Nearly Two-Thirds Discontinue Wegovy Within a Year in a Large Israeli Study
Among 34,309 adults starting Wegovy, estimated discontinuation reached 67.6% at one year. Early refill patterns may help flag patients needing support.
Summary
A large Israeli study found that stopping Wegovy was common among adults using it for obesity. Researchers followed health records for 34,309 adults without diabetes who started treatment in early 2025. Estimated discontinuation reached 36.5% at six months and 67.6% at one year, using a medication coverage gap longer than 60 days to define stopping. Smaller early weight reductions and remaining on the lowest starting dose at three months were associated with later discontinuation. However, the dose association weakened substantially after accounting for early refill patterns. Lower socioeconomic status and smoking were also associated with stopping. The findings support checking refill consistency, treatment response, and barriers early rather than assuming patients will continue. This observational study cannot establish causes, and this summary is based on the abstract only.
Detailed Summary
Semaglutide can help treat obesity, but its benefits depend partly on whether patients continue treatment. Understanding when patients stop, and which early signals predict stopping, could help clinicians target support. This study examined medication persistence rather than testing whether semaglutide improves lifespan or prevents disease over time.
Researchers analyzed health records from Clalit Health Services in Israel for 34,309 adults without diabetes who started Wegovy between January and May 2025. Participants averaged 44.6 years old, and 67% were women. Treatment discontinuation meant a gap exceeding 60 days after medication coverage ended. A separate analysis assessed early treatment patterns among 28,218 participants included at the day 90 assessment.
Estimated discontinuation reached 36.5% at six months and 67.6% at one year. Lower socioeconomic status, current smoking, and membership in the Arab population sector were associated with higher discontinuation rates. At day 90, remaining on 0.25 milligrams rather than 1.0 milligram was associated with an 88% higher subsequent stopping hazard, although accounting for early refill adherence substantially weakened this association.
Smaller early reductions in body mass index also predicted stopping. Each percentage point less reduction corresponded to a 3% higher discontinuation hazard. After tirzepatide coverage began in December 2025, 8.6% of eligible participants initiated it over a median 3.1 months. These findings suggest that reviewing refill patterns, treatment response, and practical barriers around three months may identify patients needing additional support.
However, this observational study cannot establish why patients stopped or whether faster dose increases would improve persistence. Clinicians should not use these results to rush dose escalation or override tolerability concerns. Prescription coverage does not prove medication use, and the abstract does not explain individual stopping reasons. Results from one Israeli health system may not generalize elsewhere. This summary is based on the abstract only; full methods and additional limitations were not available.
Key Findings
- Estimated Wegovy discontinuation reached 36.5% at six months and 67.6% at one year among 34,309 adults without diabetes.
- Remaining on 0.25 versus 1.0 milligram at day 90 predicted higher discontinuation, but adjustment for refill adherence substantially weakened the association.
- Each percentage-point smaller early BMI reduction was associated with a 3% higher subsequent discontinuation hazard.
- Lower socioeconomic status and current smoking were each associated with a 13% higher discontinuation hazard.
- Review refill consistency, early response, and treatment barriers around three months; these findings do not justify faster dose escalation.
Methodology
This retrospective cohort study used Clalit Health Services records for adults without diabetes initiating Wegovy between January and May 2025. Multivariable time-to-event models, including a day-90 landmark analysis, assessed discontinuation defined as a gap exceeding 60 days after medication coverage ended. Researchers separately examined tirzepatide initiation after its December 2025 coverage introduction.
Study Limitations
This summary is based on the abstract only, without access to the full methods or detailed sensitivity analyses. Observational associations cannot establish causation, medication coverage does not confirm actual use, and individual reasons for stopping were not reported in the abstract. Findings from one Israeli health system may not generalize to other coverage arrangements or populations.
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