Why many people stop their GLP-1 in the first year, and how to stay on track

What the research shows

GLP-1 medications work best when they're taken consistently for long enough. Yet in real-world practice, many people stop early. A study of more than 125,000 US adults who started semaglutide (Wegovy, Ozempic), tirzepatide (Zepbound, Mounjaro) or liraglutide (Saxenda, Victoza) for overweight or obesity found that about 65% of people without type 2 diabetes had stopped within one year, and about 84% within two years. Among people with type 2 diabetes, about 47% had stopped within a year.¹

Not everyone who stops has done anything wrong. Some people stop because of cost or insurance changes, supply problems or a medical reason agreed with their prescriber. But many stop for reasons that can often be managed with the right support.^2,3

Common reasons people stop

• Side effects. Nausea, constipation, reflux and other digestive symptoms are the most common side effects.⁴ In clinical trials, fewer than 1 in 10 people stopped because of them, but stopping may be more common in everyday life without support.^2,3 In the study above, people who had more serious digestive problems, such as gallbladder disease or pancreatitis, were more likely to stop.¹ Some people don't tell their prescriber about side effects because they worry the medication will be taken away.²
• Cost and access. Many people pay out of pocket, lose coverage or face supply problems.³ In the study above, among people with type 2 diabetes, those with lower incomes were more likely to stop.¹
• Less weight loss than hoped. In the same study, people who lost less weight were more likely to stop.¹
• A plateau. Weight loss is fastest in the first months and then slows. A research team that modeled long-term treatment showed this plateau is expected: as you lose weight, your body uses less energy and appetite gradually returns, until intake and expenditure meet again.⁵ If you aren't expecting it, a plateau can feel like the medication has stopped working.
• Not knowing what to eat. With a much smaller appetite, it's hard to eat enough protein, fiber, vitamins and minerals, and feeling tired or unwell can make it harder to keep going.³

Why stopping and starting matters

When a GLP-1 is stopped, appetite usually returns and weight often follows. There may also be a cost to your relationship with food. In one survey of more than 800 adults who had used a GLP-1 for weight, each stop-and-restart cycle was linked to nearly three times higher odds of scoring at risk for disordered eating.⁶ This was an early study that can't show cause and effect, but it's a good reason to make any change to your medication a planned decision with your prescriber, not a reaction to a hard week.

Steps that help you stay on track

1. Plan for side effects before they start. Smaller meals, eating slowly, limiting greasy foods and staying hydrated help most people, especially around dose increases.⁴ Tell your prescriber about symptoms early, as dose timing or pace can often be adjusted.
2. Protect your protein and nutrients. A personal protein target and simple, nutrient-dense meals help you feel better and protect muscle while you lose weight.³
3. Expect the plateau. Knowing that progress naturally slows makes it easier to stay the course. Focus on how you feel, your energy, your strength and your health markers, not only the scale.
4. Talk about cost early. If paying for your medication is a worry, raise it with your prescriber before you run out, so you can plan together rather than stopping suddenly.
5. Get regular support. Expert groups recommend combining GLP-1 treatment with nutrition and lifestyle support, including counseling with a Registered Dietitian Nutritionist.^2,3 Regular check-ins help you solve problems before they become reasons to stop.
6. Have a plan for the long term. Whether you stay on your medication, reduce your dose or eventually stop, a plan agreed with your prescriber, and nutrition habits built while the medication is helping, protect your progress.

The bottom line

Stopping a GLP-1 early is common, but it's often driven by things that can be planned for: side effects, plateaus, nutrition gaps and cost. With a clear plan and regular support, you're more likely to feel well on your medication and keep the results you've worked for.