalment of our In Conversation podcast, Dr. Simon Cork, senior lecturer in the Faculty of Health, Medicine and Social Care at Anglia Ruskin University in the United Kingdom helps us answer these and more questions.
Listen to our podcast episode in full below or on your preferred streaming platform.
For more information on the weight loss plateau on semaglutide, you can read our article, “Why weight loss drugs stop working and how to break past the Ozempic plateau.”
DiabetesType 2Obesity / Weight Loss / FitnessDrugs
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Written by Maria Cohut, Ph.D. on February 27, 2024
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