Hi Reader

Brand new research sheds more light on discontinuation and reinitiation patterns of GLP-1s, revealing high dropout rates and key factors influencing long term adherence.

Key Findings: Most Patients Stop Within a Year

A retrospective cohort study of over 125,000 U.S. adults found that nearly two thirds of non-diabetic patients (64.8%) discontinued their GLP-1 therapy within one year. Among patients with type 2 diabetes, discontinuation remained high at 46.5% within the first year. Notably, up to 47% of T2D patients and 36% of non-T2D patients restarted their medication within the same timeframe.

So why are so many people stopping? The study highlights several key reasons:

• Gastrointestinal Side Effects: Patients who experienced moderate to severe nausea, bloating, or other GI symptoms were significantly more likely to stop treatment.
• Cost & Accessibility: Income played a role, patients earning less than $30,000 (USD) per year were far more likely to discontinue compared to higher income individuals.
• Weight Loss Impact: The more weight a patient lost, the less likely they were to stop. For every 1% of weight lost, the likelihood of discontinuing decreased by 3%.

What This Means for You

With many patients stopping and restarting GLP-1 therapy, dietitians can play a pivotal role in providing long term support and improving outcomes.

Here are five big opportunities:

1. Offboarding: Guide patients through a structured transition to prevent rapid weight regain post medication.
2. Reinitiation: Assist those restarting GLP-1s by addressing previous challenges.
3. Medication Adherence: Offer accountability and problem solving through regular check-ins.
4. Side Effect Management: Support with the gold standard in managing nausea, bloating, and constipation through education and lifestyle strategies.
5. Cost Effective Alternatives: Help patients explore lower cost medication options or adjust nutrition strategies to sustain weight loss without ongoing GLP-1 use.

Trends to Watch: Could GLP-1 Prices Be Changing?

Liraglutide, the daily GLP-1 injectable sold as Victoza and Saxenda, has officially come off patent, with generic versions recently available in the USA. In Australia, two generic applications are currently awaiting approval. This is a promising step toward reducing costs and increasing accessibility for patients. While the price drop won’t happen overnight, as more manufacturers introduce liraglutide generics, we could see significant savings over time.

For now, newer weekly GLP-1s like semaglutide and tirzepatide remain under patent protection, meaning these generics are still many years away, unless you're in Brazil or China. But this shift with liraglutide could be a sign of what’s ahead!

Boost Your Confidence with GLP-1s

If you're looking to enhance your skills in this rapidly evolving area, I've created two practical resources to support you:

The GLP-1 Handbook: A Practical Guide for Dietitians

Launched this week, The GLP-1 Handbook is your go-to reference, filled with clear guidance and patient ready resources designed for immediate application in your consults.

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Navigating Weight Loss Medications: A Short Course for Dietitians

Want to build a deeper, strategic understanding? This structured course offers theory and real world learning to solidify your expertise and help you navigate GLP-1s with confidence.

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