Why stopping GLP-1 drugs may undo weight loss and heart gains

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A Veterans Affairs study shows that patients who discontinue GLP‑1 medications like Ozempic lose cardiovascular benefits and face higher risks of heart attack, stroke, or death. Continuous use reduced risk, while stopping for six months or two years increased it, underscoring the need for long‑term adherence.

People who quit taking popular GLP-1 drugs such as Ozempic might not only gain back lost weight. They also might be jeopardizing their heart health, according to a new report.

A study of Veterans Affairs patients published March 18 found those who quit the weight-loss medication reversed health gains from weight loss and had a higher risk for heart attack, stroke or death.

Researchers tracked more than 330,000 VA patients with Type 2 diabetes over three years who took either a GLP-1 drug or another diabetes medication, sulfonylureas.

Those who steadily took the GLP-1 medications over three years saw an 18% reduction in risk for heart attacks or strokes. Those who quit the medications for six months saw slightly higher risk. Those who halted the weight loss drugs for two years saw their risk rise 22%, according to a study published March 18 in the medical journal BMJ Medicine.

People who quit taking GLP-1 drugs might regain lost weight and experience a rise in blood pressure and cholesterol, said Dr. Ziyad Al-Aly, a study author and Chief of the Research and Education Service at the VA St. Louis Health Care System.

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"Any amount of interruption is consequential," said Al-Aly, who is also a Washington University School of Medicine epidemiologist. "It takes a whole lot of time to build protection, and half as much to undo it."

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What are the quit rates for people on GLP-1s?

The study cited past research that showed people on GLP-1 medications quit at rates ranging from 36 to 81% within one year of starting the drugs.

A 2025 study found 65% of those without diabetes discontinued GLP-1s in less than one year. Those with Type 2 diabetes were more likely to stay on the medication at least one year. And those with higher incomes and fewer side effects were also more likely to stay on the pricey drugs, according to the 2025 study from researchers at the University of Pennsylvania and Truveta, a medical research company.

One reason people are more likely to quit GLP-1s when prescribed for obesity − insurance coverage lags.

Employers usually cover GLP-1 diabetes medications such as Novo Nordisk's Ozempic and Eli Lilly's Mounjaro for their workers, but employers are less likely to pick up the tab for weight-loss medications.

A survey by benefits consultant Mercer found 49% of large employers covered GLP-1 medications for obesity in 2025, up from 41% in 2023. Another survey by health policy nonprofit KFF found 43% of larger employers in 2025 paid for anti-obesity drugs.

Both Novo and Lilly have slashed prices for people who pay cash because their insurance plan doesn't cover GLP-1s to reduce obesity.

Which types of GLP-1 medications did the VA study track?

The VA study published March 18 tracked more than a half dozen GLP-1 medications used by VA patients from 2017 through 2023.

About two in three study participants took Novo's drug semaglutide, which is prescribed as Ozempic to treat diabetes and Wegovy to reduce obesity. Less than 1% of patients were on Eli Lilly's tirzepatide, which didn't get Food and Drug Administration approval as a diabetes drug, Mounjaro, until 2022.

While the study focused on diabetes patients, Al-Aly said people who take GLP-1s to reduce obesity also should be aware of potential harms from quitting. People with obesity often lower blood pressure and cholesterol and reduce inflammation while on GLP-1s, Al-Aly said. Those cardiovascular risk factors all can increase when people quit the medications, he said.

"We're telling people that metabolic whiplash is not good for your heart," Al-Aly said.

Al-Aly said the study results underscore the importance of staying on the medications.

"I want people to understand that these medications need to be taken for the long haul," Al-Aly said. "This is not something (patients) can take for a month or two or three and get off of it. It's not going to work like that."