GLP-1 medications like semaglutide and tirzepatide can drive significant health and cost outcomes, but only if people stay on them. This article breaks down the top 5 reasons patients stop taking GLP-1s and what that means for employers trying to see long-term ROI.
GLP-1s are changing the conversation. From better health outcomes to fewer chronic conditions, they carry a powerful promise and the potential for real cost savings over time.
But there’s a catch. And it’s a big one.
These benefits only show up if people stay on the medication. And right now, most people don’t. Poor GLP-1 adherence is one of the biggest barriers to realizing meaningful GLP-1 outcomes both from a clinical and financial perspective.
According to Blue Health Intelligence, 30% of people stopped within the first 30 days. And according to Evernorth research, 50% of people have dropped off within 12 months.
And when that happens, progress doesn’t just slow; it slips away. Weight is regained (as much as 63% in the first few months of stopping).
That backslide isn’t just clinical. It’s also financial. Aon data shows that the first year often brings increased employer healthcare costs, driven by more doctor visits and treatment of obesity-related conditions. The real gains, like a 44% reduction in cardiovascular events and a 7% slowdown in medical costs, don’t show up until year two.
To be clear, GLP-1s work. And for the people who stay on them, the results offer the kind of cost relief employers are desperate for in the face of 2026’s projected 9% healthcare cost increase. Cigna found that members who stayed on GLP-1s for at least 12 months saw over $1,100 in reduced medical spend between months 19 and 24. But as we’ve seen, most patients never make it that far.
So, what’s getting in the way? And what does that mean for employers who are banking on long-term impact and GLP-1 ROI?
This article explores the five most common reasons employees stop taking GLP-1s.
Each reason reveals to a gap between how these drugs are prescribed and how people experience them. And understanding those gaps is the key to building a benefits strategy that delivers the GLP-1 outcomes and ROI you and your people are counting on.
The 5 reasons people stop taking GLP-1s:
- Side effects that derail early progress
- Coverage gaps that make staying on too costly
- Lack of provider support and follow-up
- Misunderstanding the long-term purpose of the drug
- Psychological drop-off when progress plateaus
1. Side effects that undermine staying power
Nausea. Headaches. Digestive issues. Fatigue. On paper, they sound manageable. In real life? They’re the reason nearly 28% of patients stop taking GLP-1s.
And while less common, complications like gastroparesis or intestinal blockages bring real medical risks into play and accelerate GLP-1 drop-off.
What this reveals: Most GLP-1 programs are designed around prescription access, not ongoing support. But without the real-time support of proactive coaching and clinician guidance, early side effects become early exits. This is how GLP-1 adherence becomes the exception, not the norm.
2. Coverage gaps cut the journey short
GLP-1s can cost $1,000+ per month out of pocket, and many plans only cover them for diabetes but not weight loss. That makes coverage inconsistent, renewals uncertain, and affordability a moving target.
Lower-income patients are disproportionately affected, but even high earners can face sticker shock once introductory coverage expires or formularies change.
What this reveals:
The financial model assumes long-term use, but the benefit design often doesn’t. Employers can’t expect GLP-1 ROI without addressing affordability and supporting GLp-1 adherence over time.
3. Provider disconnects leave patients unsupported
Prescribing a GLP-1 isn’t the same as managing the experience of taking one.
Many physicians still underestimate the burden GLP-1 users face. Symptoms are dismissed. Concerns about cost or access are waved off. As a result, patients feel unheard and unsupported.
What this reveals:
A prescribing relationship isn’t the same as a care relationship. Employers investing in GLP-1s need to invest in wraparound support that fills in what the clinical system misses.
4. Misunderstanding the purpose of the drug
Some patients stop taking GLP-1s as soon as they hit their weight goal, not realizing that these medications are designed for chronic, long-term use. Others assume they can “reset” and restart later without consequence.
What this reveals:
What looks like a patient problem is really a communication issue. Without a clear understanding of how these drugs work, patients are left with no other choice but to make short-term decisions that undermine long-term outcomes. Long-term success starts with crystal-clear education.
5. Plateaus that create psychological drop-off
When the scale stops moving, the doubts start creeping in. “Is this still working?” “Should I even keep taking it?”
That psychological drag, especially when paired with lingering side effects like the ones we mentioned earlier, can feel like failure. Even when plateauing is a normal part of the process.
What this reveals:
Long-term behavior change requires long-term reinforcement. Without coaching, community, or checkpoints, momentum stalls and so does GLP-1 adherence. Supporting the mental side of the journey is key to sustaining both engagement and GLP-1 ROI.
If you’re betting on GLP-1s, read this first
You’ve seen the five biggest reasons people stop taking GLP-1s and how those breakdowns derail adherence, outcomes and ROI.
Our latest light paper, The real GLP-1 cost crisis, builds on that insight by examining the deeper design flaws behind most GLP-1 strategies and what it actually takes to turn early prescriptions into lasting results.
Inside, you’ll find:
- Why early drop-off creates a rebound spiral of weight regain, rising claims, and delayed ROI
- What’s really driving chronic disease (spoiler: it’s not just obesity)
- How to build a GLP-1 strategy that’s rooted in behavior change — and built to last
If your plan is betting big on GLP-1s, this is the insight you need to protect that investment.
FAQ
How long do patients typically stay on GLP-1s?
Research shows that 30% of patients stop taking GLP-1s within the first 30 days, and 50% discontinue within one year. A sign of poor GLP-1 adherence that directly impacts outcomes.
Why do patients stop taking GLP-1 medications?
The most common reasons include side effects, cost and coverage challenges, lack of support from providers, misunderstanding the drug’s purpose, and discouragement during plateaus, all of which contribute to GLP-1 drop-off.
What can employers do to improve GLP-1 ROI?
Employers can boost GLP-1 outcomes by investing in GLP-1 wraparound support like Transform Weight Management, a digital therapeutics solution that includes coaching, education, and long-term care planning, instead of relying solely on prescription access for outcomes and ROI.
Do GLP-1s work for long-term cost savings?
Yes, but only if patients stay on them long enough. GLP-1 ROI tends to show up after 12-24 months of consistent use. So, it’s only in that timeframe that employer healthcare costs truly begin to take effect.