More than half of those who stop GLP-1s restart within a year

People prescribed GLP-1 medications are more likely to start and stop than most people assume, according to a study presented at ENDO 2026, the Endocrine Society's annual meeting in Chicago.

"Our study asked two questions that haven't been well answered until now: How many people with type 2 diabetes taking GLP-1 medications actually stop using them? And how many restart them?" said Dr Sainikhil Sontha, a research associate at Boston University School of Public Health in Boston.

The researchers performed a retrospective cohort study using Komodo Health U.S. claims data (January 2019 to June 2025). The group included adults ages 18 to 64 with a BMI ≥25 kg/m² and type 2 diabetes who started liraglutide, semaglutide or tirzepatide and had previously enrolled within the last year with more than 6 months of follow-up.

Discontinuation was defined as having more than a 60-day gap in filling their GLP-1 prescriptions. Getting a new fill after discontinuation was considered reinitiation.

"Using insurance records from more than 60,000 Americans with type 2 diabetes, we found that about 4 in 10 patients stopped their GLP-1 medication within the first year, and nearly 6 in 10 had stopped by the end of two years," Sontha said. "More than half of those who stopped restarted therapy within a year (41.5%), and nearly two-thirds did so within two years (58%). This suggests that for many patients, these medications aren't being abandoned permanently; use is more start and stop than most people assumed."

Using Cox proportional hazards models, they also took sociodemographic, clinical and provider-level predictors into consideration.

Sontha and colleagues found that those on Medicaid or Medicare, Black patients and those experiencing nausea or other stomach-related side effects (37%) were more likely to discontinue a GLP-1 medication within a year. People were 10% less likely to stop if their first GLP-1 medication was prescribed by an endocrinologist.

In addition, people taking newer medications like tirzepatide were 41% less likely to discontinue than those taking older drugs like liraglutide. Semaglutide users were 28% less likely to discontinue anti-obesity medication use than those taking older medications.

"This research matters because consistent use of these medications is what produces their protective effects," Sontha added. "Stopping early may mean missed opportunities to prevent heart attacks, kidney disease progression and other complications."

The researchers hope these findings give providers, insurers and policymakers an idea of which patients need more support to stay on GLP-1 medications, he concluded.