The news media would have you believe that the developed world is in the grip of glp-1 mania. Pundits and doctors have published editorials warning that wegovy pills are about to cause an anorexia nervosa epidemic, while fashionistas are predicting the end of the plus-size clothing industry. But is it really a concern? How many people are staying the course? Have you noticed how carefully Wegovy describes their results? It’s a hint that things might not be as they seem and researchers are now probing semaglutide discontinuation rates.
Are we all hooked on GLP-1 RAs? According to Danish researchers, the startling stats on semaglutide prescribing might not reflect real life usage after all.
Public health experts based at Aarhus University and Aarhus University Hospital say that nearly half of Danes prescribed semaglutide stick out the treatment for less than a year. While a significant number of people have another go after three months, three quarters of quitters ditched the drug. Is this a universal discontinuation rate? Maybe not, but the Danish researchers do cite the cost of semaglutide as one of several factors that might put people off renewing their prescriptions. Are people discontinuing semaglutide because of side effects? That’s also a possibility.
With the proportion of Danes identified as obese at 18% and rising, doctors are keen to know who is most likely to benefit from semaglutide and other GLP-1 RAs and who might need a different approach.
Oversized Prescription Data
The researchers, led by Aurélie Maihlac, MSc, gathered anonymized records from the Danish health care system’s national registry. They extracted every adult first time semaglutide user between December 1, 2022, and November 1, 2024, to perform a nationwide cross-sectional study.
The team excluded people who were prescribed the drug for diabetes, focusing their attention on GLP-1 receptor agonists for weight loss. They decided to build in a one to three month ‘grace period’ between a patient getting their prescription and filling it. This was so that they wouldn’t over estimate how many people completed the first year and accounted for people who were bad at going to the pharmacy on a timely schedule.
Danish government statistics put their 2023 population at 5.93 million. Between late 2022 and 2024, 157,822 Danes started their first semaglutide regimen for weight loss rather than diabetes treatment. That’s more than 2.6% of the population of Denmark in a 23-month period.
By the end of their first year of treatment, only just over half of those patients were still using semaglutide. What happened?
Who Gets It?
To start off, the researchers figured out who was being prescribed semaglutide. Around 15% of Danes with an obese BMI tried semaglutide between December 2022 and November 2024. Women made up nearly 70% of patients, with 43% aged between 45 and 59.
Nearly 80% were middle-class, living in an area with an average disposable income between DKK 240,000 and DKK 300,000. The vast majority, 85%, did not have pre-diabetes, cardiovascular disease (93%) or other complications of obesity that might make semaglutide feel like a life or death medication.
Over a twelve-month period from their first prescription, the number of people continuing to use semaglutide steadily dropped. As early as three months into the course of treatment, 13% of patients discontinued treatment, rising to 27% at six months and 39% at nine months. By month 12, up to 49% of semaglutide users had stopped taking their medicine.
Few Demographic Clues About Semaglutide Discontinuation
The drop-out rate was pretty consistent against all demographic variables, but the researchers did notice a few differences. Women were more likely to opt for semaglutide and also more likely to stick with the drug regimen for at least a year. People aged between 18 and 29 were 1.49 times more likely to discontinue semaglutide than people 45–49.
Perhaps surprisingly, money had a small effect, with people with the lowest disposable income (under DKK 240,000) 10% more likely than their more cash-flush peers (DKK 300,000 or more) to stop filling prescriptions. Taking another regular medication at the same time as semaglutide made people more likely to drop out, but none of them seemed to be much more of a factor than any others.
Notably, psychiatric medication users were13% more likely to drop semaglutide, with anti psychotics raising the risk to 20% more and drugs related to gastrointestinal issues raised the likelihood by 10%.
Comorbidities didn’t make a huge difference either. Half of participants had metabolic syndrome but very few had pre-diabetes, chronic kidney disease, cardiovascular illness, sleep apnoea or osteoarthritis, and none of these coexisting complaints seemed to dramatically increase a person’s likelihood of discontinuing semaglutide.
The Biggest Loser
The biggest factor in whether a person continued with their semaglutide regimen was age. Young people were 1.49 times more likely to drop the drug than middle-aged people. The authors speculate that this is down to money (the drugs aren’t reimbursed) and perhaps a lower tolerance in younger people for the gastrointestinal side effects.
A quarter of drop-outs had another go a few months later, trying a different GLP-1 RA, or playing around with lower doses. This was echoed by the small changes that differing grace periods indicated- setting the grace period at a slightly linger 90 days as opposed to 30, decreased people’s likelihood of discontinuing semaglutide.
If a third of people prescribed semaglutide discontinue treatment within a year, but might hint that GLP-1 RAs aren’t a magic bullet after all. While semaglutide and similar drugs are a fantastic addition to bariatric treatment, it might not be wise to put all our eggs in one basket when it comes to treating obesity. While GLP-1 RAs can help people to change their approach to eating, the actual weight loss still depends on people changing their diet and exercise habits.
Sources
Mailhac A, Pedersen L, Petersen I, Pottegård A, Sørensen HT, Thomsen RW. Discontinuation of Semaglutide Therapy for Obesity Management. JAMA Netw Open. 2026;9(8):e2631371. doi:10.1001/jamanetworkopen.2026.31371
Schramm S, Sørensen TIA, Davidsen M, Tolstrup JS. Changes in adult obesity prevalence in Denmark, 1987–2021: age-period-cohort analysis of nationally representative data. Eur J Public Health. 2023;33(3):463–467. doi:10.1093/eurpub/ckad024
