Why people quit weight loss, diabetes drugs

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Happy Tuesday! Most people quit a highly popular class of weight loss and diabetes drugs called GLP-1s within a year of starting them, several studies have shown. 

But new research has more details on who is more likely to stay on the pricey drugs, which cost roughly $1,000 per month before insurance and other rebates. Many insurance plans cover GLP-1s for diabetes, but not for obesity. 

Around 65% of patients without diabetes discontinued GLP-1s in less than one year, according to a study published Friday in JAMA Network Open, a medical journal. Those with Type 2 diabetes were less likely to quit the drugs within a year, at about 46%. 

Those rates were around 84% vs 64%, respectively, for stopping GLP-1s within two years.

The study said adverse side effects and cost were the most common reasons patients stopped the drugs that were documented in clinical notes. 

People with fewer side effects were also less likely to stop GLP-1 treatment, the study said, which is consistent with previous research. GLP-1s are linked to moderate to severe gastrointestinal side effects, such as nausea and vomiting. 

Higher income was also progressively associated with a lower rate of discontinuation among those with diabetes in particular, the study said. Researchers compared different income brackets, ranging from patients with incomes under $30,000 to people with incomes of more than $80,000.

But the study also found that results matter for patients both with and without diabetes, as those who lost more weight were more likely to stay on the drugs. People who regained weight after stopping GLP-1s were also more likely to give the drugs a second try. 

“The associations between weight loss and discontinuation and between weight regain and reinitiation suggest that weight management is an important factor regardless of type 2 diabetes status,” the study authors wrote. 

The research is based on a review of electronic health records on more than 125,000 adults who began taking GLP-1 drugs – liraglutide, semaglutide, or tirzepatide – between January 2018 and December 2023. Semaglutide is the active ingredient in Novo Nordisk‘s weight loss drug Wegovy and diabetes counterpart Ozempic, and tirzepatide is the active ingredient in Lilly‘s obesity injection Zepbound and diabetes drug Mounjaro. 

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Metabolic health startup Noom is laying off part of its staff as it focuses its workforce on “the most critical areas of the business” — including weight loss and diabetes drugs, the company confirmed to CNBC on Monday. 

Noom offers a range of behavioral and medically-assisted weight loss programs. Members of Noom Med can access several of the popular class of weight loss drugs known as GLP-1s, including Novo Nordisk’s Ozempic and Wegovy. And in September, Noom announced it would also offer compounded semaglutide, the same active ingredient in Novo Nordisk’s branded medications, through a new program called GLP-1(RX).

The company said the recent layoffs were the result of a revenue mix shift toward its fast-growing GLP-1 offerings like GLP-1(RX). Noom is investing heavily in that business, it added. 

“In an effort to build a more efficient business centered around the needs of our customers, we made the difficult decision to reduce a portion of our workforce,” a Noom spokesperson told CNBC in a statement. “With these changes, the company will be better positioned to deliver world-class products, technology, and coaching to more people looking to lead healthier lives.”

Noom did not confirm the number of employees affected by the layoffs. 

Endpoints News first reported the cuts. 

Compounded GLP-1 medications are typically much cheaper than their branded counterparts, as Wegovy and Ozempic both cost roughly $1,000 per month before insurance. Noom’s GLP-1(RX) costs participants $149 for their first month, and $279 for the following months as the dose of their medication increases. 

The compounded drugs can be produced as custom-made alternatives to the brand drugs, as well as when brand-name treatments are in shortage. In addition to Noom, several digital health companies like Hims & Hers, Ro and Sesame have been offering compounded GLP-1 medications as consumers navigate spiking demand and spotty insurance coverage.

Noom’s layoffs suggest the company is placing even more emphasis on anti-obesity medications, which some analysts estimate could grow into a $100 billion industry by the end of the decade.

Feel free to send any tips, suggestions, story ideas and data to Ashley at ashley.capoot@nbcuni.com.