Stopping GLP-1 Weight-Loss Drugs Doubles Cardiovascular Risk
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Key Clinical Takeaways:
- Patients with type 2 diabetes who discontinue GLP-1 medications face twice the risk of non-fatal heart attack, stroke, or death compared to those who continue treatment, according to research published in The Lancet Regional Health Europe.
- The elevated cardiovascular risk persists even among patients who regain very little weight or maintain blood sugar control after stopping the injections, the Daily Mail reported.
- Between 36 and 65 percent of patients stop taking GLP-1 medications at some point due to side effects, high costs, or reaching weight-loss goals, National Geographic noted.
Popular GLP-1 receptor agonists mimic natural hormones to regulate blood sugar, curb appetite, and support heart and kidney health in patients with type 2 diabetes and obesity.
Yet a substantial proportion of patients stop taking these medications within the first year, euronews reported.
Data from more than 300 diabetes clinics in Italy, covering over 80,000 patients with type 2 diabetes and no established cardiovascular disease, revealed that quitting the treatment doubles the combined risk of non-fatal heart attack, non-fatal stroke, or death from any cause. Per euronews, this translates to roughly four occurrences annually per 100 individuals who discontinued use, versus two per 100 among those maintaining therapy.
Obesity levels alter post-cessation risks
The increased cardiovascular risks following discontinuation are particularly pronounced among patients carrying excess weight. Individuals with a body mass index above 30 experienced a 127 percent higher cardiovascular risk after coming off GLP-1 medications, compared with a 61 percent increase observed among those without obesity, euronews reported.
Research led by scientists at the University of Campania found that patients who stopped treatment faced a risk of dying from any cause nearly five times higher than those who maintained their prescriptions, the Daily Mail reported. These heightened dangers appeared even when patients regained relatively little weight and showed only minor differences in blood sugar control, suggesting the medications offer protective benefits beyond weight management alone.
“The study almost makes me want to advise against medical treatment without increased physical exercise,” said Signe Sorensen Torekov, from the University of Copenhagen.
Weighing chronic treatment against discontinuation barriers
Many patients stop taking fat jabs due to side effects such as nausea and constipation, or because of high costs and lack of insurance coverage, National Geographic reported. Ziyad Al-Aly, a nephrologist at Washington University in St. Louis, emphasized that patients often hold misconceptions about the duration of therapy.
“The misconception is that I could take it for, you know, let’s say a year to lose weight,” Al-Aly told National Geographic. “I could get off of it, and then I will still be able to maintain that cardiovascular health, or that weight loss benefit. And the fact is that these are, that GLP-1 is really a chronic treatment for a chronic condition.”
The Italian study analyzed electronic medical records between 2004 and 2024, where the majority of participants received earlier-generation treatments such as liraglutide or dulaglutide. As highlighted by euronews, semaglutide made up only a small fraction of prescriptions, and tirzepatide was left out since it launched in Italy after the research concluded.
Individuals who stayed on the medication maintained their GLP-1 regimen for an average duration approaching three years, whereas those who quit used it for a little over a year.
Unresolved questions in observational data
Because the research was observational, it cannot definitively determine whether discontinuing GLP-1 medications directly causes the increased cardiovascular risk, or whether patients who stopped were already in poorer health, euronews reported.
Antonio Ceriello, head of diabetes research at the Italian IRCCS MultiMedica hospital, said that the strength of the identified association was unexpected, suggesting that GLP-1 medications may possess a direct protective effect on the cardiovascular system that dissipates once treatment ends, according to UA.NEWS.
Further research is required to clarify these mechanisms and to determine how patients can safely manage their health if they must discontinue therapy due to cost or adverse effects, euronews noted. Anyone considering stopping treatment should discuss their cardiovascular risks and medication options with a doctor first, the NHS recommends, as reported by the Daily Mail.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.