Many discontinue obesity medication – new study highlights the reasons

Earlier this summer, a U.S. research group published a study showing that a larger proportion of patients than previously known discontinue their treatment with obesity medications prematurely. Nearly half of the patients in the study had stopped treatment early, which is a significantly higher rate than observed in the clinical trials that supported the approval of new obesity drugs such as Wegovy and Mounjaro.

Now, the same research group has published a study in the journal Obesity, investigating the reasons behind treatment discontinuation.

In the new study, the researchers used medical record data from 288 randomly selected patients who had all discontinued treatment with semaglutide (the active ingredient in Ozempic and Wegovy) or tirzepatide (the active ingredient in Mounjaro/Zepbound) within one year. All patients had obesity or overweight without concurrent type 2 diabetes. The data was sourced from electronic health records from healthcare facilities in Ohio and Florida, USA.

The most common reason for discontinuing medication was cost or insurance-related issues. Nearly half of the patients stopped treatment for these reasons. The second most common reason was side effects, accounting for about 15 percent of all discontinuations.

However, less than two percent of patients discontinued treatment due to insufficient weight loss.

That financial reasons were the most common cause of early treatment termination does not surprise Ylva Trolle Lagerros, professor of cardiovascular prevention at Karolinska Institutet in Stockholm. According to her, this is likely just as true in Sweden as in the U.S., despite differences in healthcare systems – mainly because the obesity medications in question are not covered by Sweden’s high-cost protection scheme.

“These are expensive medications. For many, it’s incredibly costly. It’s a big difference compared to, for example, blood pressure or cholesterol-lowering drugs. We’re talking about thousands of kronor every month that the patient has to pay out of pocket,” she told Life Science Sweden.

Ylva Trolle Lagerros is also a physician at Liljeholmen Health Center and the Obesity Center in Region Stockholm, and the study’s findings align with her clinical experience. Although there is much discussion about side effects from drugs like Mounjaro and Wegovy, she says that financial concerns are far more often the reason patients choose to stop treatment.

In a recent in-depth interview with Life Science Sweden, Ylva Trolle Lagerros argued that certain patient groups should receive subsidized access to obesity medications.

She mentioned, for example, patients who have undergone treatment for the brain tumor craniopharyngioma and, as a result, developed a disruption in the brain’s hunger center, leading to extreme appetite. Another group she highlighted includes patients who require psychiatric medications that cause intense hunger and subsequent weight gain.

According to Hamlet Gasoyan, lead author of the new study and Assistant Professor of Medicine at Cleveland Clinic in Ohio, USA, this is the first U.S. study to quantify the reasons why patients discontinue treatment with new obesity medications.

He emphasizes that stopping treatment leads to a loss of health benefits and that many patients regain weight after ending treatment.

“In our future work, we will be generating evidence on what alternative obesity treatment works best for whom, to help patients and providers to make evidence-based decisions when continuing with a specific novel obesity medication is not possible,” he told Life Science Sweden.