GLP‑1 use: quit, then restart
Recent reporting finds a majority of people who start GLP‑1 weight‑loss drugs quit them and many later plan to restart, even though researchers don’t yet understand the health effects of cycling on and off the drugs. (npr.org) At the same time, the FDA has asked Eli Lilly for more safety data on a new GLP‑1 pill, and studies are tying genetic differences to variation in both effectiveness and side effects like nausea and muscle symptoms. (independent.co.uk) (sciencenews.org)
These drugs are meant to be taken for years, but most people who start a glucagon-like peptide 1, or GLP-1, medicine stop within a year and many expect to go back on one later. (kalw.org) In insurance-claims data cited by University of Texas Southwestern obesity specialist Dr. Jaime Almandoz, fewer than one in four patients stayed on a GLP-1 drug after 12 months. In a separate Kantar survey, 74 percent of people who had lapsed said they were likely or very likely to restart. (stlpr.org) GLP-1 drugs mimic a gut hormone that lowers blood sugar and blunts appetite, which is why medicines like Wegovy, Ozempic, Zepbound and Mounjaro are used for obesity or diabetes. Doctors say patients often stop because of cost, insurance loss, side effects or supply problems rather than because the underlying condition is gone. (sciencenews.org) (thankyou.kuow.org) Researchers still do not know the health effects of repeatedly cycling on and off these medicines. The best-known withdrawal data come from the STEP 1 extension trial, where people regained about two-thirds of their prior semaglutide weight loss within a year of stopping, while cardiometabolic gains drifted back toward baseline. (kalw.org) (pmc.ncbi.nlm.nih.gov) That uncertainty is colliding with a market that is changing fast. Eli Lilly’s once-daily pill Foundayo, which contains orforglipron, won Food and Drug Administration approval this month, but the agency’s April 1 approval letter also ordered postmarketing studies on major cardiovascular events, drug-induced liver injury and delayed gastric emptying. (cnbc.com) (accessdata.fda.gov) The Food and Drug Administration also asked Lilly to study exposure in breast milk, reflecting how little long-term safety data exist for a new oral drug in a class that is already used by millions. Lilly did not immediately respond to Reuters questions, according to CNBC’s report on April 14. (accessdata.fda.gov) (cnbc.com) At the same time, new genetics research suggests patients do not all respond the same way. A 23andMe Research Institute study published in Nature analyzed more than 27,000 GLP-1 users and linked variants in the GLP1R and GIPR genes to differences in weight loss and to nausea or vomiting risk. (nature.com) (sciencenews.org) Science News reported that one variant was tied to slightly greater weight loss, while another was linked to nausea and vomiting specifically in people taking tirzepatide, the ingredient in Mounjaro and Zepbound. The study adds one reason two patients can take similar drugs at similar doses and have very different experiences. (sciencenews.org) (mediacenter.23andme.com) For patients, the practical reality is that treatment often looks less like one uninterrupted prescription and more like stopping, switching or restarting. The science is only starting to catch up with what people are already doing. (utsouthwestern.edu) (kalw.org)
