It was bound to happen, eventually. The 21st century’s wonder drugs, GLP-1 Receptor agonists, have finally developed a chink in their armor! It’s not a big chink, but one that could affect the bottom lines of the makers of semaglutide and terzepatide.
GLP-1’s, originally developed to lower the blood sugars and HbA1C of patients with diabetes, became all the craze when prolonged use resulted in appetite suppression and weight losses of up to 25%. This increased prescriptions for Ozempic and Zepbound exponentially. GLP-1’s were quickly designated as the drugs of the century! Some of the luster of GLP-1’s has faded, however, with the realization that gastrointestinal side effects can be quite troublesome, and the loss of muscle mass and bone minerals have lead elderly patients to frailty, falls, and fractures. Thus comes an article titled “Older Americans Quit Weight-Loss Drugs in Droves.”
The gist of the article says these drugs have made billions of dollars for their manufacturers while they have been a huge financial burden to Medicare and other insurers. Also, they have been very effective for patients, both diabetic and non-diabetic, but adverse effects are beginning to cause concern. It’s costs, coverage, adverse effects, and access to the drugs that have caused many seniors to abandon GLP-1’s “in droves.”
Costs of up to $1000/month out-of-pocket have been common. If you have diabetes, chronic kidney disease, or sleep apnea, or if you take a GLP-1 to prevent heart attack or stroke, you have the blessing of the FDA, and most likely have Medicare coverage. But modifications in coverage or flat out denial of payment occur all the time. If you don’t fall in one of the categories of having an approved indication, you may decide you can’t afford a GLP-1.
Adverse effects have grown as a reason to stop taking a GLP-1. Muscle and bone mineral loss have begun to cause concern. Both have caused frailty, falls, and fractures all of which tend to accelerate debility, dependence, and death and reduce quality of life. Gastrointestinal effects are the vehicle for shedding dozens of pounds. Decreased appetite and early satiety have resulted in huge losses of weight for many, but nausea, vomiting, diarrhea, constipation, and bloating can be very bothersome and cause patients to stop a GLP-1.
Access to GLP-1’s has at time been difficult due to shortages of supply as well as insurance payment denial. Over time patients lose their fervor and decide to use their money differently.
Of Type 2 diabetics on GLP-1’s, 47% stopped taking GLP-1 within the first year. Of non-diabetics, 65% quit within one year. When a treatment makes you feel worse than you did before you started it, it’s time to reassess the wisdom of continuing it. Patients’ adverse effects caused quitting in large numbers.
It’s older folks who are quitting GLP-1’s. “Patients 65 and older were 20%-30% more likely than younger ones to discontinue the drugs and less likely to restart again later….As many as 20% of patients quit GLP-1’s due to GI side effects.”These are expensive and powerful drugs, and some side effects are completely intolerable. They still control blood sugar and cause weight loss ie. they still work. After taking them a long time, though, patients need a break from the constant GI distress they can cause. Making yourself sick so you don’t eat doesn’t make sense.
Some biochemical fine tuning needs to be done to improve the tolerance of GLP-1’s. If that happens, and the cost comes down, we’ll all be skinny.
Reference: Span P. Older Americans Quit Weight-Loss Drugs in Droves. Medscape 2026 January 8.
