Older Americans Are Stopping Weight-Loss Drugs at High Rates

Many people 65 and older who start GLP-1 drugs for diabetes or weight loss stop them within a year, with studies reporting discontinuation rates near half or higher; common reasons include side effects, muscle loss, cost, and changes in insurance coverage.

Many older Americans who begin GLP-1 medications for diabetes or weight loss stop the drugs within months. These medications, including semaglutide and tirzepatide formulations, have been shown to reduce weight and improve blood sugar and other health measures. Older patients are more likely than younger ones to discontinue treatment. Cost, coverage changes, side effects, and concerns about muscle loss are commonly reported reasons for stopping. Key facts: - Studies cited in the article found that roughly 47% to 65% of people stopped GLP-1s within a year, and patients 65 and older were about 20% to 30% more likely than younger patients to discontinue. - Reported reasons for stopping include gastrointestinal side effects, loss of lean mass (muscle and bone), high out-of-pocket costs, and insurers denying or withdrawing coverage. - Clinical trial data noted that about 35% to 45% of weight lost on these drugs can be lean mass rather than fat, which raises concerns for older adults who naturally lose muscle with age. - Supply shortages from 2022 to 2024 and patients’ expectations that treatment would be brief also contributed to high discontinuation rates. - Federal actions have been announced that could lower some out-of-pocket costs and that may expand Medicare coverage for obesity medications, but key details and timing remain unclear. Summary: Stopping GLP-1 medications often leads to weight regain and the loss of associated health benefits such as lower blood pressure and A1c. Weight fluctuations and re‑initiating treatment carry potential metabolic and functional risks, particularly for older adults. Federal proposals aim to reduce costs and potentially expand Medicare eligibility, but specific implementation details and timelines are undetermined at this time.