Why Switching GLP-1 Medications May Help Patients Stay on Weight Management Treatment Longer

A large new study from UT Southwestern Medical Center is offering a clearer picture of how GLP-1 receptor agonist medicines are used over time in adults being treated for overweight or obesity. The research found that patients without diabetes who changed from one GLP-1 medicine to another were more likely to continue treatment longer than patients who did not switch.

Published in JAMA Network Open, the study analysed insurance claims from nearly 127,000 U.S. adults who started GLP-1 therapy between 2019 and 2024. Researchers tracked medication use over a 12-month period and found that treatment often shifted over time instead of following one fixed course.

Switching was common during treatment

The study reported that changes in medication were not unusual. Many patients adjusted treatment because of side effects, access issues, insurance coverage, or the arrival of newer medicines.

GLP-1 receptor agonists, including semaglutide, liraglutide, and tirzepatide, have become an important part of obesity treatment. Even so, staying on these medicines for the long term has remained difficult.

Among the patients studied, only one quarter were still taking any GLP-1 receptor agonist one year after starting treatment. During that same period, about one in five patients moved to a different GLP-1 medicine.

Longer persistence was seen after medication changes

Patients who switched to another GLP-1 medicine were more likely to continue treatment and showed better adherence than those who stayed on their original medication. The researchers said this pattern suggests that medication changes may reflect active treatment management rather than treatment failure.

First author Luyu (Amber) Xie, Ph.D., Pharm.D., Assistant Professor in the Peter O'Donnell Jr. School of Public Health and co-Director of the Biostatistics and Data Science Core at UT Southwestern, said the study offers one of the largest real-world descriptions so far of how adults with overweight or obesity use and switch GLP-1 medicines over time. She said the findings show that long-term persistence is low and that switching is a relatively common part of ongoing care.

Senior author Sarah Messiah, Ph.D., M.P.H., Professor of Epidemiology and Pediatrics, Associate Dean for Research in the O'Donnell School of Public Health, and Director of the Child and Adolescent Population Health Program, said switching between GLP-1 medicines should be viewed as a normal part of long-term obesity care. She said treatment persistence should be judged by continued engagement in care and by working with clinicians to find sustainable treatment strategies over time, not simply by staying on one drug indefinitely.

Treatment pathways are evolving

The researchers also mapped treatment pathways to show how patients moved between medications during the study period. Newer once-weekly injectable therapies were often used both as starting treatments and as medicines patients switched to later, showing their increasing role in obesity care.

Co-author Jaime Almandoz, M.D., M.B.A., Professor of Internal Medicine in the Division of Endocrinology and Medical Director of UT Southwestern's Weight Wellness Program, said successful obesity care in current practice often depends on adapting treatment over time instead of expecting one medication to meet every patient's needs indefinitely.

The study also points to the importance of discussing expectations early. According to the findings, patients may need to know from the start that more than one medication could be used before a longer-term treatment approach is identified.

The authors said future research will examine how patient characteristics, individual medications, and the timing of therapy affect treatment pathways. The aim is to support more personalised and sustainable approaches to obesity care.

For patients, the findings may help set realistic expectations about long-term weight management treatment. The study suggests that changing GLP-1 medication does not necessarily mean treatment is failing and may help some patients remain engaged in care for longer.

For people comparing obesity treatment options, the report also highlights the value of follow-up care that can adjust medication when needed. This may matter when looking for clinics or specialists able to manage side effects, access issues, insurance barriers, and longer-term treatment planning.

FAQs

What did the new GLP-1 study find?

The study found that patients without diabetes who switched GLP-1 receptor agonist medicines for overweight or obesity were more likely to stay on treatment longer than those who did not switch.

How many patients were included in the study?

Researchers examined insurance claims from nearly 127,000 U.S. adults with overweight or obesity who began GLP-1 therapy between 2019 and 2024.

Why did patients change GLP-1 medications in the study?

Patients often adjusted treatment because of side effects, access issues, insurance coverage, and the introduction of newer medications.

How many patients stayed on GLP-1 treatment after one year?

The study found that only one quarter of patients remained on any GLP-1 receptor agonist one year after starting treatment.

Did the researchers say switching should be seen as treatment failure?

No. The study authors said switching between GLP-1 medicines should be viewed as a normal part of long-term obesity care rather than a sign of failure.

Medical Disclaimer

“This content is for informational purposes only and does not replace professional medical advice.”