Weight Changes From Glucagon‐Like Peptide‐1 Receptor Agonist Use and Discontinuation: A Retrospective Cohort Study
Open accessAbstract
Objective: This study aimed to quantify the effect of glucagon‐like peptide‐1 receptor agonists (GLP‐1s) on weight loss and weight gain following GLP‐1 discontinuation. Methods: This retrospective cohort study using electronic health records from TriNetX included individuals age 18 years or older with various lengths of continuous GLP‐1 use between September 2014 and November 2023. Applying an intention‐to‐treat framework, we used linear mixed effects models and propensity score adjustment to model changes in BMI after GLP‐1 discontinuation while accounting for correlated within‐person observations and potential confounders. Results: A total of 78,076 (19.7%) individuals used GLP‐1s continuously for 3 months, 23,861 (6.0%) for 6 months, and 12,642 (3.2%) for 9 months. The median BMI prior to initiation was 36.38 (IQR 36.30–36.46), which declined by 2.15% (IQR 2.10%–2.21%) to 35.81 (IQR 35.7–35.92) among individuals with 3 months of continuous GLP‐1 use. Median BMI declines were greater among individuals with 6 months (4.38%, IQR 4.27%–4.48%) and 9 months (5.56%, IQR 5.34%–5.78%) of continuous use. On average, weight loss among discontinuers at months 3, 6, and 9 slowed in comparison to their counterparts. Conclusions: Among this real‐world sample, GLP‐1 use was associated with more modest weight loss than has been demonstrated in randomized controlled trials.
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- Authors
- Alexander, G. C., Xu, Y., Xiao, X., Lewis, S. V., Zeger, S., & Mehta, H. B.
- Affiliations
- Johns Hopkins University (US)
- University of Utah (US)
- Corresponding author
- Alexander, G. Caleb
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2025-11-21
- Volume
- 34
- Issue
- 2
- Pages
- 482-490
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC13463575
- OpenAlex
- W4416529683
- Cited by
- 1
- References
- 27
- Citations by year
- 2026: 1
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion)
- Funders
- National Institute on Aging (K01 AG070329)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- GLP-1 receptor agonists, weight loss, weight gain, body mass index, real-world effectiveness
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Adult, Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Retrospective Studies, Weight Gain, Weight Loss, Body Mass Index, Glucagon-Like Peptide 1
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